As Syria marks eight years of unrelenting crisis, fresh violence and growing aid shortages are prompting new waves of displacement in Idlib where some three million Syrians face an especially bleak and uncertain future.


Recent days have seen a new escalation in Idlib, with a string of attacks, including medical facilities such as hospitals, a paediatric centre, a blood bank; and an ambulance garage, all hit and damaged. A medical centre supported by Islamic Relief was among those affected, with windows blown in and rubble spraying across hospital beds over the weekend. Some attacks used what is known as the ‘double tap’ technique’ which means that after the first attack when people gather to rescue people from the rubble, a second airstrike targets these people.


Naser Haghamed, CEO of Islamic Relief, said: “The crisis in Syria is far from over and for more than three million people in Idlib there is still no end to this living nightmare.


“The unconscionable attacks this weekend were the worst we have seen in Idlib for months, affecting already beleaguered hospitals and health centres – and show us that we cannot ignore the people of Idlib.  They also destroyed a public bakery, which is providing desperately needed food, keeping struggling families alive.”


Across the country, more than 450 civilians are believed to have been killed since January, with dozens of casualties every day. February saw a noticeable uptick in deaths, with some 280 people killed including high numbers of women and children and some medical staff. Islamic Relief’s mobile emergency teams alone treated some 30 civilians who suffered war-related injuries in recent weeks.


Dwindling aid supplies and restrictions on humanitarian access are only fanning the misery with widespread shortages of food, shelter and medicine all hitting residents hard and promoting mass displacement as people move from village to village in search of safety and supplies.


In February alone, 40,000 civilians were forced to uproot once again in north-west Syria, often in freezing cold and rain. Despite a temporary truce coming into force in Idlib in September, more than 200,000 people have been displaced there in the six months since, according to Camp Coordination and Management cluster data compiled by the UN and a coalition of aid groups on the ground. Many of them have been displaced several times before, with 1.5 million people in Idlib already displaced from other parts of Syria.


Camps in Idlib – currently home to more than 190,000 people – are already bursting at the seams, with conditions deteriorating for many as aid dries up and the international community shifts its attention elsewhere.

Naser Haghamed added: “There are grave shortages of food and medicine and families continue to be displaced at a shocking rate. Some families have been displaced ten times or more during the eight years of crisis and some 40,000 are having to pick up and leave again just last month in the Idlib region.


“Every time a family has to move due to security risks, or because they do not have access to the most basic of services, they become poorer as well as more at risk of abuses like child marriage and forced recruitment by armed groups. Children often have to drop out of school, while the rest of their families struggle to get jobs and are torn apart from their support networks.


“After eight years, people in Idlib increasingly feel like the international community has forgotten about them. They have no idea what will happen to them next or when or if they will ever be able to go home or if they and their families will live to see an end to this barbaric crisis.”


People dying as hospitals and health centres lose vital funding 


While a truce agreement signed in September helped to reduce the violence in the north-western enclave, uncertainty remains, and people do not know if or when a fresh assault might begin.


Their ability to cope in the event of an escalation has been severely undermined by years of brutality that has seen many hospitals and health centres damaged, destroyed or forced underground in an attempt to protect their patients from bombs and bullets.


There is not enough medicine, with widespread shortages of certain kinds of antibiotics, cancer medications and drugs to treat heart and kidney diseases as well as many other ailments. There is often not enough clean water or electricity, all of which is making even routine surgery potentially deadly, with chronic shortages of anaesthetics meaning people often only receive partial pain relief during operations.


Many doctors and medical staff have fled the country, while those who remain are running on empty and are often not being paid, forcing them to charge patients for their treatment when they can barely afford to eat, let alone pay medical fees. Nor are those injured the only ones in dire need of medical support. Treatable diseases like pneumonia are rampant. Islamic Relief is also seeing a steady stream of children who are being injured and even killed by unexploded ordnance hidden in the rubble of destroyed homes and buildings where children play or search for goods in an attempt to make a meager income.


Um Kasem, a widow with five children who has been repeatedly displaced inside Idlib, said that ongoing displacement and a lack medical care were her biggest concerns and that she has no access to a doctor.


