Since the fall of Aleppo to Syrian government forces last week, the outskirts of the battered city have become a mass of displacement camps where tiny children don't play hide and seek -- they play hide and shoot.
According to emergency response workers who are tending to the people fleeing the eastern parts of the city that the rebels held, the mental and physical condition of the children is, as one put it, "unfathomable." Many of these children of war are now playing their own war games to pass the time.
"The little boys play 'regime versus rebels.' They make pistols with their hands and have to shoot each other," 27-year-old aid worker Amjad, whose last name is being withheld, told FoxNews.com. "They like to pretend to be strong and fighting, they pretend to be bombs, count numbers and explode."
Scores of orphans are said to be among the refugees stepping off the buses, with children of all ages exhibiting symptoms of depression and even schizophrenia, say aid workers. Amjad stated that "nearly all have psychiatric illness" and there is a dire need for psychologists and trauma specialists, for both the short and long term. Nights in the crowded shelters are filled with nightmares and episodes of aggression and violence among the youngsters.
"Children have been living with the dead for so long now they now live they are dead too, like ghosts," said Amjad. "They say they hate the world."
Syrian families told FoxNews.com that the children scream at the slightest noise overhead and run for shelter. Some play games where they "dive and duck"-- whoever drops the last is out -- while another player makes weapon-like noises.
Beyond the complex of psychological damage, the physical condition of many is also of deep concern.
"Many have lost limbs and have suffered severe burns with wounds infected and not properly treated," Amjad went on. "There is flu and breathing problems, skin diseases."
The cold weather and thick dusting of snowfall this week has worsened the spread of sicknesses.
Since Dec. 15, when President Bashar al-Assad's forces, supported by Russian airstrikes, regained control of most of the city, tens of thousands of Syrians have been evacuated from the worst-hit areas, mostly on buses. After several halts in the evacuation after outbreaks of fighting, it was confirmed late Thursday that the last of the departures had been completed and the government had full control of Aleppo.
Evacuees have been transported to both camps and villages in the western part of Aleppo, as well as the countryside around the nearby city of Idlib, and even to Turkey. When arriving off the buses, the newly displaced children -- many of them starving after the long siege -- are given bags containing bananas and apples. When they can, humanitarian groups supply meals of chicken and rice, rationed into small plastic containers, as well as canned items.
But no settlement of the almost six-year civil war has been reached. Officials from Russia, Turkey and Iran met in Moscow this week to begin devising a deal. The move excludes the United States and the United Nations from the table, effectively assuring that Assad, who is supported by the Russians and Iranians, will remain in power.
"Liberating Aleppo from terrorism is a victory not only for Syria, but for those who really contributed to the fight against terrorism," Assad stated this week, according to his government's news service. "Especially Iran and Russia."
Throughout the conflict, the Syrian president and his allies have maintained that all the rebel factions are foreign-backed terrorists, many of them Islamic extremists, while opposition supporters characterize them as freedom fighters seeking democratic change.
Many in the government-held western side of Aleppo are celebrating Assad's victory, seeing it as a sign the "unnecessary" war, a war that has claimed hundreds of thousands of lives, will soon be over and they can start rebuilding their lives. Meanwhile, the uprooted residents of the rebel side of the city are tasting bitter defeat.
But despite talk of peace agreements, for many, the zest to fight has not yet faded.
"Some say they will only go home when Bashar dies or steps down for judgment," one camp worker added. "Even the kids say that now."
Hollie McKay has been a FoxNews.com staff reporter since 2007. She has reported extensively from the Middle East on the rise and fall of terrorist groups such as ISIS in Iraq. Follow her on twitter at @holliesmckay