"The situation in Syria is nothing short of catastrophic," says the International Committee of the Red Cross, after a four-day visit to the country.
Civilians are being killed and injured, millions have been displaced, and thousands have gone missing or been arrested, said ICRC director of operations Pierre Krahenbuhl.
He was speaking at a press conference during which he and Walter Cotte (Under Secretary General for Programme Services at the International Federation of Red Cross and Red Crescent Societies) reported on the unfolding situation.
Mr Krahenbuhl and Mr Cotte said that after two years, and with no end to the military confrontations in sight, the situation for the population is terrible.
In areas of rural Damascus, property and infrastructure have been destroyed, adding to the misery of the Syrian people.
ICRC teams carrying out fieldwork around the country have been speaking of the despair of civilians who have had to flee time and time again as the frontlines shift.
Women and children have taken shelter in mosques, schools, sports centres and other public buildings. Many more struggle in parks and makeshift shelters. They survive for weeks on minimal support, often without electricity or running water.
Medical facilities and personnel continue to suffer acts of violence. There are widespread reports of patients arrested inside hospitals, of reprisals against doctors and nurses, of attacks on ambulances and of misuse of these vehicles. While it is difficult to verify every such act of violence, the pattern is widespread and is of grave concern.
Humanitarian operations in Syria are highly complex. There are numerous constraints, the most daunting being the extreme lack of security, the fluidity of the frontlines and the multiplicity of armed actors, including government security forces and various groups of the armed opposition.
The ICRC has been able to carry out a significant number of field activities with its partner the Syrian Arab Red Crescent, and has also been able to carry out such work in areas under the control of the opposition.
In 2012, the ICRC and the SARC made over 100 trips to different parts of the country. They distributed food and hygiene parcels to 1.5 million people, many of them displaced, who had not had access to basic commodities or services since fleeing their homes.
ICRC water projects helped millions of people, in all provinces, regardless of where they were living, says the international organsiation.
These projects included pipeline repairs carried out with local contractors in Aleppo, the installation of a generator in Homs, providing water for 800,000 people, and deliveries of water by road to IDP centres. Throughout the country, water chlorination has ensured that the water remained safe to drink.
In addition, ICRC have been improving living conditions and water supplies at 99 centres, where 35,000 displaced persons have taken refuge, in towns such as Aleppo, Homs, Sweida and Deir Ezzor.
They have also been distributing medical supplies at many locations around the country.
For the SARC, the change of pace has been dramatic. In Damascus, for instance the SARC coordination centre used to handle about 25 ambulance operations a day. That number has doubled to 50, which brings with it the need for increased resources.
In addition to working with the ICRC, the National Society is providing psycho-social support, especially to children. The SARC has 11,000 highly committed, dedicated volunteers working on the ground, close to the community. Eight of them have paid for their dedication with their lives while on duty.
* ICRC: www.icrc.org/