Caught in the crossfire between Syrian government forces and rebel groups, Palestinian refugees in the Yarmouk camp are struggling to survive.

Yarmouk, the largest Palestinian camp in Syria, first came under attack in December 2012 when Assad’s forces began shelling the camp, dropping barrel bombs and arresting prominent activists and outspoken critics. For two and a half years, a government-imposed siege severely limited the residents’ access to food, medicine and other necessities.

Although the United Nations reclassified Yarmouk as no longer under siege on Friday, residents tell Syria Deeply that conditions on the ground have not improved. Nidal, 21, maintains that the camp is still besieged. “I never imagined living under a siege,” he told Syria Deeply. “We still suffer from a lack of everything – we have no food, no water and no medicine.”

In April, ISIS launched an offensive in Yarmouk and captured up to an estimated 90 percent of the camp. After fighting against Palestinian armed factions, opposing rebel groups and Assad loyalists, ISIS reportedly pulled most of its fighters from the camp. For now, Jabhat al-Nusra, al-Qaida’s Syrian affiliate, remains the main group in the camp.

Life in Yarmouk is “like a very slow death,” Nidal says. “We are always waiting for death from hunger, explosive barrel bombs or being beheaded. Death’s coming and we cannot stop it. If we don’t get food, we’ll all die of hunger.”

Hungry and desperate, many residents have already resorted to eating anything they could find, including grass and stray animals. Worse still, the U.N. has not been able to deliver humanitarian aid to Yarmouk since ISIS’s attacks in April, the U.N. agency for Palestine refugees’ (UNRWA), Chris Gunness told Syria Deeply last month.

“What we’re finding is that around one-third of the children we see have severe malnutrition, and about half of the children are malnourished in one form or another,” Gunness said. “It is beyond unimaginable, which is why we say that the time for humanitarian action alone has long since passed. We need concerted political action to deal with the consequences of what is a profound political crisis.”

Nidal says that even going to retrieve grass to eat is dangerous. “If we get too close to the edges of the camp to get some grass, we can be shot by the regime’s snipers,” he explained, “and when any faction tries to enter the camp, explosive barrels and bombs are rained down on us.”

Since December 2012, the camp’s population has shrunk from nearly 200,000 people to fewer than 18,000, with many searching for ways to flee the camp. But Umm Ahmad, Nidal’s 28-year-old sister, says that they have nowhere else to go. “It’s our destiny as Palestinians to constantly suffer death and displacement,” she told Syria Deeply. “I don’t understand why death follows us everywhere we go. Everyone wants to get rid of us.”

Umm Ahmad used to support the Syrian government, but she says that President Bashar al-Assad has “completely besieged” Yarmouk. “Even picking a few blades of grass isn’t allowed,” she explained. “The snipers shoot anyone who gets close.”

Although ISIS withdrew many of its fighters, the group has maintained a heavy presence in the surrounding areas. “If we try to run away from the camp, ISIS will behead us for ‘running away from jihad,’ as they say.”

One of ISIS’s main rivals inside the camp is Aknaf Bayt al-Maqdis, a militia with ties to the Palestinian political group Hamas. As Palestinian fighters attempt to evict groups such as ISIS and Jabhat al-Nusra from the camp, Palestinian leaders in the camp have been targeted in attacks.

Local Hamas leader Mustafa al-Sharaan was killed when ISIS fighters shot him in the head earlier this month as he left a local mosque, according to an Arabic-language report at Shasha News. In early July, as fighting intensified, ISIS defaced and destroyed images of Palestinian political leaders, including the late Yasser Arafat, in neighborhoods across the camp.

Meanwhile, Jabhat al-Nusra told Arabic-language media outlets that it had “made progress” in the Yarmouk camp and expanded its presence as a result of intense fighting with pro-government forces recently.

Explaining that few ISIS fighters remain inside the camp, Umm Ahmad says the group controls several of the camp’s southern exits and main throughways. “But ISIS isn’t the only group that prevents people from leaving the camp,” she said.

Two armed Palestinian groups, Fatah al-Intifada and the Popular Front for the Liberation of Palestine – General Command (PFLP-GC), are both supported by the Assad government. “[They] are worse than ISIS. We can’t even get close to the areas under their control,” Umm Ahmad remarked. “We would be killed right away.”

Hazim, 20, left his studies to join an armed Islamist group fighting against the Syrian government. He was motivated to fight by the suffering he saw around him and the restrictions on access to humanitarian aid, which he says rarely entered the camp and wasn’t enough to provide for the besieged residents even before the U.N. and other groups lost access to the camp in late March.

“All we get in this camp is death, humiliation and hunger,” he told Syria Deeply. “What has [Palestinian Authority President] Mahmoud Abbas done for us? Nothing. Why doesn’t he negotiate with his friend, Assad, to find a solution for us? Aren’t we Palestinians also? Why are we neglected and ignored by everyone?”

Hazim says that prisoners from Yarmouk have died “from excessive torture” in Syrian prisons, while those who remain in the camp suffer from illnesses and a lack of necessities. “Cholera and malaria … What century are we in? I don’t know how things will go, but I am sure that we won’t leave Yarmouk alive.”

Like Syrian communities across the country, those in Palestinian refugee camps have all been hit hard by the ongoing bloodshed. Earlier this month, the Action Group for Palestinians of Syria estimated that nearly 3,000 Palestinians have been killed during the civil war. The Yarmouk-based group says another 931 are in Syrian prisons and at least 277 have been abducted.

This camp used to be full of life, but now it’s only death,” Hazim commented. “My mother always says that death never gets bored with Palestinians – and I believe she’s right.”

In June, Fatah, the party that dominates the Palestinian Authority, announced that it intends to restore ties with the Syrian government.

Yet a political solution to end the Yarmouk crisis remains an unlikely prospect. In the meantime, people need food and medicine as soon as possible, says Omar, a 42-year-old physician at the local Halawah hospital. Because there is little to no milk available in the camp, he explained that many parents are giving their infants “water mixed with salt and black pepper. I have never seen anything like this before. I don’t understand how someone can survive on only black pepper.”

“The camp’s residents – both the kids and the adults – look like ghosts,” Omar continued. “When you look at their faces and bodies you see death. People are dying here while others in regime-controlled areas have everything they need. Even if we wanted to leave, there is no place that would take us in. Death is our destiny.”

Photo courtesy of AP