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Syria Humanitarian Crisis

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The Syrian complex humanitarian emergency is characterized by more than 10 years of ongoing hostilities and their long-term effects, including large-scale internal and cross-border displacement, widespread destruction of civilian infrastructure and significant violations of international humanitarian law.

In 2023, 15.3 million people need humanitarian assistance. Syria remains one of the largest humanitarian responses in the world. According to the UN Office for the Coordination of Humanitarian Affairs (UNOCHA), localized hostilities, the economic crisis, the water crisis and public health emergencies, including cholera and climate-related situations, are expected to remain the main drivers of humanitarian need. UN Humanitarian Affairs Coordinator, Martin Griffiths, reported in December 2022 that the vast majority of Syrian families are either struggling or unable to meet their basic needs.

On Feb. 6, 2023, a magnitude 7.8 earthquake occurred in southern Turkey near the northern border of Syria. This quake was followed approximately nine hours later by a magnitude 7.5 earthquake located around 59 miles (95 kilometers) to the southwest.

According to ACAPS, new earthquakes are among the worst-case scenarios for the region because they could impact humanitarian needs and the ability to meet them. Damaged buildings are at high risk of collapse when additional earthquakes strike, and survivors may continue to experience ongoing fear while also beginning to deal with lasting trauma.

On Feb. 14, the UN and humanitarian partners launched an earthquake Flash Appeal that requests $397.6 million to reach 4.9 million people across Syria between February and May 2023. See CDP’s 2023 Turkey-Syria Earthquake disaster profile for more.

On Jan. 9, the United Nations (UN) Security Council unanimously renewed an essential cross-border operation at Bab Al-Hawa for another six months that delivers humanitarian assistance to millions of people in northwest Syria, which is outside government control.

Syria and Russia want humanitarians to deliver aid internally across conflict lines, but the UN says such “crossline” operations cannot match cross-border operations from Turkey into northwest Syria in terms of size and scope. In the aftermath of the Feb. 6 earthquake, humanitarian access from Turkey to northwest Syria grew with the opening of Bal Al-Salam and Al Ra’ee border crossings on Feb. 14 for an initial period of three months. On May 13, the Syrian government agreed to extend by another three months the use of the two border crossings.

(Photo Source: Bo Viktor Nylund/ UNICEF MENA)

A deal brokered almost three years ago between Russia, which backs Syrian President Bashar al Assad’s forces, and Turkey, which supports opposition groups, ended fighting that had displaced thousands of people. However, there are signs of escalating hostilities.

In early November 2022, Russian jets bombed camps for internally displaced persons in Idlib killing at least nine civilians. The UN Human Rights Office released a statement expressing concern over the aerial attack and calling for the protection of civilians as outlined under international humanitarian law.

According to UN Human Rights, “over the past ten years, an average of 84 civilians have been killed every day in direct connection to the war in Syria.” Some Arab countries have begun normalizing ties with Assad’s government. Human Rights Watch has said such actions should not occur without accountability for abuses committed over the past 12 years.

In 2011, peaceful protests against Syrian President Bashar al-Assad’s government eventually escalated into a civil war between the Syrian government and anti-government rebel groups. The conflict includes many different actors with varying motivations, including foreign governments and extremist organizations such as the Islamic State.

The country of Turkey is recognized in English as Türkiye by the United Nations.

Key facts
Climatic shocks and natural hazards

The 7.8 magnitude earthquake that occurred in Turkey on Feb. 6, 2023, resulted in devastating and deadly outcomes in Syria and will only worsen the humanitarian situation in the country’s northwest. A complex humanitarian emergency (CHE) is a crisis involving multiple causes and often includes a breakdown in authority or inadequate capacity.

The recent earthquake, a natural hazard, is devastating on its own. However, in the broader context of the Syrian CHE, the earthquake is a massive catastrophe because it exacerbates underlying vulnerabilities and complicates disaster response and recovery. For example, getting aid into northwest Syria was already complicated and the earthquake ensures that the movement of aid through the border will be disrupted.

