This month's raid by Islamic State (IS) militants on the Yarmouk Palestinian refugee camp near the Syrian capital, Damascus, was "just one small step in a very deep hell" in which the camp's residents are living, says Salim Salamah, the head of the Palestinian League for Human Rights-Syria (PLHR), an independent NGO that monitors Palestinian refugees in the war-torn country.
The infiltration by IS militants on April 1 and their subsequent clashes with Palestinian fighters was terrifying, and exacerbated an already dire humanitarian situation.
"But what is going on in Yarmouk is not a single event," Salamah, who was born and raised in Yarmouk but escaped to Sweden, told Radio Free Europe via Skype on April 14.
Salamah said that the camp on the southern outskirts of Damascus has been besieged and bombed by Syrian government forces for more than two years.
As Amnesty International put it in a March 2014 report about the situation in Yarmouk, the plight of Syria's Palestinian refugees is a "catastrophe within the wider catastrophe of Syria."
Yarmouk, the largest Palestinian refugee camp in Syria, was once home to around 160,000 Palestinians and Syrians. When IS militants infiltrated two weeks ago, there were just 18,000 people left in the camp, 3,500 of them children, many malnourished or even starving.
People in Yarmouk were already suffering from extreme food shortages when IS militants invaded the camp. The siege of Yarmouk by government forces meant that aid agencies had been unable to bring necessary food and supplies into Yarmouk. In 2014, the United Nations Relief and Works Agency (UNRWA) were only able to deliver food on 131 days -- an average of just 89 boxes a day over the whole year, less than a quarter of the 400 boxes a day needed to feed the camp's population.
"People were already starving. But now things are worse. There is no food in people's houses. My sources in the camp tell me that people are consuming water with spices. Flavored water," Salamah said.
To make things worse, Yarmouk's only functioning hospital, the Palestine Hospital, was occupied by IS and then hit by government shelling.
Salamah says that the Syrian government dropped barrel bombs on the hospital on April 9.
"Barrel bombs don't discriminate between civilians and militants," he added.
Fear Of IS
Although there are no reported incidents so far of IS militants targeting civilians in Yarmouk, residents say they are frightened that the extremists will harm them.
"People in the camp are in grave fear that IS will replicate the inhuman behavior they have carried out in other parts of Syria," Salamah said.
Salamah says he spoke to eyewitnesses who saw the militants behead three Palestinian fighters, possibly from the Palestinian Ajnad Beit Al-Maqdis group that is fighting against IS in the camp.
Ayman Fahmi Abu Hashem, who heads the Syrian opposition interim government's committee on Palestinian refugees, told RFE/RL's Radio Free Iraq on April 7 that, since the IS takeover, dozens of families have been forced to flee Yarmouk for Yelda, a town to the west of the camp.
Salamah said that the PLHR are calling for safe passage for all civilians who want to leave the camp.
"We don't have answers yet about where they will be able to go. But, for example, people could go to Damascus to be treated or they could go to Europe," he said.
Syrian-Palestinian Military Operation?
While the Palestine Liberation Organization (PLO) has backed away from initial reports that it would support a joint "strike force" with the Syrian government to expel IS from Yarmouk, Salamah said that such an operation would have been "madness."
"I don't understand the military purpose of a joint operation. But I do know that it would have led to a massacre of civilians on the ground," Salamah told RFE/RL.
Some reports suggest that IS may have lost ground in Yarmouk. A resident of the camp told the AFP news agency on April 14 that IS militants have retreated from much of the territory they had initially seized.
But UNRWA Commissioner-General Pierre Krahenbühl, who is in Syria on a mission prompted by the UN's increasing concerns for the welfare of Yarmouk's residents, reported on April 13 that the "intensity of armed conflict in and to the south of Yarmouk remains high."
And while the UNRWA has been able to deliver humanitarian assistance to those civilians from Yarmouk who have managed to escape and are displaced in Tadamoun on the northeast of the camp, as well as in Yelda to the south, the situation for those remaining inside Yarmouk is still desperate.
For the PLHR's Salamah, the most important thing beyond providing immediate, emergency aid for those trapped in Yarmouk and those who have fled, is to speak out about the ongoing and longstanding plight of Yarmouk's Palestinian and Syrian civilians.
"In order for there to be justice for those who have been starved to death and bombed to death, we need to speak out not only against IS but also against the Syrian regime and all those who carried out violations," Salamah said.
-- Joanna Paraszczuk