An unprecedented three million people have fled the war in Syria, in what the UN is calling "the greatest humanitarian emergency of our era".
A further 6.5 million are internally displaced, which means over half of all Syrians have been forced out of their homes due to the conflict, according to the latest figures from the UN Refugee Agency.
"They're exhausted, sick, scared," the World Food Programme's Dina Elkassaby told the BBC World Service. She said the latest UN statistics are "a sobering reminder that this conflict is nowhere near its end".
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More than 190,000 people have been killed during the country's bloody civil war that started in 2011.
The vast majority, over one million people, have fled to neighbouring Lebanon. The rest have settled in Turkey, Jordan, Iraq and North Africa, placing enormous pressure on the infrastructure and resources of those countries.
The UN said its response to the crisis had now become the biggest refugee operation in the organisation's history, but said there had not been enough of a global response. International donors have contributed $4.1bn to help address the humanitarian crisis, but the organisation says a further $2bn is needed before the end of the year.
"The response to the Syrian crisis has been generous," said the UN High Commissioner for Refugees Antonio Guterres. "But the bitter truth is that it falls far short of what's needed. The world is failing to meet the needs of refugees and the countries hosting them."
