Years of conflict, displacement, the economic crisis, and prices that had risen ‘stratospherically’ contributed to growing levels of poverty among the population, forcing families to rely on measures such as reducing food consumption or sending children to work in order to survive [Damascus 2022, 3.2.2, p. 40].  In a survey on the socio-economic situation in the cities of Damascus, Aleppo and Homs, 10 % of respondents from Damascus stated that their children worked / contributed to the household income [Country Focus 2023, 2.2.4, p. 58]. According to UN data, 90 % of the Syrian population were living below the poverty line as of June 2023. UNOCHA pointed to the existence of and potential increase in ‘working poor’ households who were unable to cover living costs despite having an income: in areas under GoS control, incomes would need to increase by 67 % to cover the rising costs of basic needs. In Damascus governorate, 74 % of households reported being either completely unable or insufficiently able to meet basic needs. UNOCHA also pointed to the ‘increasingly desperate’ coping mechanisms to cover basic needs, including buying on credit, borrowing, and relying on protracted debt, remittances and humanitarian assistance. In Damascus governorate, 66 % of households reported relying on remittances, while particularly IDPs were relying on humanitarian aid needs. [Country Focus 2023, 2.2.4, p. 57] 

In August 2023, GoS doubled the minimum wage for public sector workers, the first increase of its kind since December 2021. Pensions were also doubled. At the same time, the GoS cut subsidies for fuel and bread as part of new austerity measures. Despite the increase, the new minimum wage could cover only 13 % of the July 2023 minimum expenditure basket (MEB) - a monetary threshold for what a family of five needs in a month to cover its essential needs, including goods, services, utilities, and resources. [COI Update 2023, 4, p. 13] 

As of April 2023, 12.1 million people were food insecure, according to the WFP. These included the 2 million people living in camps. Moreover, an additional 2.9 million people were estimated to be at risk of food insecurity. Food was the third-most reported unmet need in Damascus governorate, according to UNOCHA’s 2023 Humanitarian Needs Overview, while it was the most reported one in the majority of the other governorates. [Country Focus 2023, 2.2.5, p. 58]  

According to a survey conducted by the German Friedrich Ebert Foundation (FES) in six Syrian cities in 2022, food accounted for the largest share of the total consumption of families. In Damascus, the rate of spending on food was 42 % of families’ total consumption. 81 % of respondents in Damascus stated that their entire income (including money transfers and aid) was not sufficient to cover their basic needs. UNOCHA pointed to harmful changes in food consumption due to the economic crisis, including buying less expensive or less preferable food, and/or reducing the size of their meals at least once a week. These practices were particularly common among female-headed households, where 19 % also reported that at least one household member would go to bed hungry due to a lack of food. [Country Focus 2023, 2.2.5 p. 59]  

As of September 2023, the cost of the standard reference food basket price reached SYP 938 000 (USD 81 at the official exchange rate of SYP 11 557), doubling since the start of 2023. [COI Update 2023, 4, p. 14]  

In June 2023, the WFP announced that it would have to cut its assistance in Syria by about half – from 5.5 million to 3 million people – due to lack of funding and after exhausting other options, including the gradual downsizing of monthly rations to half the standard size [Country Focus 2023, 2.2.5, p. 59]. From July onwards, the WFP food assistance provided to Syrians was reportedly reduced by 40 % [COI Update 2023, 4, p. 14].  

According to UN-Habitat estimates, about 328 000 houses have been destroyed or damaged beyond repair as a result of the war, while a further 600 000 up to 1 million buildings have been ‘moderately or lightly’ damaged. In Damascus governorate, the estimated total damage of housing units was 12 %, or 56 792 housing units. The UN Mine Action Service (UNMAS) pointed in its Annual Report for 2022 to the presence of explosives in 140 buildings in Damascus and Rural Damascus. [Country Focus 2023, 2.2.6, p. 60] 

Legislation on urban re-development was reportedly used by the GoS to confiscate or destroy property, mainly in pro-opposition informal settlements. Urban development projects often served to change the demographic composition of the affected neighbourhoods. Moreover, many residents who were displaced abroad were unable to return to Syria to claim ownership and consequently lost their property [Damascus 2022, 3.5.2, p. 48]. Due to new regulatory measures related to real estate and property, anyone with a record of government opposition might face difficulties in buying or selling property [Damascus 2022, 3.5.3, p. 49]. Pro-opposition IDPs and refugees, who owned property in development zones of Damascus were reportedly most likely to sell their properties in the near future, out of fear that they might not receive security clearance or might be expropriated [Damascus 2022, 3.5.3, p. 50].  

