We now know the pattern of besiegement in Syria and so we know what is to come in Aleppo. Government forces surround an area of a city and cut off all food and supplies. The population weakens and thins, the elderly dying first and then next the children, often from water-borne diseases. The United Nations stands by, failing again in its humanitarian obligations through its obsequiousness to a government whose crimes long ago stripped it of any legitimacy. The West and Russia can drop bombs but not food. Support cannot go to those who might be able to break the siege because of their ideology; instead it just sloshes into a corrupt morass outside the country. Statements are issued and ignored. 2139. 2165. 2191. 2254. 2258. These are the numbers of the United Nations Security Council resolutions that are brushed off by Assad.

Somewhere between half a million and a million people are living under siege in Syria, about 150,000 of those now in Aleppo. What happens now that government forces have cut off roads to Turkey is that the only foodstuffs that get in have to be smuggled through the front lines. As people eat their way through dwindling stocks, infectious diseases are likely to claim the lives of those who are weakened easiest. The body draws down fat reserves and then consumes muscles. Autophagy, or self-eating, can last weeks. By the time people have resorted to eating grasses and tree bark, their bodies are swollen with edema, their stomachs almost unable to take in food, their skin becomes flakey and dry and their hair turns a dull copper. Every person who dies is a victim of one of the most brutal war crimes known to man.

Every actor outside Syria and all the armed men in the country long ago lost sight of why they are fighting. The militia that closed the noose around Aleppo is made up of Palestinian refugees in Syria, motivated probably by money as much as anything. Sieges can be lucrative. There is much money to be made at a checkpoint. Afghan recruits fight for Iranian-funded gangs alongside Shia Lebanese against Saudis and Tunisians recruited by Iraqi thugs. The opposition has fractured into a dark array. Assad can never recover the state he misruled. Russia’s global influence will be sapped in an incoherent and expensive conflict. Iran’s people have no interest in a war that benefits only its deep hidden state. Turkey is in chaos. Saudi Arabia is bullying, shrill and incompetent. The United States has stood by and watched half a million people die while repeating the tired platitude “Never Again.” Europe mostly sleeps, enduring a fever dream of terrorism, upturned boats and drowned children.

In Syria, the thin veil of civilization has been shredded and the efforts of the past 70 years to minimize the harm that comes to civilians in war have been tossed aside. Siege warfare – something that should have ended with the horrors of Leningrad – now kills thousands. Schools, hospitals and rescue workers are deliberately targeted to ensure that the survival of civilians becomes impossible.

There are possible responses. A no-fly zone over northern Syria. Air drops of food to besieged zones. The United Nations should cease all supplies to government-controlled areas if it cannot also access towns under siege, indeed it is time for the UN to leave Syria entirely if it cannot carry out a mandate to help all those in need. Greater efforts could be made to get what is needed into these areas, including fuel and supplies for urban food production by lifting some of the burdensome regulations on aid. We must not give up on a humanitarian imperative to do what we can for those caught in war.