A recent survey in 27 locations there found that 11.9% of children under five years old are acutely malnourished. This is the highest recorded rate in the country since the beginning of the civil war.
The United Nations Children’s Fund (UNICEF) said more than one-third of the children are stunted, "elevating their risk of delayed development, illness and death".
The acute malnutrition rates are the highest among the very young.
Mothers of children under two years old have reduced or stopped breastfeeding altogether because of their own poor nutrition and the constant violence.
“The siege must be lifted to provide them with the life-saving assistance they need now,” said Geert Cappelaere, UNICEF’s regional director for the Middle East and North Africa.
Nearly 400,000 people — half of them estimated to be children — remain trapped in this area East of Damascus, under siege by government forces since mid-2013. Only 100,000 people have received food aid this year.
Despite regular calls from aid agencies humanitarian access to the region has been highly sporadic, restricted by intense fighting. At times, aid convoys are unable to reach the critical areas due to shelling or gunfire, limiting the supply of essential nutritional supplements for children and nursing mothers.
Rapidly-rising costs of food and cooking supplies have also made preparing a meal impossible for most survivors. The price of a portion of bread costs 85 times more in East Ghouta than in the city of Damascus, just 15km away.
The World Health Organization (WHO) and World Food Programme (WFP) also recently reported on the severe shortage of food and medical supplies and said: “Children who are already weak and hungry are much more likely to contract life-threatening infectious diseases.”
“The situation is heart-breaking,” said Elizabeth Hoff, WHO representative in Syria.
“We have now reached a critical point, where the lives of hundreds of people, including many children, are at stake. If they do not immediately get the care they urgently need, they will most likely die.”
East Ghouta is one of the remaining rebel strongholds in Syria and one of four "de-escalation zones" agreed in a deal with government forces earlier this year. However, violence there has steadily increased.