KRAMATORSK, Ukraine — On the day that U.S. President Donald Trump got on the phone with Russian President Vladimir Putin, heavy blasts could be heard in the rebel-held city of Donetsk.

I had traveled from Kiev to Donetsk Oblast in eastern Ukraine, where people’s lives have once again been upended by fighting and the toll of almost three years of conflict can be read in the faces of the unsmiling children.

Families were fleeing the frontlines, a region home to more than four million people, and seeking refuge in the towns of Mariupol and Kramatorsk in Donetsk Oblast.

It is here, in the area bisected by the frozen Kalmius River and the Azov Sea, that Trump will be facing his first foreign policy test over his relationship with Moscow.

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Since 2014, eastern Ukraine has been tormented by a conflict that has cost the lives of more than 10,000 people and left cities pockmarked by shelling. A peace accord last year put a halt to the worst of the violence but hostilities have flared up again in recent weeks, in part, observers say, as a result of the new administration in Washington, which has upended the fragile balance of power.

The separatists say Ukrainian forces are engaged in a “creeping offensive.” Kiev says the Russian-backed rebels have been emboldened by the election of Trump, who favors warmer relations with Moscow.

According to one report, Ukrainian soldiers received text messages — which suggests Russian technological involvement — saying: “You are just meat to your commanders.”

Many people I spoke with in the Donetsk region — including local officials, soldiers, doctors, observers and regular citizens — wondered whether Trump and Putin will make a deal and, if so, what such a deal would mean for Ukraine.

“This is a test for Donald Trump” — Mustafa Nayem, deputy in Ukrainian parliament

The State Department issued a statement Tuesday, saying the United States is “deeply concerned with the recent spike in violence” and calling for a ceasefire. But Trump has so far remained silent and Ukraine is terrified Washington will ultimately turn its back on Kiev in an effort to appease Putin.

“This is a test for Donald Trump,” said Mustafa Nayem, a deputy in the Ukrainian parliament. “If he wants to sacrifice Ukraine and make some secret deal with Moscow behind our backs, there will be thousands of people killed and this blood of children and adults will be on Trump’s hands.”

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On the day of the Trump-Putin phone call, I heard Ukrainian soldiers talking about their “200th” and “300th” — code words for the dead and wounded — at a small store selling military uniforms in downtown Mariupol.

The casualty numbers were picking up — five dead and nine wounded in one day. Father Albert, a protestant priest with the Ukrainian forces, had just watched a soldier bleed out, the medics unable to save him, and he was angry that both the European Union and NATO appeared to have forgotten about Ukraine. “They seem too busy with Trump news to pay attention to this disaster,” he told me.

In the dead of this freezing winter, a humanitarian crisis looms: More than 20,000 residents in Avdiivka and Donetsk city have no heat, electricity or water. And it’s minus 21 degrees Celsius outside.

“Our main concern … is that the conflict boils over,” said Donald Bowser, a Canadian observer in Donbas, describing the humanitarian situation as a “catastrophe.”

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Along the old Donbas frontlines, the war-weary are once more living with the vagaries of conflict.

“We see thousands of broken lives here,” said Marina Pugacheva, the head of the Center for Social Inclusion, an NGO helping the displaced. “Doctors diagnose … kids with autism but these girls are simply shocked,” she said, pointing in the direction of children crowding her office in downtown Mariupol. One little girl had been hit by shelling: She had lost an arm and no longer had a home.

Pugacheva’s center received a $30,000 grant from USAID last year to help and counsel the displaced. Pugacheva says the center is running out of resourses and she is worried that Trump’s administration will cut off the funds.

Post-traumatic stress disorder afflicts both children and adults. They have hidden in basements and lived without routines and normalcy for years. They have seen blood and destruction, some have lost limbs, others relatives and loved ones. Teenagers wet their beds. Some no longer speak.

The city of Kramatorsk has received thousands of displaced families. Yelizaveta, a 43-year-old woman who spoke on condition that her last name not be used and who refused to talk about the whereabouts of her husband, had come here with her 14-year-old son and 5-year-old daughter from Kiyevskiy. The resurgence of violence felt like revisiting a bad dream. “You are left with nothing and your child is crying and all you want is to wake up,” she said.

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In Kiev, politicians debate whether to seal the checkpoints and create “a wall” that would separate the rebel-held territories from the rest of the country.

Ukrainians who have family members on both sides of the conflict risk their lives every time they cross the frontline. Crossing the checkpoints in Mariinka and Volnovakha, where people are first checked by Ukrainian soldiers, border customs and security officials and then by rebel militants on the other side of the so-called dividing line, can take up to 24 hours — often under artillery fire.

“The discussion about how to stop this war is two years too late” — Yevgeny Vilinsky

The government has begun evacuating hundreds of people from the Donetsk region every day. But the roads are dangerous to travel and look deserted.

Sitting in a small Chinese café in Kramatorsk, deputy governor of the Donetsk region Yevgeny Vilinsky and his staff complained that the renewed fighting makes it hard to get supplies to people or rebuild what has been destroyed.

Like many Ukrainian officials, Vilinsky is convinced that without the backing of Washington or more involvement from the EU, Ukraine will not be able to find solutions with regard to Donetsk and Luhansk.

“The discussion about how to stop this war is two years too late,” he said.

Anna Nemtsova is a correspondent for Newsweek and the Daily Beast based in Moscow. Her work has also appeared in the Washington Post, the Chronicle of Higher Education, Foreign Policy, nbcnews.com, Al Jazeera, Marie Claire and the Guardian.