Russia, Iran, and Turkey didn’t stop Syrian President Bashar al-Assad from starting a new major military offensive in his country — almost certainly condemning tens of thousands to die.
On Friday, Russian President Vladimir Putin, Iranian President Hassan Rouhani, and Turkish President Recep Tayyip Erdoğan held a summit in Tehran to discuss the ongoing conflict in Syria. At the top of their agenda was Idlib, a northwestern Syrian province and the country’s last rebel stronghold. Syrian leader Bashar al-Assad has threatened to reconquer the province with a massive, imminent military attack that would put the roughly 3 million people living there directly in harm’s way.
Russia and Iran are Assad’s main backers in the seven-year civil war, and Turkey supports anti-Assad rebels, so the three leaders, not surprisingly, had very different views about how to proceed.
Turkey wanted all sides to sign a peace deal to stem the fighting before it starts, but Russia and Iran demurred, instead opting to give Assad a green light to carry out indiscriminate bombings and a block-by-block takeover of Idlib, the rebel-controlled province. And Russia and Iran, as they have for years, will almost certainly support those efforts.
The Syrian government, Putin said at the trilateral meeting, “has a right and must eventually take under control of its entire national territory.” Rouhani echoed the sentiment, saying that “Fighting terrorism in Idlib is an unavoidable part of the mission of restoring peace and stability to Syria.”
While a powerful terrorist group does operate in Idlib, most people living there are civilians. Over half the population moved to the region to escape fighting in other parts of the country. And some, including the Trump administration, fear Assad’s troops may use chemical weapons on these innocent bystanders. Syrian and Russian warplanes are already dropping bombs on Idlib, even during the talks in Tehran on Friday.
Turkey’s Erdoğan wanted to stop all of that from happening. “We don’t want Idlib to turn into a bloodbath,” he said at the summit. Another reason Turkey is pushing back is that Idlib is on the border with Turkey, and Ankara doesn’t want thousands of refugees flooding into the country.
But Turkey failed in this seemingly last-ditch effort to stop the offensive. Which means that the already horrible reality for millions of Syrians is now about to get much, much worse.
“Increasing hostilities will turn the growing desperation into misery,” Iolanda Jaquemet, a spokesperson for the International Committee of the Red Cross, which tracks and helps alleviate humanitarian suffering in Syria, told me earlier this week.
“Siege, starve, surrender”
The Syrian civil war was born out of the Arab Spring in 2011, as citizens protested the Assad regime. The dictator cracked down on dissenters, leading to a full-scale fight that has since ravaged Syria and the region for seven years. The war continues as Syria — mainly backed by Russia and Iran — fights anti-government rebels supported by Turkey, among others.
The last reliable estimates from 2016 put the death toll at around 400,000 people, but the number is surely much higher now — especially since the war has raged even more over the past two years.
Indeed, attacking Idlib wouldn’t be the first time this year that the Assad regime launched a major offensive against a rebel stronghold. In February, for example, regime forces attacked — and eventually captured — Eastern Ghouta, a suburb of the Syrian capital of Damascus.
The Syrian government took control of the area by employing a strategy it’s used during much of the war. “The regime has been leading a ‘siege, starve, and surrender’ campaign for years,” Jennifer Cafarella, a Syria expert at the Institute for the Study of War, told me in February when we discussed the Eastern Ghouta fight.
In practice, that means the Assad government purposely overwhelms opposition-held areas with attacks to make life for the civilian population unlivable. Assad’s forces destroy hospitals, schools, markets, and even mosques, so it’s nearly impossible for noncombatants to eat regular meals, receive medical attention, or pray where they want.
Assad used that tactic and others — like extrajudicial executions and torture — when he attacked Idlib during a two-week offensive in 2012. It’s likely the regime will commit similar atrocities if it launches a campaign in the coming days or weeks.
The regime uses the “siege, starve, surrender” strategy because it works: Rebels who don’t have food or medical provisions quickly lose the will or the ability to fight, and civilians in besieged areas often start cooperating with the government just to make it stop.
Assad’s forces already bombed and killed dozens of people in Idlib in early August, but it’s unclear exactly when the regime plans to start a new full-scale attack.
But one thing is known: When the offensive starts, it will likely be a humanitarian disaster.
Why humanitarian suffering in Idlib could be “catastrophic”
In multiple interviews, humanitarian officials assisting civilians in Idlib painted a bleak picture of the expected suffering to come.
“People already live in difficult conditions, particularly those who live in makeshift camps,” and have little access to basic necessities including access to food, water, and medical care says the International Committee of the Red Cross’s Jaquemet.
Those who need medical attention will struggle. Jaquemet says eight of the 28 medical facilities in Idlib are entirely out of service. Many others function only at partial capacity because they may have little to no medicine or medical staff.
That means many Syrians who desperately need medical help will have to travel farther to find a doctor working in a standing facility — an especially dangerous endeavor in the middle of an active war zone.
Here’s just one example of how this plays out: In January, the only maternity hospital in Maarrat al-Nu’man, a city in Idlib province, was destroyed in airstrikes that killed at least five people. Jaquemet says around 90 percent of the medical equipment received damage, and now women and children in the area struggle to receive gynecological and other care. Many now have to travel elsewhere to receive that treatment.
It’s also possible that Syrian and Russian warplanes bomb more medical facilities, making it even harder for citizens to receive necessary treatment. “In case of attacks on the south of the province, we will lose major hospitals, and hospitals close to the borders won’t be able to respond,” says Mohamad Katoub, an advocacy manager for the Syrian American Medical Society, a medical relief organization that works to heal those injured or harmed in some way in the war.
The government also doesn’t provide electricity to the province, which means millions of people must rely on generators for power. But it’s hard to install generators during fighting — and it’s even more difficult to provide reliable service for so many.
The problem is made worse because people in Idlib can’t really leave. The Turkish border to the north is closed to keep refugees out, and the Assad regime controls areas to the east, south, and west. The only way they can reliably get out of the province is if Russia, Turkey, and Iran strike a deal and offer them a pathway out even as the fighting rages.
That, as of now, seems very unlikely — which means we should expect to see more strife in Syria. It’s clear that the humanitarian consequences of Assad’s planned attack “will be catastrophic,” says Fred Hof, President Obama’s special adviser for transition in Syria.