The agony of Aleppo follows Syrian refugees into exile

It was a Thursday evening last month, four years since Alaa* and her family had sought refuge in Lebanon. "Aleppo Today" was playing on the television in the background, the voice of an anchorman running through the day's casualties. When her phone rang, Alaa shuddered. "It's Aleppo," she said.

On the other end of the line, her sister Samar broke the dreadful news. Alaa's 16-year-old nephew, Samar's son, had been killed by an explosion while on his way home from school.

"I felt that my heart was about to stop beating. Tears gushed from my eyes but Samar was strangely composed. I am not sure where she found the strength. She said she would rather die a hero in Aleppo than leave the only place she can call home," Alaa said.

Lebanon is host to over one million Syrian refugees. But despite being far from the war raging in their hometown, life in Syria continues to haunt them in their place of asylum.

In the more than four years she has spent as a refugee in Lebanon, 39-year-old Alaa has grown grimly accustomed to the agony of mourning loved ones who remained in her hometown of Aleppo.

Since arriving in Lebanon with her husband and four children in 2012, she has lost 14 relatives back home. Thirteen of them, including two of her sisters and their children, were killed in the ugly brutal conflict, while her mother died "out of sheer grief", she said, and her sister Samar is the only one who now remains in the city.

Alaa's harrowing experience underlines the high human toll of Syria's brutal conflict, now in its sixth year. It also reveals how the horror currently unfolding in Aleppo reaches far beyond the city itself, impacting even those that have found relative safety in exile.

Alaa's sister Samar tells her that getting from the rebel-held Seif Al Dawleh district in eastern Aleppo, where she currently lives, to her pre-war home in Salaheddine - normally a five minute commute - is now too dangerous a route and can take up to ten hours. Reaching Damascus is ever more challenging.

"We used to pay 10 liras to visit the capital. Now my sister says it's 2,000 liras each way and reaching the city is not guaranteed." Alaa is unable to send her sister money, and often loses touch with her for days on end due to heavy fighting and the lack of communications networks. "I wait for her messages in agony but dread the moment that she will call."

Many, like Alaa and her family from Aleppo, were forced to move multiple times inside Syria before finally reaching safety in Lebanon.

Underlining the increasing dangers for those remaining in eastern Aleppo, UNHCR published findings of a survey of residents conducted with partners late last month. It showed 63 per cent of respondents knew someone who had died or was injured by explosives, while 82 per cent cited damage to their property. Many, though, said they would stay even if there were safe evacuation routes.

Intensified fighting in Aleppo has cut off humanitarian access to most parts of the city, resulting in shortages of food, medical supplies and other essentials. UNHCR, the UN Refugee Agency, has long called upon all parties to the conflict to allow humanitarian organizations to carry out their duties in safety, and to protect medical facilities, schools, water infrastructure and the lives of civilians and humanitarian workers, while allowing essential evacuations.

"They haven't had running water or electricity in years. My sister's husband works three jobs to put food on the table," said Alaa. "Humanitarian aid never reaches the area where they live." She often begs her sister to join her in Lebanon, even though she knows that leaving the city nowadays is increasingly difficult.

Alaa has spent years in Lebanon tormented in her own isolated world, grieving for lost loved ones back home and worrying about those who remained. "For a long time, all I wanted to do was sleep so that I could dream about my family, I used to get so upset when my husband woke me," she said.

Despite the pain, Alaa is trying to get back on her feet. Since April, she has been attending a UNHCR-supported community centre in Beirut where she and her family receive psycho-social support. "I look forward to Fridays because I get to go out and meet people."

Alaa says she wants to feel better so she can take better care of her four children. "They need me, and I want them to be happy, to get an education and be capable of hoping for a better future again." Her husband works odd jobs as a handyman but it is not enough to make ends meet. The family receives US$162 worth of food assistance every month.

* Names changed for protection purposes