ISTANBUL—On a remote patch of flat desert in southern Syria, some 50,000 people displaced by the war have managed to survive in primitive surroundings for years without seeing an aid convoy—until last week.

They live in self-built mud huts with plastic sheeting for roofs. There’s no electricity, no running water, no sanitation, no roads, only one small clinic and four small schools.

The camp dwellers were driven from their homes when the so-called Islamic State took over much of eastern Syria, starting in 2014. But the Assad regime, which has since regained control of their lands, doesn’t want them back.

Nothing grows on the arid land they occupy along the Jordanian border, but the hut-dwellers were able to rely on smugglers for much of their food and medicine until last month, when the regime in Damascus closed down smuggling routes.

Amid reports children were dying of malnutrition—schoolteacher Ahmed Abu Karim told The Daily Beast he knew of four such cases in the past month—pressure rose on the United States and Russia to send in humanitarian aid via United Nations convoys. But because each power mistrusts the other’s long-term plans in Syria, both were soon in a shouting match.

The U.S. responsibility in Rukban is inescapable because the entire settlement lies in a U.S. coalition-controlled security zone surrounding the Tanf military base, which was set up to fight ISIS extremists. But for reasons that no one seems able to explain, the coalition isn’t feeding the people of Rukban. Nor is U.S. ally Jordan, which has closed its border abutting Rukban, ostensibly for fear of ISIS infiltration.

The only option for the U.N. was to start aid deliveries from Damascus, the Syrian capital, traverse a government-held zone and then enter the U.S.-controlled zone, and the politics of that route are almost as treacherous as the roads.

Damascus and Moscow seized on the opportunity to challenge the legitimacy of the U.S. presence in Syria and sent query after query about the safety of the convoy inside the 55-kilometer U.S. security zone, thereby delaying deliveries most of the year.

And while the U.S. offered security guarantees for the zone, they didn’t extend to the settlement itself.

Rukban, it seems, is at the end of the Earth, or perhaps better said, like one of those outposts on forgotten planets in a Star Wars movie.

Everyone in the camp wants out. That’s what camp leaders told U.N. aid officials who accompanied the first major convoy that reached Rukban a week ago Saturday. But they want to leave with dignity, with their rights and humane treatment if a way can be found.

The 78 aid-delivery trucks arrived at a staging point some miles from the camp after a seven-hour journey from Damascus, halting at multiple checkpoints and crossing lines managed by the Syrian regime and the United States.

Family food parcels were distributed, and doctors from the Syrian health ministry vaccinated thousands of children against measles and polio. But there’s no guarantee the same drama won’t play out again when the U.N. tries to reach the camp again in December.

This first convoy took nine months to arrange.

When the Assad regime finally gave the U.N. permission for the delivery in late October, the U.N. was forced to suspend the operation after Russia warned of the “threat of an attack” on the convoy inside the U.S. controlled zone. And so, the recriminations began. And the death toll started to mount.

Russia’s Defense Ministry charged that “irresponsible actions by the United States” had caused a “disastrous humanitarian situation” at Rukban. The spokesman for the U.S. military’s Central Command fired back that Russia and the Assad regime were engaged in a “malicious campaign…to muddle ground truth and hinder humanitarian operations.”

U.S. officials say there was no threat of an attack.

“There are two groups of fighters in the zone, Coalition forces and vetted Syrian fighters,” known as the MAT (for Jaysh Maghawir Al Thawra,)” said Capt. Bill Urban, spokesman for the U.S. Central Command. The MAT are armed, paid and directed by the Coalition and maintain checkpoints and outposts throughout the zone. “When there’s another armed group comes through the de-confliction zone, we roll them up,” he told The Daily Beast.

But U.S. officials have not done any sort of census inside the makeshift camp, which could potentially reveal if there are former ISIS fighters in hiding.

What U.S. officials would not answer is why they chose to rely on U.N. deliveries, despite months of bureaucratic and supposed security delays generated by their adversaries. Since Rukban lies inside a U.S. military exclusion zone, why has the Trump Administration handed veto power to Russia and Syrian President Bashar al-Assad instead of coming up with its own solution? In 2014, for instance, the Obama administration flew supplies to besieged Yazidis trapped on Sinjar Mountain in Iraq, rather than waiting for the U.N. to reach them.

“If you’re the U.S. and your ally, Jordan. won’t supply the aid, then if you want these people to be fed maybe you just need to do it yourself,” said Aron Lund, a Syria expert who is a fellow at the Century Foundation. The U.S. could “drive the aid in or drop it by parachute.”

He says the U.S. also has an international legal obligation to take care of the civilians. “Americans are in de facto control of the area,” he said. “If you’re occupying the area, you have responsibility for the people under your control.”

A U.S. official tells The Daily Beast that it might well come to that, with the coalition air-dropping in aid if Assad and Russian officials delay future shipments, and Jordan currently reluctant to have aid deliveries over its border.

But the ultimate coalition goal is to get the 50,000 or so people out of the desert camp, as Rukban is not sustainable in the long term, the U.S. official said, speaking anonymously because he was not authorized to speak publicly.