“We have been displaced seven times because of the war. Whenever we move somewhere, war arrives. We then kept moving between small villages – there were so many that I forgot their names. Sometimes, we were in an area for a month and we would have to move. We got very tired.


“The only place we can get medicine from is the pharmacy. We may recover in a year, or not at all. It all depends on what you can get at the pharmacy. There is no hospital that offers free treatment. There is no healthcare.

“I wish I could die and not be in need from any one. Death could be much better than this life. When you have to beg for food…what is the point of life?”


In 2018, Islamic Relief supported almost 150 medical staff like doctors and nurses as well as dozens of medical facilities, but the needs are deeply daunting. So far, five major hospitals and seven other medical facilities – including some focusing on pediatrics and obstetrics – have had to close entirely or severely cut back their operations due to funding cuts and the high cost of water and electricity. As one facility after another shuts its doors, the pressure only grows on those that remain.


Haghamed added: “There is a huge sense of panic now in Idlib as more health facilities are forced to close and people are dying or suffering in acute pain because they cannot get the treatment they need. Once again, it’s the beleaguered civilians who are finding themselves under attack on all fronts. Wherever they are and regardless of who is controlling them, people must have access to life-saving healthcare and the international community must step up to ensure that aid continues to reach those in crisis.”


Desperate situation putting children at risk 


Repeated displacement, combined with growing needs, has pushed families to the brink with many reporting that they are having to go hungry or sleep in leaky tents.


As incomes and living standards have collapsed, staff on the ground in Idlib have reported widespread use of child labour. Other coping mechanisms like early marriage, and even child recruitment, are also being seen as families struggle to earn enough money to feed themselves.


In one camp designated for displaced widows, Hadeel, a 12-year-old girl, said that some girls there had already been married off by their mothers because they were struggling to support them due to rising poverty rates and poor living conditions.


Children are also being put at risk of violence as they are forced to walk for miles to go to school as local schools have been destroyed or closed down due to teacher shortages.


Haghamed said: “The danger that children are facing every single day is completely unacceptable. They do not feel safe in their homes or tents. They do not feel safe on their way to, or at school and they do not feel safe about their future – fearing that if they do not fall victim to bombs or bullets they could end up forced into often dangerous types of child labour just to make ends meet.”


“Even as this need grows though, the situation in Idlib continues to fall further down people’s priority list. But we cannot allow this tragedy to unfold unnoticed and for children here to know nothing but suffering.

“The international community cannot look away as the children of Idlib and Syria have to face yet another year of violence, displacement and deprivation. We urgently need a lasting and durable peace solution for the whole of Syria.


“As EU member states gather in Brussels, Islamic Relief is calling for immediate humanitarian support to revive the economy and essential services so that people no longer have to go hungry, so that they can access basic health services and so that children no longer go to sleep terrified of whether they will wake up or not. Eight years of this is far too much already and we deserve to give all the people of Syria hope and dignity once again.”


Islamic Relief is doing what it can to provide food, education, health care, shelter water and sanitation and opportunities to earn a living for people in Idlib and are one of the last major international NGOs to still operate on the ground. We also provide extensive support to Syrian refugees in Lebanon, Jordan and Iraq, where millions have fled due to the violence.


Video and photo content, all shot in Idlib earlier this month – contact for access.




Notes to editors 


* Islamic Relief is one of the largest aid providers in Syria (and to refugees in Iraq, Jordan, Lebanon and Turkey) and continues to operate directly on the ground in Idlib.

* By the latest estimates, 6.2 million Syrians are living in protracted displacement in the country and 5.7 million have fled as refugees. Of the 6.2m displaced, 1.5 million, are in Idlib and surrounding areas.

* In 2018, we assisted almost 2.5m people across Syria with a range of services from health and education, to food and livelihood support.

* Since the start of the crisis in 2011, we have helped funded more than £278 million worth of aid and assistance to Syria and helped more than four million Syrians inside and outside the country.

*Cluster date via –


Casualty figures obtained via: 


[1] The Syrian Observatory for Human Rights recorded 188 civilian casualties in January and 281 people including 89 children and 49 women in February. /


The Syrian Network for Human Rights has put this figure higher, saying that in January 197 civilians, including two medical personnel were killed, while in February 246 civilians, including one media worker and six medical and civil defence personnel were killed –