QAMISHLI, SYRIA - Eight-year-old Sara hardly speaks anymore. She spends most of her time watching cartoons on a mobile phone in a rugged pink cover.
One of her legs is severed above the knee, the other is broken.
On Thursday, about 15 minutes after her family decided to flee the area, a bomb fell about 8 meters from Sara and her three siblings.
Doctors say hospitals in northeastern Syria are already working beyond their capacity, as aid organizations evacuate their foreign staff. As Turkey continues to fight for a strip of land along its southern border, doctors say this war is turning into an unmitigated health disaster.
"Any further crisis will destroy us," said Dr. Furat Maqdesi Elias, who heads the Al Salam Hospital in Qamishli, a city on the Syrian border with Turkey. "What do NGOs and the U.N. give us? They give us zero."
Many Syrians here blame the United States for abandoning this region, after supporting Kurdish-led fighters against Islamic State militants for years. Turkey has long maintained it would create a buffer zone between it and the once-U.S.-supported Syrian Democratic Forces vigorously if it had to. It began assaults on the Kurdish region nearly a week ago.
Turkey blames the PKK, a Kurdish militant group it equates with the SDF, which has been attacking Turkey for decades, leading to thousands of deaths.
Sara's mother, Nariman, blames herself.
"It's my fault," she said. "We should have evacuated when things started happening."
'Humanitarian situation spirals'
Sara doesn't yet know that her 13-year-old brother Mohammad died in the bombing. Nariman whispers his name, and then hushes her daughter as she whimpers.
A door closes, and Sara starts.
"See what happened to her?" Nariman asked. "When she hears a door close, she thinks it's a bomb."
Nariman and her husband, Youssef, and their other two children are now staying with friends while Sara is in the hospital. The house is still standing, she said, but they are too afraid to go home.
They are among approximately 200,000 people who have been displaced since this war began less than a week ago. Roughly 70,000 are children, according to the U.N. Children's Fund.
Families are not the only ones fleeing in northeastern Syria. On Tuesday, Doctors Without Borders announced it would be pulling its foreign staff out of the region and stopping most of its activities. The organization said the decision comes "as the humanitarian situation spirals further out of control, and needs are likely to increase."
The International Rescue Committee also suspended health services on Tuesday after one of its facilities was hit by what IRC officials think was an airstrike, and two of the organization’s ambulances were damaged.
"Many hospitals have had to close, and those that remain open are overwhelmed with casualties," said Misty Buswell, Middle East policy director at the International Rescue Committee, in a statement Tuesday. "We expect to see an increase in deaths from what are usually preventable diseases because of this, as there simply are not enough facilities to support those who have been displaced."
Before the crisis began, Sara was at the top of her class in school, her mother said, and liked to play soccer.
"Now, she doesn't talk to us," Nariman said, stroking Sara's hair.
Other children in Qamishli are mostly inside as she speaks, and soldiers pace the sidewalks. Some businesses are open, but the usually noisy city is mostly quiet.
Reports of chaos in other cities litter the internet, with videos of Russian soldiers playing with electronic barriers, abandoned as the U.S. pulled out. Other videos show heavy fighting at the border between Syria and Turkey.
Hundreds of military deaths have been reported in the past six days, and at least 42 civilians have been killed and 123 wounded, according to the International Rescue Committee.
Soldiers say one key city has changed hands several times, with the SDF occasionally wresting it back from the Turkish-backed Syrian National Army, formerly known as the FSA, a rebel group.
Some roads have been taken by the group, and families from the region are unable to get to each other, as the alternate route is a well-known haven for Islamic State sleeper cells.
"This area used to be a safe place," Youssef said. "Everyone lived together from all over Syria. Then one day everything changed."