Around 3,000 children are among civilians facing a mounting humanitarian crisis in a town besieged by Syrian regime forces near Damascus.
Save the Children said the rebel-controlled Khan Eshieh area had been completely surrounded in recent days, with the last remaining road in and out closed by heavy shelling and snipers.
It houses a large Palestinian refugee camp, where a local aid group said three young men were shot dead while trying to escape in recent days as barrel bombs rain down on the settlement and surrounding farms.
Sonia Khush, head of Save the Children’s Syria programme, said: “Despite the supposed ceasefire across the country, people are living in terror of siege and bombardment.
“People in Khan Eshieh tell us that most medicine, fuel and flour has almost run out, and food prices have doubled in the past few days.
“They expect it to get even worse in the coming days. The roads and access to the camp must urgently be reopened and vital humanitarian aid immediately allowed in.”
The last road to the nearby town of Zakia, known locally as “the Death Road” due to the high risk of travelling on it, had been used to get food, medicine and supplies.
The Jafra Foundation, which provides education, support and aid in the camp, said basic supplies were dwindling and the situation was expected to worsen.
An opposition group published footage of explosions on Thursday, appearing to show a helicopter flying over before the sound of explosions were heard and huge mushroom clouds rose into the sky.
A Facebook page claiming to represent the local council has documented weeks of intensified barrel bombings and shelling blamed on the Bashar al-Assad’s regime in Khan Eshieh.
It said five helicopters unloaded more than 20 bombs on Thursday as well as “sporadic bombardment” with mortars and heavy artillery. Casualty figures were not immediately available.
Khan Eshieh became home to more than 20,000 Palestinians since they arrived in the 1940s, going on to settle and work as teachers, civil servants and on surrounding farms.
Since coming under the control of opposition groups in the Syrian civil war it has seen sporadic fighting and bombardment, leaving civilians and United Nations staff among the dead.
After almost three years under partial siege the number of inhabitants has fallen to around 12,000 people – a quarter of them children – Save the Children said.
All main roads between the camp and Damascus have been closed since 2013 and military checkpoints have been installed to prevent people from entering and leaving.
Only one doctor and one dentist are believed to remain in the camp, and do not have enough medicine, equipment and electricity needed to treat patients, while residents report an urgent need for water purification tablets to reduce the growing risk of disease.
The UN agency for Palestinian refugees (UNRWA) condemned attacks that killed at least one refugee and injured children in Khan Eshieh in June last year, as well as the killing of six Palestinians by mortar shells that hit a school in 2013.
Chris Gunness, a spokesperson for the agency, said it was concerned about the plight of more than 20,000 civilians in Khan Eshieh and Palestinian areas of Daraa governorate.
“In both areas, refugees have been exposed to direct armed conflict, violence and humanitarian deprivation and we need immediate and sustained humanitarian access,” he added.
“In Khan Eshieh we estimate that there are about 5,000 civilians and in the inaccessible areas of Dera’a governorate we estimate there are about 17,500 people, including many thousands of children.”
In pictures: Syria conflict
In pictures: Syria conflict
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Syrians carry children amid debris following a air strike by government forces in the northern city of Aleppo
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A Syrian man carries a girl on a street covered with dust following a air strike by government forces in the northern city of Aleppo
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Syrians react as they stand amid debris following a air strike by government forces in the northern city of Aleppo
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A Syrian man carries a girl amid debris following a air strike by government forces in the northern city of Aleppo
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An injured Syrian man walks out from the rubble of a destroyed building following a air strike by government forces in the northern city of Aleppo
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A Syrian woman makes her way through debris following a air strike by government forces in the northern city of Aleppo
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People stand on the rubble of collapsed buildings at a site hit by what activists said was a barrel bomb dropped by forces loyal to Syria's President Bashar al-Assad, in the Al-Fardous neighbourhood of Aleppo
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Syrian residents stand amid the rubble of destroyed buildings
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A Syrian resident grasps a mattress amid rubble in the al-Firdous neighborhood of the northern city of Aleppo
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A bullet-riddled parking sign stands amid debris in a deserted street leading into the old city of Homs
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A general view shows abandoned buildings on a deserted square in the old city of Homs after Syrian government forces regained control of rebel-controlled areas
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A mosque is pictured through shattered glass in the old city of Homs, as rebel fighters withdrew from the city centre in line with a negotiated withdrawal deal with the government after having held out under tight siege for nearly two years
