Northwestern Syria in the Time of Cholera, Earthquakes, and Environmental Degradation

In the aftermath of the earthquake in northwest Syria, humanitarian crises from water scarcity to displacement will only be exacerbated by climate change and political challenges. Regional and international negotiations need new frameworks to manage the disaster.

Key Themes

A decade of violent conflict has created widespread vulnerabilities throughout Syria, particularly in the northwest. However, delivering relief has been a considerable challenge, as concerns about normalization with President Bashar al-Assad’s regime have shaped how the international community has responded to the country’s crises.
The earthquake has shone a spotlight on many of these crises while producing new ones. It has contributed to the displacement of Syrians across the northwest, damaged critical infrastructure, worsened poverty, and created numerous public health concerns.
Syria’s concurrent environmental challenges have interacted with the earthquake to generate additional vulnerability. Syrians already faced issues relating to water scarcity, wildfires, reduced agricultural productivity, and public health concerns. The earthquake has amplified the impact of these crises and hampered local coping mechanisms.


Future peace talks in Syria must take climate change into account. Previous efforts have failed to address issues of environmental insecurity. All available venues should be explored in the pursuit of climate justice, with special regard for human rights.
Donors and international organizations should prioritize access to climate finance for local communities to resume agricultural activities and implement climate-resilient projects. Community-led innovations should be promoted as part of the humanitarian intervention to ensure that aid has a durable impact and is responsive to local priorities.
Disaster management and early-warning mechanisms that can predict and prepare policymakers and civilians for future natural hazards should be developed. Donors should invest in early-warning systems that are tailored to the specific needs and vulnerabilities of local communities.
Diplomatic and political pressure should be applied so that all parties to the conflict cease weaponizing aid and natural resources.


Northwestern Syria has become a paradigmatic example of acute vulnerability due to war, displacement, and natural disaster. Life conditions for internally displaced persons (IDPs) in Syria are increasingly deteriorating, as environmental threats have come to exacerbate existing water and food insecurity, acute poverty, and a public health crisis. Today, 15.3 million people across the country are in need of humanitarian assistance—4.1 million in the northwest alone. 1 As conditions for IDPs in the northwest worsen, the international community will have to address a number of complex challenges. What can be done to reduce environmental vulnerabilities for communities in the northwest? How can climate resilience in the aftermath of the earthquake be strengthened? And, amid such a dire humanitarian crisis, will political obstacles stymie humanitarian action?

To alleviate the plight of Syria’s IDPs, several measures are required. International actors and organizations involved in the Syrian recovery effort must pursue programs and policies that tackle the impact of climate and environmental insecurity holistically. This entails a triple-pronged approach: providing immediate relief to vulnerable populations, assessing and minimizing the effect of structural inequalities, and confronting the politicization of immediate recovery operations as well as longer-term aid.

Unfortunately, rather than building resilience among the most vulnerable, the current post-earthquake phase is paving the way for regime resilience and normalization—based on the very structural inequalities that accentuate environmental hazards while increasing the broader population’s vulnerability. Individuals and organizations linked to the United Nations (UN), as well as government agencies, must think critically about whether their programs entrench the status quo and empower elites or foster resilience among local communities faced with myriad environmental, social, and economic challenges.

Northwestern Syria and the Plight of IDPs

More than a decade of violent conflict and atrocities has produced widespread vulnerability in opposition-controlled northwestern Syria. This part of the country has experienced persistent hostilities, including air strikes and shelling by the Syrian regime and its Russian ally and military operations by rebel forces. Supported by Turkish soldiers on the ground, a Turkish-Russian ceasefire temporarily halted a Syrian government offensive launched in March 2020 to regain control of the northwest. 2

Today, much of northwest Syria remains separate from the part of the country governed by President Bashar al-Assad’s regime in Damascus, in what amounts to de facto cantonization. 3 Several actors vie for control over the northwest, notably rebel groups Hay’at Tahrir al-Sham (HTS), a coalition of northwest Syria–based insurgent groups that evolved from the Nusra Front, and Turkish proxy forces such as the Syrian National Army. Turkish proxies gained sway following the Turkish military’s operations against the Kurdish-dominated Syrian Democratic Forces in various parts of northern Syria. Still, the northwest specifically remains in flux, and active engagements between regime and rebel forces have generated what is now one of the direst humanitarian emergencies in the world.

The issue of Syrian sovereignty has complicated aid efforts. Under the pretense of respecting Syria’s sovereignty, Russia and China have at various times used their veto power in the UN Security Council (UNSC) to restrict humanitarian aid to Syria and to force operators to go through Damascus and its supply crossing lines. 4 Since 2020, three aid corridors (Bab al-Salam, Al-Yarubiyyah, and Al-Ramtha) have generally remained closed and have also been excluded from the scope of UNSC resolutions. 5 This has left Bab al-Hawa as the sole UN-authorized border crossing for aid.