Even for the most experienced humanitarian aid officials, Rukban is an outpost like no other.

“It is not a camp, I would call it a makeshift settlement,” said Ajmal Khybari, the deputy representative for protections issues at the U.N. High Commission for Refugees. The camp covers over 11 square miles, and has no structure, no plan, and no outside agency as its benefactor. There are no streets, no sewage pipes, no garbage collection and no electricity. For human waste, people dig a hole in the ground.

It wasn’t clear how the residents obtain wood to burn for warmth. “They said they were getting wood from outside,” said Khybari. “They have developed coping mechanisms.”

Living in the desert, the inhabitants of Rukban are subject to extremes in temperature and in weather, but the worst of all experiences is sandstorms, which blind and choke everything in their path. Women complained that a sandstorm just three weeks ago was one of the worst they ever endured. “Several of them told me about it, it was so painful,” said Khybari. “One said it was a disaster, the end of life. Another just said it was horrible.”

There is commerce of sorts. The mud bricks, for example each as big as one foot square, can be purchased from entrepreneurs for the equivalent of seven cents each. Motorbikes zip around the unpaved paths, as do pickup trucks, but Khybari saw no cars.

Then there’s the market.

“I visited what they call the shopping arcade,” Khybari said. There were 50 to 60 shops selling various goods—pharmacies, hairdressers, a butcher’s shop, selling lamb raised by Bedouin herdsmen in the area, and even produce shops. There’s a “net shop,” which has a small antenna and offers internet service.

The goods on sale were mostly brought in by traders or smugglers, and the prices are exorbitant by local standards, he said. The price for Syrian pita bread was 250 Syrian pounds or about 49 U.S. cents—five times what it costs in Damascus.

Locals said what caused the crisis in the past month was that the Syrian regime closed down the smuggling routes, severely curbing the flow of goods and jacking up the prices.

Not all the news from the camp was negative, said Khybari. People were dressed “as normal,” he said. “I didn’t see people in rags,” he said.

And considering the harsh environment they’re living in, and the recent reported deaths, he said people looked relatively healthy. There is no doctor in the settlement, but there are 14 trained nurses. There is no hospital, but there is a local dispensary. He quoted tribal elders as saying that the most deaths that were not of natural causes involved newborns.

The elders did not give him any figures on infant mortality, he said. But the UOSSM, a Syrian medical aid charity, said in its October bulletin that 15 residents had died of inadequate medical care. UNICEF said a five-day-old boy and a four-month-old girl died there in October because they could not access a hospital.

Rukban has existed as a settlement in some form for at least five years, and functioned at first as a way station for those fleeing to Jordan from eastern and southern Syria. ISIS conquered the ancient city of Palmyra in June 2015, prompting a big influx, while others fled to Rukban from Deir Ezzor, on the Iraqi border and from eastern Homs province, Khybari said. They have kept their tribal affiliations at Rukban and live in clusters with members of their tribe.

Palmyra illustrates the complexity of Syria’s war. The Assad regime had a garrison of some 10,000 security forces there but put up only token resistance and let the city fall to an ISIS force in less than a week, local residents say. That was the pattern of regime withdrawals in towns and villages in eastern Syria.

The regime recaptured Palmyra in March 2016 but then lost it again that December and regained it the following year. In the course of the chaos, nearly all the Sunni inhabitants fled, ridding Assad of a population that largely opposed his regime while opening the way for a possibly Iranian supply corridor to reach the Mediterranean.

Today, Palmyra is part of a vast area devoid of its once-dominant Sunni population, and former residents say they are not welcome to return there.

One encounter that left a deep impression on Khybari was with a sheikh from the Bani Khalid tribe who told him, simply and powerfully, about the life they left behind.

“We had nothing to do with this,” said the sheikh, who’s in his sixties, referring to the national uprising against the Assad regime in 2011. “We were displaced because of ISIS. We came walking all the way here. We want to get back our lives. We are not associated and do not want to be with any non-states armed actors. I would like for my tribe to go back.

“I was not a rich person, but I had my dignity and honor. So did my people,” he continued. “I want to regain that. We want to live with respect. We had schools, teachers, everything. We had our dignity.”

At a meeting with adolescents, a young man who was at school in Homs said that his goal was to study literature at university. At that point, Khybari recounted, “his friends surrounding him said he’s a future poet.” But he said: “My whole dream is to go back and study and be a teacher.”

Leila, a girl of about 9, told him that the happiest time in her day is going to school, even though that amounts to a mathematics class in a one-room schoolhouse. Yet when she returns to her family each day, “there is nothing. I can only hear the flapping of the plastic sheet on the roof,” she told him.

Khybari said all of the people he encountered had a similar message: “There is no solution to have these people stay in Rukban. Their dignity, rights and humanity can only be restored if they have the opportunity to make a voluntary and safe return to normal life.”

Roy Gutman reported from Istanbul, Kimberly Dozier from Washington.