GAZIANTEP, Turkey – Residents in the government-controlled neighborhoods of Deir Ezzor are suffering from two separate sieges, one imposed by the government and another by militants working with the Islamic State (ISIS) extremist group.

While ISIS controls most of the province of Deir Ezzor and majority of the city, government troops still control the neighborhoods of al-Qusour and al-Jorah on the western edge, in addition to the strategic neighborhood of Harabesh next to the military airport in the eastern part of the city.

But the nearly 200,000 people living in government-controlled neighborhoods in the city, according to figures provided by the Syrian Arab Red Crescent, have increasingly found themselves under a double blockade, one siege applied by the government and another by Islamic State militants.

While the U.N. considers Deir Ezzor as an ISIS siege only, residents and activists have said the Syrian government is denying them access to life-saving aid and medical supplies and extorting money from them if they apply to leave through the nearby military airport.

“The regime controls an airport within the siege itself, which it uses several times a day for military flights to resupply its own forces,” said James Sadri, director of The Syria Campaign. “Yet it is denying the U.N. the ability to use that airport to bring in aid for the civilian population. So the people there are essentially suffering from a double siege, with ISIS on the outside and the regime on the inside.”

ISIS loyalists block people from going in or out of government-controlled areas in the province’s capital, according to Ali al-Rahbi, co-founder of the Justice for Life Observatory in Deir Ezzor, a local organization that has been documenting human rights abuses by both sides since March 2014.

“They even prevent food from entering these neighborhoods. They’ll stop food trucks and arrest the drivers,” said Rahbi. “They’ve killed several drivers for storing food in the village of Ayash, on the northern side of the Euphrates.”

Over the weekend, ISIS fighters launched a new offensive in the area aimed at capturing the entire city. The extremist group killed scores of soldiers and civilians, kidnapped some 400 civilians and took over several villages including a good portion of Ayash.

According to U.N. figures, there are some 450,000 people trapped under siege in about 15 areas across the country, including areas controlled by the government, ISIS and other rebel groups.

The situation for those living under either power is difficult at best. Censorship, oppression, random arrests, and death are common in both areas of control, but residents have said shortages are worse in the government neighborhoods.

Rahbi said the drivers had been hoping to smuggle much-needed foodstuffs into the city’s government-controlled neighborhoods.The double-siege has led to shortages in basic necessities like sugar, oil, baby formula and vegetables.

Prices have soared in these neighborhoods to more than 15 times their original amount, according to Rahbi. The price of a kilo of sugar, for example, has risen to nearly 4,200 Syrian pounds ($22).

But fleeing the besieged government neighborhoods on foot does not necessarily mean escape. In Deir Ezzor, if an area is not controlled by Assad, it’s controlled by ISIS.

Those who cross from government-controlled areas are almost always captured by ISIS militants and transported to the city of Mayadin to appear in front of a religious judge. Some are sentenced to death, others are transferred to religious training camps. In very rare cases people with connections inside ISIS can get permission from a judge to pass through safely.

Abdullah, a 21-year-old who lived in the eastern part of the city, was arrested by ISIS when he attempted to sneak out of his government-controlled neighborhood just a few months ago. He said he was transferred to the city of Mayadin, south of Deir Ezzor along the Euphrates River, and sat before an Islamic court.

“Only 2km from the regime-controlled area, five masked men found me,” he said. “They handcuffed and blindfolded me, and in a few hours, I found myself in the religious court in Mayadin.”

Before he appeared in front of the judge, Abdullah said he was interrogated, accused of working for Bashar al-Assad’s government, and then asked to enroll in a religious course and sign a pledge that he would not return to government-controlled areas.

“I could not say no,” he said, “that would have meant instant death.”

The only safe way out for citizens in the government-held areas of Deir Ezzor, other than by working with one of the numerous people smugglers on the ground, is to bribe a government official at the military airport. Even then though, leaving may not be guaranteed.

“People who want to leave by air to Damascus must pay as much as 250,000 Syrian pounds [$1,325] per person. As for men who are of military service age, which is between 16 and 45 years old, they have to pay even more, sometimes as much as 500,000 Syrian pounds [$2,650],” said Rahbi.

For a brief period in early September, the Syrian government allowed a small number of people to leave the areas under its control. Old and disabled people, cancer patients, injured fighters and those in need of urgent surgeries were allowed to leave after navigating a nightmarish series of governmental approvals. But, according to Rahbi, after it became clear that large numbers of civilians were fleeing, the government closed the area off once again.

Nour, a 23-year-old economics graduate from the neighborhood of al-Qusour in Deir Ezzor said she and her family applied for a permit to leave the city by air over the summer. The request was only processed after several rounds of bribes to “expedite the process,” amounting to well over $1,000, she said.

“The government’s security directorates are in full control of peoples’ lives in our neighborhood,” she added.

The double siege on government-held areas of Deir Ezzor has crushed the local economy, leaving residents with little left to bribe their way out. But even when money is exchanged, safe passage is never guaranteed.

Ahmad, a 29-year-old from al-Jorah, used to smuggle families in and out of government-controlled areas. “We had to charge people a little bit of money in order to cover what we had to pay the regime officers. They are everywhere, and we had to bribe them in order to let people pass,” he said.

But Ahmad said he recently quit as the situation in Deir Ezzor has become increasingly unstable.

“I quit this work because the regime officers would sometimes shoot people even after they had granted them a permit to pass,” he said. “It was like a game for them, and no one could object.”

Top image: Anti-Syrian-government activists hold up placards during a sit-in against the sieges in Syria while standing in front of the European Union embassy in Beirut, Lebanon, Saturday, Jan. 16, 2016. (AP Photo/Hassan Ammar)