Yet for humanitarian actors and countries such as the United States, working with HTS (which controls Bab al-Hawa and which was designated a terrorist group by the U.S. government in 2018) and violating international sanctions imposed on the Syrian government pose operational challenges. 6 In January 2023, it appeared as though these problems were overcome; the UNSC passed Resolution 2672, which allowed humanitarian aid to be sent to Syria via border crossings with Turkey for six months. This happened not a moment too soon, as the earthquake occurred the following month, devastating the livelihoods of many of northwest Syria’s 4 million people, of whom almost 70 percent are IDPs. 7 Because the earthquake caused damage to Bab al-Hawa, other crossings were reopened, creating a unique opportunity for increased access to northwestern Syria. 8 Additionally, the U.S. government issued General License No. 23, which allowed for the transfer of aid to Syria (in the form of earthquake relief) that would otherwise be prohibited by international sanctions. 9

When UNSC Resolution 2672 came up for renewal in July, however, Russia vetoed it. Shortly thereafter, the Syrian government offered to accept the continuation of aid entering Syria through Bab al-Hawa for another six months, but only on condition that all transfer of aid take place under its control, rather than that of the UN. In other words, the renewal of humanitarian aid would depend on the international community granting the Syrian government some form of direct access to opposition-held areas in the northwest.

Ultimately, two factors—the delicate political climate and the bargaining game played by Syria’s allies, a game that aims at the normalization of the Syrian regime—have limited the potential scale and efficacy of foreign aid efforts. The consequences for IDPs have been damaging, locking them in a cycle of interdependent threats to their economic, environmental, and public health security. IDPs occupy an especially precarious position in Syria. The absence of any legally binding international instrument relating to IDPs means that their needs are often overlooked. Because IDPs are persons who have not crossed international borders, it is their state of origin that is normatively responsible for their protection.

As the earthquake has made clear, administering humanitarian relief to IDPs requires delicately mediating state sovereignty with urgent action on the ground. Such has been the case in northwestern Syria, which has become a site of considerable internal displacement. At the close of 2022, the total number of IDPs in Syria was nearly 7 million, of whom 2.74 million resided in the northwest. 10 Since the earthquake, more than 100,000 IDPs (many from areas around Dana, Jandairis, and Afrin) have sought safety in informal settlements or newly established last-resort sites. 11 To date, 79 percent of IDP sites are already dangerously overcrowded. 12

In northwest Syria, vulnerability to hazards and crises are also partially attributable to the marginal nature of the region that IDPs inhabit. Many of the IDP settlements are located in unforgiving terrain, such as steep, rocky, and/or arid ground, with much of it susceptible to seasonal flooding. 13 In Idlib alone, 980,000 IDPs live in one of 818 informal settlements; elsewhere in the northwest, the cities of Harim, Azaz, and Jisr al-Shughour also contain a number of such sites. 14 These spaces are often ill-equipped when it comes to site planning, infrastructure, and the camp management systems needed to withstand hazards—whether health-related, environmental, or otherwise. In 2022, rain, strong winds, heavy snow, and freezing temperatures led to the destruction of thousands of IDP tents, creating even more dangerous conditions. 15

Environmental hazards have also intensified existing vulnerabilities among IDPs and residents in northwestern Syria over the past decade. Once abundant in tree cover, areas in the northwest, such as Idlib, have suffered catastrophic losses due to wildfires and deforestation. Though these fires are not unprecedented in northwestern Syria, nor in the eastern basin of the Mediterranean Sea at large, climate change has sparked an increase in their scale and frequency. 16 In 2020, fires destroyed more than 30,000 hectares of agricultural and forested land, leading to the loss of homes, livelihoods, and access to natural resources for more than 27,000 households. 17

For many, these losses exacerbated chronic poverty. Those whose access to energy and potable water was interrupted by the fires were forced to chop down remaining trees for heating and sheltering. 18 In addition to the arid conditions and rising annual temperatures that have increased the risk of wildfires, illegal logging and bombing campaigns have further worsened living conditions. 19 The result has been a steady worsening of ecological health throughout northwest Syria, with vegetation health having declined to extremely poor levels. 20

Also, the functionality of the health system is not spread evenly throughout the country. Healthcare facilities in regime-controlled areas have fared far better than those in the rebel-held northwest—a disparity worsened by the recent earthquake. 21 The lack of healthcare and supplies in areas outside the regime’s control has had a catastrophic effect on public health, particularly with attacks on healthcare and related infrastructure continuing to take place. Hospitals and clinics often find themselves unable to cope. In 2022, only 65 percent of hospitals and 56 percent of public healthcare centers were fully functional in Syria. 22 As a result, Syria was ill-equipped to deal with the earthquake. This was significant because although the quake’s epicenter was in Turkey, where upwards of 50,000 people (including 5,439 Syrian refugees) are estimated to have been killed, it also had a devastating effect on Syria, particularly the northwest. 23