According to the survey conducted by the FES in six Syrian cities in 2022, the quality of housing and its assets, including the availability of electricity and furniture, was considered best in Damascus city. [Country Focus 2023, 2.2.6, pp. 60-61].  

An increase in house rents in Damascus by 300 % in recent years was also reported by UNOCHA. As a result of the high prices, around 600 000 IDPs were renting houses in slum areas. [COI Update 2023, 4, p. 14] 

The UN Secretary-General noted in a May 2023 report that the availably of drinking water in the country had decreased by 40 % since the beginning of the conflict. Moreover, access to water was hampered by a lack of electricity and fuel to run water pumping stations, as well as drought. An outbreak of cholera with thousands of suspected cases was related to poor water quality [Country Focus 2023, 2.2.6 p. 61]. As of March 2023, 43 suspected cases were reportedly recorded in Damascus governorate [Country Focus 2023, 2.2.6, p. 63]. 

UNOCHA stated in a report of August 2022 that 35 % of households had to spend more than 5 % of their monthly income to pay for water; some sub-districts in Damascus governorate were the most affected. [Country Focus 2023, 2.2.6, pp. 61-62]  

Sources further note that two of the main water springs in Syria and source of drinking water for the population of Damascus and Rural Damascus governorates have been severely damaged between 2015 and 2017. [Country Focus 2023, 2.2.6, p. 62] 

UNOCHA stated that countrywide people’s access to basic services continued to decline, due to damaged infrastructure, lack of critical supplies, and lack of financial means as well as restrictions on free and safe movement. Particularly serious was the lack of technical personnel needed for delivery and maintenance of basic health services and to operate potable water supply systems. In December 2021, WFP reported that almost 23 % of interviewed households across Syria had difficulties in accessing medical care facilities, 48 % struggled with purchasing necessary medicines, mainly because they lacked financial means (55 %), but also due to shortages in pharmacies (17 %) [Damascus 2022Damascus 2022, 3.6.1, p.51]. Civilians perceived to be opposed to the government claimed to have been denied access to medical treatment in Damascus [Damascus 2022Damascus 2022, 3.6.1, p.52].  

According to the latest WHO data available, as of December 2020, Damascus had 15 public hospitals, 11 of which were classified as ‘fully functioning’ and 4 as ‘partially functioning’ [Damascus 2022Damascus 2022, 3.6.2, p.51]. As of March 2022, public health care was reportedly generally available in Damascus city. However, people would often have to wait long to get treatment and would have to pay for all medical products. In addition, a general shortage of doctors has been noted, as many had left the country [Damascus 2022, 3.6.1, p.52].  

According to a report of May 2023 by the UN Secretary-General on the protection of civilians in armed conflict, only 53 % of health centres were operational in Syria. In December 2022, a representative of the World Health Organisation (WHO) noted that almost 30 % of the country’s public health facilities remained non-functional. He also pointed to the ‘chronic shortage of health care staff’. According to WHO estimates, up to 50 % of the health workforce had left the country and the remaining health workers were unequally distributed across the country, with Damascus being among the governorates with a comparably higher ratio of health personnel per population than other governorates such as Hasaka, Raqqa or Dar’a. [Country Focus 2023, 2.2.7, p. 62] 

Moreover, prices of medicines had reportedly been increased several times during the last months, including an increase by 50 % in March 2023. A second 50 %-increase was decided in August 2023, probably motivated by a lack of hard currency and raw materials necessary for the production of medicines. According to UNOCHA’s Multi-Sector Needs Assessment (MSNA), 94 % of households in Damascus (among other governorates) stated that high costs for consultations, laboratory and diagnostic procedures were a key barrier to health access. [Country Focus 2023, 2.2.7, pp. 62-63] 

In the context of a survey on the socio-economic situation in the cities of Damascus, Aleppo and Homs, respondents in Damascus indicated that access to a doctor, medical specialist and hospital was generally available. However, a significant proportion of respondents could not afford the services: 33 % could not afford the services of a doctor, 43 % could not afford the services of a medical specialist and 41 % could not afford treatment/surgery in a hospital. [Country Focus 2023, 2.2.7, pp. 62-63]