On the streets in the capital of Damascus, beggars accost motorists and passers-by, pleading for food or money. Medicines, baby milk and diapers can hardly be found.

As Syria marks the 10th anniversary Monday of the start of its uprising-turned-civil war, President Bashar Assad may still be in power, propped up by Russia and Iran. But millions of people are being pushed deeper into poverty, and a majority of households can hardly scrape together enough to secure their next meal.

With Assad preparing to run for a fourth seven-year presidential term in the spring, some have questioned whether he can survive the sharp economic deterioration and anger in areas under his control. Poverty levels are now worse than at any point throughout the 10-year conflict.

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“Life here is a portrait of everyday humiliation and suffering,” said one woman in Damascus. Her husband lost his job at an electronics store last month, and now the family is drawing on meager savings that are evaporating fast. The woman said she had taken up teaching part-time to help make ends meet. Like others, she spoke on condition her identity remains hidden, fearing arrest.

With two kids and an elderly father to care for, she said life had become unbearably difficult and she is gripped by anxiety for the future. Until recently, she could smuggle in her father’s medicines from Lebanon, but now Lebanon has its own meltdown and shortages.

“I go to the souk and really have to think of priorities, buying only the bare necessities for cooking. I try not to look at the other stuff my children might like,” she said.

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The decade of war has wreaked unfathomable destruction on Syria. Nearly half a million people have been killed and more than half the pre-war population of 23 million displaced, whether inside or outside the country's borders, the world’s worst displacement crisis since World War II. Infrastructure is in ruins.

Through most of the conflict, Assad was able to shield Syrians in government-held territory from unbearable economic pain. Even if barely sometimes, the state kept fuel, medicine and other supplies coming and the currency propped up.

Now he has gained a decisive upper hand in the war with Russia and Iran’s help, his grip on areas under his control is unquestioned, and the rebellion is largely crushed.

But the economy has fallen apart with startling swiftness. It was hit by a double blow of new, far-reaching U.S. sanctions imposed last year and the financial meltdown in Lebanon, Syria’s main link with the outside world. That proved too much, on top of the strains of war, government corruption, other Western sanctions in place for years and the coronavirus pandemic.

The United Nations says more than 80% of Syrians now live in poverty, and 60% are at risk of hunger. The currency has crashed, now at 4,000 Syrian pounds to the dollar on the black market, compared to 700 a year ago and 47 at the beginning of the conflict in 2011.

“When you put all of these things together, there is no surprise that we are seeing rising food insecurity, rising hunger," said Arif Hussein, chief economist at the U.N. World Food Program. "Not only in the breadth, meaning lots and lots of people, but also in the depth, meaning people are closer to starvation today than ever before.”

Residents of government-held areas who spoke to The Associated Press paint a grim picture. Prices go up several times a day. Families now rely on electronic “smart cards” to secure subsidized and rationed goods that include fuel, gas canisters, tea, sugar, rice and bread. To collect them, they wait in long lines, often pushing, shoving and fighting.

At gas stations, some park their cars at night to claim a place in line and come back early in the morning to fill their cars. Residents carpool or walk whenever possible, to avoid wasting fuel.

REPUBLIC OF QUEUES

“It is the ‘Republic of Queues,’” said Ibrahim Hamidi, a Syrian journalist based in London who covers Syrian affairs for the Saudi-owned newspaper Asharq Al-Awsat.

Despite the rising discontent, Assad’s rule is not threatened, because people are too busy with their own survival, he said. "They don’t have time to think about anything political. They have no time to think about transition, or the constitution or reforms, because they are busy all the time.”

Food prices have risen 230% the past year, and many Syrians say they are consumed with searching for essential goods that are no longer available. Many families go without meat and fruits for months. At vegetable markets, people often buy a single piece, because they can’t afford more. The monthly salary of a state employee is now worth $15-$20, compared to around $170 a year ago.

In the main cities, many plan their day around the electricity schedule, since power is cut four hours for every two it’s on, sometimes longer. Unlike in Lebanon, where neighborhood generators have been institutionalized, only well-off people can afford them in Syria.

In winter, with gas bottles in short supply, many resorted to using toxic old wood heaters for warmth, with children seen rummaging through trash for anything to burn.

The simultaneous crises in Lebanon and Syria have fed off each other. Where Lebanese once traveled to Damascus to buy cheaper, good quality medicine, textiles and other goods, now Lebanon’s subsidized goods, including fuel and medicine are smuggled to Syria, exacerbating Lebanon’s economic crisis.

A Syrian media activist who goes by the pseudonym of Omar Hariri said rations of bread, gasoline, cooking gas and diesel barely cover 10% of people’s needs. Waiting in line for hours has become “a way of life,” he said.

“I have a relative who got his turn for gasoline in January after two months of cold had passed, and he was forced to buy from the black market at a much higher price,” he said.

WALLS OF FEAR

Syrian economist Samir Seifan said the collapse of Lebanon's banking system, the U.S. sanctions, and the pandemic are all “factors that exploded at the same time.” Now the regime has no more sources of income, so they are printing money and fueling inflation, he said.

Frustration is voiced even among Assad's most loyal supporters. One lawmaker questioned recently why Iran and Russia were not helping by sending oil and wheat.

The government has cracked down, detaining at least nine people in the last six weeks, including a prominent state TV anchor for social media posts deemed critical.

“The regime is trying to rebuild the walls of fear, to remind people that even if you are loyalists you cannot criticize us,” Hamidi said.

Assad blames the U.S., calling its sanctions economic terrorism that seeks to starve the people. Shifting regional dynamics are boosting his confidence; some Gulf Arab countries that supported the Syrian opposition now openly criticize the sanctions.

“In 10 years of war, the (Syrian) regime did not offer a single concession. There is a general feeling that things can only get worse,” Hamidi said.

“There is no horizon, no hope.”