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. As of Feb. 6, the earthquake had killed at least 3,000 people in Turkey and Syria, however, this figure is expected to rise. The hardest hit areas of Syria are in the country’s northwest, which will only worsen the humanitarian situation there. 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 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, there are calls for the international community to relax some of the restrictions on aid entering northwest Syria.
The country of Turkey is recognized in English as Türkiye by the United Nations.
(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.
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.
- 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.
- 12.1 million people are food insecure.
- Syria has the largest number of IDPs in the world with 6.8 million.
- 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 and Oct. 29, 30,219 suspected cholera cases were reported, including 85 attributed deaths. Suspected cholera cases have been reported from all 14 of Syria’s governorates.
- 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.
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.
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 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. 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.
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 Dec. 31, 5,456,945 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.
In November 2022, the humanitarians recorded 9,012 spontaneous IDP return movements across Syria, which is almost the same as the return movements that were tracked in October 2022. Of this figure, around 5,000 (55%) occurred within Dar’a and Rural Damascus governorates.
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 past six months with at least 10,000 more children now facing malnutrition than in the previous six months. The humanitarian organization’s staff reported a fourfold increase, from 256 to over 1000, in the number of malnourished children screened in its 19 nutrition centers in camps in northeast Syria and in community settings.
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.
In July 2022, the UN Security Council adopted a resolution to extend deliveries into northwestern Syria through the Bab Al-Hawa border crossing for six months. Ongoing renewal by the Security Council of this critical humanitarian access corridor is used as a political pawn by members of the Council, with regular threats to not adopt or veto the resolution.
On Jan. 9, the UN Security Council unanimously renewed the cross-border operation for another six months, 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.
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.
According to the northwest Syria Joint Market Monitoring Initiative (JMMI) in November 2022, the cost of the Survival Minimum Expenditure Basket in northwest Syria “is currently the highest recorded since JMMI monitoring began in 2016. This increase is largely attributed to the increase in the USD exchange rate which has risen steeply in the past three months affecting the price of key food items and transportation prices.”
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.
Between Aug. 25 and Oct. 29, 30,219 suspected cases have been reported, including 85 attributed deaths. Suspected cholera cases have been reported from all 14 of Syria’s governorates. The most affected governorates are Deir-ez-Zor (12,772 cases, 51.9%), ArRaqqa (5,965 cases, 24.2%), Aleppo (3,845 cases, 15.6%) and Al-Hasakeh (1,178 cases, 4.8%).
According to the UN Children’s Fund, “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. 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, the number of malnourished children in northeast Syria has increased by over 150% in the past 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 July, the northwest Syria cash working group distributed multipurpose cash worth $460,286, benefiting 28,569 people in Idleb and Aleppo governorates.
Cash assistance and in-kind assistance, including tents, winter clothes and blankets, are needed to protect people from harsh weather conditions.
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.
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 faces 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 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.
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 have resulted in reduced operational capacities, 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 Nov. 15, Syria had 57,382 cases of COVID-19 and 3,163 deaths. Challenges to increasing vaccination rates include the lack of electricity and infrastructure and waning interest in the vaccine.
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.
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.)
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.
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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 2022-2023 Humanitarian Response Plan (HRP) seeks $4.44 billion to reach 11.8 million people in need. Through October 2022, donors have funded 43% of the current 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.
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 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.
Drought is often defined as an unusual period of drier than normal weather that leads to a water shortage. Drought causes more deaths and displaces more people than any other disaster.