The joyful spirit of Ramadan absent in northwest Syria as region suffers multiple crises in quake aftermath

Ramadan arrived in northern Syria to a devastated population, following the catastrophic earthquake that hit the region on February 6 and left survivors in the northwest struggling to cope with extremely complex and multi-layered crises.

It has not been easy for Turkey — a powerful country — to cope with the aftermath of the quake, and so in Syria, which has suffered years of war, displacement and terror, the repercussions are even more severe. 

The earthquake killed thousands, displaced hundreds of thousands more, and brought with it a host of new problems — economic, health-related and psychological, depleting what little remained of the spirit of Ramadan in northwest Syria.

Unimaginable loss

Najiba Karmo's eyes fill with tears as she speaks about the unimaginable loss she and her husband suffered a few months ago. The earthquake killed their son, his wife, and their four children, all of whom were buried under the rubble of their home in Sarmada city in northern Idlib, as well as killing their daughter and her family, who were living in Antakya, Turkey.

"Ramadan arrived in northern Syria to a devastated population, following the catastrophic earthquake which hit the region on February 6

"Ramadan has brought a lot of pain this year… we've lost our children, and with them any hope of future happiness," she says. 

Najiba, who is in her sixties, adds that since the Syrian war broke out, they'd been unable to enjoy a normal life. Their lives had become defined by displacement and loss, and the recent earthquake had come to finish off the catastrophe, she says.

She didn't realise that Ramadan was about to begin until just a few hours before. In any case, she can't afford even the basic necessities following her son's death – he had been the breadwinner for all of them.

Rocketing prices and scenes of ruin

Nabil Harani (41) is an internally displaced person (IDP) from Al-Tah village in southern Idlib, who now lives in Jindires. He hasn't prepared to participate in the usual Ramadan customs this year like in the past. Instead, he is grieving his relatives and neighbours who were killed in the earthquake, as well as the loss of his livelihood – his shop was completely destroyed.

"Ramadan no longer gathers people the way it used to […] this [Ramadan] season, destruction and ruin is everywhere — grief and poverty are affecting a vast majority of people," he says.

Record price hikes in food and essential items have hit Syrian markets following the earthquake and in northwest Syria these range from around 20-50 percent.

The current price hikes are partly due to increased demand for various commodities to provide relief to the afflicted in Syria. Then came Ramadan, before which traders habitually raise prices to exploit the annual uptick in spending. All this comes as Syrians face the worst living conditions ever since the outbreak of the war 12 years ago.

For an example of the price rises; across northwest Syria at the beginning of Ramadan, the price of 1 kilo of cows yoghurt (laban) had jumped from 11-13 Turkish lira (TRY), a tray of eggs from 35-48 TRY, and a kilo of mutton from 120-180 TRY. Tomatoes have risen from 10-14 TRY per kilo, and potatoes from 4-8 TRY per kilo.

"Syrians' deteriorating reality comes as the World Food Programme (WFP) continues to reduce the number of items in its monthly food basket for Syrian IDPs"

Syrians' deteriorating reality comes as the World Food Programme (WFP) continues to reduce the number of items in its monthly food basket for Syrian IDPs – for the sixth time since 2020. According to the Syrian Response Coordinators group, the WFP announced a further reduction of the calorie content in the food basket to 991 calories in March.

The group stated that the latest reduction was not consistent with an assessment of humanitarian needs in the region in the wake of the earthquake, and did not seem to consider civilians' urgent need for food security, and the loss of thousands of their sources of income.

Disease spreads in wake of disaster

The physical and psychological health conditions after the earthquake are another story. The water and sewage networks in the afflicted areas have been damaged, leading to an increasing spread of contagious diseases like cholera. This has caused an additional burden for the medical sector which was struggling before from a lack of funding, medicines and equipment among other issues.

The Syrian Civil Defence in northwest Idlib reported that 568 cases of cholera had been registered due to "damage to infrastructure including water and sewage networks after the earthquake."

