In the space of just five days, at least 100,000 people have been forced to flee their homes in Idlib, northwest Syria – with thousands more unable to reach safety due to the intensity of hostilities and now fearing for their lives, according to the International Rescue Committee.

With the frequency of airstrikes having increased, and a large-scale ground offensive having begun, the organization is extremely concerned that a return to the intense fighting seen earlier this year may soon take place – having a devastating impact on civilians.

It is estimated that an additional half a million people could be displaced over the coming weeks if the violence escalates, which would be the largest displacement seen since the war started eight years ago.

With 500,000 people now having been displaced since April, this could push the number of displaced people inside Idlib to over a million – triggering a major humanitarian crisis.

Rehana Zawar, the IRC’s Country Director for northwest Syria, said: “The conditions in northwest Syria are already at breaking point. The areas housing those who were forced to flee their homes earlier this year have been over capacity for months, which means that most of the 400,000 who were displaced during the offensive back in April are still living in informal, overcrowded settlements – many of which lack access to even the most basic services, such as toilets or clean water.

“With a further 100,000 people now having joined them, humanitarian organisations are reeling under the weight of Idlib’s overwhelming needs. We are hearing reports that thousands of people – including children – were already living in the open air under olive trees, and our partner organisations report that 11 per cent of children attending the health clinics we support are suffering from acute malnutrition.

“Families we have spoken to in a number of districts have told us that they have had to ration food because of the increasing costs and, more worrying still, even nursing mothers have at times resorted to feeding their infants herbal tea because they themselves are malnourished and cannot feed their babies.

“The people of Idlib have lived under the threat of bombing and shelling for nearly nine years, and they are once again fearing for their lives. With many humanitarian services suspended, it means that an already vulnerable population coping with the psychological terror of war is now even more vulnerable. They have little access to the support they desperately need and are living in a constant state of uncertainty.

“To prevent a humanitarian catastrophe on a massive scale, we are making an urgent call for an immediate ceasefire; for all parties to the conflict to commit to the UN peace process in Geneva to bring an end to the Syrian conflict, and for all parties to abide by their obligations under international humanitarian law to protect civilians and ensure they are spared from the worst effects of the fighting.

“We also urge all members of the UN Security Council to restart negotiations on the cross-border resolution before it is too late. The Russian and Chinese vetoes of Resolution 2449 have put the humanitarian response in Syria in jeopardy at a critical time. Four million people inside the country depend on aid delivered across borders in order to survive. The UN and its partners, including the IRC, depend on this resolution to reach them. The Council must urgently resume negotiations on this matter and adopt a one-year renewal – as it has done for the past five years – before the mandate expires on January 10.”

The IRC and its partners reached over 350,000 patients in 2018 through 12 static health facilities and four mobile health teams in Idlib province. The IRC also provides specialist care to vulnerable women and girls and helps thousands of Syrians gain an income through emergency cash distributions, business grants and training.