MDOUKHA, Lebanon — The winds spilling down off snow-covered Mount Hermon, bearing the first nip of winter, rattled the broken windows of an abandoned elementary school where Syrian refugees are huddled in this Bekaa Valley hamlet.
Hundreds of thousands of Syrians displaced by the war, many of them stumbling out of Syria during the summer wearing little more than T-shirts and flip-flops, now face the onslaught of winter with inadequate shelter, senior government officials and aid organizations say.
"It will be winter outside and winter inside," said Mohamed Khair al-Oraiby, a burly 27-year-old who fled here over the summer with his wife and two infants. "We already wake up early because it is so cold."
With temperatures already plunging to zero overnight in the hills framing this valley, the humanitarian crisis facing millions of displaced Syrians is deepening. More than a million people in need of aid remain out of reach of international relief efforts, the United Nations says.
The inability of international aid groups to cope with the crisis, which has mushroomed in recent months, is partly a question of access to war zones.
More than 400,000 people have fled Syria, and 1.2 million have been driven from their homes within the country, according to the U.N. refugee agency. Some 2.5 million people need humanitarian assistance, and the number keeps climbing. The United Nations said it had reached only one million of them.
But efforts have also been hampered by lack of resources. The United Nations is seeking some $487 million for refugees across the region, of which about 35 percent has been collected.
"The capacity of the international donor community to support the crisis is not happening at the same speed at which the crisis is unfolding," said Panos Moumtzis, the regional coordinator for the Office of the U.N. High Commissioner for Refugees.
Neighboring countries coping with the influx are developing their own plans: Jordan is seeking about $700 million, and Turkey, which has spent $400 million of its money on state-of-the-art camps with three hot meals daily, is also now seeking aid.
Inside Syria, conditions are even worse. The distribution of aid is plagued by problems of access, security and a lack of organizations to carry out the work, according to aid officials. Most deploy from Damascus, where fighting has been so fierce in recent weeks that aid workers have occasionally been instructed not to leave their houses. Some areas have fallen under the sway of shadowy jihadist forces that eye Western aid organizations as espionage networks.
In November, the International Committee of the Red Cross finally negotiated brief access to the old city of Homs with the fundamentalist militia that controls it. The locals jeered the relief workers for taking more than four months to reach them.
The largest aid donors are the United States, at $8.5 million, and Britain, at $7.8 million. The wealthy Arab gulf states have contributed little via the U.N. system, with the exception of Kuwait, which has contributed $1 million.
Now the cold is adding another layer of need. Middle Eastern winters can be bitter, with snow in some areas and chilly winds slamming across the deserts.