Hussam Sheikh Ahmad (6) contracted cholera just before Ramadan began. His symptoms started with diarrhoea, nausea and vomiting, and within hours he was showing signs of severe dehydration; exhaustion, sunken eyes, dry mouth, extreme thirst, sagging skin, and painful muscle cramps. His mother, Mariam Al-Kuraid (33), took him to a hospital near Dana city in northern Idlib, where the family had been displaced following the earthquake.

But once they got to the hospital, Mariam was shocked at how long it took for Hussam to be treated – he didn't receive emergency treatment for several hours, despite the diagnosis of the disease and its seriousness. She says the hospital was clearly unable to cope with a large number of patients and earthquake victims.

"As well as infectious diseases, war and natural disasters have led to the neglect of those with serious chronic diseases like cancer"

Mariam believes her child contracted cholera due to the proximity of their tent to open sewage, and because they have been forced to use unsterilised, unclean water for a lack of other options in the camp, set up after the earthquake. 

Moreover, seven other children in the camp had contracted it before Hussam, yet no measures were taken, no solutions offered, and no concern was shown for the seriousness of the situation, she says.

As well as infectious diseases, war and natural disasters have led to the neglect of those with serious chronic diseases like cancer, heart disease, diabetes, high blood pressure and lung diseases.

"I survived the earthquake, but I don't think I'll survive my illness. Perhaps this is the last Ramadan I'll live through," says Ghalia Al-Bakri in a summary of her situation. She has leukaemia, but the radiation therapy she requires isn't available in the region, and she can no longer access it in Turkish hospitals. This followed Ankara's declaration that Turkey would stop receiving those with chronic diseases (for treatment) from northwest Syria for at least three months after the earthquake.

Regarding the psychological impact left by the disaster – millions across northwest Syria are living in fear that another earthquake could occur at any moment. Aside from that, mental health has been deeply impacted by the unimaginable trauma and irreparable losses people have suffered.

Reem Al-Hanini (17) feels constantly stressed, anxious, fearful, confused and angry. She is also overwhelmed with feelings of remorse and shame that she was the sole survivor of her family.

"I live in fear and sadness and feel that every night will be my last. These feelings torment me and stop me sleeping… visions of my family under the rubble won't leave my mind," she says, in tears as she explains she never imagined she would ever spend Ramadan in a tent, far from anything, without her family.

"Mental health has been deeply impacted by the unimaginable trauma and irreparable losses people have suffered"

Murhaf Wajdi (6) hasn't stopped crying since the earthquake, says his mother, Maysoon. He's also shown other signs of psychological disturbance – bouts of sadness, uncontrollable fear and involuntary urination — and Maysoon hasn't been able to find treatment for him.

She says her son's condition started when their apartment building in Salqin city started shaking when the earthquake hit, before starting to crack and crumble minutes before they managed to get out.

Counsellor Alia Al-Rami (41) says the psychological effects of trauma need to be dealt with quickly and effectively and peoples' basic needs secured. She says people need to be listened to without pressure, especially children, who are the most vulnerable to psychological damage from such disasters.  

She explained that symptoms usually manifested as mental disturbances and problems like anxiety, depression, and eating disorders, and sometimes would go as far as suicidal behaviours. Psychological trauma is often accompanied by physical symptoms, she said, like dizziness, fainting, copious sweating, trembling, chest pain, difficulty breathing and stomach upsets, as well as memory problems and unexplained pains.

The opposition-held province of Idlib in north-west Syria was already struggling to cope after years of targeted airstrikes destroyed clinics and hospitals.

Now the #TurkeySyriaEarthquake has complicated things even further ⬇

✍ @PaullMcLoughlin https://t.co/lakgw6VO0F

— The New Arab (@The_NewArab) February 10, 2023

She believes the best way to deal with children in the post-disaster phase of trauma is to try to stop them from reliving the traumatic event, by keeping things like pictures or videos linked to the earthquake away from them.

It is also important to get close to the child and give them a feeling of security, as well as allow them to express their feelings fully. The child’s condition should be followed with care, and they need to be reintegrated into their normal life and have their routine prior to the earthquake restored as far as possible, she said.

Hadia Al Mansour is a freelance journalist from Syria who has written for Asharq Al-Awsat, Al-Monitor, SyriaUntold and Rising for Freedom Magazine.

Article translated from Arabic by Rose Chacko