Injured woman in Syria
Syrian rescue workers and residents help an injured woman following a reported airstrike by government forces on the rebel-held neighborhood of Haydariya in the northern city of Aleppo on April 10, 2016. THAER MOHAMMED/AFP/Getty Images

BEIRUT— It might seem pointless to ask for a death toll during a ceasefire, but the five-year conflict in Syria has gone through so many permutations that its complexities no longer fit the confines of conventional warfare, including what is generally understood as a ceasefire. But in this civil war, which courts fighters from every corner of the globe, a truce or ceasefire means a lower body count, not a break from fatalities.

At the end of February, a partial cessation of hostilities was implemented with the intention of clearing a path to achieve a political solution to the crisis. Despite a reduction in fighting, aerial bombardments and ground clashes have continued, allowing both the Syrian opposition and forces loyal to Syrian President Bashar Assad to consolidate their respective gains. Over the weekend, both parties announced new operations, leaving observers to question the viability of an enduring truce.

“Despite a [partial] ceasefire in fighting and the arrival of humanitarian convoys, the situation remains critical in many besieged areas of Syria,” international medical humanitarian organization Doctors Without Borders said in a statement Thursday.

Manal, a search and rescue volunteer with the Syrian Civil Defense in the rebel-held southern province of Daraa, who gave only her first name, citing threats to her security, told International Business Times that a “quiet week” followed the implementation of the ceasefire at the end of February.

“The situation is good and quiet in many areas, but the situation in the western countryside is very bad because of the dominance of Daash,” Manal said, using the Arabic acronym for the Islamic State group, also known as ISIS. “In some areas there are battles between the army and the free Daash.”

Areas held by terrorist organizations such as the Islamic State group and al Qaeda’s Syrian branch, Jabhat al-Nusra, are exempt from the cessation of hostilities, according to the agreement Russia and the U.S. drew up at the beginning of February. All violations of this agreement were to be reported to a joint U.S.-Russian task force assigned to monitor the situation on the ground.

Some 100 fighting forces, including both the Syrian and Russian air forces, agreed to these terms, according to the Guardian. But more than 50 days later, nearly all parties have been accused of violating the ceasefire. Fighting ISIS, as the opposition forces are doing in Daraa, is not a violation under the agreement, but airstrikes on opposition-held towns or rebel attacks on regime-held areas, are viewed as breaches of the deal.

The Hemeimeem Coordination Center, at the site of Russia’s air base in the Syrian province of Latakia, has documented 372 breaches in the ceasefire agreement since its implementation, a spokesman for Russia’s Defense Ministry said last week.

The number of violations recorded by groups sympathetic to the opposition are much higher. The Syrian Network For Human Rights reported 896 ceasefire violations of “military operations and detention and obstruction of humanitarian aid access” that resulted in at least 129 civilian deaths since the start of the ceasefire. According to the organization's data, the regime committed roughly half of the violations and was responsible for the deaths of 32 civilians.

The Syria Campaign, a global advocacy group that has been monitoring and recording ceasefire violations, documented the deaths of at least 31 civilians — including 11 children — and dozens more injuries when, a little under two weeks ago, 14 airstrikes hit the rebel-held town of Deir Al Asafir, a Damascus suburb in an area known as Eastern Ghouta.

Strikes hit a school, a medical center, a center of the Syrian Civil Defense group and the fuel depot for the Eastern Ghouta sector. The latter two were completely destroyed and at least one member of the Syrian Civil Defense was killed, according to the civilian volunteer group.

Russian or Syrian forces — the only belligerents with air forces — were responsible for the strike. In other rebel-held areas, sources on the ground reported fewer airstrikes but not a total cessation. Abu Ahmad, a doctor in a field hospital in an area of Homs that was one of the first areas to be targeted by Russian bombs last year, lives and works in a small region of Homs on the border with Hama province. Much of Homs and Hama is controlled by ISIS or pro-regime forces, but the small border town is “one of the few places in Syria where ISIS has never set foot,” Nidal Ezeddin, the Homs representative for Syrian Civil Defense told IBT after the first strikes last October.

Ahamd said the ceasefire had slowed the rate of aerial attacks in Homs but had not stopped them completely.

“There are still bombings, but [fewer] than before. Generally speaking, poverty is a [greater] problem,” Ahmad told IBT. “Nowadays, aid is getting into some villages here.”

Since the implementation of the ceasefire, aid groups have been able to access territory that was previously too dangerous. In Homs, airstrikes were so frequent that aid convoys were only able to enter roughly once a year, Ahmad said. The humanitarian situation has improved here, but areas controlled by terrorist groups such as ISIS or al Qaeda have continued to be subject to prolonged bombardments, with little or no recourse to aid for their besieged citizens.

In the first week after the truce was implemented Feb. 27, 135 people were killed in areas covered by the truce, according to the monitoring group Syrian Observatory for Human Rights. The equivalent figures for those areas not covered by the ceasefire was 552.

U.S. State Department spokesman Mark Toner said in a press briefing last week that Assad was the biggest violator of the ceasefire agreement. Violations from all sides have been most prevalent in Aleppo, Syria’s largest city, site of a major highway that connects supply routes from the country's eastern provinces to the western governorates and home to a melting pot of fighters, including various Syrian rebel groups as well as ISIS, Jabhat al-Nusra and different units fighting alongside the regime.

Syrians inspect their homes upon their return to the modern town of Palmyra, adjacent to the ancient Syrian city, on April 9, 2016. LOUAI BESHARA/AFP/Getty Images

The fourth battle for Aleppo has been raging since the beginning of the year, but the fight is far from over. Over the weekend, Syrian opposition groups launched an attack on a regime-held town in southern Aleppo. The attack came just after Syrian Prime Minister Wael al-Halaki, during a visit to Moscow, announced that the Syrian regime was planning a new operation to “liberate” Aleppo.

The situation in Aleppo is “threatening to drive a wider breakdown of the tenuous ceasefire,” Christopher Kozak, Syria analyst for the Institute for the Study of War, wrote in a recent report.

"Continued violations by both pro-regime and opposition factions have fueled the largest outbreak of violence in northern Syria since the [ceasefire] agreement,” he said.