Aid agencies struggle to cope with rise in new arrivals, with scores dying on the way to the settlements

An estimated 7,000 women and children from more than 40 nations, including the US, UK, Australia and Europe, are living in tense and chaotic conditions in camps in north-eastern Syria, where they are “not wanted” due to their supposed affiliation with Islamic State.

Among them are hundreds of unaccompanied or separated children, some just babies as young as five months, according to aid groups and other sources.

To ease potential tension among the many groups, the foreign nationals – hailing from countries as varied as Indonesia, Kyrgyzstan, Somalia and Trinidad and Tobago – have been segregated into separate annexes in two of the three camps, which include Ain Issa, al-Roj and the severely overcrowded al-Hawl centre, where Shamima Begum’s baby son died just under a fortnight ago.

“The message that they are not wanted is growing stronger,” said Unicef’s regional director for the Middle East, Geert Cappelaere. “They are not wanted in the camp. They are often not wanted in their countries of origin, still waiting for third countries to come forward and offer resettlement.”

Up to 5,000 children in the camps are believed to be foreign nationals, according to Save the Children’s Syria response director Sonia Khush, a figure that does not include Iraqi children. But the exact numbers are difficult to assess, said Khush, due to the sheer number of people arriving every day.

Keeping track of unaccompanied children is extremely difficult, as they are often passed from family to family.

Some 58,000 newcomers – 90% of them women and children – have arrived in the past three months alone, many of them from the last Isis enclave of Baghuz, said Ghassan Mediah, who heads the Unicef field office near al-Hawl, close to the Iraq border. There have been 123 deaths, including 108 children, on the way to al-Hawl camp or soon after arriving, according to the International Rescue Committee.

The number of arrivals has inundated aid agencies, which are struggling to provide adequate housing, food and medical and educational support. Hygiene standards are so poor the camp administration is now worried about an outbreak of dysentery, and the overcrowded conditions have led to fires caused by cooking and heating stoves, which have killed at least two children in the last week.

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The families arrive after a seven-hour drive in the back of filthy trucks normally used for transporting animals and through sub-zero temperatures, said Mediah. The infants who have died en route to the camp or on the way to the hospital were suffering from hypothermia and malnutrition of significant concern, he added.

A high number of the new arrivals are pregnant and some have been giving birth during the journey, adding to the complicated medical needs of the camp’s population.

“The children are sick, injured, hungry, cold, malnourished and, above all, traumatised,” said Mediah. “One thousand people arrived just the other night. Four infants died on the way here or en route to hospital. Probably around 300 children had cases of complicated and severe malnutrition. They are also traumatised by what they have seen. These children have never lived a normal childhood, so we are still figuring out what kind of psycho-social support to provide them.”

Facebook Twitter Pinterest Children at al-Hawl camp in Syria. Photograph: Reuters

Most of the newly arrived children are extremely quiet and do not talk or smile. Even though some have obvious injuries or are without coats and shoes in the cold weather they do not cry.

Foreign women and children began arriving in the camps 18 months ago, but figures have risen sharply in recent weeks as Kurdish forces have launched attacks on the final Isis enclave. According to one source, authorities decided to segregate the foreign nationals from the others for “various reasons”, the most significant being their “perceived identification with Isis”.

“Isis is perhaps why the Syrians left, or the reason why they resented living under Isis control, so the decision was made to separate them. Tensions do break out between the groups, but that’s normal in any camp,” the source added.

The foreign women have given various reasons for how they ended up in Syria, said Khush. “A lot of women say they didn’t know where their husbands were taking them. They thought they were going to Turkey but ended up in Raqqa. Another story is that the women were recruited online on Facebook or other social media sites, where they were given a very rosy picture of life in the Islamic caliphate.

“Some women just picked up and moved on their own, knowing exactly what they were doing, heading to Raqqa with their children but not their husbands … Then you get the teenage girls brought over by their parents who ended up getting married [in Isis territory] as teens, and now they have their own children.”

Whatever the reason for their being in the camps now, they all deserved adequate shelter, food and water, and healthcare, she said.

Both Khush and Mediah stated that housing was of primary concern in the camps. The population in al-Hawl in December was just 9,500; today it is 68,000. “We are expecting to have as many as 75,000 people here, but the maximum capacity is 55,000, so we definitely have a problem with shelter,” said Mediah.

Facebook Twitter Pinterest Al-Hawl camp, where hundreds of families have been forced to sleep outside while tents are found. Photograph: Achilleas Zavallis/The Guardian

“Any tent that’s available, no matter what it was for originally, is now sheltering the new arrivals,” said Khush.

At al-Hawl, the arrivals and screening area is so overwhelmed that hundreds of families have been forced to sleep outside in the mud and rain for several nights before tents are found.

Schooling is also an issue. Last year, Unicef prepared for 4,000 school-age children in al-Hawl camp; after the recent population influxes, however, that number has jumped fivefold to 22,000.

“Every single child I’ve spoken to, whether six or 14, has never been to school because they’ve been in conflict their whole lives. Imagine a child who has never been to school – you have to start from scratch. How do you bring the kid back to play, provide hope, a different life from what they’ve seen so far?”

Save the Children has set up activities for children in all three camps and is aiming to do more to help the foreign women socialise. “So far their activities are limited to day-to-day things like cooking or getting oil to light the stoves,” said Khush. “It’s been a really cold and rainy winter, so there hasn’t been much for them to do.”

The largest issue facing authorities was the poor mental health of the new arrivals, specifically the children.

“A lot of them do have behavioural issues, showing either as aggression or withdrawal or fear when they see an aeroplane, for example,” said Khush. “A lot of the children talk about having witnessed beheadings or being exposed to significant violence, and one of the best ways to counter that is to get them into school and give them routines and normality.”