As if the war which drove them out of Syria and the hardships of exile were not enough, refugee women and children in Lebanon are facing domestic violence born of stress, deprivation and frustration.
"Many women have already suffered violent shocks because of the army and the war, and now it's their families," said Syrian medic Ghazi Aswad, who treats dozens of women each day in a clinic in the north Lebanese city of Tripoli.
"Many women have suffered violence in their homes, sometimes at the hands of their husbands," Aswad added.
"I am a surgeon, but most of the time I serve as an amateur psychologist. Every day, I see strong women who carry all their families' burdens and then collapse in tears right before my eyes," he told AFP.
The violence of a war that has left more than 60,000 dead in less than two years, according to UN figures, has made the lives of thousands of families tense and precarious.
The combination of everyday stress, poverty and rough living conditions for more than 240,000 Syrian refugees in Lebanon has sparked a rise in violence inside the family, experts say.
"In Syria, my husband was a lawyer. Now, in Lebanon, nobody wants to hire him, even as a construction worker. That makes him really nervous," said Maryam.
According to the UN Population Fund (UNFPA), 31 percent of 460 women surveyed have been threatened by weapon-wielding family members while seven percent have suffered sexual aggression.
The International Rescue Committee said rape was one of the main causes of women and young girls fleeing Syria. But the increase in domestic violence as refugees was not specific to the Syrian conflict, the IRC added.
Poor living conditions, stress, hopelessness and social downgrading have all played key roles in conflicts the world over in turning women and children into victims.
Many Syrian refugees have suffered "a traumatising social downgrade. Many suddenly feel worthless," said Abbas Alameddine, a psychiatrist with the medical charity Medecins Sans Frontieres (MSF).
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Back in Syria, men were the families' main providers. But in Lebanon, most refugee men have been unable to find work or provide decent living conditions for their wives and children.
"This new kind of suffering has led to an increase in verbal abuse, neglect and physical violence," Alameddine told AFP.
"Men feel frustrated and nervous. At the same time, they are mourning the loss of their lives in Syria, and all that they have lost," said Layal Rahhal, an MSF psychologist in Tripoli.
"In some cases, they have projected this violence on the children, who are the most vulnerable members of the family," said Rahhal.
According to the United Nations children's fund, UNICEF, some 50 percent of the 700,000 Syrians who have been fled to neighbouring countries are children. A quarter of the refugees are children under four.
Now pregnant with her fourth child, Maryam shares two cramped rooms with 11 other people in a marginal Tripoli neighbourhood.
Amineh, also pregnant, lives in equally poor conditions. While on a visit to a Tripoli clinic, she told AFP that the feeling of helplessness at home was overwhelming.
"Children are screaming all day long, the house is overcrowded, we all feel impotent. To make things worse, we don't feel welcome here. People tell us we shouldn't be here because we're Syrian," Amineh said.
"It's really hard and I can't do anything to make my family's life better," she added.
In an interview published by UNFPA, a Syrian woman admitted: "We take it out on our children. They want to go home (to Syria) because they feel we've changed, and they don't like that."
According to the UNFPA, 74 percent of refugees surveyed said they now beat their children more often than back home.