Truce crumbles in Syria’s last refuge, and residents fear the worst

One of the toughest things this Ramadan for Umm Mohammed, a widow now living in a displaced persons camp in Syria’s Idlib province without water or electricity, has been explaining to her young son and daughter that this year they will be unable to visit the grave of their father.

He was killed by regime forces in the early days of the Syrian civil war, and for the past seven years, on the Eid holiday that follows Ramadan, it has been the family tradition to visit him – one impossible to keep after their hometown in Hama province fell this month to government forces.

“War has deprived us of so many things,” she says. “My son was weeping last night because he will not be able to see his father’s grave this year. Even this simple dream has been snatched from my children by the army of [President] Bashar al-Assad.”

Such stories are commonplace in Syria, where more than half the population has either fled the country or endured repeated internal displacement. And ever since Russian-backed government troops began reclaiming territory from rebel forces, analysts have warned – and regime opponents have feared – that a final attack on Idlib would come.

For years, the province in northwestern Syria has been the last major refuge of rebel forces, their families, and civilians who had nowhere else to go. Hundreds of thousands of them fled to Idlib as opposition strongholds fell. Today, more than 3 million people are crowded into the province next to the border with Turkey, enduring jihadist rule even as they fear slaughter by forces loyal to Mr. Assad.

Now, a so-called de-escalation agreement brokered by Russia and Turkey has collapsed, and, on April 28, the Syrian army launched a campaign that residents in opposition areas in and around Idlib describe as the worst to date.

As the Syrian regime widens the scope of its operations, which have also affected parts of Hama and Aleppo province, civilians are flooding camps closer to the Turkish border, in the hope of finding relative safety. But with Ankara unwilling to play host to even more refugees, the border is closed.

Ursula Mueller, the United Nations assistant secretary-general for Humanitarian Affairs, told the Security Council Wednesday that heavy shelling and aerial bombardment since April 28 had killed more than 160 civilians and displaced some 279,000 people in northwest Syria, with attacks targeting markets, schools, hospitals, and sites for already displaced people.

Preparing for the worst

The fighting has continued despite the announcement of a cease-fire May 17. Its failure has reinforced the sense of abandonment among Syrians who have suffered only disappointment whenever they have placed their faith in international institutions and global or regional powers.

For now, the hoped-for revival of the de-escalation deal is the best shot at a semblance of peace amid dire humanitarian conditions. On the ground, activists capture the daily grind of horrors with shaky cameras and dogged determination that every name and face (when possible) will be remembered.

Yet analysts are quick to say the current offensive is likely not the final push, if only because the government is not yet ready.

The United Nations has warned that an all-out offensive in Idlib would create a humanitarian catastrophe of a magnitude that dwarfs the many bloody chapters of the conflict, possibly making Idlib the worst humanitarian crisis of the 21st century.

This apocalyptic scenario had been delayed by the tenuous deal that Russia and Turkey reached last September, laying the foundations for joint or coordinated patrols in a buffer zone separating regime from opposition forces and clearing that space of “terrorist groups.”

“Both Russia and Turkey had seemed committed to the maintenance of the deal right up until this most recent escalation,” says Beirut-based Sam Heller, senior analyst for the International Crisis Group, pointing out how Turkey had initiated patrols as recently as March. “Why precisely it [the government offensive] started and why Russia has lent its support to the Syrian army is less clear.”

Damascus, he says, aims to retake Idlib in the long term, but he doubts that is the goal now. “I don’t think that this is likely to be their current aim if only because the recapture of the entirety of Idlib would be a major lift militarily,” he says.

Scorched earth policy

But that’s little consolation for residents of Idlib.

Mustafa al-Haj Yousef, head of the Idlib civil defense, a rescue service commonly known as the “White Helmets,” says the Syrian regime is pursuing a “scorched earth” campaign in Idlib and Hama. The asymmetry of the conflict is evident in dynamics such as seven attack helicopters targeting villages of no more than 5,000 people – as was the case Tuesday.

Yet again the Syrian regime is serving up its lethal cocktail of air attacks, missiles, barrel bombs, and cluster munitions. There have also been unconfirmed reports of chemical attacks.

