The lavatory is outside in another cave, along the narrow ledge. A plastic sheet strung along the front provides privacy but it does little to cover the smell. "This is a hard existence. If I knew I was going to live through this situation I would not have brought so many children into the world," said Um Salem, who shares the small cave with her husband and 10 children. "We have been here since the end of the summer. It takes me all day to heat a little water from the river to keep us clean."