Not Just an IDP Crisis: Food Insecurity, Water Shortages, and Environmental Challenges

The earthquake and its aftershocks led to the death of 4,540 people in rebel-held northwestern Syria and 1,414 in regime-held areas. One-third of the dead were children and women. 24 The number of persons displaced by the earthquake was 86,000, 25 and at least fifty-five health facilities and 599 schools were damaged or destroyed. 26 Economic losses have reached $5.1 billion, with Aleppo and Idlib alone accounting for $4.2 billion. 27 Nevertheless, with the earthquake having refocused international media attention on Syria (albeit to a lesser degree than on Turkey) following years of war-weariness, hope has risen in some quarters that the northwest’s crises might receive their due. There are several such crises aside from that of IDPs, and they predate the earthquake, even if some have been worsened by it.

Acute poverty has emerged as a particularly worrisome consequence of northwestern Syria’s political and environmental challenges. For households that receive relief from humanitarian organizations, 78 percent of residents and 80 percent of IDPs report that the aid received is not enough to cover all household members. 28 In response to these conditions, many families have found themselves obliged to borrow money, purchase essential items on credit, or send their children to work to supplement household income. 29 These decisions make families even more vulnerable and leave them in greater need of recovery assistance in the long run.

Water is another complex environmental challenge that has exacerbated vulnerability in northwestern Syria, both with regard to its excess (for example, flooding and erratic rainfall) and its scarcity (owing to drought and lack of potability). In the three-year span from 2019 to 2022, Syria’s annual water production plummeted from 1 billion cubic meters to 600 million cubic meters. 30 But, as is the case for other environmental insecurities, increased water scarcity in the northwest is not an exclusively natural phenomenon. While hot and dry conditions and historically low water levels in the Euphrates River are leading causes of water shortages, Syria’s water security has also suffered due to armed conflict, not least the deliberate attacks on, or manipulation of, key water infrastructure. 31

The Alouk water pumping station, which services up to 100,000 people in Al-Hol and other IDP camps, has been operating with interrupted service and at less than 50 percent capacity, due in part to foreign interference. 32 For example, beginning in early 2020, Turkish authorities repeatedly shut off water to 460,000 people in Hasakeh Governorate after seizing the Alouk pumping station as part of the Turkish military’s offensive against Kurdish forces. 33 The conflict’s impact on access to fuel for power plants and water supply systems generators has caused Syria’s water infrastructure to seriously underperform. 34

The earthquake has caused additional damage to Syria’s sewage and water treatment network. Six dams located within areas impacted by the earthquake, some of which already lack adequate structural integrity, have been affected by seismic activity, as evidenced by cracking in the Talul packwall dam. 35 Following intense rains that swelled the Orontes River on February 9, flooding of the Talul dam led to a new wave of population displacement, while service from the Maydanki dam in the north was severed. 36 In northwest Syria, water pumping stations in al-Khafsa and Ain al-Bayda have not been operational, forcing 184,000 people to rely on potentially unsafe water sources. 37

As a result, more than half of all Syrians (52 percent) and 79 percent of IDP camps lack access to piped water. 38 To compensate for the shortage, 73 percent of IDPs and 63 percent of residents in northwest Syria now rely on water that is trucked in from other areas of the country or across the border. 39 Yet this method is often cost-prohibitive, especially for those experiencing acute poverty. For households that are unable to reliably access safe water, there remains no option but to reduce daily water consumption. 40 In turn, the water crisis in northwest Syria has forced many Syrians to sacrifice daily hygiene practices and safe drinking habits, 41 thereby impairing maternal, infant, and childcare practices in the process. 42

Linked to water scarcity is food insecurity. In 2022, 12 million Syrians, roughly 54 percent of the population, were estimated to be food insecure. 43 Rates of severe malnutrition have doubled this year. 44 Prohibitive costs and a lack of access have had a particularly harsh effect on IDP communities, for which food expenditure makes up an average of 46 percent of household income. 45 Even with such high relative expenditure, 100 percent of IDPs living in camps are considered food insecure. 46

Low agricultural productivity has also contributed to food insecurity. Farmers in the northwest face several intersecting challenges: low rainfall, delays to agricultural activities, and increased production costs resulting from rising fuel prices. 47 They also have to navigate worsening water scarcity. For example, 40 percent of irrigated agricultural areas are no longer able to rely on the availability of water, forcing many to pump for water—raising operational costs even more. 48 That as much as 70 percent of cropland in the northwest has experienced acute agricultural stress during the last year has further strained an already fragile food system.49