Source: The Guardian

Following the Feb. 6 earthquake, a dam collapsed in northwestern Syria, causing the overflow of the Orontes River. The flood led to the displacements of people from the village of Al-Tlul in Idlib governorate. Approximately 7,000 people were evacuated, and 1,000 houses flooded across the nearby villages of Hardana, Delbiya, Jakara and Hamziyeh. The flood was an example of an indirect and cascading disaster impact that humanitarians must account for while trying to minimize risk as they provide assistance and begin earthquake recovery.

Even relatively minor weather events can be disastrous for already vulnerable populations and infrastructure. For example, on March 29, 2023, a windstorm hit several parts of Syria. One person was killed in Homs City and the storm damaged electricity lines and ruined an electricity post in Nawa.

Syria saw its worst drought in 70 years in 2021, which affected access to drinking water, electricity generation and irrigation. The water crisis was particularly damaging for the country’s wheat harvest, with a loss in production of more than 1 million tons in 2021 compared to the previous year.

The long-running war has severely damaged and neglected infrastructure, but the water situation is exacerbated by the impacts of climate change and other weather events. An estimated 52% of Syrians rely on often unsafe alternatives to piped water. Water deficits have been exacerbated by unusually dry conditions during the wet season and by abnormally high air temperatures.

UNOCHA says “a severe drought and lower than expected flows of the Euphrates River, coupled with the high cost of fuel and price increases, resulted in a contraction of the harvestable cereal area at a time when 12.6m people.”

In March 2023, the Alouk water station in Al-Hasakeh Governorate had not been operational for the past seven months, causing critical drinking water shortages for some 500,000 people in Hassakeh and surrounding areas. OnMarch 28, the Governmental Directorate of Water Services and the WASH sub-national sector reported that the Alouk water station resumed operation. Unfortunately, a power station that supports Alouk ceased functioning due to technical problems, leaving Alouk non-functional again.

In northeast Syria, known as the country’s food basket, the quantity and quality of wheat flour has declined due in part to drought.

Deteriorating economy

Socio-economic conditions have been deteriorating rapidly in Syria, with the depreciation of the local currency leading to inflation that worsens food insecurity and pushes people into poverty. According to the World Bank, between 2010 and 2019, Syria’s GDP shrunk by more than half 

Syria’s economy has arguably hit its lowest point since the start of its civil war nearly 12 years ago. The currency collapse in neighboring Lebanon has driven devaluation and higher prices in Syria. The country was also affected by the COVID-19 downturn, Russia’s war in Ukraine which increased prices and a slowdown in shipments of oil from Iran.

The country’s debilitating economic crisis is severely affecting Syrian families. According to UNOCHA, “The crippled economy, which is characterized by high inflation, currency depreciation and increases in the prices of commodities, remains one of the biggest drivers of need. It drives more people towards poverty, makes them more reliant on humanitarian assistance, increases resort to harmful coping mechanisms and increases the cost.”

A report released in May 2022 by the Norwegian Refugee Council found only one in 10 people reported being able to meet the $206 needed each month to cover food, rent, education and other essentials. The situation forced people into new survival strategies such as eating less, selling fuel aid to buy food, burning old shoes to keep warm and skipping urgent medical procedures. 

Displacement

During the second half of 2021, hostilities re-intensified in northern and southern Syria, triggering new displacements and destruction. There are an estimated 6.8 million IDPs in Syria, the largest concentration of IDPs in any single country globally.

There are more than 2.87 million IDPs in northwest Syria alone with 1.9 million living in camps. For IDPs inside camps, limited livelihood opportunities, poor shelter and overcrowding conditions contribute to vulnerability. For IDPs outside camps, shelter needs remain high. Additionally, many lack access to non-food items and have limited access to basic services and infrastructures.

The Feb. 6 earthquakes and aftershocks have caused ongoing displacement. In northwest Syria, more than 57,000 displacements were recorded between Feb. 6 and Feb. 13 after the earthquakes. As of March 15, an estimated 500,000 people have been displaced across Syria by the earthquake. The earthquake affected people already displaced in addition to causing new displacements, which are a significant change in people’s way of life, perhaps including loss of livelihood, extreme poverty and damaged social support structure.

