It was only when his children began to starve that Abdullah Al Amour decided time had come to leave the sanctuary of Rukban camp with his family to face an uncertain fate back under Syrian President Bashar Al Assad.

The cattle trader from Palmyra fled to Rukban on the Syrian border with Jordan and Iraq more than three years ago after his home was destroyed in Russian air strikes targeting areas that were held at the time by Daesh.

Conditions at Rukban are tough, but it offers one big advantage to the 36,000 people sheltering there: protection from Russian air strikes and pro-Assad forces thanks to its location near a US base.

But in recent weeks life in the camp has gone from bad to near impossible. Food shortages have got a lot worse as a result of a siege by government and Russian forces that want to see Rukban dismantled and US forces out of Syria, according to people living in the camp and diplomats.

“Today you eat. Tomorrow there is nothing to eat,” said Amour, 46.

Amour says his son Hamza, three, has become frail from being fed sugared water instead of powdered milk. Gravel and dirt are being added to dough to make flour supplies go further.

“No one is leaving out of their own will. I can no longer sleep with my children hungry,” he said.

Local sources say Russian and Syrian government forces have choked off supplies to Rukban since mid-February, blocking access for smugglers who used to bribe their way through army checkpoints, and firing on some vehicles.

On Thursday, Washington urged Damascus and Moscow to allow international aid deliveries to Rukban and stop blocking commercial routes into the camp to “avert further suffering.”

As shortages have hit, a steady stream of people have crossed out of Rukban into government territory. OCHA, the UN humanitarian agency, said around 7,000 had left in the last month or so. Some were in shelters in Homs city where some of the men were settling their status with the authorities, and others had gone to their areas of origin in Homs governorate. Relatives say the Homs city shelters amount to internment centres for many of the men.

Rukban camp is at the heart of a struggle between Russia and the United States for control of southeastern Syria and with it a land route to Iraq and Assad’s major regional ally, Iran.

Reuters