No way out
SYRIA, 10 YEARS OF WAR

Syrian families displaced in Idlib province live in precarious conditions. The last opposition stronghold, Idlib is regularly the target of airstrikes launched by Syria’s government and its Russian ally. Left with nothing, most of the displaced shelter in insalubrious camps where Médecins Sans Frontières/Doctors Without Borders (MSF) provides assistance.

At the end of April 2019, Syrian military launches an offensive in the north of Hama. In late August, the fighting and advancing troops oblige 300,000 people to displace to the north of Idlib province.

On 15 February 2016, Syrian forces and their Russian allies bomb MSF supported hospital in Maarat Al Numan in Idlib. Four rockets hit the hospital in two separate attacks launched within minutes of each other, leaving 25 people dead and 11 wounded. It’s the third time the hospital has been targeted since the start of the war. This ‘double-tap’ attack strategy has been documented in other airstrikes on Syrian medical facilities. It consists in targeting them a second time, when the first responders are already on the scene tending to the victims of the first strike.

Meanwhile, on the other side of the country, the Islamic State group has reigned over Raqqa since seizing the city in March 2013. Raqqa’s inhabitants witness the rise of IS in Syria, until now confined to Iraq.

MSF secures guarantees of protection from IS to continue to treat people in Qabassin in Aleppo province, under the group’s control. However, the aid organisation soon realises that relations are deteriorating and its safety is no longer assured. In January 2014, following the kidnap by IS of five MSF staff, the international teams leave the region and medical assistance is organised from neighbouring countries.

In Raqqa, the civilian population has been living under the yoke of IS for four years.

In June 2017, the Syrian Democratic Forces (SDF) backed by the US-led international coalition air force launch a military offensive on Raqqa.

In the whole of June, MSF teams working in Kobanî/Ain al Arab hospital—a two and a half hour drive from Raqqa—treat just 64 war-wounded patients. Most arrive from the bombed suburbs, not the centre of the city. The majority have been wounded by landmines during their escape. The contrast between the violence of the offensive on a limited, surrounded area, and the few wounded casualties they treat is manifest. Groups of civilians manage to get out, but 30,000 to 50,000 are still inside. Cornered, IS’s fighters use the inhabitants as human shields. They’re grouped together in the old town where most of the fighting is concentrated.

The coalition launches intense airstrikes on the city, making no distinction between combatants and ordinary citizens and no plans for evacuating the civilians. An investigation by Amnesty International and Airwars later reveals the scale of the civilian fatalities: over 1,600 people are killed by coalition bombs during the offensive on Raqqa.

Trapped, every day Raqqa’s inhabitants endure IS’s summary executions and the coalition’s indiscriminate airstrikes. Those who do manage to survive are considered pro-IS and risk indefinite imprisonment without trial.

In 2015, the large number of people reported to have starved to death in Madaya, a besieged city in the Damascus region, is a harrowing indication of the horrendous consequences for civilians trapped by military strategies designed to prolong the sieges. Between October and December 2015, not one medical or food convoy is allowed into the city. The critically ill aren’t authorised for evacuation to a hospital, even when they’re at risk of dying. In besieged towns and cities the fighting rages on, leaving their inhabitants no respite.

On 27 April 2016, at the height of the Syrian government’s offensive on opposition-held east Aleppo, the district around Al Quds hospital comes under a deluge of fire. Ain Jalout school opposite is bombed in the evening. After the first strike, medical staff from Al Quds treat and transport the wounded to the hospital. Not long after, a second strike hits the house below where personnel from the hospital live.

A few minutes later, the emergency room entrance is bombed in a third strike, and after another five minutes, a fourth destroys the two top floors. The health facility has been treating large numbers of casualties wounded in five airstrikes on east Aleppo earlier in the day. 55 people are killed, and over 80 wounded.

The area’s health facilities are bombed every day for the next four days. In all, 14 medical facilities are hit in east Aleppo in April 2016. From July on, successive sieges prevent the city’s inhabitants from fleeing.

During the summer, the eight hospitals still open in east Aleppo sustain damage in airstrikes and shelling at least once. Four are hit several times—proof of the Syrian government's relentless attacks on rebel-held east Aleppo. The last medical aid convoy MSF teams manage to get through to the hospitals is in August. During the following months of uninterrupted siege, doctors trapped in Aleppo tell them about the shortages, their wish to be evacuated, their fear of the bombing, but also reprisals for accepting to deliver medical assistance in the area. The Syrian government and Russia announce the setting up of "humanitarian corridors" to enable the population to leave. However, afraid for their lives, few are ready to take the risk, particularly as several armed opposition groups prevent civilians from using them.

Part of the city is surrounded by government forces, and cut off from supply routes.

During years of war and displacements, Syrians fleeing the violence find themselves crowded into already overpopulated Idlib province hemmed in to the north by the Turkish border.

Each displacement and resettlement plunges them into greater hardship, and the economic crisis that hits the country in 2020 exacerbates their situation. In less than 12 months, the Syrian pound has lost 98% of its value against the US dollar. This is due to the crisis in Lebanon and devaluation of the Iraqi dinar, further compounded by the effects of the US-imposed sanctions and Covid-19 pandemic.

They’re still exposed to airstrikes, particularly during the Syrian government’s military offensives, even when they live in clearly identified displaced persons camps. On 20 November 2019, a missile destroys part of Qah camp set up in 2012 and sheltering 4,000 refugees. According to Idlib’s Health Department, 12 people, 8 of them children, are killed in the attack and 58 others wounded. Many families pack up for the umpteenth time and move to camps nearer the Turkish border. Qah’s maternity department is also damaged in the attack.

Living conditions are disastrous in the northwest of the country. In a region where 2.8 million people already depend on humanitarian aid for their basic needs—food, water, shelter, health care and education— every new military attack, every economic crisis affects directly a population left shattered by ten years of war and countless displacements.

Over 12 million people, more than half the population, have been displaced by the war in Syria. Among them, 5.6 million have taken refuge in other countries, primarily Turkey, Lebanon and Jordan, and Europe.