To be a child in war-ravaged Syria is to know fear and suffering, death and destruction. But there is a difference, especially for children, between knowing terrible things and comprehending them. Imagine the panic and confusion early Tuesday after the bombs dropped in northern Syria as children began struggling to breathe. There was something poisonous in the air, causing asphyxiation and foaming at the mouth: a gas attack!

Dozens of people were killed, including at least 11 children, and hundreds were injured in an apparent chemical weapons attack that, if proved, would constitute a war crime. Those taken to clinics stood a better chance of recovering, though an antidote, pralidoxime, is said to be in short supply.

Syria’s chaos meant confirming details was difficult. The attack occurred in Khan Sheikhoun, a rebel-held town. Witnesses, including victims and anti-government sources, linked the gassing to a Syrian government aerial bombing. Doctors suspected nerve gas – a mix of sarin and chlorine. “The symptoms were pale skin, sweating, narrow or pin-eye pupils, very intense respiratory detachments,” one doctor told CNN. “Those symptoms match the usage of sarin.”

The war in Syria grinds on without mercy: The despot leader of the government, Bashar Assad, is squared off against anti-government forces in a vicious civil war; at the same time, the Islamic State tries to occupy the power vacuum in Syria’s interior and struggles against the U.S.-led coalition. The Russians are in Syria, too, at Assad’s side. The Syrian government denied responsibility for the gas attack, but Assad on several documented occasions has used chemical weapons on his own people.

Assad’s war has killed nearly 500,000 people and driven 6 million from their homes and villages. The fighting has lasted six years, which means many Syrian children know nothing of the world but war and worry.

To be a child in Syria is to live or die with these truths, secure in the knowledge that for six years the rest of us have let them happen.