I have never met Dr. Mohammed Abu Omar. All I know of what he might look like is a tiny Skype avatar, in which a male with longish, dark hair wears a surgical mask, presumably to hide his identity.

But sometimes all it takes to understand the suffering of another human being is to hear their voice.

In steady, almost monotone English, Dr. Abu Omar tells me he's an emergency room doctor who lives full time at the hospital where he works. Home is a Damascus suburb, one of those contested areas largely controlled by rebel fighters directly affected by the chemical attack on Aug. 21. He says he was one of the front-line doctors who treated some of the hundreds of victims that morning.

His testimony of the horror of those hours following the attack was heart wrenching.

His explanation for why people in his suburb were in favour of a foreign intervention was impassioned. 

His account of daily life, though, in a part of Syria that’s been under siege for a year, was devastating.

"The situation here is a disastrous situation," said Dr. Abu Omar. "We are living like 1,000 years ago: No electricity, no energy, no food, no medication, under siege. No one can leave the town, no one can enter the town. No help can enter."

"The people here lost a lot of their weight because there’s not enough nutrition…I lost about 20 kilograms from the beginning of the siege here until now. Some children died by malnutrition. We had two children die three days ago."

"At least save our children's lives," says Dr. Abu Omar. "If you have enough humanity, just punish the killer as soon as possible. Just feel what we are suffering."

Lull in fighting

It's hard to overstate Syria's losses, the cost paid thus far for its ugly war. This week, the United Nations said one-third of Syria's homes have been destroyed in the fighting, so have thousands of schools.

Millions have been displaced, many of them likely for the rest of their lives. Untold numbers are dead. A lot has happened over the past weeks — denunciations, threats, diplomatic wrangles, deployment of warships, votes, speeches, finger pointing, and, now, negotiations.

Changes happened on the ground in Syria, too. In the wake of outrage over the Aug. 21 attack, there was a lull in the fighting, the first in many months.

As talk of a U.S. strike intensified, there was a sense of dread that drove thousands of Syrians to renew their passports. For thousands of others, there was a renewed sense of hope. Maybe, they thought, the status quo was about to change.

But apparently, within minutes of U.S. President Barack Obama’s speech Tuesday in which he formally announced a delay of the congressional vote on a punitive strike against Bashar al-Assad’s regime, Syrian airstrikes resumed over the devastated suburbs of Damascus. Presumably over Dr. Abu Omar’s neighbourhood, too.

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Free Syrian Army fighters run to take cover in the refugee camp of Yarmouk, near Damascus on September 11, 2013. (Ward Al-Keswani/Reuters)

Military units that had repositioned themselves in preparation for a U.S. strike, returned to their normal posture.

For Assad’s regime, it was back to business as usual, as it is now for the rebels, and the people of Syria whether they live in the relative safety of central Damascus, in the unpredictability in the north of the country or across its borders in the inhospitable, dusty tents of the displaced.

Without the brief distraction of the possibility of a foreign intervention, Syria’s conflict is back on track. Life is back to what you might describe as normal, though it is anything but. And it’s growing worse.

Living hand-to-mouth

Mustafa Haid, a long-time Syrian activist, is in the trade of peddling optimism. He founded a non-profit group called Dawlaty, which translates to my state,that promotes a new notion of what a state should be, far different from the one that exists now.

He holds regular workshops for activists on everything from transitional justice, to constitutions and journalism. But even Haid is daunted by the growing complexity of the conflict and its resilience.

People in rebel-held areas are fighting on different levels, he says, and they are desperate for basic needs like electricity, communication and food.

"At the same time there are the airstrikes, the shelling," said Haid, "you just have to save your life. You have to be an escaper.

"You have these jihadi groups. They are [from] outside of the country coming there, putting [on] masks and trying to impose their beliefs."

Children aren’t going to school, says Haid. People are unemployed, living hand-to-mouth.

"I was going to do training or something, and it’s kind of like, what’s the point? If I cannot give them food, if I cannot guarantee their safety?" said Haid.

"Some of them, they told me that 'Look, I don’t believe in your concerns of tomorrow, of the future, because simply I might not live until then. I just want to do stuff for today.' And I think this is stronger than any logic I might have."

What the future holds

Negotiations may have now started over chemical weapons but they stand apart,almost irrelevant  in the everyday of Syria’s conflict which is conducted mostly with conventional weapons.

Everywhere you look the outlook is bleak. Paul Salem, director of the Carnegie Middle East Center, predicts the status quo is here to stay.

"The regime and its allies are not weak, and the rebels and their allies are not weak," said Salem. "They hold half of the country each.

"Regardless of what happens in the next few weeks, I think sadly this conflict is set to go on for several years with massive loss of life in Syria, further de-stabilization of the region and no near end in sight," he says.

It's bad news for all those already well into hard times. Nadim Houry of Human Rights Watch, who has snuck into Syria several times, says conditions are worse than we think.

"There are entire villages that have been abandoned," said Houry. "There are families who live in constant fear of when a random airstrike will fall. There have been executions."

Houry says that the humanitarian situation is a disaster.  

"People feel abandoned," he said. "This is a rich society that is being blown to bits."

And will continue to be. The rebels have no intentions of giving up. Neither does the regime. That siege on the outskirts of Damascus — on Dr. Abu Omar's hospital — is still a siege.

"We are humans just like you," he told me in a sombre soliloquy just before we hung up. "We have lives to live. We have children. We have pasts, and we have a terrible present, but we have a future."

For the moment, it is not a future to look forward to.