Since late last year, fighting and air strikes have intensified in the north-western province of Idlib, and in neighbouring parts of Hama and Aleppo.
The situation is depressingly familiar - deadly airstrikes on medical facilities, bakeries, water stations and market-places. Innocent lives shattered, families divided and homes destroyed.
As this is happening, hundreds of people have been killed as a result of the relentless bombing of Eastern Ghouta, a suburb of the capital, Damascus, about 300km to the south.
The latest round of violence in Idlib has already caused at least 200,000 people to flee further into the province as the frontline of the war shifts northward. Many are people who had been previously displaced from other parts of the country.
Their situation was already desperate. Now, it’s even worse.
If these current hostilities continue, another 400,000 people could very soon be affected. But that may only be the beginning.
"If the frontline continues to creep further and further north, we could soon be bearing witness to the almost unthinkable scenario of two and a half million people trapped against the Turkish border, with no route out."
While more than five million people have fled Syria, over six million are internally displaced within the country. Almost a fifth of that number (1.1 million) have ended up in Idlib province – an area roughly equal in size to County Galway.
With the violence raging, there only option is to flee further north, towards the border with Turkey. However, Turkey already hosts 3.4 million refugees - most of them Syrian - and understandably, is not in favour of accepting any more.
It is that area of Idlib, close to the Turkish border, where GOAL has worked since 2012, and it is there that GOAL provides food and water to three quarters of a million people. GOAL has seen major arrivals of people before and we have met them with emergency aid. And we have already begun responding to those arriving now.
"But what’s happening now has the potential to be more catastrophic than anything our staff on the ground has seen before. "
For the last seven years, the world has been abject in their inability to do anything about the conflict in Syria. World leaders seem unable or unwilling to find a way to end the killing, even as the slaughter and the displacement continues unabated.
Now, the people of Idlib wait to see if anyone will intervene before their last refuge is brutally and bloodily removed.