“I’m sorry,” said Ms. Najjar, 26, wiping her eyes. Hisham, who is shy and has large dark brown eyes, left the room to play with balloons. “It’s just that I almost lost him, not to violence or to war, but to diabetes.”
A few birds singing in their cages brighten the grim space where Hisham’s family lives. But they also remind the family of what it left behind and how the lives of the couple and their children have been upended.
About a year after the civil war started in Syria in 2011, the family packed up a few of its belongings, leaving behind almost everything, and left its apartment in Homs for the nearby home of Mr. Abrash’s parents. Ms. Najjar and Mr. Abrash thought they would be gone for 10 days, waiting for the fighting to dissipate.
Most of the family’s neighbors in western Syria were also leaving. The temporary departure soon became permanent. After tank fire and shelling erupted one day near the home where the family had sought refuge, it drove to Damascus to get passports, then south to enter Jordan legally at the Jaber border crossing.
Back in Homs, the third-largest city in Syria, hundreds of buildings were damaged or destroyed. Many structures remain skeletons of their former selves, the walls and windows blasted out.
The city was once a foothold for rebels fighting the regime of Syria’s president, Bashar al-Assad, but many fighters started to leave at the end of 2015 under a cease-fire deal with the government. The city is now back under the president’s control.
Ms. Najjar knows that if Hisham had fallen sick while in Syria, he probably would have died. Power disruptions, common in Syria, essentially shut down hospitals, cutting off electricity to refrigerators storing insulin. And he and his family would have risked their lives just trying to travel to the hospital.
They have no plans to return. “Of course I was sad when I realized I wasn’t going to return home after a few months,” Ms. Najjar said. “There is nothing really to return to anymore.”
More than 650,000 Syrian refugees have fled to Jordan, many of them settling in urban areas. They mostly live in cramped apartments where the rent consumes any humanitarian aid they may receive. The rest of the refugees, about 8 percent, according to some estimates, live in three refugee camps that offer basic services and are free, but also limit freedom of movement.
Many of the Syrians arrived in Jordan six years ago, near the start of the civil war. The flood of refugees has put a strain on the country’s limited resources, and public clinics in Jordan no longer provide free health care to Syrians. The protracted crisis is increasing pressure on aid organizations to take on additional roles and provide refugees with more than emergency care, such as treatment for cardiovascular diseases, respiratory ailments and diabetes.
Nearly a year ago, Amnesty International warned that Syrian refugees in Jordan were unable to get access to health care and other vital services, citing “the combination of grossly inadequate support from the international community and barriers imposed by the government of Jordan.” The report also found that even if Syrian refugees could get access to health care, many could not afford it without forgoing basic needs.
The United Nations refugee agency provides Hisham’s family with $137 a month in cash assistance; the money goes directly toward the $193 rent and the electricity bill, which is $28. In addition, the family receives $70 in food coupons.
The International Rescue Committee, one of the eight organizations supported by The New York Times Neediest Cases Fund, provides Hisham with free regular checkups and insulin, worth nearly $30 a month. The organization also paid for a glucose meter, but lacks the funding to pay for glucose test strips. The family must pay for them — $27 a month.
Ms. Najjar takes her son to a diabetes clinic every three months in the northern town of Irbid, about 30 miles from here. Each checkup, including the cost of travel, is $35.
Across northern Jordan, the International Rescue Committee provides nearly 9,000 refugees and vulnerable locals with free primary health care. The group uses mobile health clinics, each with two doctors, two nurses, a midwife, a counselor and a mobile pharmacy. Patients with diabetes require more frequent care, and wait times for consultations at the group’s clinics are increasing.
When the family first arrived, some Jordanians and informal charities helped it cover the rent. But with no immediate prospects of returning to Syria and Jordanian poverty levels rising, it is becoming harder for this family of five to pay the bills. When Mr. Abrash, 37, first arrived in Jordan in 2012, he spent five months searching for work.
The unemployment rate among Jordanians exceeds 14 percent, and is almost double that among youth. Syrians, until recently, were not allowed to work.
In Syria, Mr. Abrash was a tailor, mainly sewing women’s jeans. Five months after he arrived in Jordan, he began working as a tailor, sewing pillows and mattresses for customers who were referred to him. More recently, he also began selling birds. A bulging disk in his neck is preventing him from working full time at garment factories.
After Hisham was found to have Type 1 diabetes, his mother attended awareness sessions about the disease and started to change the way the family eats. Today, it mainly eats vegetables and rice.
In the morning before school, Hisham eats wheat bread with eggplant and has a cup of tea. He walks to school with his friends. His mother makes sure he takes an insulin shot before he leaves in the morning, after lunch and before he sleeps at night.
“The insulin shots let me lead a normal life, like my friends,” Hisham, 7, said as he watched cartoons. “Sometimes I cheat and I eat something I’m not supposed to at school, but my mom makes sure I eat well at home.” His mother also checks his blood glucose levels regularly.
Hisham does not remember his home in Syria. All his memories are in Jordan. “Nothing,” he said. “I don’t remember anything.” His home here has two small plastic toy cars and a few plush animals donated by a charity nearby.
“When I’m not at school, I mostly jump on the sofas, play soccer with the inflatable balls we have,” he said, as his younger sister followed him around from one room to another.