Under the already heavy sun of a September morning, about fifty people wait among the dusty tents of the Sahlat al Banat camp in northeastern Syria. As the vehicle arrives, a murmur rises in front of the tent: everyone pleads their case, hoping to be registered on the list of one hundred medical consultations scheduled for the coming days.

Since 2018, more than 2,000 families have taken refuge on the outskirts of the vast landfill site of Raqqa. From the towns of Deir ez-Zor or Maadan, they fled successive offensives that put an end to several years of Islamic State control. Over time, shelters have multiplied: as far as the eye can see, sheets of fabric, blankets, and tarpaulins—sometimes marked with the UNHCR logo—bear witness to the gradual withdrawal of humanitarian aid. A heavy odor hangs over the camp, a mix of waste and burning plastic that clings to the air and to the clothes. Here, children sort through mountains of garbage, searching for pieces of metal they can sell for a few cents. For many, it is the only means of survival.

For several years now, we at SOLINFO have been running psychosocial support workshops for about a hundred children every month. For an hour or two, they can escape their daily lives and simply be children again—no longer worrying about how many scraps of metal they collected or how many Syrian pounds they managed to earn. Under this tent, teacher Naji Al Matrood constantly imagines new ways to capture the children’s attention and restore to them the lightness of their age.

My role as a doctor and the association’s medical coordinator strengthens this support by providing both medical care and preventive action, including hygiene awareness sessions and the distribution of kits containing essential items: toothbrush, toothpaste, soap, nail clippers, and disinfectant solution.

These moments spent with the children also reveal the daily lives of the men and women living in an extremely degraded environment. The dust and the smell permeate everything. The children often arrive barefoot, their clothes dirty or torn. The most common diseases tell their own story: scabies, diarrhea, and malnutrition are almost constant.

We conducted a nutritional survey of one hundred children in the camp, and the results are alarming: more than half show signs of undernutrition—53%, one third of them severely malnourished and two thirds moderately. In concrete terms, this means that most of the children examined are not growing normally: their weight is insufficient for their height or age, which can lead to bone fragility, developmental delays, edema, and greater vulnerability to infections. These data confirm the seriousness of the situation and illustrate the lack of sustainable nutritional programs in the region.

Dangerous Budget Cuts for Relief Efforts

These figures are not an exception; they reflect a broader reality—the humanitarian deadlock in northeastern Syria. Since early 2025, budget restrictions decided by Washington have led to the suspension of many USAID-funded programs. In practice, numerous international NGOs have seen their funding cut by 40%, forcing them to reduce staff and scale down their projects in the region.

On the ground, the consequences are visible: many NGOs have withdrawn, projects have been halted, and staff remain in limbo. Local NGOs are trying to compensate for the absence of international actors, but they lack the logistical and financial means that previously gave strength to the humanitarian apparatus. This paradigm shift now highlights the responsibility of the Autonomous Administration of North and East Syria (AANES), which finds itself alone in front of camps it can neither manage nor close.

In this fragmented humanitarian landscape, Damascus is gradually regaining control, starting with the administrative level: from now on, all UN agencies must submit their project proposals to the Syrian government before any field action. At the same time, international NGOs wishing to collaborate with the United Nations must register with the Ministry of Foreign Affairs, an obligatory step to obtain legal authorization to operate. This ministry imposes long, redundant, and sometimes arbitrary procedures.

Local NGOs, for their part, are subject to a similar process: they must obtain registration with the Ministry of Social Affairs, which reviews their statutes and funding sources. This supervision allows the government to filter and channel aid toward the areas it deems a priority.

Despite these constraints, the Health Authority Office (HAO)—the AANES’s health body—tries to maintain a parallel coordination system. Acting as a “Ministry of Health,” it manages hospitals, primary health centers, and coordinates humanitarian activities of both international and local NGOs to best respond to the population’s needs.

Beyond the humanitarian emergency, northeastern Syria has for several months been awaiting negotiations between the new government led by Ahmed Al Charaa and the Autonomous Administration of North and East Syria. In early October, several meetings took place, driven by U.S. efforts to maintain a fragile balance between their Kurdish allies and a Syrian regime seeking regional normalization.

Like the Druze and Alawite communities, Kurdish representatives appear to be advocating for a federal modelguaranteeing administrative, cultural, and security autonomy. Damascus, on the other hand, favors the establishment of a centralized state and the integration of the various armed groups.

During my mission, clashes broke out in Aleppo’s Kurdish neighborhoods of Ashrafieh and Sheikh Maqsoud, opposing local units to pro-government factions. On October 8, a ceasefire was negotiated between the two parties, restoring a fragile calm to the city. These episodes reflect the fragility of coexistence between the regime and Kurdish forces and recall the community violence recently inflicted on the Druze and Alawites.

Even within Kurdish circles, opinions diverge. Some express cautious optimism, seeing a chance for recognition or even the promise of a federal state. Others, more disillusioned, fear renewed conflict, the disenchantment of a people exhausted by war. “Talks will never succeed as long as Damascus remains torn both internally and by its foreign sponsors,” says a local official in Qamishli.

Hope for Peace Above All

On the ground, this political stalemate is ever-present and translates into constant security fragility. Roads are closed or blocked by makeshift checkpoints; local partners tell rumors of attacks, kidnappings, and revenge killings—all of which contribute to the population’s sense of insecurity. The fear of the Islamic State still lingers in some villages where sporadic attacks occur.

Yet, we encountered no incidents during our mission. Movements took place without hindrance, and the region remains relatively stable. This observation reveals a fragile stability, where life continues despite everything.

Northeastern Syria today is a humanitarian gray zone, where neither war nor peace truly prevails. International attention has turned elsewhere, cameras have moved on, and displaced populations—now invisible—are rarely mentioned. Yet life here remains marked by extreme precariousness. In Raqqa, the national hospital still stands, supported almost entirely by NGOs. Care is provided free of charge, allowing the population to access a minimal level of healthcare.

Like many humanitarian actors in the region, we work exclusively with local NGOs—the only ones who truly know the realities on the ground. Mustapha, our country director, and Driss, our project manager, embody this quiet resistance and remain committed despite the uncertainty weighing on the current political situation.

I will return soon to continue this modest but essential work for those who have nothing left—except the hope of peace above all.

Juliette Elie.

 

Docteur Juliette ELIE : 

After earning a doctorate in medicine from Université Paris Diderot and a master’s degree in research on inflammation and inflammatory diseases, Dr. Juliette Elie works as an associate practitioner at Necker–Enfants Malades Hospital in Paris.

She currently serves as a volunteer humanitarian doctor within the NGO SOLINFO, chaired by Edouard Lagourgue, where she oversees medical projects, particularly in the fields of nutrition, community health, and support to displaced populations.

Her commitment reflects an approach that combines scientific rigor, field action, and support for local actors to sustainably strengthen health capacities in crisis zones