More than 10 years of ongoing hostilities have led millions of Syrians to flee the country in search of safety and basic needs. As of May 11, 2023, 5,303,746 Syrian refugees were formally registered in neighboring countries.

Inflation and deteriorating economic conditions in Turkey have led Syrian refugees to report increased tension with host community members. Fearing discrimination and negative attitudes, some Syrians report a reluctance to speak Arabic in public spaces or feeling unsafe.  

According to Human Rights Watch, Turkish authorities arbitrarily arrested, detained, and deported hundreds of Syrian refugee men and boys to Syria between February and July 2022. The deportations stand in contrast to Turkey’s record of generosity as host to more refugees than any other country in the world.

Between January and December 2022, humanitarians recorded 200,100 spontaneous IDP return movements. Of this figure, the majority were recorded in Idleb governorate.

Food insecurity

According to Syria’s 2023 Humanitarian Needs Overview, 12.1 million people in Syria are food insecure. In June 2022, WFP and the Food and Agriculture Organization of the United Nations (FAO) released the Hunger Hotspots early warning report on acute food insecurity covering June to September 2022. In the report, Syria is among the hotspots with deteriorating conditions and is a country of very high concern.

According to a Save the Children report from Nov. 10, the number of malnourished children in northeast Syria has increased by over 150% in the previous six months with at least 10,000 more children facing malnutrition than in the previous six months. Near the 100-day mark since the earthquakes, Save the Children said the disaster threatens to push at least another 665,000 Syrians into hunger, with doctors and aid agencies warning that levels of child stunting and maternal malnutrition are reaching levels never seen before.

On March 15, 2023, UNICEF warned that after 12 years of conflict, and the recent deadly earthquakes, millions of children in Syria at heightened risk of malnutrition. The number of 6-59-month-old children suffering from severe acute malnutrition increased by 48% from 2021 to 2022.

In the third week of February 2023, nearly three weeks after the earthquakes, food prices remained high in the affected areas. Diesel fuel affects everything from agriculture production, heating and transportation. The WFP said in its Feb. 18-25 markets update, “The increased inflationary pressures stemming from the rise in fuel prices will remain a hurdle to taming food inflation.”

The Syrian government has long kept aid from moving across front lines from government-held parts of the country into non-government-controlled areas. Crossborder aid from Turkey to northwestern Syria has become a critical avenue for getting humanitarian assistance to those who need it.  

Millions of displaced people depend on cross-border aid, including the delivery of food, for their survival. The food security and livelihoods sector has targeted 1.4 million people for assistance through the Bab Al-Hawa crossing point. In the aftermath of the Feb. 6 earthquake, humanitarian access from Turkey to northwest Syria grew with the opening of Bal Al-Salam and Al Ra’ee border crossings on Feb. 14 for an initial period of three months.

Health

A deadly cholera outbreak is spreading in Syria where a shortage of clean water, dense living conditions and few healthcare facilities provide the opportunity for the disease to thrive. The Feb. 6 earthquake will only exacerbate the situation and put additional people at risk.

On March 8, 2023, WHO and partners announced the start of a cholera vaccination campaign in earthquake-hit areas of northwest Syria. Since the cholera outbreak was first declared in Syria on Sept. 10, 2022, more than 50,000 suspected cases have been reported in both Idlib and Aleppo governorates, of which 18% of suspected cases were from IDP camps.

Between Aug. 25, 2022 and Feb. 15, 2023, 92,649 suspected cases have been reported from all 14 governorates, including 101 associated deaths to date at a case fatality rate of 0.11%. According to WHO and humanitarian partners, “The devastating earthquake had a significant impact on the cholera response operations. The earthquake affected access to services, reduced partner capacity, diverted already limited funds available, and also affected negatively the mental health of the workforce.”

According to the UN Children’s Fund in November 2022, “Of the suspected cases of cholera, 1 out of 4 are children under the age of 5. Malnutrition is increasing and diarrhoeal diseases further worsens the condition of malnourished children. This impacts the overall survival rate of children suffering from severe wasting.”

