“It is like a terrifying nightmare that just keeps going on and on.” The words of a doctor from rural Damascus. The Syrian conflict which has its roots in protests by opposition supporters in the southern city of Deera in March 2011 has entered its fourth year.

There are daily and deadly battles between rebel groups and regime forces. As many as 140,000 have died, millions driven from their homes, whole communities shattered.

There was a time two years into the fighting when international observers predicted the downfall of President Bashar al-Assad. It has not happened and he remains secure.

“If there is a popular demand for me to be nominated, I will run. I will not abandon my national duty,” he is quoted as saying of his intentions for forthcoming presidential elections.

A US – Russian deal was brokered for the removal and destruction of chemical weapons. But it has been frustration for the international community in attempts to end the civil war.

On Friday UN Secretary-General Ban Ki-moon said Iran and Russia should pressure their ally Damascus to re-start peace talks.

The numbers of those who have fled are by any estimation staggering – one of the largest refugee exoduses in recent history. Neighbouring countries have borne the brunt of the problem. Millions have been displaced internally.

The United Nations has called for 6.5 billion dollars to provide medical care, food, water and shelter for these people. It is the UN’s largest appeal.

“Much said and little done” were the words of UN Secretary-General Ban Ki-moon That was one year ago. Twelve months on what has changed for the next generation of Syrians?