Tent fires happen frequently – more than a dozen times last winter – killing young children. 68. Extreme weather conditions make living conditions in the camps intolerable. Heavy rains in December 2019 caused serious flooding and damaged a large number of tents in the al Hol Annex. According to the UN OCHA, ‘200 tents were relocated within the Annex due to flooding.’53 A Dutch detainee told RSI, ‘My tent was flooded twice. I had to change tent each time and to buy everything again.’ A major concern for women is the risk of fire due to the basic gas heaters supplied for the tented accommodation. Tent fires happen frequently – more than a dozen times last winter – killing young children. But, as one Dutch mother told RSI, ‘I’m afraid that the heating explodes in the tent and kills a child. But if we don’t use it, they will die from cold.’ 69. When women and children are sick or injured, medical care is inadequate. In the al Hol Annex, the UN OCHA has noted an ‘inadequate coverage of health overall, particularly as the winter weather puts more residents, including young children, at risk of seasonal illnesses. In just one week in December 2019, mobile teams identified 2,000 medical cases – the majority children – in the Annex.’54 Many detained women and children suffer from war wounds, such as imbedded shrapnel, and associated infections. According to Professor Loots, ‘Several mothers and children displayed orthopaedic war wounds that had not healed and necessitated follow up care. This follow up care is not available.’ Moreover, given the unsanitary living conditions, camp residents suffer from diarrhoea, gastroenteritis, malnutrition, and respiratory infections. Some women and children suffer from hepatitis, epilepsy, pertussis, measles, diabetes, and asthma. 70. Currently, MSF operates a medical centre in the main al Hol camp (although the centre was closed between September 2019 and July 2020 in light of concerns over staff safety), and there are five smaller clinics operating (down from a pre-2020 number of 24). The Roj camp and the al Hol camp currently host one small clinic each, although the al Hol Annex clinic was not in operation for a number of months in 2019. Nevertheless, facilities are very constrained and access to medicine limited. In the Roj clinic, medical staff cannot treat conditions of any complexity, and have access only to antibiotics and basic pain relief. A Belgian woman told RSI, ‘When I get sick, I didn’t go to the hospital because they only gave you paracetamol.’ A French girl aged six was at risk of serious complications associated with a congenital heart defect. Until her urgent compassionate repatriation to France in April 2020, she had received no adequate treatment. 28 RIGHTS & SECURITY INTERNATIONAL