Thousands of desperate refugees fleeing Syria and surroundings are at risk of freezing to death in the coming weeks as a bleak winter takes hold, aid workers have warned.
Families forced to sleep outdoors in increasingly-chilly and rain-sodden misery are already suffering spreading disease and in some cases frostbitten feet.
Babies are being treated for hypothermia, while some migrants have become so cold they have inadvertently pulled off layers of skin when adjusting their clothing.
And medical workers say the conditions in makeshift refugee camps in eastern Europe and on Mediterranean islands will become more treacherous as winter looms.
MSF’s Sophie-Jane Madden, who was on the ground with aid workers in Serbia and Croatia, said: ‘Winter is a real worry - we’re genuinely scared that people will freeze to death.
‘There are so few places for people to sleep inside - twice as many people cross into Serbia every day as there are places to sleep.
‘Authorities are failing to meet basic standards of care and the risks will only get worse as the winter comes in.
‘We’ve seen people who have lost a foot through frostbite - others who, when trying to take off their T-shirts, pulled off layers of skin, they were so frozen.
‘Often there is nowhere for parents to change their kids and get them warm and dry,’
More than 3,000 people are stranded in no man’s land between the Serbian and Croatian border with no access to shelter or hygiene facilities, says MSF.
Meanwhile, 16,000 people are ‘abandoned’ on the Greek island of Lesbos, where water and food distribution was stopped three weeks ago - and large containers which could hold 600 people remain locked.
Ms Madden said new European Union ‘hotspot’ registration centres were ‘simply not working’.
More than 680,000 migrants and refugees have crossed to Europe by sea so far this year from the Middle East, Africa and Asia, according to the International Organisation for Migration.
Among those needing MSF help in Serbia were Mohammed and Bayan, from Idlib in Syria, who had travelled with their cousin Suha and her two children Waleed, five, and four-year-old Leen.
Mohammed described their boat crossing from Turkey to Greece, saying: ‘‘We tried to tell the children that it was like an adventure to try to keep them calm, but it was very dangerous.
‘A wave crashed over the side and my clothes were completely soaked through.’
Their queues for registration and aid in Serbia have dragged on for days, often in ‘continuous’ rain and with only limited plastic sheeting for protection, he added.
‘There was thunder and lightning and the children were shaking with the cold, but also with fear.
‘We are all very tired, and the children are cold and hungry.’
Rand, 30, from Syrian capital Damascus, brought her friends’ eight-year-old son Brahim and two-year-old daughter Julie to MSF’s clinic at Bapska on the border with Croatia for treatment.
She said: ‘It’s very hard for them, they don’t understand what is happening and they’re always terrified.
‘They say things like, “Will the police come to take us to prison?”, and they ask if they are going to die.
‘I don’t have any children of my own, and I thank God - I could not stand to see a child of mine sitting on the side of the road needing food, warmth, rest.
‘They just don’t understand what is happening. They say, “Syria was okay, we want to go back home to our own beds, our own pillows”.
‘Just imagine — they see war as being preferable to this journey.’