Rainfall shortages and destruction to cropland by the ongoing conflict have caused agricultural production to diminish significantly. The size of areas suitable for harvesting barley decreased by 75 percent from 2020 to 2021, 50 and 12 percent of farmers reported decreases in the size of land given over to wheat production for the 2021–2022 season. 51 Vegetable production has also taken a hit. 52 As a result, farmers throughout the northwest have contemplated shifting to cash crop production, which has the potential to lower costs, lower irrigation needs, and facilitate higher selling prices. 53 However, such a shift would undercut Syria’s already limited agricultural production and render households throughout the northwest increasingly reliant on humanitarian relief to meet their dietary needs. The Rapid Damage and Needs Assessment of the World Bank estimated recovery and reconstruction needs across the six governorates affected by the earthquake at $7.9 billion, with the first post-quake year estimated at $3.7 billion and a further $4.2 billion needed over the next two years. The agriculture sector recorded the highest needs (27 percent), followed by housing (18 percent), social protection (16 percent), and transportation (12 percent). 54

Food insecurity is also a direct consequence of inaccessibility issues and low production rates, such as drastically reduced bread production. According to reports, in the whole of Syria 82 percent of bakeries and 80 percent of mills are only partially operational, 55 and only four out of fifteen surveyed silos are functioning normally. 56 While subsidies have improved bread production in the northwest since 2020, bread subsidies do not cover local standards for minimum bread quantity needs. 57 Indeed, even with subsidies, bread remains inaccessible to much of the general population. In Aleppo Governorate, subsidized bread meets only 53 percent of the local minimum daily needs of bread per individual; in Idlib Governorate, it covers only 11 percent. 58 As a result, the rate of severe acute malnutrition in the northwest has doubled to 1.7 percent since 2022. 59 Furthermore, the proportion of food-insecure Syrian families in Idlib now stands at 74 percent, the highest concentration in the country. 60

Consequent widespread hunger has led to serious concerns relating to nutritional health. The United Nations Office for the Coordination of Humanitarian Affairs (OCHA) reports that 3.8 million children need lifesaving nutrition assistance in Syria. 61 And in the northwest, acute malnutrition levels have grown in recent years and now stand at 5 percent. 62 Malnutrition levels have also seen a worrisome spike due to an increased frequency of diarrhea among children. For already malnourished children, diarrhea can intensify the effects of malnutrition, decreasing their appetite and reducing their ability to absorb essential nutrients. 63 OCHA has found that over 50 percent of children with moderate to severe malnutrition suffer from diarrhea—the highest level ever reported in Syria. 64 Data have also shown that the growth of more than a quarter of Syrian children under five has been stunted. 65

In conjunction with water and malnutrition, the rise of communicable and water-borne diseases threatens Syrians in the northwest. As a result, cholera, measles, mumps, polio, tuberculosis, typhoid fever, acute diarrhea, hepatitis A and E, and leishmaniasis have spread and placed further strain on already vulnerable communities. 66 Areas in Aleppo Governorate (such as Manbij, Jebel Saman, and Azaz) and Idlib Governorate (for example, Harim, Jisr al-Shughour, and Ariha) have reached severe levels of waterborne disease spread. The principal cause was contaminated water supplies and poor sanitation, both consequences of the water crisis that has afflicted the northwest. 67 The risk of exposure to waterborne disease is especially high in IDP living spaces, which see a combination of poor drainage and persistent stagnant water. 68 Given that most water stations are either suspended or functioning without disinfection in the Aleppo and Idlib Governorates (64 percent and 49 percent, respectively), 69 the risk of further spread of disease remains high.

Indeed, the recent cholera outbreak in northwest Syria has confirmed this fear. Since the new year, there have been more than 61,075 suspected cases of cholera. 70 Contaminated food and water sources and poor sanitation are the leading drivers of the spread, with Syria’s health systems entirely overwhelmed. 71 As it stands, there are only seven functioning cholera treatment centers or units in Aleppo and Idlib Governorates, with a total of only 252 beds available to treat patients. 72 The deterioration of the public health situation—caused by increases in preventable, waterborne disease—has brought additional focus to the scale of relief that is needed in Syria, as mitigating health risks to displaced populations remains an unresolved challenge.

Syria’s public health crisis has also had a disproportionate effect on women’s health. Maternal mortality rates have risen across the country since the beginning of the crisis, rising from 49 deaths per 100,000 live births in 2010 to 68 per 100,000 in 2016. 73 Over the same period, the prevalence of anemia among women of reproductive age grew to 33.6 percent. 74 The gendered effects of the public health crisis are a direct consequence of economic precarity and the destruction of public infrastructure.

