BEIRUT, Lebanon — As many as 100,000 people have been forced to flee their homes in northwestern Syria as the government of President Bashar al-Assad and his patron, Russia, have intensified a military offensive there in recent days, aid groups said.

Trapped between the violence and a closed Turkish border, the civilians are huddling in makeshift settlements that, in many cases, lack toilets or clean water.

There is no foreseeable end to the suffering for the roughly three million residents of Idlib Province, which has been slipping out of the Syrian rebels’ grip, airstrike by airstrike, skirmish by skirmish, bringing Mr. Assad increasingly close to controlling the entire country again after more than eight years of civil war.

To the north, Turkey has sealed its border, keeping displaced civilians out. Other international powers have long since stopped efforts to intervene against the government’s advances, even as they call for political change in Damascus.

The renewed violence comes as the government pushes farther into Idlib, nibbling at the last patch of territory held by the Syrian opposition — in this case, rebels led by a group linked to Al Qaeda and known as Hayat Tahrir al-Sham. The Syrian Army has been pushing toward the town of Maarat al Noaman in what appears to be an effort to capture a strategic highway to Aleppo, a major city in the northwest.

The past few days have brought a spike in urgency and desperation for civilians in Idlib, many of whom landed there from other parts of Syria after the government retook their home areas from the rebels. Drivers and cars were scarce as people hurried to find a way out of Maarat al Noaman, which Russian and Syrian government warplanes have been bombarding relentlessly during the latest assault.

Now they are homeless, sleeping under strung-up blankets, on sidewalks and in the open, amid olive trees, in near-freezing temperatures.

Zein Samer, a photographer from Maarat al Noaman, said on Sunday that he had left with nothing, not even clothing. With his family’s house and shops destroyed, he had almost nothing left.

“Everything is gone,” he said. “Simply vanished.”

Before leaving, he visited his brother’s grave a final time. His brother died during a previous government assault on Idlib. “At that moment, I wished a rocket would fall on me and kill me,” he said.

Since the military offensive in Idlib started in the spring, at least 5,262 civilians have died, including 246 children, according to the Syrian Observatory for Human Rights, a Britain-based war monitoring group. About 400,000 residents were displaced in the spring, most of them moving toward the Turkish border, and aid groups warned that the number could soar if the current campaign continues.

“I don’t want to think about what’s coming next,” said Mona Khayti, a social worker who arrived in Idlib more than a year ago after her home in Douma, a Damascus suburb, was destroyed by a government offensive last year. “Our turn is coming again, and I might be displaced again. The same scenes are being repeated here in Idlib, but uglier.”

Humanitarian workers said conditions for the displaced were already untenable and would probably get worse as more people arrived, in northern Idlib near the Turkish border, looking for shelter. Whether people are sleeping in informal camps or in the open, as thousands are reportedly doing, the settlements are overcrowded, and hunger is rampant.

Medical organizations have reported that 11 percent of children who come to local clinics are acutely malnourished, and food has become so expensive that nursing mothers give their infants herbal tea because they can no longer feed them, the International Rescue Committee said.

Residents and local aid workers in Idlib described chaotic scenes as people fled, with some elderly people refusing to leave their homes.

“It’s really stressful and sad,” said Abdulatif Mardati, who works with a local Islamic charity. “These people don’t even know where to go, what direction to go. A lot of people fled with no place to stay.”

President Recep Tayyip Erdogan of Turkey said on Monday that more than 80,000 people had fled the bombing in recent days and moved toward the Turkish border. If more people are displaced, he warned, Europe would probably see another wave of refugees — a reminder that Mr. Erdogan is refusing to accept more from Syria. He has repeatedly threatened to relax restrictions on migrants in Turkey who have so far been prevented from trying to cross to Europe.

Though the border is shut, diplomats say Turkey will not be able to keep all those fleeing from crossing into its territory.

“If the atrocity against the people of Idlib doesn’t end, this number will increase,” Mr. Erdogan said at an academic award ceremony. “Turkey will not be able to carry the load of migration alone. The negative of the pressure we would be exposed to will be an issue that will be felt by European countries, primarily Greece.”

While a humanitarian emergency looms in Idlib, a vital channel for delivering aid to Syrian civilians has come under threat. On Friday, Russia and China vetoed a United Nations Security Council resolution that would have allowed aid to continue flowing from Iraq and Turkey to millions of Syrian civilians for another year, as it has done for the past five years.

“To Russia and China, who have chosen to make a political statement by opposing this resolution, you have blood on your hands,” Secretary of State Mike Pompeo said in a statement.

But Russia’s ambassador, who had proposed an alternate resolution that would have extended the aid deliveries for six months instead of a year, said the humanitarian situation in Syria had improved.

Unless a solution is found, the legal authorization for the aid channel will expire on Jan. 10.

Rehana Zawar, the International Rescue Committee’s northwest Syria director, said four million Syrian civilians relied on the aid they received via Turkey and Iraq. “The Russian and Chinese vetoes of Resolution 2449 have put the humanitarian response in Syria in jeopardy at a critical time,” she said. “The Council must urgently resume negotiations on this matter.”



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