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The devastating on Feb. 6, 2023, killed more than 59,000 people in Syria and Turkey.

For its survivors in Syria, the massive temblor destroyed hospitals and electrical and water systems, and forced to move into tented settlements.

In Jinderis, as in many of Syria's earthquake-hit areas, there has been nearly no reconstruction and whole blocks still lie in rubble. Naji, whose leg was amputated, lives in a muddy tent.

“It’s cold at night and there is no lumber (for heating) or anything," he said.

Syria has been wracked by an uprising-turned-civil war since 2011, and the conflict in is at its worst in years. Syrian and Russian military shelling and strikes have killed dozens of people and displaced more than 100,000 others there since August.

The earthquake killed at least 6,000 people in Syria, mainly in the northwest, where most of the 4.5 million people to survive. Some 800,000 people living in tents need to be rehoused.

The World Bank estimates the quake caused in damage across northern Syria.

Nonetheless, an initial outpouring of

and other humanitarian organizations have been struggling to fund programs that provide a lifeline in Syria, blaming the COVID-19 pandemic, and conflicts elsewhere that have erupted in recent years.

The U.N.'s World Food Program, which estimates that over 12 million Syrians lack regular access to food, announced in December that it would in Syria in 2024.

Tanya Evans, the International Rescue Committee’s Syria Country Director says needs on both sides of Syria's frontline have never been higher.

“Families are facing rampant inflation coupled with loss of jobs, and having to make heartbreaking decisions about getting food on the table or going hungry,� Evans told The Associated Press.

Yasmine al-Ali at the Salah ad-Din camp in the Idlib countryside shivers as she tries to tie her ragged tent together and digs a ditch in the mud to stop water from flooding her makeshift home.

Patting a drenched mat inside the tent, she says: “Look, it’s just water and mud. … We need new tents.�

Yasine al-Ahmad, who manages the camp of more than 500 families, says wood for heating is far too expensive, so most people burn plastic instead, filling the camps with toxic smoke as they do whatever they can to get through the winter. Many have to skip meals due to food insecurity and rationing.

“There’s also been difficulties in supporting water stations, education services, medical support in hospitals,� U.N. Deputy Regional Humanitarian Coordinator for the Syria Crisis David Carden told the AP during a visit to northwestern Syria in late January. While the needs are growing, he said, “We cannot do more with less.�

The U.N. was only able to secure 37% of the $5.3 billion needed for its 2023 humanitarian response in Syria, which Carden said was one of the lowest funding targets since the conflict started.

And with Syria's conflict has become a major obstacle for humanitarian organizations.

It is "hard to convince donors to build for longer term, for development,� said Rosa Cresanti, the head of the World Health Organization office in Gaziantep, Turkey. “We are still in a humanitarian situation because of the ongoing conflict. This is the main reason why there are no long-term plans.�

Ahmed Koteich, a construction worker, said people have stopped waiting for aid and are trying to cobble together whatever resources they can to restore and restock their shops and farms.

“The international community said it stood with the residents, with their thoughts and rhetoric,� Koteich said. “But this talk won’t help the people here.�

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Chehayeb reported from Beirut. Associated Press journalist Ghaith Al-Sayed in Idlib, Syria, contributed to this report.