The image is epic. It shows thousands of desperate people waiting in a gray canyon of rubble framed by shattered buildings to receive food aid in Yarmouk camp, near Damascus. The photo was shared millions of times last month via social media, and on Thursday, the image appears on a big screen in New York's Times Square in an effort to focus attention on besieged neighborhoods inside Syria and civilians who are literally starving to death.
The image has become an instant icon as the Syrian conflict enters a fourth year. Yarmouk is a neighborhood of mostly Palestinian refugees who fled to Syria decades ago. For more than a year, Syrian government forces have held 20,000 people there under siege. The photograph documents a food distribution in January by the U.N. Relief and Works Agency for Palestinian Refugees.
The photo is "cinematic in its scope and grandeur, and yet, it's deeply personal," says Chris Gunness, the group's spokesman. "Etched on each small face is a very personal private story. And I think it's the combination of the epic and the miniature which partly explains it."
It's about timing, too, he says. He released the photograph as the U.N. Security Council debated a resolution last month urging Syria's government to open besieged areas for aid. The social media reaction was unexpected.
"It's been extraordinary," he says. "Within minutes of that iconic photograph being sent out, it went viral," and then 130 international aid organizations got behind the social media campaign.
When charges surfaced that the photograph was a fake, Gunness released a video from Yarmouk recorded at the same time.
The food distribution came after a fragile cease-fire between government forces and rebels inside Yarmouk. The video shows the magnitude of humanitarian crisis for civilians.
"A lot of children that I saw, their hands were completely black," says an aid worker who wants her name withheld. She's not authorized to speak to the media. A lot of people had grease and dirt stained hands, she says, "because of the inability to wash with soap on the regular basis."
Hands were also blackened from scrabbling in the dirt for food; as those in line explained, many of the women had been digging in backyard gardens, "to pick weeds to try to get by."
In Yarmouk, says the aid worker, a woman in the food line who was hungry like the rest, whispered, "We are not beggars."
"It's very, very powerful. She's like, 'I have never stood in a bread line in my life,' " the aid worker says. "They were people who were middle class, people who had businesses. They were teachers, they had their kids in university."
And they are trapped, says Amr Al Azm, an academic with ties to the Syrian opposition.
Syrian government officials say Yarmouk is held hostage by "terrorists" and besieged the camp to flush them out. Western governments charge that the Syrian regime deliberately blocked food and medicine to starving people. Azm says the U.N. system has failed Syrians, a system dependent on approvals from a host government to deliver aid.
"The whole aid program has been a total catastrophe. It's been allowed to be used by the regime to advance its own agenda, for its own purposes, and they've done nothing about it," he says. "The international community has done very little to prevent this from happening."
But international aid workers say they struggle to keep working in Syria because the crisis is so dire. More than 5 million children need aid, double the number a year ago. With more than half of the country's hospitals destroyed, thousands of Syrians now die from preventable disease. Starvation is a growing cause of death.
Gareth Price-Jones directed Oxfam's program there, a country he rarely visited, he says, because the Syrian government restricts visas to aid workers.
"I think we're all deeply troubled. There are many, many compromises that we're unhappy about having to make," Price-Jones says.
But compromises are made because there are still successes. Oxfam has delivered generators that now pump clean water for a half-million people, according to UK based charities website. There are plans to install more than a dozen generators over the next year.
The conflict in Syria tests a basic principle of every humanitarian organization: neutrality. Humanitarian groups are dedicated to helping all civilians in a conflict. "This is something that we are all accountable for," adds Price-Jones, addressing the organizations working in Syria.
"The whole of the international system was set up after World War II to address these grand challenges, and it's clearly failing dismally," he says in frustration after his time in Syria.
And that brings us back to the photograph from Yarmouk camp, which sparked a social media campaign, generated international sympathy, made a debut in Times Square, but has done little to open the many other besieged neighborhoods in Syria.