The cholera outbreak makes more apparent and more urgent the need to repair damaged water networks, improve communities’ access to safe drinking water and provide safer sanitation options. The earthquake damaged some of the remaining functioning water sources. Repairs to newly damaged sources and networks will be challenging but critical to reduce the risk of an increase in waterborne diseases after the disaster.

With the increased number of cholera cases and expansion into new geographical areas, persistent funding challenges limit the scale-up of health and water, sanitation and hygiene response activities.

According to Human Rights Watch, Turkish authorities are exacerbating the water crisis that is believed to have given rise to the deadly cholera outbreak spreading across Syria and into nearby countries. The World Health Organization has linked cholera’s comeback in neighboring Lebanon to the outbreak in Syria, where it had spread from Afghanistan via Iran and Iraq.

In addition to managing the cholera outbreak, humanitarians are also providing immunizations, maternal health care, mental health consultations and COVID-19 response. Syria’s Health Cluster says that as of the end of September, donors have funded only 13.2% of the sector’s request for $583 million.

Food and cash assistance 

High food prices and lower-than-average agricultural yields, compounded by ongoing inflation, exacerbates food insecurity in Syria. Children’s nutrition remains a critical concern, with the rate of severe acute malnutrition (SAM) increasing this year in northwest Syria. According to a Save the Children report on Nov. 10, 2022, the number of malnourished children in northeast Syria had increased by over 150% in the previous six months.

A combination of emergency food products, food rations and cash transfers for food are needed to meet the diversity of nutritional needs of affected people. In its April 14, 2023, Northwest Syria Situation Report, UNOCHA said, “Cash support is a priority in the earthquake response given the resilience of markets.” As of April 13, 2023, humanitarian had distributed multi-purpose cash assistance to 448,317 people with a total value of $13 million.

Cash assistance and in-kind assistance, including tents, winter clothes and blankets, are needed to protect people from harsh weather conditions. UNOCHA identified cash assistance as a primary need following the earthquake in their first flash update. According to a REACH rapid assessment involving 604 communities in northwest Syria, multi-purpose cash assistance was the top priority need among affected communities.

Functioning markets that are accessible to the population are needed for cash assistance to be effective.

According to the Joint Rapid Assessment of Markets for northwest Syria in April 2023, “Two months since the earthquakes, assessed markets were in general reported as physically and socially accessible to consumers. However, access to markets appears more difficult for certain groups including women, older people, people with disabilities, and people with chronic health conditions, and consumers reported feeling unsafe at marketplaces in several communities as a result of both earthquake-related and human-related security factors.”

The Center for Disaster Philanthropy recommends cash both as a donation method and a recovery strategy. Direct cash assistance can allow families to purchase items and services that address their multiple needs. It gives each family flexibility and choice, ensuring that support is relevant and timely. Cash-based approaches to disaster recovery also give people the freedom to choose how they rebuild their lives and provide a pathway to economic empowerment.

Access to water and sanitation 

UNOCHA has described water access in northwest Syria as unpredictable, unsustainable and costly. More than a decade of war has damaged infrastructure and climate change exacerbates the situation. Of out 667 water systems in the northwest, 43% of them are not functional, forcing families to depend on water delivered by truck which is expensive and often cost prohibitive. CDP’s NGO partners have reported that access to clean water is an immediate significant need in northwest Syria after the Feb. 6.

Additionally, insufficient rainfall and low water levels in the Euphrates River have resulted in reduced access to water for drinking and domestic use for more than 5 million people. This has also led to harvest and income losses, an increase in waterborne diseases and protection risks. The cholera outbreak makes clearer and more urgent the need to repair damaged water networks, improve communities’ access to safe drinking water and provide safer sanitation options.

Gaps in funding are an obstacle to providing clean water and sanitation in northwest Syria. According to UNOCHA’s Funding Gap Analysis for July to September 2022, the water, sanitation and hygiene cluster faced an 85% funding gap.  

In a region where more than 90% of people live in poverty, purchasing water has a negative impact on household income.  

