– They escaped snipers, aerial bombardment and shelling back home in Yemen, only to end up facing a new and bewildering struggle: surviving as refugees on a remote coastal stretch of Djibouti, where shelter from a punishing sun is scarce and the shrieks of hyenas and jackals echo in the evenings.

“It seems we ran away from death just to die slowly here,” said Rasha Abdullah, a 27-year-old from the embattled Yemeni port city of Aden, cradling her barefoot daughter, Nourhan, 2, at a rudimentary camp. “In Aden, at least we only died once. Here we die 100 times.”

These are the Middle East’s newest refugees — thousands of civilians fleeing the civil war that has engulfed Yemen, just a few miles across the Gulf of Aden from Djibouti, a strategically situated but impoverished African nation that houses a major U.S. military base. The war in Yemen has reverberated profoundly in Djibouti.

Besides hosting a new flow of refugees, who mostly arrive via boats across the gulf, Djibouti was also a logistics hub for a massive relief effort to Yemen during a five-day cease-fire. The truce ended Sunday, bringing renewed bombardment — and more refugees.

The fighting in Yemen has forced almost half a million people to flee their homes, according to the United Nations. Most have remained in the country, internally displaced, often trapped. About 30,000 people — Yemenis and foreign nationals, including U.S. citizens — have left Yemen since a Saudi-led bombing campaign against rebels challenging the Yemeni government began in March, the U.N. says.

But officials fear the relative trickle of Yemenis escaping the country could become a torrent now that the oft-broken truce is over.