°®Âþµº

The footage of the shell-shocked five-year-old made headlines around the world and was dubbed by Washington "the real face" of Syria's five-year war.

"Omran's case isn't rare – we treat dozens of cases like him every day, with wounds that are typically worse," Dr Abu al-Baraa, a paediatrician in a rebel-held eastern neighbourhood of Aleppo, told AFP.

The footage from activists at the Aleppo Media Centre shows Omran sitting quietly in an ambulance, his bare, dust-covered feet barely reaching the edge of the orange chair.

He touches his forehead with a tiny hand and seems surprised to see blood on his fingers – then wipes it off on the orange chair with the timidity of a child who feels he has done something wrong.

"There are thousands of stories of wounded children whose limbs have been blown off, with wounds to the stomach and head," said Dr Abu al-Baraa.

A bombing raid on the rebel-held district of Salhin in Aleppo killed seven people on Thursday and wounded many more, he added.

"One child was wounded in the chest and head. We tried to stop the bleeding and give him a transfusion, but he was in critical condition and he died."

"He was almost six years old. These are the cases we see every day."

	This image of Omran shocked the world, but this is an everyday reality for children of Syria [Getty]

One child was wounded in the chest and head. We tried to stop the bleeding and give him a transfusion, but he was in critical condition and he died

'Empty words' 

Despite the international outcry, Dr Abu al-Baraa said nothing would change.

"The world can see videos of children every day on YouTube, the children dying in the raids, stuck under the rubble. But the world isn't focusing on this. These are just empty words."

Omran's haunting photo has sparked a series of caricatures and edited images.

In one, Omran sits unassumingly between US President Barack Obama and his Russian counterpart Vladimir Putin, deep in discussion.

In another, the toddler occupies the seat held by Syria at the Arab League, as if to criticise international inaction on the crisis.

And Sudanese artist Khaled Albaih drew Omran near Aylan Kurdi, the three-year-old whose tiny body washed up on a Turkish beach in September after a desperate attempt by his family to reach Europe by boat.

"Choices for Syrian children," reads the bold text over the picture. Omran's blank stare is captioned with "if you stay," and Aylan's crumpled body with "if you leave".

The world can see videos of children every day on YouTube, the children dying in the raids, stuck under the rubble. But the world isn't focusing on this. These are just empty words

Online supporters of Syrian President Bashar al-Assad, meanwhile, shared photographs of children wounded in rebel fire on government-held parts of Aleppo city.

Once Syria's economic hub, Aleppo has been divided by government control in the west and opposition fighters in the east since 2012.

Regime warplanes, backed by Russia's air force since September 2015, bombard the eastern districts while rebel groups fire rockets into the west.

'State of shock' 

Of the estimated 250,000 people still living in the eastern parts of the city, 100,000 are children, said Juliette Touma from the UN children agency (UNICEF).

Omran's photograph "is a reminder of how horrific the war in Syria is and how brutal the impact on children is," she told AFP.

"This photo should shake the conscience of the world."

More than 290,000 people have been killed since Syria's conflict broke out, including nearly 15,000 children.

Of the estimated 250,000 people still living in the eastern parts of the city, 100,000 are children

At least 2.8 million Syrian children – some in their home country, others living as refugees in neighbouring countries – are without school.

Across Syria at least six million children are in urgent need of humanitarian assistance, Touma said, adding that children make up half of the 600,000 people living under siege in the country.

"There are millions of kids who are in a state of shock as a result of violence because of the horrors they witness," she added.

According to UNICEF, a third of Syrian children have only known war, born after the conflict erupted in March 2011 and forced to grow "up too fast and way ahead of their time".

On Friday, 13 sick children were among 18 people evacuated from the besieged town of Madaya.

The cases included children with meningitis and malnutrition, two babies with blood poisoning and a pregnant woman whose baby died in her womb.

The Syrian Arab Red Crescent confirmed in a tweet that it was evacuating "36 humanitarian cases" from Madaya and two government-held towns, Kafraya and Fuaa, in northwestern Idlib province.

Under a UN-brokered agreement, aid deliveries to and evacuations from the towns always occur simultaneously.