23 August 2019, source: UNOCHA

The humanitarian situation in northwest Syria continues to deteriorate as the most recent upscale in violence is set to enter its fourth month. Hostilities between Government of Syria (GoS) forces and their allies and non-state armed groups (NSAGs) across Idleb, northern Hama and western Aleppo governorates has dire humanitarian consequences for an estimated three million people, of whom 76% are estimated to be women and children.
After a brief lull in airstrikes from 2 to 4 August, as a result of a conditional ceasefire, airstrikes resumed on 5 August. There was renewed violence on 7 August when fighting between ground forces resumed. This resulted in GoS forces gaining
control of several towns and villages including Skik, Hbit, Abdin, Arbain, Zakat, Um Zaytuna and, eventually, Khan Shaykun on the M5 highway – the major road running north-south in northwest Syria. These areas as well as Kafr Zeita, Latmana
and Latmin in northern Hama are not accessible to humanitarian organizations, meaning that any civilians who remain in these areas cannot receive assistance and services that they may depend prior to the latest fighting.
Military activity in northern Hama and southern Idleb that led to shifting frontlines has a drastic impact on the people living in these areas. Since the collapse of the conditional ceasefire on 5 August, local sources are reporting that civilians are
fleeing en masse towards the north. While the exact number of displaced individuals is difficult to ascertain at this stage, local sources are reporting that entire communities are fleeing from the hostilities. Between 1 and 18 August, more than 72,000 displacements have been recorded from northern Hama and southern Idleb. Local sources are reporting that population movements are continuing. Many of these individuals and families have been displaced before, some of them multiple times, which makes them extremely vulnerable to this additional shock. The most recent wave of displacement adds to an already dire humanitarian situation in northwest Syria. From 1 May to 18 August, some 576,000 individual displacements, which includes secondary displacements have been recorded. Overall, it is estimated that well over 400,000 people have fled from their communities in northern Hama and southern Idleb to look for safety.
Reports from the ground suggest that the patterns of displacement largely remain the same, with most people moving north close to the border with Turkey to areas that are already densely-populated in northern Idleb and a small number of individuals moving to northern Aleppo governorate. Many displaced individuals move to overcrowded displacement sites or makeshift shelters, placing additional strain on overstretched humanitarian assistance available in these areas. While displaced individuals, as well as receiving communities, have immediate humanitarian needs across all sectors, finding
shelter remains one of the most pressing needs. Large scale and frequent population movements pose a particular challenge to humanitarian partners. Humanitarian partners in northern Idleb are increasingly reporting on the shortage of shelter options, increases in rents and a number of displaced people staying out in the open.
Since late April, hundreds of civilians, many of whom are women and children, have lost their lives while countless others have suffered severe injuries, often leaving them with permanent disabilities. Since late April, the Office of the UN High Commissioner for Human Rights (OHCHR) has documented the deaths of more than 500 civilians while information provided by local sources indicates that as of August 23, more than 870 civilians may have been killed, including some 180 children and 145 women. Since the resumption of airstrikes on 5 August, these continue to take a heavy toll on civilian lives. On 14 August, a series of airstrikes in the Ma’arrat Humeh area in southern Idleb resulted in the death of two humanitarian workers, a paramedic and an ambulance driver. Their ambulance was completely destroyed, and a rescue worker coming
to their aid was also killed. On 16 August, airstrikes reportedly hit residential buildings that were constructed to house IDPs and supported by a humanitarian organization in the city of Has, killing 20 people, including seven children and eight women, and injuring more than 50 civilians.
The widespread destruction of civilian infrastructure, such as people’s homes, IDP settlements, bakeries, markets, hospitals, schools and water stations, adds to the suffering of civilians in northwest Syria. Since late April, at least 43 incidents impacting health facilities or personnel in northwest Syria have been confirmed by the World Health Organization, killing and injuring patients, and damaging or destroying vital health facilities. In addition, a total of 87 incidents damaging or destroying educational facilities have been verified by the United Nations Children’s Fund during this same period.
Moreover, several water stations were reportedly damaged or destroyed by airstrikes or shelling, disrupting access to clean water and education for hundreds of thousands of people.

Read more about the latest updates on the humanitarian response here.