Health

Health care access and quality have severely deteriorated after years of conflict, an economic crisis, and reduced donor funding. The water crisis has forced families and aid organizations to truck in water, which is becoming more costly due to rising fuel and electricity prices.

Without access to water, there has been an increase in diseases such as diarrhea, malnutrition, skin conditions and cholera. Needs include increasing cholera treatment capacity, especially in Northeast Syria, to address critical gaps.

Following the devastating earthquakes, the risk of an increase in waterborne diseases including cholera is very high due to over-crowded settings. There is also extensive damage to water and sanitation infrastructure, and damage and disruption to cholera treatment infrastructure that require support.

According to the International Committee of the Red Cross, after earthquake damage in northwest Syria, urgent action is needed “to prevent collapse of water systems and avoid devastating humanitarian consequences.”

Families often cannot afford medications, and health care workers are working in challenging environments without access to adequate equipment and medicines.  

Additional funding is needed to address shortages in staff, medicines and equipment. Funding cuts resulted in reduced operational capacities in 2022, prompting some hospitals to scale back their services, putting people’s lives at risk.

In northwest Syria, keeping the cross-border points open is essential for ensuring humanitarian aid reaches affected people, including medical supplies. In short, border closures put people’s lives at risk 

Syrian refugees living in Turkey the country and those who cross the border for health care also need health services. According to the Syria Health Cluster, 74% of antenatal care visits in 2022 were cross-border visits.  

Hospitals in Syria have been subjected to airstrikes, missile attacks and shelling, resulting in fewer patient consultations, loss of health-related infrastructure and increased risks for health workers. Health workers in Syria have been targeted and face risks to their lives. Supporting these workers and providing them with the protection and equipment required to treat people is critical.  

Continued promotion of COVID-19 vaccinations is needed, including increasing vaccine literacy. As of March 15, 2023, Syria had 57,478 cases of COVID-19 and 3,164 deaths. Challenges to increasing vaccination rates include the lack of electricity and infrastructure and waning interest in the vaccine.

After enduring 12 years of conflict and devastating earthquakes, mental health and psychosocial support for people in Syria is a critical need. After the earthquake, Doctors Without Borders/Médecins Sans Frontières provided psychological first aid and then focuses on trauma.

In its April 14, 2023, Northwest Syria Situation Report, UNOCHA said, “Funding remains a concern, with three out of 25 health facilities lacking resources to continue beyond another three months. This is equivalent to a potential reduction of 700 rehabilitation sessions and 20 prostheses per month.”

Shelter

In the aftermath of the earthquakes, affected people will need access to safe, warm shelters in the short term. All emergency shelters should be winterized and built with disaster risk in mind.

In the longer-term, housing reconstruction will be required. However, such reconstruction will be challenging given the complexity of Syria’s crisis and the various authorities that control parts of the country. In Idlib, Syria the destruction from conflict combined with earthquake damage has only increased the shelter needs there.

According to a REACH rapid assessment involving 604 communities in northwest Syria, shelter is among the top priority needs. Additionally, at least 50,000 households need tents or emergency shelters and 88,000 households need mattresses, high thermal blankets and clothing, according to REACH.

According to the Syria earthquake Flash Appeal, “The earthquake has not only resulted in additional displacement due to damaged/unsafe shelter but has also diminished the prospects for safe return of IDPs originally from earthquake-affected areas. Safe shelter will be one of the main needs in the aftermath of the earthquake.”

The shelter recovery process is ongoing but faces many challenges. By April 2023, humanitarians had rehabilitated several mid-term shelters in Aleppo. In May 2023, shelter partners continue to provide assistance through a variety of emergency shelter options, including adaptations to collective centers, rehabilitation of collective shelters, mobilizing resources for cash for minor repairs and supporting authorities in the design of temporary settlements.

Syrian woman and three children standing in front of a store

The Center for Disaster Philanthropy has a Global Recovery Fund that provides an opportunity for donors to meet the ongoing and ever-expanding challenges presented by global crises, including finding long-term solutions for communities in protracted humanitarian crises like Syria.

