The United Nations said that the worsening conflict in Syria has left 13.5 million Syrians in need of aid and some form of protection, including more than six million children. UN humanitarian chief Stephen O’Brien told the Security Council that the figure represents an increase of some 1.2 million people in just 10 months, and with winter fast approaching the situation for many families is likely to deteriorate.

O’Brien said there are now some 6.5 million people displaced inside Syria, including well over 1.2 million so far this year and over 120,000 who have fled their homes in the country’s north since early October as a result of aerial bombardment and ground offensives. Russia’s aerial campaign in support of Syrian President Bashar Assad’s government has enabled government troops to launch a new campaign in the north.

Syria has been gripped by foreign-backed militancy since March 2011. The crisis has claimed the lives of more than 250,000 people and left over one million injured, according to the UN. O’Brien said attacks on health facilities and health workers “remain relentless.” Five hospitals in Hama, Idlib and Aleppo have been attacked since the launch of recent offensives, leading to casualties and their closure. O’Brien said despite its best efforts, the U.N. has only been able to reach a small fraction of the 4.5 million people living in hard-to-reach areas.

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