Yarmouk camp remains open to the dead and closed to the living.

This is the ironic reality in the southern Damascus camp for Palestinian refugees, which has been under partial or total siege since late 2012, barring most residents from exit and re-entry.

Yarmouk has all but emptied since then, with multiple attacks causing mass displacements. Hundreds of Palestinians have died in and around Yarmouk in recent years, either as a result of starvation or a lack of access to medical supplies.

But through a complex bureaucratic process, those who died outside of the camp have been able to secure burial within its borders.

For nearly two years, Syrian and Palestinian officials have been helping to facilitate the process of returning bodies to Yarmouk for burial. In Damascus, the Palestine Liberation Organization (PLO) arranges for the bodies to be transferred to Yarmouk, while a Syrian security agency approves a permit allowing them to be brought across a checkpoint separating regime-held and rebel-controlled areas of Damascus. A local organisation, known as the Palestinian Civil Committee, then liaises with Syrian opposition groups in areas bordering Yarmouk to handle funeral arrangements.

There have been several such burials in recent weeks, including that of a one-year-old girl.

'They need graves'

"People are dying every day, and they need graves," Ibrahim, a Palestinian in Damascus who declined to give his last name for security reasons, told Al Jazeera. "Before, people were struggling to find cemeteries to bury their loved ones."

More than 315 Palestinians have been buried in Yarmouk under this arrangement since the first burial in January 2016, according to local activists and relief workers.

A manager with the civil committee told Al Jazeera that people insisted on returning bodies to Yarmouk for burial "because of the symbolism of the camp and also because of the high prices of graves in cemeteries in Damascus", with the cost for a grave in Damascus pegged at around 300,000 Syrian pounds ($580), compared with 10,000 pounds ($19) in Yarmouk.

Bodies must cross front lines through areas controlled variously by regime forces, rebels and Islamic State of Iraq and the Levant (ISIL, also known as ISIS) fighters.

Ibrahim has had two relatives buried in Yarmouk, accompanying their bodies through the south of the city.

"If you are in a regime area, you have to obey their laws, and the same in the opposition areas. In the camp, you have to follow ISIL's rules," Ibrahim said.

Much of Yarmouk remains under ISIL's control after the group stormed the camp in 2015.

Symbolic ritual

The return to Yarmouk is suffused with symbolism. Palestinian-Syrians sometimes refer to the devastated camp as their piece of Palestine in lieu of Palestine itself. Some 4,500 civilians currently remain inside Yarmouk, compared with a prewar Palestinian population of around 150,000, according to aid agencies.

"Everyone who has been displaced from Yarmouk has the hope and desire that one day they will go back ... alive or dead," local relief worker Obaydah al-Masri told Al Jazeera. "The people who are returned for burial in the camp were born there, raised there. They lived the best days of their lives there."

With Yarmouk still besieged and under the control of armed groups, however, death is all too often the only way that displaced residents can return home. Recent clashes between rebels and ISIL fighters have resulted in fresh checkpoint closures and further access complications. Students and teachers have been refused entry to rebel-held southern Damascus, while civilians injured in clashes have been trapped inside the camp.

Earlier this year, Palestinian-Syrian refugee Wafa Idrees travelled to Damascus with the body of her elderly mother, who died in Lebanon and was finally laid to rest in Yarmouk. "It was easy because the PLO was there to help us, to the point that we buried my mother the same day that her body arrived to Damascus," Idrees told Al Jazeera.

It can seem like a miracle of sorts that the passage of the dead involves so many groups active in the Syrian conflict: the regime, the PLO, opposition groups and armed fighters, who provide tacit permission for the process.

'Cemetery of the Palestinians'

But local activists say that while the PLO might be honouring the dead, it is not doing enough to protect the living, either by helping to transfer emergency medical cases out of Yarmouk and the southern suburbs for treatment, or by pushing for better humanitarian access into and out of the camp.

The status quo is still costing lives on a regular basis. In September, Palestinian refugee Mahmoud Daniel Fadel died of cancer in a neighbourhood next to Yarmouk. Activists and relief workers reportedly appealed to the PLO on several occasions to help get Fadel into Damascus for life-saving chemotherapy treatment, but to no avail.

There are rare exceptions, and last week a handful of ill or injured Palestinians were transferred out of Yarmouk. But for most, the only route in and out of the camp is in a coffin.

"Palestinians from Yarmouk aren't allowed to enter or leave the camp … except when they are dead and need to be buried," said former resident Muhammad al-Najmeh, who fled towards Germany in 2012.

"Palestinians started calling the PLO the 'cemetery of the Palestinians.' It's supposed to be there to help Palestinians, but it can only help them once they've died."