THE UN has warned that, despite a recent respite in the fighting in Syria, civilians are still at risk as the winter sets in.

While there is a reduction in hostilities in some parts of the country, the civil war goes on, particularly in the north-east. A UN spokesman, Stéphane Dujarric, said that the fighting in southern Idleb and Hama was forcing civilians to flee, in freezing conditions, to regions where there was not enough food to sustain them.

“The UN is deeply concerned for the safety and protection of tens of thousands of people in southern Idleb and rural Hama in north-eastern Syria, where ongoing hostilities have reportedly caused hundreds of deaths and injuries of civilians,” he said on Monday.

“With the onset of winter, safe shelter is among the biggest concerns, as many families are fleeing into areas that are already at full capacity, or into communities with depleted resources.”

Idleb is the only province still under (largely Islamist) opposition control (News, 22 December). Tens of thousands of fighters and civilians have been transferred to there from areas recaptured by government forces, and thousands have been killed in air strikes as the Syrian army, supported by Iranian-backed militias and the Russian air force, seeks to regain control. An aid worker told The Guardian this week that eight hospitals had been hit since late December. It is supposed to be one of the “de-escalation zones” agreed in talks between Russia, Iran, and Turkey (News, 6 January 2017).

“For the third time in less than a week, the Maternity and Pediatric Hospital in Ma’arrat An Numan [in Idlib] had been damaged and taken out of service. Such actions are utterly unacceptable and must stop,” the UN Office for the Co-ordination of Humanitarian Affairs, which co-ordinates the humanitarian response in Syria, posted on Twitter on Saturday.

Near Damascus, the rebel-held enclave of Eastern Ghouta, described as the “epicentre” of suffering in Syria, continues to endure bombardment. The White Helmets rescue volunteers report that a day of air strikes over the past week killed at least 17 civilians and injured about 40 more. The bombing has also targeted medical facilities; civilians are now struggling to gain access to any treatment.

Shortly after Christmas, the Syrian government permitted some medical evacuations from the area, where an estimated 400,000 people have been almost completely cut off from humanitarian assistance since 2013. Other towns, such as Foua and Kefraya, are besieged by opposition groups.

Meanwhile, the five million Syrian refugees living in neighbouring countries are more vulnerable than ever. The UN estimates that more than half of the one million in Lebanon are living in extreme poverty (less than $2.87 per person per day) and reports that and borrowing money for food and to pay rent has become commonplace. Last year, only only 36 per cent of the total funding needed to provide adequate humanitarian support in the country was received,