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Philanthropic contributions

If you would like to make a donation to the CDP Global Recovery Fund, please contact development. 

(Photo: Shukran returned to her home in Deir ez-Zor a year ago. She received training and support for small projects from UNHCR and is now able to provide for her family’s needs. Source: UN Refugee Agency in Syria via Twitter.)

Recovery updates

If you are a responding NGO or a donor, please send updates on how you are working on recovery from this disaster to Tanya Gulliver-Garcia. 

We welcome the republication of our content. Please credit the Center for Disaster Philanthropy.

Donor Recommendations

If you are a donor looking for recommendations on how to help with disaster recovery, please email Regine A. Webster. 

Philanthropic and government support

CDP, through its COVID-19 Response Fund, awarded $200,000 to Medair in 2020 to support national efforts to reduce COVID-19 transmission in Lebanon and Sudan. In Lebanon, Medair provided technical support to staff working in triage and isolation centers, training for community health workers and information dissemination to counter myths about the virus in the Bekaa Valley, where many Syrian refugees lived.  

Syria’s 2023 Humanitarian Response Plan (HRP) seeks $4.81 billion to reach 13 million of the 15.3 million people in need. As of April 21, 2023, donors had funded only 7.5% of the HRP. The response plan funding requirements have grown nearly annually since 2012, demonstrating the significant and growing humanitarian needs in the country.

More ways to help

As with most disasters and emergencies, cash donations are recommended by disaster experts as they allow for on-the-ground agencies to direct funds to the most significant area of need, support local economic recovery and ensure material donations do not detract from disaster recovery needs. 

Donors can help in the following ways: 

  • Provide unrestricted core funding for vetted humanitarian NGO partners that support the HRP. This is an efficient way to ensure the best use of resources in a coordinated manner. Funding the NGOs that have contributed to the HRP ensures that resources are directed to support the plan and use humanitarian partners’ best knowledge. 
  • Understand that recovery is possible in protracted and complex crisis settings. Even while focusing on immediate needs, remember that there are early and long-term recovery needs, too. We know that people who have been affected by shocks in complex humanitarian contexts can recover, improve their situation and build their resilience to withstand future shocks without waiting until the crisis is over, which may take years. Recovery is possible, and funding will be needed for recovery and resilience efforts alongside humanitarian funding. Recovery will take a long time, and funding will be needed now and throughout. 
  • Support institutional development of local and national civil society in Syria. Civil society was extremely underdeveloped and nascent in Syria before the crisis began, yet most of the humanitarian response is implemented by local groups formed in the last 10 years.  Supporting these newly formed local civil society actors with unrestricted operational support and capacity strengthening is critical to rebuilding Syria and helping communities recover.
  • Recognize there are places and ways that private philanthropy can help that other donors may not. Private funders can support nimble and innovative solutions that leverage or augment the larger humanitarian system response, either filling gaps or modeling change that, once tested and proven, can be taken to scale within the broader humanitarian response structure. Philanthropy can also provide sustainable funding to national and local organizations that support needed operational costs.

Fund resources

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Complex Humanitarian Emergencies

Complex Humanitarian Emergencies

CHEs involve an acute emergency layered over ongoing instability. Multiple scenarios can cause CHEs, like the civil wars in Syria and Yemen, the man-made political crisis in Venezuela, or the public health crisis in Congo.

Water, Sanitation and Hygiene (WASH)

Water, Sanitation and Hygiene (WASH)

Water is one of the most necessary elements for life, yet according to the World Health Organization/UNICEF, 2.1 billion people lack access to safely managed drinking water. In addition, 4.5 billion people lack safely-managed sanitation facilities. Water, sanitation and hygiene (WASH) principles are of tremendous concern in everyday life, but can be heightened during an emergency or disaster.

Earthquakes
Destroyed building Haiti earthquake 2021

Earthquakes

Striking without warning, earthquakes often are among the most devastating disasters. Caused by the movement of plates along fault lines on the earth’s surface, earthquakes often leave a monumental path of instant death and destruction.