Syrians face staggering needs amid insecurity and healthcare crisis

Wrapping up a visit to the country, Edem Wosornu, who heads operations and advocacy for the UN humanitarian affairs coordination office (OCHA) said that she could “feel the momentum for change” on the ground after years of suffering and hardship under the Assad regime ended with its overthrow last December.

But formidable challenges remain as 16.5 million Syrians require humanitarian assistance and protection, and needs are “staggering”.

Speaking from Gaziantep, a humanitarian hub in Türkiye just across the Syrian border, Ms. Wosornu noted an “encouraging trend of returns” since last December.

Over one million internally displaced people have come back to their areas of origin, she said, and more than half a million refugees have returned from neighbouring countries according to the UN refugee agency (UNHCR).

Devastated homes and opportunities

The OCHA official cited insecurity, damaged homes, inadequate services, lack of livelihood opportunities and the threat of unexploded ordnance as “key barriers” preventing people returning.

“People say, first and foremost they want security,” she stressed.

While the level of hostilities in the country has subsided, Ms. Wosornu said, localized tensions and clashes remain a “major concern”.

Remnants of heavy fighting pose a continued threat to civilians, said Dr Altaf Musani, the UN World Health Organization (WHO)’s Director of Health Emergencies.

He pointed to at least 909 casualties from unexploded ordnance since December 2024, including some 400 deaths – a majority of them women and children.

We’re starting to see the admission rates and consultation rates in emergency rooms increase… Children and women, going about their daily life, trying to get water, trying to get food, trying to rebuild,” are walking through agricultural land, roads and rivers where unexploded munitions could be hiding, he said.

Camp residents at highest risk

Diseases, such as cholera and acute watery diarrhoea, are spreading, Dr. Musani said, stressing that more than 1,444 suspect cases of cholera and seven associated deaths have been recorded.

“This is particularly in Latakia and Aleppo, particularly around displacement camps,” he said.

“We know that when cholera gets hold in camps, it can serve as a brush fire, increasing both morbidity and mortality.”

The WHO official warned that more than 416,000 children in Syria are at risk from severe malnutrition and that more than half of children under five suffering from severe acute malnutrition are not receiving treatment.

“From a public health standpoint, we need to be able to watch that risk and intervene and save those children,” he said.

Boys play in an informal camp in Syria.

Pregnancy dangers

Dr. Musani also noted that half of the maternity hospitals in northwest Syria have suspended operations since September 2024 owing to financial cuts, which humanitarians are “witnessing globally” but which are “really apparent” in Syria.

Underfunding of the humanitarian operation in Syria is already severe. Earlier this week, OCHA’s Coordination Division head, Ramesh Rajasingham, told the Security Council that out of the $2 billion required for the UN and its partners to reach eight million of the most vulnerable people from January through June 2025, only 10 per cent has been received.

The country’s cash-strapped health facilities face a lack of skilled workers and equipment, said WHO’s Dr. Musani. The war had pushed some 50 to 70 per cent of the health workforce to leave the country in search of other opportunities, and the health infrastructure is in dire need of investment.

The WHO official noted that for the health system – the “heartbeat of the nation” – the sanctions imposed on the country during the Assad regime had resulted in a lack of much-needed upgrades, compromising the purchase of new MRI machines, CT scanners, laboratory equipment and software upgrades.

Over the past two weeks, both the United States and the European Union have moved to lift the sanctions. OCHA’s Ms. Wosornu expressed hope that thanks to this development “we’ll see the impact on goods and services, on the cost of doing operations in the country, on the ability to move goods quicker into the country”.

But “it will take time”, she added. “I believe the people of Syria are hopeful that this will change their everyday lives.”

Home-bound Syrians find few of the basics needed to survive

Hopes rose last week in Damascus when fuel prices dropped instantly following Donald Trump’s move to end punitive sanctions.

But after more than 13 years of civil war that ended with the fall of the Assad regime last December, ordinary Syrians face an exhausting list of other problems.

These include an absence of housing – caused by bomb damage on a scale with Gaza – unreliable access to electricity, clean water, healthcare and work.

Refugee agency call

Since last December, half a million Syrians have returned home, many for the first time since the war began, according to the UN refugee agency, UNHCR.  

“We must ensure that people who return can stay and thrive: that is also why the lifting of sanctions is crucial, as reconstruction is urgently needed,” said High Commissioner Filippo Grandi, in an online message.

Today, transitional authorities govern Syria under President Ahmad al-Sharaa.  

‘Destroyed at all levels’

But the once-prosperous country remains scarred – “the infrastructure in Syria is almost completely destroyed at all levels,” said Hail Khalaf, Officer-in-Charge for Syria at the UN International Organization for Migration (IOM).

Mr. Khalaf, who spoke to UN News from the capital Damascus where electricity only comes on for four hours a day, confirmed that the protracted war had impacted Syrian society in its entirety – not least education.

“The impact of the removal of US sanctions on Syria was observed very quickly on the daily lives of Syrians,” he said. “There was an instant drop in fuel prices in Syria the moment the removal of sanctions was announced.”

“We hope that the American government will expedite the removal of the Caesar Act,” he stressed, referring to the sanctions package against the former Syrian Government signed into law by the first Trump administration in 2019.

Dilapidated economy 

Those returning to Syria and looking for a job in the agricultural sector in particular are confronted with an industry in shambles, IOM said in a report.

Farmers make up the great majority of those who were internally displaced by the fighting to camps. Most – 88 per cent – say they cannot work the soil again, as most farms are either operating at half-capacity or unable to function at all, according to IOM’s Displacement Tracking Matrix.

“The country is exhausted, and the economy is also exhausted,” explained Mr. Khalaf.

Today, more than 90 per cent of Syria’s population lives below the poverty line as of December 2024, according to UNHCR data.

The war uprooted around 7.4 million people inside Syria and at least six million are refugees, mainly in neighboring countries including Türkiye, Lebanon and Jordan, the UN agency noted.

Working at a loss

The national currency – the Syrian lira – has been exponentially devalued by the conflict.

Before the war, one US dollar was equivalent to 50 Syrian lira. Today it is worth about 9,000 Syrian lira – leaving livelihoods in disarray.  

“Most Syrians do not earn enough,” Mr. Khalaf explained. “In the public sector, most employees earn approximately $35 to $40 a month, which is not even enough for transportation between work and home.”

Missing paper trail

Gaps in civil documentation also complicate people’s ability to claim housing and land rights.

Damaged public infrastructure has also fuelled outbreaks of waterborne diseases, vaccine-preventable illnesses and malnutrition, aid teams have warned.

“Syrians are resilient and innovative, but they need significant help to rebuild their communities and their lives,” insisted IOM Director General Amy Pope.  

In a bid to help, UN agencies including IOM are working with the Syrian Government to “find a formula for action” and “sustainable solutions” for all returnees so that they can rebuild their lives again.

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