Last Thursday was a deadly day for residents of Khan Eshieh.

Russian and Syrian government air strikes hit the Palestinian refugee camp west of Damascus in the pre-dawn hours, killing a baby, while shelling throughout the day killed another two.

“Since the end of last month, shelling on the camp has intensified,” said Emad al-Muslimani, a media activist inside the camp. “Barrel bombs, cluster munitions, bunker-buster missiles, you name it. It is like the camp is being used as a testing ground for weapons.”

On one day during last week, al-Muslimani counted 50 shells pounding the camp within the space of 15 minutes. He described it as the worst period he can remember going through.

An 18-month-old baby identified only as Isra was the youngest casualty on 6 October. The bombing that killed her also caused moderate injuries to her grandfather. According to residents, Isra’s parents have been out of the camp, leaving her in her grandfather’s care. The elderly man is recovering but had not been able to break the news to her parents, a task which fell to others.

Artillery shelling from government-held hills overlooking the camp as well as air strikes continued through the day, killing two, a refugee and another man who had been displaced from Daraya.

Government offensive

On 11 October, residents staged a protest to demand an end to the shelling, and the creation of a safe passage in and out of the camp for urgently needed medical supplies.

UNRWA, the UN body tasked with providing for Palestinian refugees, was singled out for criticism for closing the camp’s schools, and the Palestine Liberation Organization and Palestinian factions were also called upon to protect the camp and its residents.

The protest shows just how difficult the situation has become in Khan Eshieh.

“The latest escalation began following a massive offensive by the Syrian army, backed by Russian jets, to retake the nearby towns of Deir Khabiyeh and al-Muqayliba,” al-Muslimani told The Electronic Intifada in a recent Skype interview. “Although we insist on the neutrality of the camp and that there are absolutely no fighters or military presence by the opposition inside, we continue to pay the price.”

In August, several armed opposition groups working in Western Ghouta issued a statement vowing to respect the demands of Khan Eshieh’s residents to keep the camp neutral. They also withdrew from farms on the camp’s outskirts, according to camp residents contacted by The Electronic Intifada, who said Khan Eshieh has been free of any fighting factions for the past three years.

“The residents and the local reconciliation committee have spared no effort to maintain the camp’s neutrality,” said Rafiq Hadi, an editor at the Palestinian Refugees Portal media collective, which covers the plight of Palestinians in Syria. “Pressure was exerted so as not to provide the regime with any pretext to attack Khan Eshieh, keeping in mind the fragile situation of Palestinian refugees in Syria.”

Khan Eshieh was under daily attack between the months of May and August, when the main road in and out of the camp was sealed off, supplies cut off and residents faced a serious humanitarian crisis. The bombing tapered off for most of September.

Targeting area’s only hospital

But a similar scenario now looms again.

On 28 September, government forces hit an UNRWA-run school with two mortar shells, injuring two teachers and a pupil.

UNRWA issued a statement condemning the shelling and those responsible, but activists inside the camp accused the UN body of a “cover up” by not explicitly naming the perpetrators. They also called for UN officials to visit the camp to confirm that it was free of any armed presence, as well as for the swift provision of medical and humanitarian aid.

Shelling also targeted a makeshift hospital just outside the camp that treats wounded camp residents. The makeshift hospital has been hit several times in recent months.

Even though it is the only operating hospital in the area, some Khan Eshieh residents remain reluctant to send their wounded children there for fear of retribution by government forces and their allies. A resident who works in Damascus and spoke on condition of anonymity said he was too scared to send his injured daughter to the hospital.

“My 14-year-old son was killed in shelling and my daughter was wounded,” he recalled. “Neighbors wanted to carry her to the field hospital but I was worried about the repercussions should officials find out.”

A nurse was eventually brought to treat the child, he said.

Uncertain future

According to Ahmad Hussein, a Khan Eshieh correspondent for the Action Group for Palestinians of Syria, 30 doctors were forced to leave the camp. Only two medical doctors have remained, including a dentist, compounding the problems for the health infrastructure in the camp.

Yet for all that Khan Eshieh’s residents have already endured, it is, they say, the future that scares them most. They are preoccupied with the thought that Khan Eshieh will turn into a second Yarmouk, the Palestinian camp that has been under a tight siege since July 2013.

“Those left in Khan Eshieh cannot cope with a siege. They don’t have the economic resources, the energy, or the supplies,” al-Muslimani said. “Anyone who can afford to leave Khan Eshieh has already done so. The 12,000 who are still here have nowhere to go.”

More generally, Palestinian-Syrian activists are beginning to see the crisis in Yarmouk and Khan Eshieh, two of the largest Palestinian camps in Syria, as attempts at putting an end to the Palestinian presence in in the country.

“As much as we would like to talk about defiance and steadfastness, people here are tired and if they have the opportunity to leave, most of them will not think twice,” al-Muslimani said.

He feared, he said, this would have a negative impact on the Palestinian cause. As Palestinian refugees are scattered even further, some seeking refuge in Europe, their attachment to their homeland might suffer irreparable damage, he argued.

“This is not only a disaster for Palestinians in Syria, but a blow for the Palestinian refugee cause in general.”

Budour Youssef Hassan is a Palestinian writer and law graduate based in occupied Jerusalem. Blog:budourhassan.wordpress.com. Twitter: @Budour48