How to Remedy the Desperate Situation in Northwestern Syria

The earthquake has exacerbated many of the insecurities experienced by IDPs, in addition to producing new ones. Yet it is not too late to tackle the intertwining crises plaguing the northwest, in part because of the renewed attention paid to the region following the earthquake itself.

To do this, international organizations and donors must start by increasing the relief they provide to vulnerable communities. The latter are displaced and exiled, subjected to intensive air strikes, at the mercy of severe groundwater and air pollution, and suffering from deadly diseases—sometimes all at once. They require immediate and transparent communication and intervention to ensure their resilience and survival. But it is crucial that international organizations and donors also look at the larger equation and factor into their aid calculations the structural inequalities at play, especially when the northwest is compared to regime-held Syria. Finally, these organizations and donors must confront the politicization of aid and recovery operations, particularly by the Syrian regime and its allies. By adopting such an approach, the concerned parties can remedy both the immediate and the long-term water, food, and health insecurities of the most vulnerable populations and even facilitate a green reconstruction process that accounts for gender disparities.

The earthquake has raised public health concerns that must be addressed in the current recovery phase. In this regard, support for Syrian medical organizations on the ground is imperative. Examples of organizations worthy of support include AlSeeraj, the Syrian American Medical Society, the Union of Medical Relief and Care Organizations, Idlib Health Directorate, and MedGlobal. Moreover, humanitarian corridors must be opened so that critical health cases can be transferred outside Syria for medical care. Additionally, the distribution of vaccines remains a priority for local healthcare providers, namely the Early Warning Alert and Response Network, led by the Assistance Coordination Unit.

Recovery efforts aside, the international community should support efforts to develop disaster management and early-warning mechanisms that can predict and prepare policymakers, civilians, and IDPs for future natural hazards. Such systems must be developed in collaboration with local communities to ensure that risk-reduction activities are tailored to specific vulnerabilities. For example, they are especially important for women and girls, who often suffer disproportionately in the aftermath of natural hazards. Providing direct support to IDP- and women-led organizations, such as Women Now for Development, can ensure that gendered experiences of climate insecurity are integrated into climate resilience planning.

The earthquake has highlighted the link between environmental and political issues. Efforts to resolve the Syrian conflict and promote post-conflict reconstruction in Syria must incorporate climate-centered development. Indeed, sustainable peace in the country is not possible unless environmental threats are taken seriously. Climate justice is integral to this work, and the international community should encourage accountability for Syria’s environmental and human degradation. To do so, it can promote independent monitoring mechanisms, such as a special rapporteur for green reconstruction. Syrian civilians have an impressive track record of pursuing justice for crimes committed during the past decade. Climate justice and accountability efforts should seek to optimize such mechanisms.

In addition to encouraging climate justice, donors and international organizations can play a critical role in developing Syria’s climate resilience. This effort could be sustained by reshaping aid priorities to increase climate-forward and climate-conscious programming. To ensure that help reaches the most vulnerable, international organizations should also support grassroots efforts, which are more attuned to local dynamics and needs. This will lead to community participation and knowledge-sharing between local and international actors. Participatory monitoring and evaluation frameworks should also be developed to track the progress and effectiveness of environmental projects.

Another way to achieve the objective of human and climate resilience is to improve access to green finance. Creating pathways to multiyear core funding and microcredit can help local actors, farmers, and humanitarian organizations implement climate-resilient projects in the service of IDPs. The Syrian government joined the Paris Climate Agreement in 2017 and received funding from the Green Climate Fund, 75 yet this left the opposition-held northwest without any support. Donors and UN agencies must not separate the human rights situation in Syria from environmental concerns and should instead leverage funding to prioritize the human security of those most vulnerable. Unless their actions are subject to scrutiny, state elites will continue to engage in greenwashing at the expense of accountability and justice.

To address water security issues in Syria, greater collaboration should be fostered between local and international organizations. Organizations such as the Syrian Water Resources Platform and the Assistance Coordination Unit are leading coordination efforts between actors on the ground, while facilitating collaboration with international initiatives. Such work must be supported while applying political pressure to end the weaponization of water by all parties to the conflict.

With regard to food insecurity, several avenues can pave the way for restoring the farming sector and reducing malnutrition in northwest Syria. Financial support is needed to help local organizations such as the White Helmets remove unexploded ordnance from contaminated farms and agricultural land and to protect agricultural land from wildfires. The release of immediate, flexible, and long-term funding to the efforts led by the Syria Recovery Trust Fund, which implements recovery and rehabilitation projects, would also provide meaningful support to local farmers across northern Syria.

