Last week, Turkey agreed to a cease-fire in its military offensive targeting Kurdish-led forces in northeastern Syria. But even with hostilities largely on hold, the invasion's humanitarian impact continues to unfold.

According to the United Nations, nearly 180,000 people have been displaced since the Turkish offensive began Oct. 9, including many who had previously been displaced from elsewhere in Syria during the country's protracted civil war. Most fled from the area around Syria's border with Turkey to towns further south, where they're now finding shelter in converted schools and in the homes of friends and relatives.

Fran Equiza, UNICEF's top official in Syria, tells NPR that Turkey's invasion has created new complications in what was already one of the world's worst humanitarian crises — especially for an estimated 80,000 children who are among those most recently displaced.

Equiza spoke with NPR by phone on Thursday from his home in Damascus, Syria's capital. This interview has been edited for length and clarity.

Since the cease-fire was announced, have you seen a break in the fighting?

Mostly, the cease-fire is holding. The level of fighting we witnessed at the beginning of the offensive has certainly reduced, but we cannot say that it's completely peaceful now. We've had reports from the field in which there [is] still some fighting in the areas around where the Turkish have taken territory in Syria. But we don't now see many more people being displaced.

What has the situation been since the Turkish military offensive began?

So, in that moment, there was shelling, there were air raids, and most of the people there started to flee from the border towards the south and east, mainly to Raqqa and Hasakah. As of today [Oct. 24], it's around 180,000 people that fled.

Luckily, the death toll of civilians has been limited compared to a lot of other operations that have happened in Syria, like in Aleppo or in Mosul against the Islamic State.

Some of these people fled to shelters that have been opened for them, mostly in Hasakah, where there are 55 shelters, most of which are in schools. But the majority of the people fled to the homes of relatives or friends and are being hosted in various towns and communities. Inshallah, it will not be a much bigger displacement than we have now. But the cease-fire is fragile, so we have to see how things evolve in the coming days.

What are your priorities for humanitarian assistance at this point?

We are looking at a scenario in which everybody is in need of humanitarian assistance. Those who are in shelters, they need everything: The shelter itself, water, food, health and nutrition services.

And for the host communities in Raqqa, Hasakah and elsewhere, it's important to remember that all those areas were also quite deprived of basic services before. In a small town that has just received maybe 40,000 extra people, we need to expand their water systems, create new schools. And we don't know if the displacement is going to be for a few weeks, a few months or a few years.

Water is clearly critical, and water and sanitation systems are critical vectors for many kinds of illnesses. The A'llouk water pumping station, which was the source for at least 400,000 people, stopped working because of the conflict. It has 30 wells and only 15 are operating so far, because there are some armed groups around and we haven't been able to go back to connect the other [15 wells].

The other important thing is also vaccination. Not everyone is vaccinated, and the concentration of people can make it easy for diseases to spread. We have to be careful about malnutrition. And the northeast of Syria can be extremely cold in winter. So we've started to distribute winter kits with clothes specifically for children and for babies, because obviously for them, the risk of compounding the stress of the displacement with the cold and any other sickness can really put them into a panic.

What's happening for the children who are caught in the middle of this?

Out of these 180,000 displaced people, there are around 80,000 children, and we have witnessed huge amounts of distress. We have witnessed five children killed and 60 children injured so far.

Kids are really in deep distress because they see their families leaving, they see their families panicking and moving quickly to another location. They're afraid of the bombing and fighting around. And all these displaced kids are not in school.

The most dramatic impact of any conflict in the world is that the price children pay is absolutely disproportionate. They don't have a chair at the table to make decisions. They lose their education, and their health conditions are much more affected.

And there's a high level of stress. Someone asked me how many kids I've seen in Syria who are in need of psycho-social support. And my answer was every one of them.

Kids in Syria have been witnessing destruction for years. Even kids who have never seen a bomb falling have been living in a context in which the fear of death is there, because you know this could happen at any minute. And we have more than 4 million children in Syria who were born during the conflict and whose only experience in life is conflict.

Many of the families who are displaced now have been displaced multiple times over the last few years. How are people coping?

Something common is the constant frustration that this is happening, the constant feeling that we are not safe, and we have lost control of the future of our life. It's difficult to plan for the next two or three months, let alone the next two or three years. So there's a sense of losing agency about themselves.

But at the same time, in my experience serving in Syria, the Syrian people are one of the most resilient people I have ever met in my life. They have the capacity to say we will survive this, we will overcome this, we will rebuild our country and our communities, we will put our kids back into school.

I've met people just getting out literally a few hours ago from a bombing or from fighting, and immediately asking, "Please, when can my kid get back to school?" That tells you that there is hope and the willingness to continue ahead.

UNICEF and other aid agencies have been working in northeast Syria for a number of years. How did the Turkish invasion change the situation for you?

I don't remember a single week of calm, of things are not getting more complicated. Still, it's even more complicated now than before. You have a huge number of people displaced at the same time. We're talking about 180,000 people displaced over 10 or 12 days. And many are displaced into host communities, which requires a different kind of intervention. You can't dig latrines in the middle of a town; you have to make sure the sewage system can operate.

Another concern is who, in the end, is going to control the territory. And then, what will be our capacity to access people there. We keep saying that no matter who's in charge of an area, the children cannot be paying the price of what the adults decide to do.

And in the north, we already have more than 90,000 people who were living in displaced-persons camps, some of them for a number of years, and they rely on us for almost everything. So this current round of displacement is added to the camps we already had before.

On the other hand, we're used to operating in an environment in which we go from one crisis to another.

So what happens next for people who have been displaced in this region?

In Syria, I think it's very good to keep humble about our ability to read the future. But if the cease-fire holds, if there's no more fighting, I may anticipate a certain level of stability, by which I mean people not fearing they'll have to flee, of being in the line of fire. How this is going to translate into the lives of the people is a bit more difficult. How long will people be displaced? I don't know.

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