The number of Syrian refugees living in neighboring countries will reach 3.59 million people by the end of the year, the U.N. predicts. But despite continuing violence in Syria, host countries are closing their borders and the cost of travel is climbing too high for Syrians who want to flee their homes.

“The overall number of refugees leaving the country has declined dramatically,” according to a recent report by the International Rescue Committee and the Norwegian Refugee Council. By U.N. estimates, the number of refugees that registered with authorities dropped by 88 percent from 2013.

“Civilians are not getting out and sufficient aid is not getting in. It is a collective betrayal against men, women and children inside Syria, who are living in danger and destitution and are in acute need of assistance,” said Jan Egeland, secretary-general of the Norwegian Refugee Council.

The report calls on regional and global powers “to support neighboring countries supporting Syrian refugees, to ensure that Syrians continue to receive assistance and protection.”

Sarah Case, senior policy and advocacy adviser for the International Rescue Committee, spoke to Syria Deeply about “the new level of hopelessness” that Syrian refugees face. She explains how the international community can step up to provide protection and assistance to the millions of Syrians trying to escape Syria’s brutal war.

Syria Deeply: Why has the overall number of Syrians leaving the country decreased dramatically, despite the ongoing violence?

Case: It is very difficult, due to the nature of the conflict, to even leave Syria, and it is increasingly difficult to seek asylum in neighboring countries. There are many Syrians living in besieged areas that are hard to get in and out of.

For those who want to leave and can leave, it’s harder to get out of Syria because over time they’ve had less financial resources available to them and face ongoing violence. In neighboring countries themselves, we are seeing a decrease in the ability to host and protect refugees. The challenges of crossing borders have also increased.

Syria Deeply: What conditions and treatment are Syrians refugees facing at the borders now?

Case: We’ve seen the implementation of border controls and restriction in numerous countries neighboring Syria. Treatment at the borders depends on who is crossing and what type of documentation they have.

Lebanon announced in October that it would significantly restrict refugees from entering the country. The number of Syrian refugees in Lebanon is tantamount to the United States absorbing the entire population of Germany, according to the report …[it’s] the highest per capita refugee hosting country in the world. We are hearing from Lebanon that up to 60% of Syrians fleeing the country are turned away.

We are also finding that there have been a number of refugees who return to Syria, but only go there temporarily to check on property and documents. With the increasing border restrictions, it is much more difficult for Syrians to go back to Syria and re-enter the neighboring countries where they left from.

Syria Deeply: Can you describe conditions facing Syrians living as refugees in neighboring countries?

Case: We are watching with concern as the crisis is now protracted and refugees are living in host countries for several years. The ability to retain documents and access social services is of critical importance. The legal status of refugees is contingent on what documents they have and what documents they are able to obtain in different countries.

The documents they get in country are essential for them to access social services. Registration and residency is usually a precondition for accessing healthcare, education etc. There is a regime in place for this but, that being said, we are seeing some challenges with documentation around the region as these documents come up for renewal – sometimes there is a fee associated with renewal; in certain cases if refugees don’t reside in camps they can’t get their documents renewed at all.

Some Syrians flee without documentation or have their documentation stripped from them as they are leaving.

Syria Deeply: The hospitality of neighboring countries is at a breaking point. Can you describe the social, economic and security threats facing these countries?

The increased restrictions towards Syrian refugees has to be understood in the greater context. The countries surrounding Syria have taken on the vast majority of the burden of hosting refugees, at an unprecedented level. We have to understand the role of these countries in the context of the economic hit they are taking by hosting refugees.

The World Bank estimated that the impact of the Syria crisis on the Lebanese economy was $7.5 billion. Overcrowded schools and health facilities, and the deterioration in water, sanitation and other infrastructure will require an additional $2.5 billion just to be restored to pre-Syria crisis levels.

In Jordan, the cost of hosting refugees in 2014 will reach $871 million, or 2.4 percent of GDP, according to a USAID and [Jordanian] Ministry of Finance report. The financial cost of hosting Syrian refugees in Turkey reached $2.3 billion in November 2014.

In the communities where IRC works, we are noticing increased tensions and in some cases deportations and detentions of refugees because of the perception that they pose security challenges and threats.

We are also seeing a deteriorating environment for refugees and communities in the countries that are hosting them. Some Lebanese towns have larger Syrian populations than Lebanese, with over 50% of the population made up of Syrian refugees. The fabric of host communities has also changed dramatically as countries try to cope with the high number of refugees.

Economic and humanitarian aid from countries like the U.K. and U.S. is vital, and in order to ensure that borders of neighboring countries stay open, their aid needs to increase in tandem with resettlement options for refugees.

Syria Deeply: What steps can countries take to ensure Syrians fleeing war are safe and their rights protected, and that countries bordering Syria are protected?

Case: The issue of resettlement is very important and countries outside of the region need to open their doors to resettlement as well. On December 9 there will be a high-level pledging conference for resettlement. We are hoping countries will step up to the plate and increase the number of refugees they are willing to take within their own borders. This is important to provide safety for the most vulnerable refugees who are residing in the region, and to show solidarity to the countries that have been hosting refugees for several years and who bear the brunt of the burden.

Resettlement is one track, which is usually meant for the most vulnerable. However there are other types of admission that could apply to Syrians in order for them to live outside the region, including other humanitarian admission programs, family reunification programs, student visa programs and private sponsorship programs.

The second track is to make sure humanitarian and development funding is increased and in line with the U.N. appeals. The U.N. appeal for 2014 is only 52% funded on the refugee side. States need to increase their support in funding in order to ensure that the states neighboring Syria can continue to host refugees.

We are at a moment in time, with the pledging conference in December, where the international communities and donors can and should step up so that Syrian refugees have options for resettlement. Donor countries must share some of the burdens of neighboring countries hosting refugees. We can’t wait any longer.