Finally, the recent earthquake has revealed the extent to which recovery operations continue to serve as a bargaining chip in the hands of the Syrian government and its major ally Russia. In response to the blockade of humanitarian aid by the Syrian government and the growing need for such aid in opposition-held areas, the UNSC adopted Resolution 2165 in 2014, enabling the UN to deliver aid to Syria through four designated border crossings without seeking permission from the Syrian government; simply informing the latter of operations would suffice. The four crossings included the Bab al-Hawa and Bab al-Salam crossings from Turkey, which facilitate aid delivery to northwestern Syria; Al-Ramtha crossing from Jordan, which provides access to southern Syria; and Al-Yarubiyya crossing from Iraq, which enables aid delivery to northeastern Syria. 76

The situation changed in 2015 when Russia launched massive military operations in support of the Syrian regime and began politicizing the delivery of aid to opposition-held areas by repeatedly using its veto power to block the renewal of Resolution 2165 at the Security Council. 77 Later, both Russia and China conditionally approved the renewal of the resolution, but on conditions that Al-Yarubiyya and Al-Ramtha crossings be shut down permanently and that Bab al-Hawa and Bab al-Salam crossings remain operational for only six months of the year. 78 Russia also sought to establish additional crossing lines through Damascus as entry points for aid delivery in order to gain control over the humanitarian aid distribution process. 79 If measures such as economic sanctions are not taken to penalize actors who engage in such weaponization of aid, the reprehensible practice will continue to hinder the recovery and jeopardize the resilience of millions of civilians in northwest Syria.


Northwest Syria is a microcosm of the multifaceted hardships experienced by IDPs following more than a decade of war in the country. The earthquake has compounded their tragedy, as well as the northwest’s other crises. A responsible and proactive response to the overall dismal situation would entail a holistic approach to immediate relief and long-term recovery, given the region’s limited access to safe water resources, the collapse of its agricultural sector, and the Syrian regime’s bombardment of its health infrastructure.

However, if recent history is any indication, the international community is unlikely to adopt robust measures in this regard. It has been at best passive and at worst criminally complicit in abandoning Syrian civilians to their fate, especially children faced with a lifetime of poverty, hunger, and disease. The forcible return of Syrian refugees to Syria, which Turkey and Lebanon have already embarked upon, has elicited little international concern and even less action. As the international community shifts to other priorities, even the question of aid entering northwestern Syria has become uncertain and, increasingly, a bargaining tool in the hands of many, including Turkey. 80 Given the successful weaponization of aid and recovery operations by the Syrian government, its allies, and neighbors, the likeliest scenario is that assistance will come at the price of normalization with the Assad regime, which is trying to acquire regional and international legitimacy in exchange for allowing humanitarian access to the country and paying lip service to climate adaptation. 81

Indeed, the regime has already been rehabilitated by previous foes such as Saudi Arabia, Turkey, and the United Arab Emirates, which officially invited Syria to attend the COP28 international climate conference scheduled to take place in November in Dubai. This occurred in the context of a recent rapprochement between Iran and Saudi Arabia. In this scenario, the intrinsic needs of local populations, whose livelihoods continue to be shattered by human-made and natural disasters alike, will be of secondary importance. The human toll, in the end, will probably continue to be borne by the most economically, politically, and environmentally vulnerable—the internally displaced population of northwest Syria. 82


The authors would like to convey their sincere thanks to Adam Al-Daher for his extensive research in support of this paper.


1 United Nations Office for the Coordination of Humanitarian Affairs (OCHA), “Humanitarian Needs Overview: Syrian Arab Republic,” 2023,; and OCHA,” North-West Syria Situation Report,” April 2023,

2 Vladimir Isachenkov and Suzan Fraser, “Russia, Turkey Reach Cease-Fire Deal in Northwestern Syria,” AP News,March 5, 2020,

3 Armenak Tokmajyan and Khedder Khaddour, “A Fractured Border: Syria, Türkiye, and Cantonization,” Malcolm H. Kerr Carnegie Middle East Center, March 27, 2023,

4 UN, “Speakers Debate Terms, Merits of Cross-Border Aid Operations in Syria’s North-West, as General Assembly Considers Security Council Text Vetoed by Russian Federation,” July 21, 2022,

5 Information Management and Mine Action Programs (iMMAP), “Northwest Syria January 2023 Context Update,” 2023,, 4.

6 U.S. Department of State, “Foreign Terrorist Organizations,” Bureau of Counterterrorism, accessed July 18, 2023,

7 Natasha Hall, “Rescuing Aid in Syria,” Center for Strategic and International Studies, February 14, 2022, public/publication/220214_Hall_Rescuing_Aid_Syria.pdf?VersionId=L_U.TWZsv4VvgD7jVGcDhLsDSt4l7_HM.

