Quobayet, Akkar, Lebanon: "From the moment she opened her eyes in this world all she heard was shelling and war."

Umm Azzam is cradling Fatima – just under two years old – as the little girl listens, terrified, to the powerful winter winds howling and thumping on the tin roof of their tiny, makeshift home in the north of Lebanon. As the fury of the wind intensifies, so too does Fatima's fear.

Living in fear: Syrian refugees Um Azzam and her two-year-old daughter Fatima. Photo: Ruth Pollard

"When she hears the wind, she thinks it is shelling, when she hears a car drive along the road at night she thinks it is someone coming to take us," Umm Azzam says.

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Such fear in a child so young is not uncommon in those who have lived their lives in war, experts say, pointing to the trauma that now runs deep through a generation of Syrian children.

In the other room, Umm Azzam's six-month-old daughter Kareema sleeps in a borrowed cot made for a child twice her age, blankets piled high over her tiny body in an attempt to keep out the cold.

Uncertain future: Some of the 11 Syrian refugee children who live in the small room. Photo: Ruth Pollard

Both little girls suffer from congenital heart defects – Fatima has two holes in her heart, Kareema has one – but after more than three years of war in their home country Syria, and more than a year as refugees in Lebanon, Umm Azzam and her husband do not have enough money to buy food for their family, let alone two heart surgeries for their girls.

"My girls are sick, and it is so difficult to look after them in these conditions, when you are living day-by-day, where maybe you have just enough for today, but not for tomorrow," the 30-year-old mother says.

A day before Fairfax Media visited her family, Umm Azzam, along with 1.7 million other Syrian refugees, received a text message from the UN World Food Program announcing it was suspending its food aid because it had run out of funds.

Make-do: Six-month-old Kareema sleeps in a borrowed cot, blankets piled high in an attempt to keep out the cold. Photo: Ruth Pollard

"When we got married, my husband and his family had large farmlands, they grew olives, pomegranates, figs, there were vines everywhere and roses growing around the house," Umm Azzam says. "When Fatima was born we were thinking she would have such a bright future and now we have lost everything."

In the north of Lebanon, where many of the country's more than 1.15 million Syrian refugees are living, there are no formal UN camps for families who have fled across the border. Instead, with the rental market near saturation point and with their savings exhausted, up to 750,000 Syrians have taken shelter in sub-standard conditions, living in unfinished buildings, sheds, barns, abandoned shops and schools, often paying high rents for barely habitable dwellings.

Under a program run by Save the Children, Lebanese landlords are asked to allow rehabilitation work on their unfinished buildings. Refugee families receive a grant to carry out the work, which includes weatherproofing, fitting doors, windows, insulation, basic plumbing and electricity. In return, the family can live in the building for a year at significantly reduced rent, or no rent at all, Save the Children says.

"We can really only make temporary changes to the building, so people have safer shelter but the broader hopelessness of the situation and the desperate need to find a long-term political settlement to the Syrian civil war remains," says the chief executive officer of Save The Children Australia, Paul Ronalds, who visited Lebanon this week.

In a three-storey apartment block in Akkar – until recently just a concrete skeleton of a building with no walls, doors or windows, electricity, water or sewage – 11 Syrian families are taking shelter. Plastic sheeting still covers several openings where windows are yet to be installed as the winter weather bears down on the unfinished building. Water pools along one side of the block, seeping into the dirt floors to create a permanent dampness inside.

In a small room empty of everything but a few thin mattresses and a tiny stove, 22 people crowd around to tell their story. The extended family of four brothers, their wives, 11 children and their 70-year-old grandmother fled Syria 15 months ago after spending two awful years "under siege", trapped as the regime and opposition groups fought it out in the province of Homs.

"Nothing entered or left our village, we could not sell our produce, we were just eating off the land until, for the last two months, we had nothing left but the meat from our goats," says Sami, 30, his three young children gathered close. 

They "paid a fortune to smuggle the children in twos and threes" the few kilometres to the safety of the next village, and when that was done, the women went. Finally, when everyone else was safe, in the dead of night, the brothers walked out through the shelling and snipers. Miraculously everyone survived.

"We were already dead there," Sami says. "There was no choice but to leave."

The family of farmers are unable to say how they will cope if the food assistance they receive is reduced or suspended but they are confident of one thing: "We would turn this into a paradise, these lands can feed everyone here if we were just allowed to farm them, but they don't allow us," he says with frustration.

In a war that has already costs the lives of more than 200,000 people, internally displaced 7.2 million and forced 3.2 million to flee, mostly to neighbouring countries such as Lebanon, Jordan and Turkey, the cost to refugees is unfathomably high, says Lama Fakih, Syria and Lebanon Researcher at Human Rights Watch.

"Their inability to meet their basic needs with the level of humanitarian assistance they are getting is of particular concern as we come into the winter months when people are living in shelters that are not built for the cold."