“There are many families that are still sleeping out in the open,” says Mr. Yousef. “For civilians who were able to find indoor shelter in buildings or caves, these shelters have turned into mass graves.”

The toll on the population in opposition areas is evident in a steady stream of grisly photos and footage: collapsed buildings, lifeless children and adults caked in dust or buried in rubble, body bag after body bag.

Mr. Yousef also notes it is spring harvest season in Idlib and that the Syrian regime is systematically obliterating wheat fields and other crops – a move consistent with its widely tested and consistently successful strategy of bombing and starving opposition hubs into submission.

“Every day we have at least 40 cases of agricultural storage facilities burning down,” he says. “Our people are working day and night to put out and contain the fires arising from direct hits to wheat fields and silos in the liberated areas.”

Before and after satellite photos from al-Habeet village in Idlib and the town of Kafr Nabouda in Hama show scorched orchards and olive groves, craters in the middle of fields and fires that appear to rage on. Kafr Nabouda is one of the front-line towns in northwest Syria and has changed hands several times in recent weeks.

Damascus defends the escalation as a necessary response to “terrorist breaches,” a reference to Idlib-based jihadists carrying out raids on neighboring government-held areas. Caught in the middle, as always, are the civilians.

Attacks on hospitals

The president of the Syrian American Medical Society (SAMS) is clear on what needs to happen in the wake of the third attack targeting a women’s hospital in the last few weeks. On Tuesday, a missile landed just 200 yards from the women’s facility in Atareb, forcing the hospital to downgrade its services to emergency women’s health services.

“Why anyone would target a women’s hospital is beyond me,” says Dr. Ahmad Tarakji. “The United Nations Security Council needs to establish a mechanism to investigate attacks on hospitals. Some sides may not want to have this, but that is the most ethical stand they can have in a conflict – to at least say we will protect hospitals.”

Targeting hospitals is a war crime under international law, but a total of 25 health care facilities have been attacked in the past month alone, according to the World Health Organization. It has about 1,800 medical personnel spread in hospitals and clinics across towns and villages in northwest Syria. The strategy has been to address medical needs where they arise in order to stabilize communities and prevent further displacement.

Being in the middle of it all comes at a cost – about 30% of the hospitals that have been hit in Syria are linked to SAMS. The organization has lost 35 members of its medical staff since the start of the Syrian conflict, one in the latest offensive.

Dr. Tarakji says he took part in talks with the United Nations to “de-conflict” hospitals, which involved sharing the coordinates of medical facilities. That risk was taken primarily for well-known hospitals and ones that had been hit in the past.

“For patients, for the physicians, this is their last line of security,” he notes. “If there is 1% chance that the missile will miss them and not hit them, they will take it. When they agreed to give the coordinates, that was based on trust that the U.N. would do something to protect them.”

That has not been the case. In order to ensure the safety of doctors and staff it also runs a handful of undisclosed hospitals in underground basements and caves. These too have been targeted by shelling but have been able to withstand the pressure, no small miracle in an area where activities at more than 49 medical facilities have been partially or fully suspended due to security concerns.

“The underground and cave ones have been effective in terms of protecting patients and staff,” Dr. Taraki notes. “We use them as backup hospitals.”

A chronicle

Yousef Qarbi in Ariha, which was pounded by Syrian war planes during noon prayers Monday, struggled to convey in words the magnitude of the suffering. He turned to videos and pictures instead – sharing first footage of the aftermath of the air strike in Ariha, showing a man rushing away with a child covered in dust as others came forward to help survivors.

Next up was a portrait of a relatively happy-looking redhead, his cousin who had come to Syria from Turkey to see his mother for Ramadan. That image was followed by a video of the same man’s body being washed for burial. Rescue workers were still searching for his cousin’s wife and a daughter, he said, sharing an image of the blast site, while he struggled to tell two surviving boys what had happened.

The day’s casualties also included his neighbors – a family of five, including twin girls whose last picture shows them smiling ear to ear, dressed in pretty shirts, hair swept up in tidy ponytails.

“What is the point of Turkey’s observation points [in Syria] amid all this bombing?” he asks depleted. “Turkey is now complicit in our suffering. Every day it witnesses the crimes committed against us and stays silent.”