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As temperatures drop, tens of thousands of civilians forced out of their homes by Syria's war are spending yet another winter in flimsy plastic tents or abandoned half-finished buildings. 

Without heating, blankets and warm clothes, or access to proper medical care, even a simple cold can turn deadly. 

"There are no statistics on infant mortality, but deaths have been caused by illnesses" exacerbated by the cold, Jalal al-Ayyaf said, manager at the Ain Issa camp where more than 17,000 people have sought refuge in the tents.

According to the United Nations, which supports the camp, there is no new health care clinic to cater for expanding areas of the sprawling facility.

More than half of the residents say their tents need repairs or maintenance to protect against the cold.

To keep the inside of their tents dry, many in the camp have put up an extra layer of nylon tarps and resort to using rocks to weigh down plastic sheeting to prevent water seeping in.  

Ayyaf also acknowledged there was a "lack of medication" available to displaced families in Ain Issa.

"My son died because of the cold," Khadija, 35, told AFP. 

After fleeing fighting in the Islamic State group's former bastion Raqqa, Khadija's family sought refuge in the Ain Issa camp about 50 kilometres (30 miles) north.

Now nighttime temperatures are plummeting to just four degrees Celsius (39 Fahrenheit).

"He coughed and had a fever in the middle of the night. The next day, he was dead," Khadija said.

"May God spare us in this cold," she said.

We spent 10 days without mattresses or blankets. There's no heating and it's freezing

For many refugees, returning home is not an option, with houses and facilities reduced to ruins without electricity or running water. 

Children dash between the camp's makeshift alleyways, some of them barefoot despite the chill. A few are wrapped up in oversized sweaters and jackets, some of it secondhand clothing.

Without enough winter clothes, families are using blankets to fashion coats and other warm garments, says International Committee of the Red Cross spokeswoman Ingy Sedky.

"In winter time, children become even more vulnerable and exposed to additional health hazards," she said.

Zeinab Khalil, a mother of four from Syria's eastern Albu Kamal, says they are being treated well at the camp, "but we need heating, blankets".

"Because of the cold, my children and I haven't stopped coughing since we arrived," said the 35-year-old.

"We spent 10 days without mattresses or blankets. There's no heating and it's freezing," says Umm Omar, 50, a native of Syria's Deir Ezzor who sought refuge in the camp two months ago with her family.

"We have nothing in the tents, we sleep one on top of the other. They gave us five blankets but we're seven people," she said, describing aid distributions as increasingly irregular.

Since Syria's conflict erupted in 2011, more than six million people have been displaced internally, many of them multiple times as fighting engulfed the country.

Some 750,000 of them live in camps, transit centres, and other buildings like schools or warehouses, according to the UN.