U.N. investigators warn millions of Syrians, who have endured more than a decade of war, are likely to face more death and injury as fighting intensifies along the country’s northern borders. The Independent International Commission of Inquiry on Syria will submit the report on its latest findings to the U.N. Human Rights Council next week.

The report finds a significant reduction in the number of government air strikes in northwest Syria during the period under review between January 1 and June 30.  

However, the three-member commission notes hostilities escalated significantly in Idlib and Aleppo, the last rebel stronghold, in August. It says civilians bear the brunt of the intensified fighting.

The report details attacks in northern Aleppo that have killed and injured at least 92 civilians, destroyed civilian homes, schools, mosques, medical facilities, and administrative buildings.

Commission chair Paulo Pinheiro says scores of civilians, including children, have been killed and injured in fighting between pro-government forces and armed opposition groups.

“In addition, Russia is still actively supporting the Syrian government, particularly concerning air strikes that have killed civilians and targeted food and water sources,” Pinheiro said. “Families living in front-line areas have borne the brunt of pro-government forces ground-to-ground shelling in those areas.”

Pinheiro says there continues to be military involvement in this protracted conflict by Israel, the United States and Turkey.

“I must say that Syria cannot afford a return to large-scale fighting but that is where it may perhaps be heading,” Pinheiro said.

The report highlights the worsening conditions in al-Hawl camp, where tens of thousands of former wives and children of Islamic State militants are being held.

Pinheiro says the situation of children in al-Hawl and other camps in the northeast are in a particularly concerning situation.

“They lack sufficient health care and education. And many are traumatized by the violence within those camps,” Pinheiro said. “Young boys, once they reach puberty, risk being transferred to military detention centers alongside adult alleged Da’esh fighters, doomed to detention without legal recourse.”

The report notes tens of thousands of Syrians remain forcibly disappeared or missing. It says families searching for their loved ones, often undertaken by women, are in danger of being arrested, extorted, and abused.

The commission has documented multiple cases of Syrian refugees who have been arrested and detained by government forces shortly after they have returned home. It says many are unable to go back to hometowns and villages because their properties have been confiscated.

The commissioners urge neighboring countries to drop plans they may have for the mass return of Syrian refugees because their safety cannot be guaranteed.

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