8 UN, “Statement by the Secretary-General—on Opening of Crossing Points,” February 23, 2023,

9 U.S. Department of the Treasury, “Treasury Issues Syria General License 23 to Aid in Earthquake Relief Efforts,” press release, February 9, 2023,

10 Internal Displacement Monitoring Centre (IDMC), “Syrian Arab Republic Displacement Data,” 2021,; and Global Shelter Cluster, NorthWest Syria Hub, “SNFI Factsheet NW Syria April 2023,” June 1, 2023,

11 IMPACT Initiatives, “Türkiye and Syria | Emergency Response Activated Following Two Powerful Earthquakes,” March 14, 2023,

12 OCHA, “Humanitarian Needs Overview: Syrian Arab Republic,” 2023, 49.

13 REACH, “Syria South Dana Sub-District | Idleb IDP Camps and Informal Sites Flood Susceptibility and Flood Hazard,” 2021,, 3.

14 OCHA, “Humanitarian Needs Overview: Syrian Arab Republic,” 2023.

15 OCHA, “Humanitarian Needs Overview: Syrian Arab Republic,” 2022,, 13.

16 International Federation of Red Cross and Red Crescent Societies, “Final Report Syria /MENA: Wildfires,” 2020,, 1.

17 International Federation of Red Cross and Red Crescent Societies, “Final Report Syria /MENA: Wildfires,” 1.

18 Roba Gaafar, “The Environmental Impact of Syria’s Conflict: A Preliminary Survey of Issues,” Arab Reform Initiative, 2021,, 7.

19 Azzam Daaboul, “Looting, Burning, Cutting: How a Decade of War Has Shrunk Syria’s Forests,” Syria Direct (blog), September 29, 2020,; and Gaafar, “The Environmental Impact of Syria’s Conflict: A Preliminary Survey of Issues,” 7.

20 Food and Agricultural Organization of the United Nations (FAO), “GIEWS, Earth Observation, Syrian Arab Republic,” 2023,

21 Aula Abbara et al., “The Health of Internally Displaced People in Syria: Are Current Systems Fit for Purpose?,” Journal of Migration and Health 6 (summer 2022):, 3.

22 OCHA, “Humanitarian Needs Overview: Syrian Arab Republic,” 2022, 6.

23 Syrian Network for Human Rights, “Third Update on the Death of Syrians Who Died as a Result of the Earthquake and Humanitarian Assistance Deficiencies,” March 28, 2023,

24 Syrian Network for Human Rights, “Third Update on the Death of Syrians Who Died as a Result of the Earthquake and Humanitarian Assistance Deficiencies.”

25 OCHA, “North-West Syria 2023 Earthquake: Situation Overview in North-West Syria,” March 8, 2023,

26 World Bank, “Global Rapid Post-Disaster Damage Estimation (GRADE) Report, February 6, 2023 Kahramanmaraş Earthquakes, Türkiye Report,” February 27, 2023,

27 World Bank, “Earthquake Direct Damage in Syria Estimated at $5.1 Billion in Areas Already Severely Ravaged by Long Conflict and Displacement,” press release, 2023,

28 REACH, “Humanitarian Situation Overview of Syria,” 2022,

29 REACH, “Humanitarian Situation Overview of Syria.”

30 United Nations Development Programme, “Syrian Arab Republic: Access to Electricity and Humanitarian Needs,” 2022,, 3.

31 Marwa Daoudy, “Water Weaponization in the Syrian Conflict: Strategies of Domination and Cooperation,” International Affairs 96, no. 5 (fall 2020): 1347–1366; and Marwa Daoudy, “Syria’s Human Security Is Inseparable from Its Environmental Security,” The Century Foundation, December 14, 2020,

32 OCHA, “Critical Response and Funding Requirements—Response to the Water Crisis in Syria (August 2022),” September 15, 2022,, 10.

33 Amberin Zaman, “Turkey-Backed Syrian Forces Accused of Cutting Water to Syrian Kurdish-Run Region,” Al-Monitor, February 25, 2020,

34 OCHA, “Humanitarian Needs Overview: Syrian Arab Republic,” 2022, 8.

35 IMPACT Initiatives, “Türkiye and Syria | Emergency Response Activated Following Two Powerful Earthquakes,” February 6, 2023,

36 IMPACT Initiatives, “Türkiye and Syria | Emergency Response Activated Following Two Powerful Earthquakes,” February 6, 2023.

37 OCHA, “Humanitarian Needs Overview: Syrian Arab Republic,” 2022, 27.

38 OCHA, “Humanitarian Needs Overview: Syrian Arab Republic,” 2023, 5.

39 OCHA, “Humanitarian Needs Overview: Syrian Arab Republic,” 2023, 114.

40 OCHA, “Critical Response and Funding Requirements—Response to the Water Crisis in Syria (August 2022),” 11.

41 OCHA, “Critical Response and Funding Requirements—Response to the Water Crisis in Syria (August 2022),” 11.

42 OCHA, “Critical Response and Funding Requirements—Response to the Water Crisis in Syria (August 2022),” 23.

43 OCHA, “Humanitarian Needs Overview: Syrian Arab Republic,” 2023, 5.

44 OCHA, “Humanitarian Needs Overview: Syrian Arab Republic,” 2022, 41.

45 OCHA, “Humanitarian Needs Overview: Syrian Arab Republic,” 2022, 36.

46 OCHA, “Humanitarian Needs Overview: Syrian Arab Republic,” 2023, 95.

47 iMMAP, “Mapping of Wheat-to-Bread Processing Facilities,” 2021,, 6.

