In the wake of the Turkey and Syria earthquakes, rescue workers searched through the rubble of thousands of collapsed buildings in freezing winter temperatures. But in many areas of northwestern Syria, survivors were left waiting for rescue teams with the necessary machinery and emergency relief.

The impacts of the Turkey and Syria earthquakes are hitting refugees, children, and other overlooked groups the hardest. Here’s why.

1. This is a crisis within a crisis.
For 12 years, Syria has been suffering from war. The COVID-19 pandemic and a new cholera epidemic in the country’s northwest are also adding to the strain on communities. About 6.8 million people were displaced within Syria before the massive quakes struck.

2. Aid has been slow to trickle into Syria.
Without assistance in the immediate aftermath of the earthquakes, only 5% of the affected areas have been searched, according to a joint statement published by 35 international and Syrian aid groups calling for greater support. While global rescue teams and aid flowed into Turkey, Syrians didn’t have access to fuel and heavy machinery. They were left to dig for survivors with shovels and their bare hands.

3. Medical systems in the earthquake zone were already stressed.
In northwestern Syria, the earthquakes added to the impacts of the civil war and put even more pressure on the medical support system. Before the earthquakes, vital infrastructure, including hospitals and entire neighborhoods, were in ruins as a result of the fighting across the country. Roughly half of hospitals, primary health care facilities, and specialized centers were fully functional before Feb. 6. Now, the remaining hospitals are overwhelmed.

4. Millions of refugees and displaced people were in the hardest-hit areas.
Humanitarian needs in Turkey and Syria were significant before the earthquakes. Turkey hosts the largest number of refugees worldwide, including about 3.6 million registered Syrian refugees. Many refugee communities live in camps along the Turkey-Syria border, close to the epicenter of the earthquakes.

5. Millions of children have been impacted.
At least 4.6 million children lived in the 10 provinces of Turkey that were hit by the quakes, and more than 2.5 million children were affected in Syria, according to UNICEF. Although the total number of children in need of assistance is unclear, the estimate is in the millions.

6. There’s a shortage of safe shelter.
For years, Syrians in the country’s northwest have endured crossfire between the Syrian government and opposition forces, destroying most emergency infrastructure.

Read the full article about refugees by Tebben Lopez at GlobalGiving.