We see the explosions from the artillery shells. There are photos of charred or bullet ridden bodies, crying children and cowering civilians. These are the faces of war that are easily captured and conveyed, and they tell a lot.
What is not captured is the struggle to survive the night. War has many tools to kill and the more silent ones are the disease, the malnutrition and the harsh elements that scorn diplomats and strategists.
As winter approaches in Syria, the drop in temperatures will make the perilous situation many Syrians civilians now face even worse. Whether in refugee camps or in villages with no infrastructure or medical care and suffering from malnutrition, these civilians will continue to weaken.
This has happened before, of course. In 1991, many Kurds froze to death in the mountains as they fled Iraqi troops. Humanitarian workers used to wait until morning to see what lumps of snow did not move in order to determine who recently died.
It is the survival of the fittest, albeit among those not very fit to begin with. Winter comes as people's immune systems are already weakened by lack of food and hygiene. Doctors and humanitarian workers in Syria are now seeing a number of other deadly diseases on the rise, including typhoid, hepatitis and leishmaniasis (the "flesh-eating" disease), as well as chronic diseases returning from a lack of basic heath care.
Infectious diseases are ravaging the war-torn nation, including a new outbreak of polio, which has not been seen in Syria since the late 1990s. Prior to recent confirmation of 22 Syrian polio cases, only Pakistan, Afghanistan and Nigeria still have victims and have never managed to interrupt person-to-person spread of the virus.
This is a humanitarian catastrophe, and it will just get worse. About 9.3 million of Syria's 23 million inhabitants need help, U.N. humanitarian chief Valerie Amos told reporters. That's about 40 percent of the population.
"I've never seen anything that has grown so big, so quickly, in such a short amount of time. Over the past year, we've gone from 230,000 refugees to 2.2 million refugees," Anne Richard, the Assistant Secretary for Population, Refugees and Migration at the U.S. Department of State, told NPR.
The timing of Syria's case is particularly ironic because October 24 is World Polio Day. The Syrian government has promised to permit vaccinations, although past actions have not supported such a promise.
"We want vaccinations to reach every Syrian child wherever they are — either in a conflict zone or an area where the Syrian army is present," Deputy Foreign Minister Faisal Mekdad said, according to Reuters. "This must reach every Syrian child and we pledge this [will happen], and we will grant every opportunity to humanitarian organizations to reach every Syrian child."
Other government officials have blamed the spread of polio on the rebels entering the country from Pakistan, where a Taliban ban on vaccination is exacerbating a serious polio outbreak, health officials say. Health care providers in Pakistan have been attacked repeatedly, ever since the Taliban denounced vaccines as a Western plot to sterilize Muslims and imposed bans on inoculation in June 2012.
In North Waziristan, a region near the Afghan border that has been cordoned off by the Taliban, dozens of children, many under the age of two, have been crippled by disease in the past six months. Tests conducted on sewage samples in some of Pakistan's major cities show the polio virus is starting to spread beyond these isolated pockets and could soon spark polio outbreaks in more densely populated areas.
Unlike some diseases, polio can, in theory, be eradicated, and global efforts have made impressive progress. Twenty years ago, polio was the leading cause of disability in developing countries, with half a million cases worldwide; last year there were only 223 cases throughout the world. But armed conflict and instability are making it difficult to wipe out the virus completely.
Along with Syria, a polio outbreak in the Horn of Africa has ballooned into more than 190 cases. The epicenter is Somalia, where fighting and violence have kept vaccinators from reaching hundreds of thousands of children in the past few years.
There are, of course, many different kinds of war waged on innocent people. Loudly or quietly, in the end they both deliver the same fate.
Tom Squitieri is a college professor and award-winning foreign correspondent. He also writes for the Foreign Policy Association. You can follow him on Twitter: @TomSquitieri.