The death toll in the Syrian conflict has risen beyond 200,000 people after four-and-a-half-years of civil war.

The violence has forced more than four million to flee the country, fueling a refugee crisis in the Middle East and Europe and more than 3 million are displaced internally.

The Syrian death toll has now risen beyond 200,00 people.

The region is so dangerous that a definitive tally of deaths is not possible, but several groups are trying to document how many Syrians have died, and what killed them.

“With each passing day there are fewer safe places in Syria,” said Paulo Sérgio Pinheiro, chairman of the United Nations panel investigating human rights abuses in Syria in a recent report.

“Everyday decisions — whether to visit a neighbor, to go out to buy bread — have become, potentially, decisions about life and death,” he said

At least 28,277 civilians have died in shootings and mass killings. Thousands of civilians have been victims of mass shootings and in crossfire between government forces and insurgents.

In one case reported by the UN, more than 100 people, including at least 49 children, were killed in Homs on May 25, 2012. Most were shot at close range.

The UN reports that armed opposition groups have also executed children, but lack of access in areas controlled by the Islamic State has prevented systematic documentation.

At least 27,006 civilians were killed in mortar, artillery and rocket attacks – 20 per cent of them children. Both government and insurgent forces have used weapons that cause civilian damage, according to Amnesty International.

The Syrian government has repeatedly fired imprecise rockets and unguided bombs, according to the United Nations and other monitoring groups. Insurgent groups have used so-called “hell cannons” — improvised artillery devices fitted with explosive gas canisters that cause widespread damage.

“What we are seeing in Syria is war crime on both sides,” Mr. Mock said.

At least 18,866 civilians were killed in Syrian government air attacks.

Civilian deaths caused by government air attacks

Syrian jets and helicopters have blasted civilian targets like mosques, schools and shopping markets in insurgent-controlled areas with barrel bombs — large containers filled with explosives and projectiles — and other weapons. More than a quarter of the dead are children.

At least 8,871 civilians were killed after being kidnapped, detained and/or tortured.

The United Nations has documented rampant use of torture by both government and opposition forces, including crimes against children targeted for appearing to be pro-government.

In March, this year, thousands of photos surfaced showing detainees who were said to have died in Syrian prisons. The photos were smuggled out of Syria by a former Syrian military photographer.

US Secretary of State John Kerry said that the photos showed evidence of torture.

At least 984 civilians were killed by exposure to chemical or toxic substances.

The Syrian government has been accused of using chlorine-filled barrel bombs. An attack in 2013 killed hundreds of people – with some estimates as high as 1,500 – in Ghouta, a suburb of Damascus controlled by the opposition, when the area was struck by several rockets containing sarin, a nerve agent known to be part of the Syrian military’s stockpile.

There are also reports that the Islamic State, also known as ISIS or ISIL, has used mustard gas in northern Syria.

At least 654 medical workers were killed in attacks on hospitals.

Syria ISIS map

The United Nations has accused the Syrian government of using attacks on hospitals as a “weapon of war.” A doctors’ group ‘Physicians for Human Rights,’ claims nearly 300 attacks were carried out on hospitals in July, most of them by pro-Assad forces in opposition-controlled areas.

At least 565 civilians died from starvation, dehydration or lack of basic medical care.

The death toll, documented by the Syrian-American Medical Society through January 2015, does not capture the many people — estimates range from 200,000 to more than 600,000 — who have been under siege for more than a year and are at risk of starving to death or dying from other preventable causes.

An estimated 181 civilians were killed in the US-led air campaign against ISIS.

The Syrian Observatory for Human Rights has estimated that 181 civilians have been killed in the coalition airstrike campaign against the Islamic State, as of mid-August.

 
Laurie Nowell
AMES Australia Senior Journalist