'We're condemning children': Raqqa four years on from IS
The scale of the crisis, which has left nearly three in four residents dependent on assistance for food and other essentials, was revealed by Save the Children in a new report released on Tuesday, entitled "'I must live amidst the rubble': Inclusive recovery in Al-Raqqa".
The housing stock, much of which was decimated during intense bombardment by the US-led international anti-IS coalition of Raqqa, has not been revived. Half of those with their own homes are residing in damaged buildings.
Save the Children's Syria Response Office Advocacy Director and report co-author Kathryn Achilles told The New Arab: "If the situation is not resolved, we're essentially condemning children… to live in ruins with very little opportunity, very little ability to rebuild their lives and grow up safely.
"Some of the children we spoke to are seven years old and have only known displacement and violence."
They "have seen things that children just should never have to see and are now living in conditions that children should never have to live in", Achilles added.
The profound violence Raqqa residents have been exposed to has caused significant damage to their "psycho-social" health, the Save the Children report explains, noting factors like poverty are widely acknowledged as being damaging to children's psychological welfare.
Meanwhile, the devastated housing and infrastructure in Raqqa makes even home a physically unsafe place for many children.
Farah*, 24 and a mother of six, said of her house: "The roof is falling which makes me fear that one day one of the kids would get hurt if a rock fell on them.
"It started raining once so I had to take the kids outside as big chunks of the roof started falling in."
The damage to buildings has also seriously impacted schools, with 80 percent still damaged.
Only around one in five have been repaired, Save the Children's sources told the NGO.
What's more, many families are unable to afford books, bags or, where applicable, tuition fees, and desperately require additional income, meaning children often end up working instead of gaining an education.
All this leaves 14 percent of children not going to school whatsoever, with nearly one in five attending class less than three times a week.
Disabled children are particularly hard hit, with 65 percent of them completely out of school.
Though families often see girls' education as vital, boys' education is generally prioritised later in their development, meaning that from around 14 or 15 the rate of girls in school starts to fall behind, Achilles said.
Meanwhile, one of the biggest risks for boys is child labour, with many parents feeling they are "too old" to return to education.
This leaves children as young as 14 picking plastic out of debris for cash.
One boy mentioned in Save the Children's report had witnessed peers killed in landmine explosions as he searched for plastic.
Despite this, when children are able to access schooling, it is a source of joy for them.
Amira, 9, said: "When I go to the school here, I feel happy. Because at least I'm studying."
She has hopes of studying to become a doctor in Aleppo, where she comes from.
Even in her dreams of going home, school features prominently.
"When I close my eyes, I dream of Aleppo and how we will return there… Children will be playing. They will be carrying their bags to go to school."
Issa, 7, recently began his school education for the first time in his life.
"I was very happy when I first went to school", he explained.
Issa said he "used to look at the kids going to school and cry to [his] mother" and would "get sad and stop eating" when she told him she didn’t have the cash to enrol him.
The autonomous area in North and East Syria, where Raqqa is located, run by Kurdish-dominated authorities, experienced its most serious drought for nine years, meaning residents of the city and its sub-district have been unable to practice proper hygiene.
With the Syrian pound losing its value, the cost of water has also risen.
Without access to vaccines amid the raging Covid-19 pandemic, this places them at an elevated risk of infection.
The drought and infrastructural damage also mean that water-borne diseases have risen astronomically.
Medical facilities have noted a jump of 300 percent on what is typical for this time of year, Save the Children said.
While numbers are not available by age, the London-based NGO pointed to Al-Hasakah, also in the autonomous region, as experiencing a large rise in cases of diarrhoea among under-fives.
This suggests a significant proportion of those affected by water-borne diseases in Raqqa could be children too.
Amid this water catastrophe, many are without jobs, with 74 percent depending on aid and remittances to some extent.
Internally displaced people (IDPs) are more dependent on work for their money than others, meaning they have 13 percent less cash coming in, on average.
Save the Children workers are hearing of rising numbers of IDPs going or trying return to camps from places such as Raqqa, feeling they'll have improved provisions there.
In the face of all this suffering for the families of Raqqa, Achilles said "it's really not acceptable that they should be left in this situation".
Save the Children is planning to step up its efforts in Raqqa in the coming months, particularly on water, sanitation and food.
It already does work on education for children aged 16 and 17 and, in conjunction with families, helps safeguard children facing early marriage, violence, or child labour.
The NGO calls for "area-based approaches" to the plight of Raqqa that tackle the people's requirements in all of life's interconnectedness, from food to healthcare to schooling and regardless of race, gender or displacement status.
Addressing the US-led coalition that fought in 2017's Battle of Raqqa, she said "they need to take responsibility for the consequences of their military objectives."
"That means really stepping up and providing the support that people need to begin to recover", she added, calling for this assistance to begin immediately.
This includes fixing schools, housing and infrastructure, in addition to "psychosocial support" given the "unimaginable trauma" residents have been through.
"It's not acceptable to leave people languishing with nothing, risking children's entire futures", she said.
* = the names of all Raqqa residents have been changed by Save the Children for safety reasons.