Even when Syrians flee across the border of their country into northern Iraq, their troubles are far from over. Many of those I met on a recent visit to the region saying they feel forgotten - their most basic human needs for food, clean water, medical care, and shelter are often unmet.
Along with the physical hardship, many carry haunting memories of the carnage they have left behind.
'The bodies and blood in the streets is something I will never forget' said Habib, who now lives in a former animal shelter outside the city of Sulaimaniya.
The first arrivals cleaned out the shelters, and now families of up to 20 people can be found living in each ancient stone building, their numbers growing week by week as the conflict in Syria continues.
The makeshift settlement has been home to Avaline and her two daughters, aged ten and eleven, for the past two years. They share one contaminated water source with 150 others, but while illness is an ever present threat, they say there has been just one visit from a mobile health clinic during their stay.
At another settlement nearby, at the end of an unpaved track beneath the hills that surround Sulaimaniya, some 600 refugees are crammed into a mixture of UNHCR tents and temporary shelters made seemingly from whatever people have been able to lay their hands on; bits of material, plastic and wood bound together with scraps of rope.
Here, hunger is a constant complaint, the inhabitants saying they don't get enough food to live on. What supplies they do receive come from the host Kurdish community, for which they are grateful, but they say these are not enough.
The arrival of a consignment of meals of rice and chicken provided by the local community during my visit saw dozens of refugees besiege the vehicle, fearful of being left out.
Everywhere I went, refugees told me of their urgent need for medical care, which they are unable to access, with no money to pay for either transport to the local town or for the treatment itself. One elderly man called Mohammed told me his wife was ill, but he simply could not afford to take her to hospital let alone pay for medicine.
One agency trying to make a difference is Christian Aid partner REACH, will provide support to 1,500 refugee families around Sulaimaniya and the nearby city of Erbil in the form of food, infant kits for babies, and hygiene kits containing first aid equipment, water purifiers, sanitary products and other essential items.
Education for the children, meanwhile, is on indefinite hold. No facilities existed at either of the settlements I visited, and some children and young teenagers have now gone up to a year without schooling of any kind.
'Our children need education or they will grow up with no future' said one father. Instead of being at school children spend their time playing near electric pylons and in an empty warehouse that used to be an animal feed store, and as a result is now infested with scorpions.
All the refugees I met want to work, but there is hardly any available. People who were engineers, teachers and students in Syria are now at best getting piecemeal work as labourers - if they are lucky.
"We are ready to work but there is nothing", said one young man. "We are just staying here, sleeping in tents throughout winter, waiting, because we can't work and we can't go back to Syria".
The refugees I spoke with voiced their fears, but also their hopes for the future. Expressing gratitude to the local communities who have supported them, they nonetheless said: "our future is not here. It is back in Syria. Our dream is to go back to Syria".
You can see some of photos from this visit to these camps on Flickr: http://www.flickr.com/photos/christianaidimages/sets/72157633040860119/with/8574008495/
Iraq is now host to over 115,000 Syrian refugees.
The total number of refugees fleeing Syria has grown from 1,000 a day at the start of the year to over 8,000 a day to neighbouring countries. In total, some three million people have now been forced from their homes and their needs are acute, particularly for food, shelter and medical care.
DEC member agencies, including Christian Aid, are providing aid inside Syria and to those who have fled to neighbouring countries. You can help now by donating online to the DEC Syria Crisis Appeal at dec.org.uk or by calling 0370 60 60 900.