Once again, Syrians heard the roar and thud of buildings coming down, once again saw dust rising from the mounds of gray, jagged concrete and twisted metal where houses and offices had stood. Once again, people dug in the ruins with their hands, hoping, often in vain, to save the people they loved.
Across northwestern Syria on Monday, apartment blocks, shops, even entire neighborhoods were wiped out in seconds by a powerful earthquake, in scenes that were all too familiar to a region devastated by more than a decade of civil war. Millions of people displaced by the years of fighting have fled to the north, the only place that remains outside government control. They sheltered in tents, ancient ruins and any other place they could find after their former homes were destroyed.
The economic collapse the war brought on had made it impossible for many of them to get a decent meal. This winter’s fuel crisis had them shivering in their beds, without heat. Syria’s wrecked infrastructure had caused thousands to fall sick with cholera in recent months; the ruin of its hospitals meant many could get no health care.
Then came Monday’s earthquake.
“How can we tolerate all this?” said Ibrahim al-Khatib, a resident of Taftanaz in northwestern Syria who was startled from his sleep early in the morning and rushed into the street along with his neighbors. “With the Russian airstrikes, and then Bashar al-Assad’s attacks, and today the earthquake?”
Southern Turkey and a large area of northwestern Syria were hardest hit, leaving more than 3,800 dead in both countries with the toll likely to rise further. In Syria, where more than 1,200 people died, entire neighborhoods were leveled all at once, causing in just seconds the kind of devastation that the population had grown used to being meted out airstrike by airstrike, shell by shell.
At a hospital just outside Idlib, Syria, “every moment, fresh bodies were being brought in,” said Dr. Osama Salloum. One boy, estimated to be about 6 years old, died as Salloum performed CPR on him. “I saw the life leave his face,” he said.
“We kept looking up to the sky for jets,” Salloum said. “My mind was playing tricks on me, telling me it was war again.”
Mark Kaye, spokesperson for the International Rescue Committee, echoed many United Nations and aid groups’ pleas for more aid to be sent to Syria in the earthquake’s aftermath. “Anywhere else in the world, this would be an emergency,” he said. “What we have in Syria is an emergency within an emergency.”
Much of Syria still bears the scars of the conflict, which has been in a fragile cease-fire since early 2020. Faced with sanctions, no reconstruction aid from international donors and its own economy in shambles, rebuilding has been piecemeal and limited.
The war’s toll — massive destruction, an acute economic crisis, a collapsing currency — will make responding to the quake even more difficult for all sides.
Although emergency crews across the stricken area responded quickly, digging in the freezing cold and the rain, the scale of the destruction was too great even for rescuers accustomed to collapsed buildings.
There was not enough rescue equipment to keep up with the large numbers of people trapped in the debris. Buildings that survived the powerful 7.8-magnitude initial earthquake collapsed from the repeated aftershocks, reflecting the fragile state of Syria’s infrastructure after years of airstrikes and artillery bombardments.
In Aleppo, Syria, residents said people too afraid to stay in buildings that might yet collapse were camping in cars in open spaces such as soccer fields.
The northwestern corner of the country, along the border with Turkey, is controlled by Turkish-based opposition groups and home to about 4.6 million people. Tens of thousands of people in that area were newly homeless, said Raed Saleh, director of the White Helmets, a civil defense and rescue group that operates in areas outside government control.
Camps for those displaced by the war were full, already housing some of the 2.7 million people who had come to the northwest from other parts of the country.
Scenes from hospitals resembled those from the height of the fighting, as wards overflowed with patients sharing beds and doctors treating victims in every corner.
Even though major hostilities have ended, the health care system still has not recovered. Only about 45% of Syria’s prewar health care facilities are now operating, according to the International Rescue Committee.
Until now, there has not been any large-scale effort to rebuild Syria’s ruined infrastructure, something the government blames at least partly on Western sanctions.
Across the country, people had been reduced to a level of hardship that resembled some of the worst phases of the conflict, which began after Syrian President Bashar Assad tried to forcibly put down mass anti-government protests in 2011, inspired by the Arab Spring uprisings sweeping the region at the time. His Russian allies eventually intervened militarily, tipping the balance in his favor.
This winter, Syrians were burning trash and pistachio shells just to keep warm, showering only once a week and staying home from school and work for lack of gas to get them there. Some abandoned hot meals. Others sold their winter jackets to afford any meals at all.
In some places, electricity was down to less than an hour a day, rendering electric heaters and mobile phones useless. Water pumps at farms had gone still, pushing food prices up; the pumps were also not working in apartment buildings, leaving people to drink from contaminated sources.
Syria’s gross domestic product shrank by more than half between 2010 and 2020, according to the World Bank, and it was reclassified as a low-income country in 2018. The coronavirus pandemic caused yet more economic pain and strained the country’s health care system further.
Despite having all but won the war, the Assad government has been so short on cash in recent years that it has resorted to forcing wealthy business owners to help fund government salaries and services.
Amid the nationwide fuel shortage, Syria’s oil ministry announced Monday that it was sending additional supplies of gasoline and diesel to the affected provinces to help power the machinery needed for rescue operations and debris removal. The move highlighted how little fuel regions beyond Damascus, the capital, had been receiving in recent months, after the government heavily cut fuel subsidies.
All most Syrians knew was that the shortages had made even the most basic activities a nightmare, even before the earthquake struck.
No fuel meant little electricity, which meant little hot water for showering and few ways to cook or prepare hot tea, residents and an aid worker based in Damascus said. Trees in Damascus and Ghouta, an agricultural suburb nearby, were missing their branches as people cut them down to burn. Others burned industrial oil residue, the dregs left over after pressing olives for oil, tires, old clothes or simply trash they sent their children out to gather from the street. Homes rang with coughing caused by the fires.
Outside the house, life all but ground to a halt as taxis and public transportation shut down for lack of gas.
Schools closed or saw their students stay home because they could not turn the lights on or heat classrooms. The internet and mobile networks were down. Government offices were closed for two Sundays in December to save fuel; dozens of employees around Tartus, on Syria’s Mediterranean coast, resigned recently rather than spend their paychecks on getting to and from work, according to a journalist in the area who did not want to be named for fear of government retribution.
The journalist, his wife and their three children had taken to getting into bed as early as possible, around 6 p.m., just to keep warm.
The scarcity of fuel had combined with Syria’s crumbling water infrastructure to set off yet another crisis last year: a cholera outbreak. By mid-December, the United Nations said there were more than 60,000 suspected cases of cholera throughout the country.
Access to clean water was so limited that some Syrians reported giving up washing their hands to preserve drinking water or drinking directly from the polluted Euphrates River, according to a recent survey in northeastern Syria conducted by REACH, a humanitarian group focused on data collection; wallets were so empty that 82% of respondents said the majority of people where they lived could not afford a bar of soap.
“Public services were already at the point of collapse after 12 years of crisis,” said Emma Forster, a policy and communications manager for the Norwegian Refugee Council, who is based in Damascus. “People are saying it’s the worst year yet, including the years of war.”
Searching for victims and survivors amid the rubble of collapsed buildings on Monday in the village of Besnia in Idlib Province in northwest Syria. (Getty Image) 
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