When the ambulance arrived at the Salqeen Cemetery in north-western Syria, a small crowd was already waiting. Three men dressed in white hazmat suits opened the back door to reveal a body bag. Ghada Ismael was only 25 years old. She survived a decade-long civil war before the Covid-19 pandemic came. Friends and family gathered in front of the deceased and began praying, led by an imam. A grieving relative broke down in tears. "Did you place her body in the right direction so that her head faces Makkah?" one of the men in white enquired as his colleagues delicately placed the body in a grave. "OK, that's it, get out of there and let one person finish the job," he ordered. The White Helmets, officially known as the Syria Civil Defence, have been credited with saving thousands of civilians targeted by the regime and Russian warplanes during Syria's decade-old civil war. But there is no one to save now. In the region of Idlib, these volunteers are tasked with burying the victims of the pandemic, carrying bodies that are possibly still contagious from the hospital to their final resting place. Since the first case was confirmed in July, this last opposition-controlled part of the country has registered more than 20,000 cases and nearly 400 deaths – figures that may well be underestimated and push Syria's death toll to new heights after 10 years of conflict. What began in March 2011 as peaceful protests against President Bashar Al Assad’s regime quickly escalated into a full-blown war that claimed the lives of hundreds of thousands and displaced millions. Now, the White Helmets have to adapt to a new threat and swap their immaculate headgear for protective masks. "This work is extremely difficult, but we have no choice but to continue. People need us,” said Ahmed Al Masry. The 32-year-old joined the White Helmets in 2015. Back from the cemetery, he invited <em>The National</em> into the small flat in downtown Idlib where he lives with his wife and their three children. It is all he can afford with a monthly salary of about $200. Mr Al Masry was welcomed home by the cheers of his toddlers. "Daddy!" they yelled excitedly as he opened the front door. His face briefly lit up at the sight of his children, then darkened again as he told his story. "Whether it's the virus or the bombs, it's a hard job. And of course, it is difficult for my family too. They worry a lot about me. My relatives often ask me why I don't quit,” he said. His wife Ruba confirmed, her voice breaking. Why take so many risks, she wondered. Perhaps it was time for him to choose a safer path, she hoped. "Since the death of several of his friends, I'm terrified and I don't want him to do this job anymore,” she said. From the songs of the revolution to cries of agony, Mr Al Masry’s nights are filled with haunting memories. For six years he saw death, he often smelt it too. Despite the risks of transmission, burying coronavirus victims is almost a relief. At least the bodies are not in pieces. "Every memory is an agony. But some are worse than others. I have images in my head of dead children, buried under the rubble. Two years ago, I was called to the scene of an airstrike where there were no survivors. It turned out it was the home of relatives,” he said. “My aunt, her husband, and their daughter. What a horrible scene.” The coronavirus is yet another plague on an already vulnerable population. North-west Syria is home to 2.7 million civilians displaced from other parts of the country. The spread of the virus in densely populated camps is a cause of great concern. Added to this is the spectre of renewed fighting. Despite a fragile ceasefire negotiated in March 2020, Damascus and Moscow continue to occasionally carry out airstrikes. "We are caught between the virus and Assad's bombs,” said Firas Al Khalifa, a spokesman for the White Helmets. "Each time there is a new bombing, we are confused. Should we go to help the wounded or take care of coronavirus patients? Do our teams have to transport the sick or take care of burying the bodies of the victims?” he wondered. “Our efforts are dispersed.” Years of war and the deliberate and systematic targeting of medical facilities by Al Assad's air force brought the region's healthcare system to its knees. There were only nine hospitals dedicated to the coronavirus and 36 isolation centres as of mid-November, according to Doctors Without Borders. Far too few, the NGO warned, for the four million civilians crammed inside the rebel stronghold. A vaccine campaign is nowhere in sight. Idlib’s only hope for now seems to be the World Health Organisation’s (WHO) Covax programme – a global scheme to vaccinate people in poor and middle-income countries around the world. "The WHO and other humanitarian organisations are discussing mechanisms and ways to improve the delivery of the vaccines regardless of the location. Whether it's Syria, Yemen or Libya, places where the territory is divided and under the control of different groups," Dr Abdinasir Abu Baker, a team leader of hazard management at WHO, told <em>The National</em>. Covax aims to deliver at least 2 billion vaccine doses by the end of 2021 to protect high-risk and vulnerable people in poorer nations. It is a titanic task. Acquiring enough vaccines is one challenge, bringing them to a war zone and successfully distributing them is another. “I am sure there will be some delays to get vaccines to countries facing complex emergencies, but we have to make it our top priority,” Dr Abu Baker said. Reuters reported last December that the Covax programme faces a “very high” risk of failure, potentially leaving billions of people with no access to the precious doses until as late as 2024. A shortage of vaccines may prove lethal for Idlib’s war-battered population. In the city's eastern side cemetery, there is barely enough room left for Covid-19 victims. Tombstones stretch as far as the eye can see, bathed in a soft orange light as the sun sets. "Before the revolution, I wondered if this place would ever be filled. But in the past year and a half, we used several thousand square metres,” said Abdul Mohsen Latif, who has been a gravedigger there for the better part of the decade. He stopped tallying the number of bodies a while ago – there were just too many – and calculates in metres instead. "This cemetery is not big enough for both the victims of the bombings and the coronavirus. I would need a few more plots of land," he added. Idlib’s graveyards are black boxes of the war. Every life cut short and buried there tells the story of a nation’s destruction. "I never imagined that I would bury so many people. I thought [the war] would last a month or two, maybe a year at most, and that everything would then be fine, that the revolution would win," he said. “Obviously, it's taking a lot longer than expected.” The gravedigger said he was growing tired. His battered, dirt-covered hands were struggling to cope with the rocky ground. Each time he hammered his pickaxe, a new bead of sweat appeared on his forehead. But more digging was needed, still. Coronavirus, he said, is a war within a war. <em>Karam Al Hindi contributed to this story</em>