Nine months of war in Yemen have left hundreds of children dead, and many more maimed or deeply traumatized by the ongoing violence.

A report by international charity Save the Children last week found that at least three children have been killed every day in Yemen since the conflict broke out in March.

A coalition of Gulf nations led by Saudi Arabia are fighting to reinstall Yemeni President Abed-Rabbo Mansour Hadi after Yemen’s Houthi rebels and their allies seized the reins of government earlier this year. The United Nations says over 5,700 people have been killed in airstrikes and armed clashes since March, including more than 600 children.

Coalition airstrikes were responsible for almost three-quarters of child deaths and injuries in the second quarter of 2015, according to Leila Zerrougui, the U.N. special representative for Children and Armed Conflict.

The ubiquity of death is shattering childhoods across Yemen, an impoverished nation with a rich cultural heritage and thorny politics.

“I was playing in our garden when the missile hit my house … I saw my mum burning in front of me,” 7-year-old Raja’a told Save the Children. “Now I don’t have a house or my family … I don’t like the war and I hate the planes.”

Thousands of children in Yemen have been exposed to traumatic events during the conflict, the Save the Children report said. Many parents told the charity their children are plagued by nightmares, are afraid of loud noises, and cry when they hear planes overhead. 

Children in the Yemeni city of Taiz have started playing a game they call “one two three airstrike,” in which they all throw themselves to the ground, Doctors Without Borders emergency coordinator Karline Kleijer wrote in the Guardian last month.

Meanwhile, it is increasingly difficult for wounded children to get medical care. Since the war broke out, over 600 hospitals have closed due to lack of staff, fuel or supplies, and at least 69 health facilities have been fully or partially damaged by fighting, according to the World Health Organization.

In one incident documented by Save the Children, the main pediatric hospital in the capital city of Sanaa was damaged by a nearby airstrike in September, forcing the relocation of many children being treated there. Several infants died when their ventilators cut out after the airstrike, according to the charity.

Children suffer particularly complex injuries from explosive weapons and require specialized treatment “because their bodies are smaller, more delicate and still developing,” the report said.

“It’s bitterly ironic that the very health facilities needed to treat injured children have often been damaged or destroyed by explosive weapons themselves,” Save the Children’s Yemen director Edward Santiago said in a statement.

Children are also particularly vulnerable to malnutrition and disease, the report warned. The war has exacerbated Yemen’s already fragile humanitarian situation, as markets, agriculture and fishing are disrupted by conflict. The U.N. says 1.8 million children are at risk of malnutrition in Yemen.

The war has also forced thousands of schools to close, and hundreds of schools have been damaged by the fighting. Some school buildings are being used as temporary accommodation for families displaced by the conflict.

The violence has also impeded international efforts to end the recruitment of children as fighters in Yemen, a long-standing practice employed by Yemen's military and myriad armed groups operating in the nation, including the Houthi rebels, tribal militias and al Qaeda.