“The humanitarian situation of civilians in east Ghouta is spiralling out of control”, Panos Moumtzis, UN Regional Humanitarian Coordinator for the Syria Crisis, said in a statement issued by the UN Headquarters. The “extreme escalation” in hostilities on Monday claimed the lives of 40 civilians and injured more than 150 in the besieged enclave. In addition to this, Mr Moumtzis highlighted, the “lack of access to besieged areas has led to severe food shortages and a sharp rise in food prices; malnutrition rates have now reached unprecedented levels, and the number of people requiring medical evacuations continues to surge”. In vain, Mr Moumtzis said, “we continue to call for unconditional, unimpeded and sustained access to close to 3 million people in besieged and hard-to-reach locations across Syria, including east Ghouta”, and urge all parties to the conflict to “strictly adhere to their obligations” to protect civilians. UN data speak of hundreds of civilians, including many women and children, who have been killed or wounded since November; of schools and hospitals that have been damaged or destroyed; and of a “precarious humanitarian situation” for the 393,000 residents of east Ghouta, many of whom are internally displaced.