Normally widow Samar Al Hussein and her 11-year-old son have their two-roomed flat in the Palestinian refugee camp of Bourj al Barajneh to themselves. But a few days ago 23 relatives came to stay, followed by a further seven.

The unexpected guests are refugees from Nahr al Bared, the Palestinian camp in the north of Lebanon that has been locked into a battle between the Lebanese army and Fatah al Islam militants for the past two weeks.

According to the U.N. Relief and Works Agency for Palestinian Refugees in the Near East, around 27,000 of the camp's 40,000 residents have fled from the violence so far, mostly to the neighbouring camp of Beddawi 10 km (6 miles) away.

But as the crisis has worn on, Beddawi has become severely overcrowded, with the result that several hundred people have decamped a second time to relatives in the Palestinian refugee camps of Bourj al Barajneh and Shatila in south Beirut.

Samar's roof terrace - a godsend now that she has 30 people to accommodate - is noisy even by the standards of large Palestinian families. The children are constantly running about and shouting and, with chairs drawn up so that everyone can meet the British journalist, the circle is so big that Hoda Abbas, a worker from the Lebanese NGO Najdeh who is acting as translator, can't hear what anyone says.

The matriarch of the family, 60-year-old Zuhreyeh Abed Al Razek, explains why she and her children, in-laws and grandchildren decided to leave the school building in Beddawi where they had been sleeping since they left Nahr al Bared earlier in the week.

"The numbers were increasing," she says. "There was no bathroom door, and some of the men were not wearing trousers. There were many diseases - we couldn't stand it."

Despite the provision of basic food supplies and mattresses from Najdeh and other NGOs, the extended household is struggling to meet its basic needs. Without the income from the shops they ran in Nahr al Bared, they have no money - and only the clothes they were wearing when they fled.

"We haven't enough cooking tools, and the washing machine is broken, so we wash everything by hand," says Samar.

The faces of the adults are strained as they talk about their situation. Zuhreyeh's son Majdi talks every day to relatives still in Nahr al Bared, and is concerned that news about what is really going on is not getting through to the outside world. But despite his awareness of deteriorating conditions there, he can only think about one thing: "To return to our houses and rebuild our homes. We can't live like this all our lives," he says, gesturing to the shouting children and putting his hands over his ears.

When I ask his mother whether there are enough supplies to tide her family over the next few days, she is equally preoccupied with the desire to go home. "All of us want to return to Nahr al Bared," she says. "If I could enter the camp now, I would go."

Along the camp's narrow alleys a few hundred yards away, Najdeh's Vocational Training Centre is packed with staff and volunteers handing out aid packages to the refugees. Centre manager Wisal Al Jishi says the organisation, which normally runs development projects for the local Palestinian population, is used to switching to emergency work when Lebanon's volatile conditions demand it, and to carrying out rapid needs assessments.

"We've been working in the camp since 1984," she says. "We know most of the people, and it's easy to know who the refugees are. The new thing is that this time we have big families - of 12, 14, 16."

The staff are also aware that the Nahr al Bared conflict is creating psychological as well as physical problems. "This crisis is difficult to understand in a few days," says Ali Ahmad, a youth worker specialising in psychological work. "You have to wait to see the real effects, especially on the children."

The organisation plans to devise projects with a psychological focus to cope with the longer term consequences, but in the meantime setting up activities for children has been a priority. Hoda, who runs the organisation's children's activity centre in quieter times, has hastily assembled a programme for the hundred children from Nahr al Bared. The 21 volunteer-facilitators she's recruited involve the children in outdoor games and creative work.

She shows me the children's drawings from the past few days: a hotch-potch of damaged buildings and military hardware that already reveal signs of disturbance. "The children from Nahr al Bared are drawing from their experience of violence," she says. "But it's better for them to bring it out."

Intriguingly, the pictures also feature Israeli rockets and military aircraft not part of the fighting at Nahr al Bared. "They are confused," explains Hoda. "They mix everything together because they see the news and they see what happens in Gaza."

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