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Only 30 percent of the more than 612,000 Syrian refugees actually live in camps. The rest, so-called urban refugees, have moved into neighborhoods where they crowd into rented apartments or abandoned buildings and compete for scarce resources and services. Their presence has caused prices of commodities and rents to soar and created resentment from the host population.

Many of the refugees fled with nothing but the clothes they were wearing. Now, as an unusually harsh winter sets in, they are ill equipped to cope with cold weather.

Crisis inside Syria

Inside Syria, food, water and medicines are in short supply, several Syrian activists said in Skype interviews this week.

The Assad regime’s forces have targeted hospitals and doctors, depriving civilians access to medical care. Children are routinely kidnapped and tortured, and women raped.

Syrian refugees said sexual assault was the “primary reason” their families fled Syria, according to the report by the International Rescue Committee.

“Many women and girls relayed accounts of being attacked in public or in their homes, primarily by armed men. These rapes, sometimes by multiple perpetrators, often occur in front of family members,” the report said.

“To say it is a humanitarian crisis at this point is a bit of an understatement,” said Yassar Bittar, a Washington-based member of the Syrian American Council, who earlier this month visited makeshift camps in Syria for those who have fled their homes.

While the camps are located in areas controlled by the rebels’ Free Syria Army, they are vulnerable to airstrikes by the regime’s jets.

“The international community should also focus on helping Syrians in camps inside Syria,” said Miss Bittar. “These people are freezing. They desperately need fuel and food.”

Those lucky enough to leave Syria bear horrific physical and emotional scars.

Mr. Moumtzis recalled how a woman he met in Lebanon told him of her family’s nightmarish escape from Syria.
Syrian forces attacked the truck in which they were traveling and two of her children, who had been sitting in the back with her, were killed. She didn’t have the heart to tell her husband, who was also wounded, about their deaths. By the time they reached the Lebanese border, he too had died and she had to have both her legs amputated from her own wounds.

“It’s an extraordinary story, but it is also a common story,” said Mr. Moumtzis.