The five-year-old boy was passed between the hands of rescue workers and journalists, away from the rubble created by an airstrike in Aleppo that nearly took his life alongside those of his whole family. Moments later, caked in dust and blood, he found himself in the hands of a yellow-vested rescue worker who rushed him away.

The boy sat silently as cameras recorded him from outside the ambulance he was taken to. He wiped his face and discovered blood. He tried to wipe the blood on his orange seat.

The child sitting stunned in the video that has caused international outrage is Omran Daqneesh. He’s also been called “the boy in the ambulance.” But, after years of civil war in Syria that has displaced millions of children and left them without basic necessities, just being alive — before or after the airstrike — may also make calling him “lucky” improbably appropriate.

The United Nations has found determining the exact number of child casualties during the Syrian civil war to be difficult. The conflict has killed an estimated 470,000 Syrians in total and the UN has placed the number of children in that total at least in the tens of thousands. Some estimates put the tally at around 50,000. Others say there have been at least 11,500, including some who have been executed and tortured.

Still, for Daqneesh, “lucky” may be much too strong of a word. The United Nations Office for the Coordination of Humanitarian affairs says that a staggering eight in 10 children in Syria need humanitarian assistance. Four in 10 have been displaced from their homes. When it comes to routine and everyday activities, their lives have been disrupted: three in 10 children under five haven’t received routine vaccination, one in four of their schools have been damaged, destroyed or occupied and only half of kids even attend school now.

The video of Daqneesh spread quickly on social media after it was posted on YouTube Wednesday, prompting international outcry condemning the violence. Australian lawyer and community advocate Lydia Shelly was one of them.

“We need a political & social resolution to conflict in Syria & Iraq,” she tweeted, “we are losing a whole generation of children.”