Use of cluster munitions is escalating London - Arabstoday According to an international aid agency, Syria's civil war is unleashing a "staggering humanitarian crisis" on the Middle East. Hundreds of thousands of people are trying to escape the violence that has killed an estimated 60,000 people in the last 21 months. Around 600,000 Syrians have fled to neighbouring nations including Turkey, Lebanon and Jordan. Refugees interviewed by the International Rescue Committee (IRC) in a 23-page report on the crisis published on Monday cited sexual violence as a major reason they fled the country. The New York-based organisation said gang rape, kidnapping, rape, torture and murder are rampant. "After decades of working in war and disaster zones, the IRC knows that women and girls suffer physical and sexual violence in every conflict. Syria is no exception," the group added. Harsh winter weather has worsened the chaotic and desperate situation of cold and hungry refugees, "Nearly two years into Syria's civil war, the region faces a staggering humanitarian disaster," the IRC report said. An activist in Moadamiyeh, a rebel-held town southwest of Damascus, said an air strike there killed 20 people on Monday. The Syrian Observatory for Human Rights, a Britain-based monitoring group, said at least 13 people had died in the air raid but the number was likely to increase. Meanwhile the overall death toll is set to rise as the Human Rights Watch said it had evidence that in recent attacks government forces had used multi-barrel rocket launchers to deliver Egyptian-made cluster munitions. "Syria is escalating and expanding its use of cluster munitions, despite international condemnation of its embrace of this banned weapon," it said.