A/HRC/22/59 and diseases has risen, compounded by the decreasing availability of support systems, facilities and infrastructure. 32. Basic commodity prices, including for bread, have soared. Over the past four months of the period under review, inflation exceeded 50 per cent. The crippling effects of the sanctions regime remain. Coping mechanisms among the population, and particularly communities hosting internally displaced persons, are collapsing, leaving those trapped by and fleeing the conflict in appalling conditions. Hostilities have denied people access to basic necessities, including food and water. Food sources, such as bakeries, have been deliberately targeted. 33. Education continues to suffer in the conflict. In December 2012, the Syrian Ministry of Education reported that 1,468 schools were being used as collective centres, while another 2,362 (10 per cent of the total number of schools) had been damaged or looted. 34. The delivery of medicine has been hindered in some situations, and the denial of medical care continues to be reported. Government forces have attacked hospitals and field clinics and prevented physical access to hospitals by snipers. 35. Attacks on hospitals, medical units and personnel aggravate the socioeconomic cost of violence. Health-care staff are leaving their posts, hospitals are running out of supplies and vaccination campaigns have ceased in some areas. These effects substantially limit access to health care, including for the most vulnerable. 36. On 7 January 2013, the Government reported that factories in Aleppo had been looted or destroyed. It provided further information on attacks by armed groups on warehouses of medical supplies, and stated that medicines had been destroyed or sold overseas. The Government also alleged that crops had been destroyed and grain had been stolen from warehouses. 37. The humanitarian situation has deteriorated alarmingly. The number of casualties is on the rise. In December, the Office of the United Nations High Commissioner for Human Rights reported 60,000 deaths since March 2011 based on an external assessment of figures from six non-governmental organizations6 and the Government. The latter put the number of casualties at 11,713. There is a need for further disaggregation of data from all sources. The number of deaths verified by the commission on the basis of 1,391 interviews was 1,190. 38. Armed actors inside the Syrian Arab Republic are not upholding their shared responsibility to ensure access to humanitarian aid. On the contrary, attacks against humanitarian staff, aid buildings and supply routes are frequent amid the ongoing fighting, severely constraining humanitarian operations. 39. Syrians are fleeing their homes in ever increasing numbers. By 6 January 2013, the Office of the United Nations High Commissioner for Refugees estimated that 2 million people had been internally displaced. By 21 January, an estimated 671,262 Syrian refugees were present in five neighbouring countries and North Africa, further destabilizing the region, both economically and politically. 40. Prior to the conflict, the Syrian Arab Republic played host to various groups of refugees, including 500,000 Palestinians and 150,000 Iraqis. Both groups were already living in precarious conditions. The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) estimates that 400,000 Palestine refugees across the Syrian Arab Republic are now in urgent need of assistance. Approximately 17,000 have 6 GE.13-10627 The numbers provided by individual non-governmental organizations ranged from 36,000 to 50,000. 9