The number of internally displaced people in the Middle East and North Africa almost doubled in 2017, with some 4.5 million forced to flee their homes to escape conflict and violence.
Underscoring the scale of human flight within the people's home countries, the statistics compound the already huge numbers from war-hit countries who have become refugees.
The number of those affected – around 12,000 people a day last year were internally displaced across the Middle East alone - was near twice the figure, 2.4 million, compared with 12 months earlier.
A report by the Internal Displacement Monitoring Centre (IDMC) and the Norwegian Refugee Council (NRC) said on Wednesday that the rise is largely due to Syria's ongoing civil war.
Unlike refugees, IDPs stay within their state borders and therefore remain under the protection and rule of their own government, even if that government is the reason for their displacement. They often move to areas where it is difficult to deliver humanitarian assistance and as a result, these people are among the most vulnerable in the world, says the UN’s refugee agency UNHCR.
In 2017 the region accounted for 38 per cent of the global total of 11.8 million internally displaced people, with 2.9 million new movements that year in Syria alone.
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The report said that some 6.7 million Syrians are displaced within the country due to the eight-year conflict, the largest internally displaced population in the world.
Doctor Ali Kamal and his family were displaced inside Syria last year when rebel forces in the Homs countryside surrendered to the Syrian regime. They moved to a camp on the outskirts of Idlib in the country’s northwest.
"Most of the displaced people are living miserable lives," Dr Kamal told The National. "The hope was at least things would be more calm and basic services would be better than when we were under siege in our village."
But, like most IDPs, Dr Kamal and his family found no solace in relocation. Instead they were confronted with a dire security situation, health problems like typhoid fever and scabies and being far from the familiarity of their hometowns.
"The internally displaced do not feel any safer or happier than they were in the homes they were forced to leave," he said.
Many Syrians have been displaced several times, IDMC Director Alexandra Bilak told The National, adding that some families have been displaced a total of 25 times since the start of the war.
The recent major offensive on Eastern Ghouta near Damascus saw tens of thousands of the 400,000 residents bussed north to seemingly safer rebel-held areas. The move followed a weeks-long assault by the Syrian regime and its Russian allies on the Damascus suburbs.
In neighbouring Iraq, the fight against ISIS also caused widespread displacement, with the battle to retake the city of Mosul accounting for more than 730,000 displacements in 2017. Iraq now has 2.6 million IDPs.
But even returnees are faced with dangers, aid workers say. Dozens of Iraqi returnees to liberated areas have been killed by unexploded ordinance and IEDs left by ISIS or acts of vigilante reprisal since government forces retook the city.
On 25 November last year Saleh Ahmed, 37, and his family were forced to return to their hometown of Betaya in Anbar.
“They [Iraqi forces] gave him a tent. He went back to our destroyed house and tried to pitch it in our yard,” Saleh's father, Mahdi Ahmed, said.
An explosive went off. Saleh’s wife was killed instantly and his daughter sustained full body burns. Saleh lost one eye and was seriously injured in the other, according to one of his sons, who witnessed the incident.
Imad Mohammed, 35, returned to Fallujah in December 2016 after three years of displacement in the leafy Kurdish city of Shaqlawa.
"The city [Fallujah] was destroyed, everything was destroyed," Mr Mohammed told The National. "There were no facilities, no hospitals, no houses - I didn't want to go back because of that."
Mr Mohammed, whose family was displaced twice in 2004 following the two battles for Fallujah, continued to worry about being displaced. "We are used to being displaced," he said.
"Premature return is extremely dangerous," said Ms Bilak. Early return often puts more pressure on communities that are already very vulnerable, fraying an already delicate social fabric, Ms Bilak said.
“This report shows why we need a new approach to address the huge costs of internal displacement, not only to individuals, but also to the economy, stability and security of affected countries,” Ms Bilak said.
There's a need for a longer-term approach and the coming together of both national and international actors, she said.
"We need to recognise that the states themselves need to take action ... support them in finding their own solution. Support them in integrating internal displacement as the core part for their ongoing national priorities."
"Return is always treated as the favourite solution," explained Ms Bilak. "But in many contexts it won’t be the option any time soon."
A total of 11.8 million people worldwide were uprooted from their homes and displaced internally in 2017 - nearly double the 6.9 million who suffered the same fate a year earlier.
The report found that 76 per cent of those newly displaced last year were concentrated in just 10 countries, with Syria, the Democratic Republic of Congo and Iraq alone accounting for more than half.
"The staggering number of people forced to flee from their homes due to conflict and violence must serve as an eye-opener to us all," said NRC chief Jan Egeland. With additional reporting by Jacob Wirtschafter