The humanitarian crisis in northwestern Syria has largely disappeared from news headlines in recent weeks, yet people uprooted by recent fighting continue to face dire conditions. On March 5, 2020, the governments of Turkey and Russia agreed to a ceasefire in Syria’s northwestern Idlib province, where months of bombing, shelling, and ground offensives by the Syrian government and its allies have displaced nearly a million people. While both the intensity of the fighting and the scale of population movements have decreased in the weeks since, the desperate situation of Syrians forced to flee has not changed.

“The recent ceasefire in northwest Syria doesn’t mean that living conditions in all these camps have improved or that people have returned back to their home,” said Cristian Reynders, Doctors Without Borders/Médecins Sans Frontières (MSF) field coordinator for northwestern Syria. “On the contrary—not only do almost a million people still live in the cold today, many do so in very unsanitary conditions and they sometimes don’t even have access to basic things like drinkable water and health services if they get sick.”

Last month, MSF began providing safe water to approximately 40,000 people in more than 15 camps in the region. And since December 2019 our mobile clinic teams have provided services in various locations, providing medical consultations to more than 17,000 people. Forty percent of these patients presented with upper respiratory tract infections and 13 percent presented with lower respiratory tract infections.

In addition to overcrowded camps and a lack of access to essential services, displaced people in northwestern Syria have also had to contend with freezing winter temperatures. “It’s just one other factor complicating an already incredibly difficult and dramatic situation,” said Reynders. “Some people are so desperate that they’ve been using dangerous materials to heat their tent.”

A month ago, a family of four died of suffocation in a camp for displaced people in the town of Kili, north of Idlib city, after burning dangerous fuel in their tent in an attempt to keep warm. And at the beginning of March, a fire started by the use of unsafe fuel in another camp in northern Idlib province led to an influx of 12 burn patients at the Atmeh hospital run by MSF.

In response, MSF has been distributing more than 300 tons of heating materials to more than 22,000 people in 21 camps and settlements hosting displaced families in the region. “We had already considerably scaled up our activities since the beginning of the [Syrian government’s] offensive,” said Reynders. “But we felt like tackling this particular issue up-front was also extremely important.” MSF has also distributed other essential items like hygiene kits and mattresses to more than 17,000 people in 19 camps and settlements over the past months. By the end of March, 2,000 additional kits of essential items will be distributed.

MSF is working to meet the massive needs, however more help is urgently needed. “Covering the medical needs of the displaced people in Idlib is challenging for multiple reasons, such as the insecure environment our teams work in and the limits of our own resources,” said Reynders. “But we have to continue helping people there, many of whom have lost everything and [now rely entirely] on humanitarian assistance. We cannot just close our eyes on what is happening or get discouraged by the fact that much more still needs to be done to help the population here.”

Across northwestern Syria, MSF teams provide general and maternal health care and treatment for noncommunicable diseases (NCDs). They distribute relief items, improve water and sanitation systems, and support regular vaccination activities in two vaccination centers and one hospital and through mobile clinic services.

We also run a specialized burns unit in the region that provides surgery, skin grafts, dressings, physiotherapy, and psychological support. MSF also provides distance support to primary and secondary health care in several hospitals and clinics around Idlib and Aleppo and has co-management partnerships with three hospitals.

Our medical programs across Raqqa, Hasakeh, and Aleppo governorates in northeastern Syria continue. MSF runs activities in Al Raqqa, Kobane/Ain Al Arab, Al Hol camp, Washokani camp, and Tal Kochar/Yaroubiyah, and is supporting local health authorities with coronavirus preparedness.

To ensure independence from political pressures, MSF receives no government funding for its work in Syria.