Syria Humanitarian Crisis

• In 2023, 15.3 million people in Syria require humanitarian assistance, including 7 million children and 4.5 million women. For the first time, Syrians living across every sub-district are experiencing some degree of humanitarian stress.
• In Syria, 8.8 million people live in areas most affected by the earthquake. Overall, 170 sub-districts in 43 districts in 10 of Syria’s governorates were impacted by the earthquake.
• At least 10,600 buildings have been completely or partially destroyed in northwest Syria. In Aleppo alone, around 3,500 buildings are damaged and need structural repair and 700 buildings are classified as unsafe.
• According to the World Bank’s Global Rapid Post-Disaster Damage Estimation Report for Syria, direct damages from the earthquakes are estimated at $5.1 billion.
• The World Bank estimates that Syria’s real gross domestic product will contract by 5.5% in 2023 following the February earthquakes. Due to the earthquakes, around 170,000 workers have lost their jobs, leaving about 725,000 people directly affected.
• 12.1 million people are food insecure. Acute malnutrition among children is growing.
• Syria has the largest number of IDPs in the world with 6.8 million. There are more than 2.74 million IDPs in northwest Syria alone with 1.9 million living in camps.
• The World Bank estimates more than 50% of Syrians live in extreme poverty. Before the conflict, extreme poverty in Syria was virtually non-existent.
• Between Aug. 25, 2022 and Feb. 15, 2023, 92,649 suspected cases of cholera have been reported from all 14 governorates, including 101 associated deaths to date at a case fatality rate of 0.11%.
• The United Nations (UN) says that between March 2011 and March 2021, more than 350,000 people were killed in the Syrian conflict. However, the number of people killed is believed to be higher. The Syrian Observatory for Human Rights documented more than 494,000 fatalities during this same period.

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.

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.

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. 

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.

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. Cross–border 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.

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.