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As the rebels and government vie for the upper hand in an increasingly bloody struggle, the conflict’s toll on civilians is worsening.

The U.N. refugee agency said Friday it found desperate conditions in the Syrian city of Homs, where thousands of people are living in unheated shelters and a quarter of million people are displaced from their homes.

An assessment team visiting this week saw half of the city’s hospitals shut down and “severe shortages of basic supplies ranging from medicine to blankets, winter clothes and children’s shoes,” the agency’s spokeswoman, Melissa Fleming, said.

The violence on the ground, meanwhile, has overshadowed a slow diplomatic process.

Lakhdar Brahimi, the United Nations envoy for Syria, said Thursday that divisions in the Security Council are blocking progress toward ending the violence in Syria, and any eventual cease-fire will require the presence of an international peacekeeping force.

Brahimi said he has the elements for a possible peace plan, but those elements “cannot be put together until the (Security) Council has come together and is ready to adopt a resolution that will be the basis for a political process.”

World powers remain divided on how to stop Syria’s crisis, with the U.S. and many Arab and European nations calling for Assad to step down, while Russia, China and Iran continue to back the regime. Moscow and Beijing have vetoed three Western-backed Security Council resolutions that would pressure Assad, including with the threat of sanctions, to halt the violence, and the U.N.’s most powerful body remains paralyzed.

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Associated Press writer Albert Aji in Damascus, Syria, contributed to this report.