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Buses carrying Free Syrian Army fighters leaving Homs. Exhausted and worn out from a year-long siege, hundreds of Syrian rebels left their last remaining bastions in the heart of the central city of Homs under a cease-fire deal with government forces. The exit of some 1,200 fighters and civilians will mark a de facto end of the rebellion in the battered city, which was one of the first places to rise up against President Bashar Assad's rule, earning it the nickname of "capital of the revolution"
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Syrian government forces hold up a portrait of President Bashar al-Assad (L) while others raise the national flag on top of a pole in the old city of Homs
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Forces loyal to Syria's President Bashar al-Assad run through Aleppo's Bustan al-Qasr crossing after their release by rebels. They were freed as part of a larger deal which saw the last remaining Syrian rebels in central Homs city evacuate their positions and free captives in several locations in northern Syria
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A Syrian woman and two children walk past heavily damaged buildings in the northern city of Aleppo
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A man carries a wounded girl following a reported bombardment with explosive-packed "barrel bombs" by Syrian government forces in the al-Mowasalat neighborhood of the northern Syrian city of Aleppo
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A wounded man sits as he is treated at a makeshift hospital following a reported bombardment with explosive-packed "barrel bombs" by Syrian government forces in the al-Sakhour district of the northern city of Aleppo
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Debris rises in what Free Syrian Army fighters and Islamic rebels said was an operation to strike Al-Sahaba checkpoint, which is considered a gateway to Al-Dayf valley, and remove forces loyal to Syria's President Bashar Al-Assad in Maarat Al-Nouman, Idlib province
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Men try to put out fire at a site hit by what activists said was an air strike by forces loyal to Syria's President Bashar al-Assad in the town of Azaz, north of Aleppo, near the border with Turkey
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Civil Defence members try to put out fire
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Survivors react at a site hit by what activists said was an air strike by forces loyal to Syria's President Bashar al-Assad in the town of Azaz, north of Aleppo, near the border with Turkey
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Residents queue as they wait to receive food aid distributed by the UNRWA at the Palestinian refugee camp of Yarmouk, south of Damascus
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Belongings of Syrian rebels inside a chapel at Crac des Chevaliers, the world's best preserved medieval Crusader castle in Syria. The village was destroyed in fighting between the government and rebel forces while the castle, listed as a UNESCO world heritage site, also has been damaged over the past two years
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Hosen Sabah, a 16-year-old student is comforted by his mother at a hospital in Damascus. Nosen was wounded by a mortar outside his school, while 14 other students were killed and over 80 wounded
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A Free Syrian Army fighter works on a locally made launcher before firing it towards forces loyal to Syria's President Bashar Al-Assad in Mork town
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Syrian policemen and citizens inspecting the site of a car bomb at the entrance of Moadhamiyet al-Sham neighborhood in rural Damascus. According to Syria's Arab News Agency (SANA), a car bomb explosion has gone off in the countryside of Damascus and initial information say there are casualties, where a car rigged with explosions was remotely detonated at the entrance of Moadhamiyet al-Sham neighborhood in rural Damascus during engineering units it was trying to dismantled it
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Opposition fighters carrying a rocket launcher during clashes against government forces in the Sheikh Lutfi area, west of the airport in the northern Syrian city of Aleppo
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A Syrian man helps a woman to make her way through debris following reported air strikes by government forces in the Halak neighbourhood in northeastern Aleppo
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A Syrian man reacts as he carries the body of injured boy following reported air strikes by government forces in the Halak neighbourhood in northeastern Aleppo. According to the Syrian Observatory for Human Rights, at least 33 civilians were killed in the attack
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Syrian rescue workers carry the body of a woman following reported air strikes by government forces in the Halak neighbourhood in northeastern Aleppo
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Syrians gather at the site of reported air strikes by government forces in the Halak neighbourhood in northeastern Aleppo
Despite the “cessation of hostilities” agreed in February and accompanying pledge by the Syrian regime and rebel groups to allow humanitarian access into besieged areas, Khan Eshieh is one of many cut off and under attack.
Only 17 per cent of the more than 4.5 million people in surrounded and hard-to-reach areas have so far received assistance, Save the Children said, and UN aid convoys continue to be denied permission. At least six besieged areas have still not received any aid at all.
One convoy was refused entry to Daraya on Thursday,despite having obtained prior clearance from all sides that it could proceed.
The International Rescue Committee said the situation was “desperate” after three-and-a-half years of fighting and that the convoy, due to be the town’s first ever aid delivery, was taking baby milk, vaccinations and medical supplies.
There is also concern about the situation in another Palestinian refugee camp – Yarmouk in Damascus – which has been overrun by Isis in weeks of fighting, leaving families without access to food, clean water and medical treatment.