Rape and other forms of extreme sexual violence in Syria, often committed in front of family members, is a major reason for increasing numbers of people fleeing their homeland, the International Rescue Commission has said.
"Many women and girls relayed accounts of being attacked in public or in their homes, primarily by armed men," according to the 28-page report from the New York-based refugee assistance agency. "Sexual violence was consistently identified by Syrian women, men and community leaders as a primary reason their families fled the country."
Cases described in the report included attacks by armed rapists, especially at the roadblocks that have proliferated across Syria. The IRC was told of a nine-year-old girl who had been brutally raped, of a man whose genitalia were mutilated by attackers and of a father "who shot his daughter when an armed group approached to prevent the 'disgrace' of her being raped".
More than 600,000 Syrians have fled the country to seek refuge in countries including Lebanon, Jordan and Turkey since the conflict began in March 2011, the United Nations estimates. Another 200,000 are awaiting registration or are unaccounted for, and about four million Syrians are in dire need of assistance, the IRC said.
The last four months of 2012 saw a "dramatic spike" in Syrian refugee numbers which would strain the already limited resources in host countries and threaten to increase political, ethnic and sectarian tensions throughout the region, it said.
"The Middle East is once again facing a human displacement tragedy," the IRC said. "The magnitude of the crisis demands a decisive response from the international community."
The group proposed a six-point plan to address the crisis that includes increasing humanitarian aid and preparations for a protracted humanitarian emergency.
In addition, the IRC recommends opening borders, expanding assistance inside Syria and offering additional assistance to women and girls in and outside refugee camps. Victims of sexual violence need medical and counselling services in the countries to which they have fled to help them recover, the IRC said. They also need help in face of unsafe conditions in camps and increased levels of domestic violence.
The stigma around the "dishonour" of rape means the crime is rarely reported, the IRC said. Many of those interviewed said they feared retribution or were afraid of being killed by family members for bringing shame to the family if they spoke out, it added.
As a result, reports of early and or forced marriage of women and girls are increasing, it said.
The IRC was founded in 1933 after Albert Einstein called for an American branch of the European International Relief Association. It works in more than 40 countries, according to its website.