The Washington Post reported earlier this week that images smuggled out of a Palestinian refugee camp in Syria show “disturbing images of emaciated children and elderly people” and indicate that there are thousands of residents in the Yarmouk camp at risk of starvation, the result of a siege being maintained by Syria’s Bashar al-Assad regime and its Iranian backers.

But although the United Nations is feeding more than 3.8 million people in Syria, those most in need are not being reached because of the complicated dynamics of the battlefield. Fighters loyal to the government of President Bashar al-Assad surround numerous rebel-held neighborhoods, notably in the suburbs of Damascus, and refuse to allow access to food or medical aid as part of what U.S. and other Western leaders have repeatedly described as a policy of deliberate obstruction.U.N. officials say they are especially alarmed at the reports of a growing number of deaths emanating from Yarmouk, just a few miles from the heart of Damascus, the capital.

“There is profound civilian suffering in Yarmouk, with widespread incidence of malnutrition and the absence of medical care,” said Chris Gunness of the U.N. Relief and Works Agency, which is charged with helping displaced Palestinians across the region.

The tactic is also being used elsewhere in the country against areas controlled by regime opponents. Last week, dozens of men attempting to break the siege of Homs were attacked and killed. The United Nations had already reported weeks ago that it has  literally stopped trying to count how many people have died in the nearly three year conflict, though the organization’s secretary general Ban Ki-moon added this week that an estimated 9.3 million people – half of Syria’s population – are in immediate need of humanitarian assistance. The Geneva II peace talks scheduled to start in Switzerland on January 22nd will seek to at least dampen the violence, though efforts to secure a lull in the fighting as the conference approaches have had little effect. Fighting between the government and the rebels are ongoing, as is fighting between various opposition factions. Earlier this month fighting between rebel groups killed roughly 500 people in one week.

[Photo: FreedomHouse / Flickr]