The military siege imposed by the Syrian regime and its Russian ally has entered its second month. Its effects on the close to 4,000,000 people that are estimated to be living in this area are becoming more severe—most food and medical supplies are running out.

With the resumption of bombardment after a period of relative calm, Mustafa al-Shamali—a resident of the besieged al-Sakhour District—confirms that residents are being forced to go to the markets daily in hopes of securing food, especially since matters deteriorated further with bread flour beginning to run out. Most residents have exhausted their stocks of rice, sugar, and pasta—items aid organizations had previously provided to residents. Muhammad Fadila, the head of the Aleppo Provincial Council, said in an interview with SyriaSource that, prior to the siege, they had expected supplies to last for six months. Now, with the severe bombardment, it appears that the items will run out before then.

Since 2012, Aleppo has been divided into two parts—the eastern districts controlled by the resistance groups and the western districts controlled by the Assad regime and its allies. For more than two years, the residents of eastern Aleppo—most of them poor and hit by price increases—have depended on the aid distributed before the siege.

With Syrian regime forces cutting off all of the supply routes into Aleppo to prevent the entry of foodstuffs, these markets have been lacking the basic provisions residents depend on for their daily subsistence, such as oils, vegetables, and chicken. According to al-Shamali, people have been “eating one meal a day, predominantly greens like herbs, parsley, and lettuce and any eggplant or potatoes they can obtain at prices vastly inflated due to the siege.”  

Al-Shamali went on to explain that “today, potatoes are the food of the rich. Before the siege, the price of one kilogram was under 300 Syrian pounds [less than one US dollar] whereas by the second day of the siege it had gone beyond 1500 Syrian pounds [three US dollars]. The quality of the potatoes has not changed, but there are very few available.”

Mustafa believes that if all other foods run out, residents will subsist on greens—similar to how locals have survived in other besieged areas of Syria. They may even resort to eating grass. But the basic fear, in his opinion, lies in “the loss of baby formula, medicine, and the needs of the elderly. These are supplies you cannot secure under siege conditions.”

The Aleppo City Council, along with some local activists, are making an effort to cultivate gardens with available spaces on the outskirts of the city. According to activist Meelad Al-Shuhabi, who works with the volunteer team “Red” (Ahmar) from Revolutionary Council of Masaakin Hanano (RCMH), the organization was able to transform a four-hectare piece of land into an agricultural plot capable of producing close to ten percent of residents’ needs. He added that the current goal is to cultivate ten hectares over the coming month.

However, al-Shuhabi emphasized that it is not at all certain if Aleppo’s residents will be able to grow food while under a state of continuous siege. This is due to the scarcity of spaces suitable for agriculture in safe spaces within the city; the agricultural areas are predominantly found in the southern sections, which are active war zones and nearly impossible for residents to access.

The Collapse of the Medical Sector
According to the international organization Doctors Without Borders, during the first three weeks of this past month, no fewer than 114 civilians were killed and close to 1,300 were injured, including 320 children. These casualties were the result of Russian airstrikes on civilian areas. The repeated targeting of medical facilities in Aleppo has led to the destruction of six of these facilities in the past month alone. As confirmed by The Syrian Media Center, the last of these was al-Sakhour Hospital—the largest of the region’s medical centers—which provides medical services to hundreds of wounded patients daily. Since the regime and Russia restarted their aerial campaign earlier this week, they have already struck a children’s hospital and a blood bank.

According to the World Health Organization, there are at maximum thirty specialist doctors caring for 250,000 people, including just one pediatrician and one women’s health specialist, who cares for pregnant women and the 85,000 children living in the area.

In a press statement issued from Geneva, the spokeswoman for a local organization, Fadilat Shayib, called for the removal of dozens of wounded patients from the hospitals because of the doctors’ inability to treat them. The spokeswoman stated that each hospital had been conducting thirty operations per day since the beginning of the latest attack on September 19, despite their lack of supplies and equipment.

According to Abdulrahman al-Umr, the pediatrician working for the American-Syrian Medical Group in east Aleppo, “there is enough fuel to run Aleppo’s hospitals’ generators for just 20 days;” running out of fuel would put hundreds of patients at risk.

According to the doctor, the shortages in the besieged hospitals are typified by a total lack of anesthetics, but also extends to equipment for maternity wards, where there are no respirators for newborns, just as there are no qualified nurses to oversee them.

Health sector worker Ahmad Musa, who recently began to volunteer in Aleppo, explained that “medicines began to run out [in Aleppo] as a result of a number of major injuries and, recently, it forced us to close some of the small medical clinics and move their contents to more secure hospitals.” According to Musa, this is because “the doctors fear the loss of more medical facilities as a result of repeated bombardment.”

He went on to explain that “dozens of the wounded had limbs amputated in order to save their lives because the doctors were unable to perform surgery on them. There were too many patients coming in to the medical centers.”

The activist expects that the medical sector will completely collapse in less than a month unless the international community is able to break the siege and assist at-risk civilians who have completely run out of medicine.

Aleppo Braces for a Harsh Winter
Without fuel and electricity, residents in Aleppo will face heating problems as temperatures fall, rains begin, and winter approaches.

Trading firewood has recently become a daily job for Aleppo residents, who now rely on the furniture of destroyed homes to cut, collect, and then store for burning.

Entire markets for home furniture have sprung up, providing an opportunity for hundreds of workers to obtain food to meet their daily needs—the price of one ton of firewood is estimated at 50,000 lira (approximately US$100).

Some civilians have devised another solution—gathering plastic from destroyed infrastructure and burning it in a rudimentary way to extract the residue, which they use as fuel in electric generators.

This method consists of plastic being placed in barrels, where it is exposed to high heat until it boils. The resulting gasses rise into a pipe installed on the barrel and then pass across a water basin to be cooled. From the other side, the yellowish handmade fuel is removed.

Despite the danger of this method and its harmfulness to workers, it has become a widespread phenomenon in certain districts. There are some regions where one liter of this fuel is sold for close to 1,200 Syrian pounds (US$2.30) instead of the 350 Syrian pounds it used to sell for. The same applies to gasoline—the price for one liter has reached 5,000 Syrian pounds instead of the 500 pounds it used to sell for.

Abu Ahmad, one practitioner of this method, explained in an interview that he and his friends have been able to extract close to seventy or eighty liters of fuel per day. This is, in essence, the amount of fuel needed to power an electric generator for one day; it allows residents, at the very least, to pump water from the wells.

He went on to say that the objective of this fuel production “was not to make a profit, but rather to provide assistance for our neighborhood after the electric generators stopped working to make us self-sufficient.”

Hosam al-Jablawi is a Syrian citizen journalist.

Image: Photo: Residents use rudimentary methods to extract fuel from plastics. Courtesy of the author.