Hundreds of thousands of children who have fled the fighting in Syria are at risk from cold and disease as winter approaches, according to aid agencies. There are fears that scores of vulnerable children could die in the makeshift camps that litter the border regions in countries like Lebanon and Iraq.
Outside the family's tent in the Domiz refugee camp, northern Iraq, Nawar's seven sons and daughters play with fellow refugee children.
Inside, Nawar and her two friends talk with growing fear over the coming winter months.
A thin sheet of plastic is all that protects the refugees from the deepening chill of the desert. Nawar's story is typical of the more than 20,000 Syrians who have fled to Iraq.
She says "We are from Damascus in Syria. They bombed our house, everything was destroyed. We had to go somewhere - there was nowhere for us to live there. So we ran away and came here."
The family has lived in the camp for several months. But the coming winter will be their first. One of Nawar's friends - who did not want to be named - voiced fears for her family's health.
She says "My husband died in the fighting. I have five small children and they are already in a very bad condition and there is nothing we can do, no one who can help. We don't know what to do."
An estimated 2.5 million people have fled their homes in Syria because of the fighting. Around 400,000 are registered as refugees in neighboring countries including Iraq, Turkey, Jordan and Lebanon.
But it is those living outside the camps who are drawing most concern. VOA visited refugees sheltering in a disused school in Lebanon's mountainous border with Syria last winter. The only source of warmth - a charcoal stove that kicks out choking fumes. The refugees sleep on the concrete floor.
There are dozens of makeshift shelters like this dotted along Syria's borders. The lives of 200,000 refugee children are at risk in the coming months, says Ruba Khoury, Lebanon country director for aid agency Save the Children.
"Most of the areas have snow during winter. Their houses don't have windows, some of them don't have doors, they don't have fuel for heating which is very expensive in Lebanon and especially for people coming from Syria as Lebanon is more expensive. Most of the children who arrived came in summer clothes, they have just T-shirts and shorts and flip-flops," said Khoury.
Aid agencies have launched appeals for extra funding. Khoury says the need to get help to the refugees is urgent.
"Save the Children is asking everybody from the local communities to the international community to the international donors, to contribute and to be able to respond to the needs of the children in the areas surrounding Syria. Because if we don't do it now, it will be too late. Winterization has already started, winter is here, the cold is here, long nights," she said.
Since last winter, tens of thousands more refugees fled their homes in Syria for an unknown future over the border. For the most vulnerable, the coming months will be a test of survival.
General view of damaged buildings after a Syrian Air Force fighter jet fired missiles at Daria near Damascus, Syria, November 23, 2012.
A Syrian man walks in front of his house during heavy rain in the northern Syrian town of Ras al-Ain, as seen from the Turkish border town of Ceylanpinar, Sanliurfa province, November 23, 2012.
Smoke rises over the Syrian town of Ras al-Ain as gunfire is heard, as seen from the Turkish border town of Ceylanpinar, Sanliurfa province, November 22, 2012.
Members of the Free Syrian Army in the northern Syrian town of Ras al-Ain, as seen from Turkey's Sanliurfa province, November 22, 2012.
Syrian refugees in the northern Syrian town Ras al-Ain run to cross the border fence into Turkey during gunfire, as seen from Turkey's Sanliurfa province, November 22, 2012.
This Shaam news network image shows residents carrying the bodies of men activists say were killed during shelling by forces loyal to Syria's President Bashar al-Assad, Damascus, Syria, November 22, 2012.
Syrian army soldier prisoners stand near ammunition after Syrian fighters took over the military base in Aleppo, November 19, 2012.
Syrian fighters stand guard in front of a destroyed building at a military base they took over from the Syrian army in Aleppo, November 19, 2012.
A girl sits on a railway track as she looks to cross the border fence from Ras al-Ain into Turkey, November 20, 2012.
Turkish soldiers take up position at the border town of Ceylanpinar, Turkey, November 20, 2012.
Residents walk near buildings damaged after shelling by forces loyal to Syria's President Bashar al-Assad, near Damascus, November 19, 2012.
Syrian fighters celebrate the victory on top of a tank they took after storming a military base in Aleppo, November 19, 2012.
A rebel fighter prepares to fire a homemade rocket towards a Syrian air force compound on the outskirts of Aleppo, November 17, 2012.