NEW YORK, 21st January 2016 (WAM) — Outlining a series of immediate, practical steps that can improve humanitarian access and the delivery of aid to those in need inside Syria, more than 120 humanitarian organisations and United Nations agencies issued a joint appeal today urging the world to raise their voices and call for an end to the Syria crisis.

Three years ago, leaders of UN humanitarian agencies issued an urgent appeal, calling for every effort to save the Syrian people, declaring in a video message that civilians had suffered enough bloodshed.

With the war now approaching its sixth year, the new appeal warns that “the bloodshed continues,” and “the suffering deepens.” This time, humanitarian organizations and UN agencies are not only appealing to governments but to citizens around the world – asking them to add their voices in urging “an end to the carnage,” and for parties to reach an agreement on a ceasefire and a path to peace.

“More than ever before, the world needs to hear a collective public voice calling for an end to this outrage. Because this conflict and its consequences touch us all,” the appeal stresses.

“It touches those in Syria who have lost loved ones and livelihoods, who have been uprooted from their homes, or who live in desperation under siege. Today, some 13.5 million people inside Syria need humanitarian assistance. That is not simply a statistic. These are 13.5 million individual human beings whose lives and futures are in jeopardy,” it adds.

Recalling that the war has seen 4.6 million people flee to neighbouring countries and beyond, the appeal underlines that the conflict also touches those far beyond Syria “who have seen the violent repercussions of the crisis reach the streets, offices and restaurants closer to their homes.”

“Those with the ability to stop the suffering can – and therefore should – take action now,” humanitarian organisations insisted, noting that until there is a diplomatic solution to the fighting, such action should feature a number of measures.

These include unimpeded access for humanitarian organisations to bring immediate relief to all those in need; humanitarian pauses and unconditional, monitored ceasefires; a cessation of attacks on civilian infrastructure; and freedom of movement for all civilians and the immediate lifting of all sieges by all parties.

“These are practical actions. There is no practical reason they could not be implemented if there is the will to do so,” the appeal concludes, adding that “for the sake of the millions of innocents who have already suffered so much, and for the millions more whose lives and futures hang in the balance,” action is needed now.

Earlier this month, footage on social media of crying, emaciated, starving children in the Syrian town of #Madaya shocked the world.

The 40,000-strong town near the Lebanese border has been under siege by Syrian government forces and Hezbollah militants for more than 200 days.

It has been confirmed by the United Nations that more than 30 people have died of severe malnutrition in Madaya, including five since the first aid trucks arrived, exposing the Syrian Government’s policy of starving people to death until they surrender.

As the full scale of the horror in Madaya emerges, questions are being asked about what the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) in Syria knew about starvation in the town and why they were not the ones to bring it to the attention of the world.

On 15th January, the Foreign Policy magazine, said the U.N. knew for months that Madaya was starving. The magazine wondered, “Why did it wait until January to provide humanitarian aid to suffering Syrians?”

It cited a leaked “Flash Update” issued on 6th January by the U.N. Office for the Coordination of Humanitarian Affairs (OCHA), which negotiates aid deliveries, spoke of “desperate conditions,” including “severe malnutrition reported across the community.” OCHA’s update said there was an “urgent need” for humanitarian assistance. In October, community leaders reported some 1,000 cases of malnutrition in children under the age of 1, it said.

But the general public could not have known this, because OCHA classified the bulletin as “Internal, Not for Quotation.” OCHA had no immediate comment on why the update, leaked to Foreign Policy, wasn’t published.