The 7.8 magnitude earthquake that hit southern Turkey and northern Syria last week has compounded the devastating effects of a twelve-year-long civil war in Syria, particularly in the hard-hit northwest. Controlled primarily by Hayat Tahrir al-Sham, a coalition of armed groups formerly affiliated with al-Qaeda, Syrians in the northwest are under siege by the Syrian state, compounding a decade-plus of misery.

The regime of Syrian President Bashar al-Assad has effectively blockaded the region, which includes the city and governorate of Idlib, preventing the humanitarian aid that goes through Damascus from reaching the already-besieged area. Instead, basic necessities like fuel and medicine must come to the region through through Turkey.

The official death toll of the earthquake has reached more than 33,000 in both Turkey and Syria, though the actual number is undoubtedly much higher. In northwest Syria, cascading crises including a grueling civil war, internal displacement due to that war and to ISIS’s reign of terror, Russian bombings campaigns, the government’s blockade, ongoing conflict, and now a massive earthquake have brought untold suffering to the area.

“This is the perfect storm that I was worried about for a very long time,” Natasha Hall, a senior fellow with the Middle East Program at the Center for Strategic and International Studies, told Vox in an interview. “You have [a large portion of] 5 million people who have been dependent on emergency assistance for years now. About two-thirds of those have been displaced from other parts of Syria; about 80 percent have been displaced between six and 25 times.”

Some search-and-rescue operations have reportedly been suspended a week in, as groups like the White Helmets doubt any survivors remain. And the capacity to care for the survivors is restricted without massive inflows of foreign aid, experts told Vox. “Civil society is active in the sense of, whatever support they’re getting externally, whether from Europe or the US, and from Turkey that’s coming through Bab al-Hawa — that’s only one limited entry point,” Sahr Muhammedally, an expert in international humanitarian law and the protection of civilians in conflict, told Vox in an interview.

Confusion and fear regarding sanctions against the Assad regime, as well as a misunderstanding of the political situation prevents financial assistance and other aid from reaching the some of the people most affected by the earthquake, too.

“As [Assad’s] main international backers, the governments of Iran and Russia have tried hard to shift the blame for Syria’s economic woes from Assad’s role in destroying the country to the sanctions,” Wa’el Alzayat, the president of Emgage, a national Muslim voter mobilization and advocacy organization and a former State Department expert on Middle East policy, wrote in the Washington Post Friday. “While sanctions have certainly contributed to stunting government expenditures and the Syrian lira’s depreciation, they have had no significant bearing on the delivery of humanitarian assistance,” since the sanctions have humanitarian carve-outs that allow aid into Damascus.

The government’s siege is making the crisis much worse.

The Assad regime has recovered about 70 percent of Syrian territory after losing its grip on the country — first due to the revolution that began in 2011, then to ISIS. Some of the remaining territory, namely the northeast, is controlled by the Syrian Democratic Forces made up primarily of Syrian Kurds. The northwest is controlled by HTS as well as some Turkish-backed groups; HTS has controlled at least portions of the region since its formal split with al-Qaeda in 2017. The US government designated HTS a foreign terrorist organization (FTO) in 2018, as an addendum to the designation of the group’s predecessor, al-Nusra Front.

Whatever the group’s actual affiliation with al-Qaeda is, it does conduct violent actions in the region. Still, the regime’s blockade — a tactic of “starvation or surrender,” Muhammedally said — has led to cruel, humiliating conditions in Idlib. “This area is an open-air prison that is disconnected from everywhere else,” Zaher Sahloul, the president of the aid organization MedGlobal, told Vox in an interview. MedGlobal has teams on the ground in Gaziantep, the southern Turkish city close to the Syrian border that’s home to 462,000 Syrian refugees, as well as in northwestern Syria.

The armed groups in charge of the region “maintain limited civil and public functions, such as maintaining repairs of water systems, but they rely on humanitarian organizations to provide services,” Muhammedally said. “They don’t have the resources to fulfill the role that a government would play in providing essential services.”

Furthermore, Russian and regime forces have attacked civilian targets including hospitals, sanitation facilities — fostering ongoing cholera outbreak that started in the northeast — doctors, and civil defense organizations like the White Helmets, weakening the healthcare infrastructure. The regime has also cut off electricity to the region and stopped paying public workers’ salaries, so search-and-rescue operations and medical services are dependent on generators, which run on diesel fuel.

Groups like MedGlobal have built hospitals and clinics in more resilient spaces — in mountains and underground — as well as provided medical care and fuel for search-and-rescue operations, but the level of need is incredibly high and will only grow as time goes on, Sahloul said.

The question remains whether the rest of the world will step up to provide ongoing aid. “It’s a failure of the international community to just focus on emergency aid,” Muhammedally said. “Donor governments’ aid agencies need to look at this tragedy and say, ‘What needs to be done?’ Right now it’s emergency aid and response, but it has to move to an assistance form to make communities more resilient.”

We have to stop the politicization of humanitarian aid

Because the region is so conflicted, it’s led to confusion and politicization, both by the Assad regime and due to confusion over how sanctions against HTS and the regime apply to humanitarian assistance. That means that a region that is almost fully dependent on outside aid is only seeing a trickle come in — and what has entered so far isn’t even disaster aid, but rather resources that were already bound for northwestern Syria before the earthquake.

“The dependency on emergency aid becomes dangerous because funding is dwindling and if it’s only allowed because of a [UN] Security Council resolution, then it can be cut off by a veto in the Security Council,” Muhammedally said. Should Russia, for example, veto a future resolution to allow cross-border aid from Turkey to northwestern Syria — similar to what happened in July 2022 — it would be even more difficult to get critical aid to the region.

Some observers have called for an end to sanctions against Syria in order to get aid to people in need, but experts say that’s an incredibly misguided point of view.

“UN agencies work out of Damascus — all of them,” Hall said. “They get billions of dollars of funding, as do [international nongovernmental organizations] through European governments, the UK, and the United States, and that has been going on for the past 12 years, and even before that. So the sanctions are not connected to humanitarian assistance, there are waivers for humanitarian assistance, but the issue is more, banks and other countries being scared to operate in Syria because of the sanctions and because they’re worried about legal risk.”

The US on Friday issued an order extending general licensing agreement for humanitarian aid for six months. “It’s very broad and all-encompassing, and basically in response to the claims that the Europeans and the sanctions were prohibiting a proper response,” Hall said.

Eliminating sanctions against the regime, then, wouldn’t make a difference for people in northwest Syria, although clarifying the ability of banks and businesses’ ability to contribute to earthquake response is a positive step. Still, the disinformation campaign aimed at taking pressure off the Assad regime continues, despite the fact that, “They’re responsible for the horrors that have taken place for the past 12 years, and there have always been a way to get around sanctions for regime actors,” Muhammedally said.

Dealing with the immense politicization of humanitarian aid in this situation requires thinking creatively about alternatives, Sahloul told Vox. “Why not airlift medical supplies? We have American military bases not far from there, in northeast Syria,” which US forces have used in anti-terrorism operations. “If there’s a political will to help the people, don’t blame it on the bottleneck or the border crossing, do it yourself!”

But that’s exactly the problem, Sahloul said — the lack of political will to actually get aid to the millions of people in northwest Syria whom more than a decade of conflict, displacement, and terror have already deeply traumatized.

Ellen Ioanes

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