48 OCHA, “Humanitarian Needs Overview: Syrian Arab Republic,” 2022, 21.

49 FAO, “GIEWS, Earth Observation, Syrian Arab Republic.”

50 OCHA, “Humanitarian Needs Overview: Syrian Arab Republic,” 2022, 21.

51 iMMAP, “Mapping of Wheat-to-Bread Processing Facilities,” 2022,, 6.

52 World Bank, “The Mobility of Displaced Syrians: An Economic and Social Analysis,” 2020,, 81.

53 iMMAP, “Mapping of Wheat-to-Bread Processing Facilities,” 2021, 11.

54 The World Bank, Syria Earthquake 2023: Rapid Damage and Needs Assessment (RDNA), 2023,

55 iMMAP, “Mapping of Wheat-to-Bread Processing Facilities,” 2021, 1.

56 iMMAP, “Mapping of Wheat-to-Bread Processing Facilities,” 2021, 2.

57 iMMAP, “Mapping of Wheat-to-Bread Processing Facilities,” 2021, 3.

58 iMMAP, “Mapping of Wheat-to-Bread Processing Facilities,” 2022, 3.

59 OCHA, “Humanitarian Needs Overview: Syrian Arab Republic,” 2023, 41.

60 OCHA, “Humanitarian Needs Overview: Syrian Arab Republic,” 2023, 96.

61 OCHA, “Humanitarian Needs Overview: Syrian Arab Republic,” 2022, 30.

62 OCHA, “Critical Response and Funding Requirements—Response to the Water Crisis in Syria (August 2022),” 23.

63 OCHA, “Critical Response and Funding Requirements—Response to the Water Crisis in Syria (August 2022),” 23.

64 OCHA, “Critical Response and Funding Requirements—Response to the Water Crisis in Syria (August 2022),” 23.

65 World Bank, “The Mobility of Displaced Syrians: An Economic and Social Analysis,” 123.

66 Early Warning Alert and Response Network (EWARN), “Water-Borne Diseases and Water Stations’ Status,” 2023,; and World Bank, “The Mobility of Displaced Syrians: An Economic and Social Analysis,” 123.

67 OCHA, “Critical Response and Funding Requirements—Response to the Water Crisis in Syria (August 2022),” 23.

68 REACH, “Syria South Dana Sub-District | Idleb IDP Camps and Informal Sites Flood Susceptibility and Flood Hazard,” 3.

69 EWARN, “Water-Borne Diseases and Water Stations’ Status.”

70 World Health Organization (WHO), “Cholera Response Tracking Dashboard 2022–2023 Northwest Syria,” 2023,

71 WHO and OCHA, “Whole of Syria Cholera Outbreak Situation Report No. 12 Issued 31 January 2023,” February 5, 2023,, 3.

72 WHO, “Cholera Response Tracking Dashboard 2022–2023 Northwest Syria.”

73 World Bank, “The Mobility of Displaced Syrians: An Economic and Social Analysis,” 120.

74 World Bank, “The Mobility of Displaced Syrians: An Economic and Social Analysis,” 100.

75 United Nations Treaty Collection, “Paris Agreement,” United Nations Framework Convention on Climate Change, Conference of the Parties, Paris, December 12, 2015,; and Green Climate Fund, “Syrian Arab Republic,”[]=field_date_content:2023.

76 United Nations, “With Millions of Syrians in Need, Security Council Adopts Resolution 2165 (2014) Directing Relief Delivery Through More Border Crossings, Across Conflict Lines,” meetings coverage, July 14, 2014,

77 United Nations, “Security Council Rejects 2 Draft Resolutions Authorizing Cross-Border, Cross-Line Humanitarian Access in Syria,” December 20, 2019,

78 Natasha Hall, “The Implications of the UN Cross-Border Vote in Syria,” June 4, 2021,

79 Hall, “The Implications of the UN Cross-Border Vote in Syria.”

80 Tokmajyan and Khaddour, “A Fractured Border: Syria, Türkiye, and Cantonization.”

81 Reva Dhingra, “Syrian Refugees Face a Grim Future Without International Policy Shifts,” Brookings Institute, May 2, 2023,

82 Joey Shea, “UAE Invites Syrian President Bashar al-Assad to COP28,” Human Rights Watch, May 18, 2023,

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