Emergency aid efforts for tens of thousands of refugees who have fled to Armenia from the Nagorno-Karabakh enclave in Azerbaijan are gathering speed as the exodus from the disputed region shows no signs of letting up.

Since Azerbaijan launched an attack on Nagorno-Karabakh on September 19, the United Nations refugee agency says, more than 88,700 refugees have arrived in Armenia, mainly in the country’s southern Syunik region.

“The numbers are increasing as we speak, and the needs are also really increasing,” said Kavita Belani, UNHCR representative in Armenia, speaking in the capital, Yerevan, Friday.

She said the government has registered more than 63,000 of the 88,700 refugees.

“There are huge crowds at the registration centers,” Belani said. “There is congestion simply because the sheer numbers are so high.”

She said the government, United Nations and international and nongovernmental agencies were setting up tents, providing mattresses, blankets, hot meals and other essential items to the growing community.

One of the most urgent needs, she said, was for psycho-social support as people were arriving exhausted, hungry, frightened and not knowing what to expect.

“When they come, they are full of anxiety. … They want answers as to what is going to happen next,” she said. “They have questions about compensation, about the houses they have left behind, including whether they will be able to return to their houses, at least to pick up their goods, because many arrive with very little luggage.”

The International Federation of Red Cross and Red Crescent Societies has activated contingency plans to protect and provide for vulnerable communities affected by the escalating hostilities.

The IFRC launched an emergency appeal Friday for nearly $22 million to provide immediate relief and long-term support to tens of thousands of people who have recently crossed into Armenia via the Lachin corridor.

“As we confront the growing humanitarian needs, we must also look ahead,” said Birgitte Bischoff Ebbesen, regional director of IFRC Europe. “They will need further support as they navigate the many questions of settling somewhere new.”

Her colleague, Hicham Diab, IFRC operations manager in Armenia, is on the ground in Yerevan and is witness to the dire situation facing the new arrivals that Diab says “often involves families arriving with children so weak that they have fainted in their parents’ arms.”

“It feels like the people affected reached the finish line of a marathon and crashed on the spot, which I have never seen before,” said Diab.

Diab noted that more than 100 staff and volunteers have been mobilized and positioned at the registration points to help the refugees as they arrive. He said that the conflict has worsened existing vulnerabilities and that the affected regions face severe challenges.

Essential goods and services are scarce, and hospitals are stretched.

“There is a massive need for mental health and psychosocial support. … As the weather is getting colder, shelter is becoming the most critical need for vulnerable families,” he said.

UNICEF reports that children account for about 30% of the arrivals and that many have been separated from their families while making their escape.

“We are working to provide psychosocial support and working with the ministries and local authorities to ensure that family tracing is done immediately and that families can reunite,” said Regina De Dominicis, UNICEF regional director for Europe and Central Asia.

She added that UNICEF was working with Armenia’s Ministry of Education to set up child-friendly spaces in the town of Goris and was providing educational supplies for the arriving children.

Carlos Morazzani, operations manager at the International Committee of the Red Cross, or ICRC, said his agency was working to reunite separated families in the region. He said that was especially important now because “when mass movements of people take place, people get separated, leading to real emotional distress.”

However, given the critical developments following the recent conflict in Nagorno-Karabakh, he said, the priority for the ICRC was on life-saving activities in the region, “including the transfer of wounded to hospitals into Armenia for treatment and bringing in medical supplies.”

“Over the past week, we have transferred around 130 people for medical care,” said Morazzani. “Another important element of our work right now is working to ensure the dignified management of the dead.”

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