Escaping the fighting in Raqqa involves perilous journeys to reach safety. Mothers, fathers and children must be able to dodge the snipers and landmines along the way, then spend weeks running from farm to farm, sleeping in the open before they arrive at a camp where they can at least get access to basic services again. Those who are trapped inside Raqqa city remain in grave danger as heavy fighting continues.
I recently visited two camps that house thousands of families who managed to flee Raqqa. First: Ain Issa, 50 kilometres north of the city.
We left the UNICEF office at 5AM, reaching camp five hours later. It was already hot. Temperatures can go as high as 45 degrees Celsius, making life even harder for families in the camp, especially children.
Health workers told me that two siblings, a 1-year-old and a 7-month-old, had died immediately after arriving. They had complications as a result of severe acute malnutrition, and health workers could not evacuate them to a hospital for specialized treatment.
The camp’s medical facilities are equipped for basic primary care, immunization and nutrition screening. People requiring specialized medical treatment need to be evacuated. But this is a challenge. I have seen many children, elderly people and women in critical condition unable to receive treatment quickly enough. Security concerns and slow administrative procedures limit freedom of movement, affecting the wellbeing of children and their families.
Ain Issa camp currently houses about 6,000 people, though many families stay only a short time. Camp mangers told me that up to 200 families arrive from Raqqa every day. Three weeks ago, around 39,000 people arrived in one day, and then left after a week. This is a huge caseload for humanitarian workers and frontline responders.
A lost community
After years under siege, many of the families I met in the camp looked lost. They were present only physically.
Many of the children had been exposed to extreme violence and conflict. They looked traumatized. They did not play, run or laugh like normal children. They did not want to engage. They just looked numb and cold.
Families were struggling to adjust to life on the run. They told me how they had owned homes, farms; they had led normal lives. But they lost everything, and quickly. Now, they were concerned about one thing – their safety and the safety of their children.
Physically, many children had severe micronutrient deficiencies that can cause significant damage to their mental and physical growth. I screened 20 children for malnutrition in Ain Issa. Some of the youngest had dislocated hips or shoulders, which should have been treated immediately. It was clear that the children’s mothers did not have access to skilled attendants when they gave birth.
Many of the mothers themselves looked malnourished, weak and exhausted.
I taught them how to use the micronutrient sachets that UNICEF distributed. They contain multi-vitamins for children who have no access to fresh food.
Proper hygiene is also an immediate priority, with diarrhoea cases increasing. Health workers said they receive about 200 cases per week.
Escaping to safety
One mother told me how she and her children fled Raqqa with nothing. One day, after spending an afternoon with her parents, she and her children returned to find their home destroyed. They ran for their lives.
The mother, her eight children, her elderly father and her two brothers, blind since birth, spent four weeks running. The only shelters they found were the odd bushes dotted across the arid landscape until they finally reached the camp. “We are happy to have arrived here alive,” she told me.
Of what they left behind in Raqqa, she said, “Our life is gone. Everything has been destroyed.”
Most of the mothers I spoke with were emotionally numb. They could not speak in complete sentences, but would just throw out words, or short answers that told me little. The more I probed, the more painful it was.
They were cut off from life, they said. They did not have electricity. It had been years since they watched TV. They had nothing.
“We were living in hell,” one mother told me.
They wanted to forget the past, like it never happened. Every person I met – mothers, fathers, children – were traumatized. They did not want to talk about their past. Their suffering remained, bottled up inside them.
Stuck in limbo
From Ain Issa we moved on, driving two hours to visit Mabrouka, another camp sheltering about 1,700 people from Raqqa.
Mabrouka is located in a deserted, isolated area. It’s a tough environment and all the people I met want to get out but they are safe for now.
One young mother who looked very sad was not able to say a single full sentence. She wanted to cry, but she could not.
Eventually, she started to open up. “I want to get out,” she whispered.
“I lost my niece yesterday. Help me save my two daughters,” she pleaded.
I saw another woman suffering from severe bleeding. Her life was in danger, and she needed to be evacuated urgently.
The movement of people to and from these sites, particularly Mabrouka, is an immense challenge. To get there is dangerous, while the clearance required to move from the camp is sporadically granted and can take up to a month. In the meantime, mothers and children cannot always get the medical treatment they urgently need.
I think of the families still trapped amid intense fighting in Raqqa who must be living through hell. And if they manage to survive the fighting, they may die as they flee to safety. If they survive the journey, they need immediate lifesaving assistance once they arrive in the camps.
We are ready to provide such services, but we must have safe access so we can respond effectively. At the same time, children and all civilians with life-threatening conditions need to be given a safe passage out of Raqqa, as well as the camps when necessary so they can properly treated.
Dr Rajia Sharhan is a nutrition specialist with UNICEF Syria