A year after Bashar Assad fled, Syria struggles to heal

HOMS, Syria (AP) — A year ago, Mohammad Marwan found himself stumbling, barefoot and dazed, out of Syria’s notorious Saydnaya prison on the outskirts of Damascus as rebel forces pushing toward the capital threw open its doors to release the prisoners.

Arrested in 2018 for fleeing compulsory military service, the father of three had cycled through four other lockups before landing in Saydnaya, a sprawling complex just north of Damascus that became synonymous with some of the worst atrocities committed under the rule of now-ousted President Bashar Assad.

He recalled guards waiting to welcome new prisoners with a gauntlet of beatings and electric shocks. “They said, ‘You have no rights here, and we’re not calling an ambulance unless we have a dead body,’” Marwan said.

His Dec. 8, 2024, homecoming to a house full of relatives and friends in his village in Homs province was joyful.

But in the year since then, he has struggled to overcome the physical and psychological effects of his six-year imprisonment. He suffered from chest pain and difficulty breathing that turned out to be the result of tuberculosis. He was beset by crippling anxiety and difficulty sleeping.

He’s now undergoing treatment for tuberculosis and attending therapy sessions at a center in Homs focused on rehabilitating former prisoners, and Marwan said his physical and mental situations have gradually improved.

“We were in something like a state of death” in Saydnaya, he said. “Now we’ve come back to life.”

On Monday, thousands of Syrians took to the streets to celebrate the anniversary of Assad's fall.

Like Marwan, the country is struggling to heal a year after the Assad dynasty’s repressive 50-year reign came to an end following 14 years of civil war that left an estimated half a million people dead, millions more displaced, and the country battered and divided.

Assad's downfall came as a shock, even to the insurgents who unseated him. In late November 2024, groups in the country’s northwest — led by Hayat Tahrir al-Sham, an Islamist rebel group whose then-leader, Ahmad al-Sharaa, is now the country’s interim president — launched an offensive on the city of Aleppo, aiming to take it back from Assad’s forces.

They were startled when the Syrian army collapsed with little resistance, first in Aleppo, then the key cities of Hama and Homs, leaving the road to Damascus open. Meanwhile, insurgent groups in the country’s south mobilized to make their own push toward the capital.

The rebels took Damascus on Dec. 8 while Assad was whisked away by Russian forces and remains in exile in Moscow. But Russia, a longtime Assad ally, did not intervene militarily to defend him and has since established ties with the country's new rulers and maintained its bases on the Syrian coast.

Hassan Abdul Ghani, spokesperson for Syrian Ministry of Defense, said HTS and its allies had launched a major organizational overhaul after Assad’s forces regained control of a number of formerly rebel-controlled areas in 2019 and 2020.

The rebel offensive in November 2024 was not initially aimed at seizing Damascus but was meant to preempt an expected major offensive by Assad’s forces in opposition-held Idlib intending to “finish the Idlib file,” Abdul Ghani said.

Launching an attack on Aleppo “was a military solution to expand the radius of the battle and thus safeguard the liberated interior areas," he said.

In timing the attack, the insurgents also took advantage of the fact that Russia was distracted by its war in Ukraine and that the Iran-backed Lebanese militant group Hezbollah, another Assad ally, was licking its wounds after a damaging war with Israel.

When the Syrian army’s defenses collapsed, the rebels pressed on, “taking advantage of every golden opportunity,” Abdul Ghani said.

Since his sudden ascent to power, al-Sharaa has launched a diplomatic charm offensive, building ties with Western and Arab countries that shunned Assad and that once considered al-Sharaa a terrorist.

In November, he became the first Syrian president since the country’s independence in 1946 to visit Washington.

But the diplomatic successes have been offset by outbreaks of sectarian violence in which hundreds of civilians from the Alawite and Druze minorities were killed by pro-government Sunni fighters. Local Druze groups have now set up their own de facto government and military in the southern Sweida province.

There are ongoing tensions between the new government in Damascus and Kurdish-led forces controlling the country’s northeast, despite an agreement inked in March that was supposed to lead to a merger of their forces.

Israel is wary of Syria's new Islamist-led government even though al-Sharaa has said he wants no conflict with the country. Israel has seized a formerly U.N.-patrolled buffer zone in southern Syria and launched regular airstrikes and incursions since Assad’s fall. Negotiations for a security agreement have stalled.

Remnants of the civil war are everywhere. The Mines Advisory Group reported Monday that at least 590 people have been killed by landmines in Syria since Assad’s fall, including 167 children, putting the country on track to record the world’s highest landmine casualty rate in 2025.

Meanwhile, the economy has remained sluggish, despite the lifting of most Western sanctions. While Gulf countries have promised to invest in reconstruction projects, little has materialized on the ground. The World Bank estimates that rebuilding the country’s war-damaged areas will cost $216 billion.

The rebuilding that has taken place has largely been individual owners paying to fix their own damaged houses and businesses.

On the outskirts of Damascus, the once-vibrant Yarmouk Palestinian camp today largely resembles a moonscape. Taken over by a series of militant groups then bombarded by government planes, the camp was all but abandoned after 2018.

Since Assad’s fall, a steady stream of former residents have come back.

The most damaged areas remain largely deserted but on the main street leading into the camp, bit by bit, blasted-out walls have been replaced in the buildings that remain structurally sound. Shops have reopened and families have come back to their apartments. But any larger reconstruction initiative appears to still be far off.

“It’s been a year since the regime fell. I would hope they could remove the old destroyed houses and build towers,” said Maher al-Homsi, who is fixing his damaged home to move back, although the area doesn't even have a water connection.

His neighbor, Etab al-Hawari, was willing to cut the new authorities some slack.

“They inherited an empty country — the banks are empty, the infrastructure was robbed, the homes were robbed," she said.

Bassam Dimashqi, a dentist from Damascus, said of the country after Assad’s fall, “Of course it’s better, there’s freedom of some sort.”

But he remains anxious about the precarious security situation and its economic impacts.

“The job of the state is to impose security, and once you impose security, everything else will come," he said. "The security situation is what encourages investors to come and do projects.”

The U.N refugee agency reports that more than 1 million refugees and nearly 2 million internally displaced Syrians have returned to their homes since Assad’s fall. But without jobs and reconstruction, some will leave again.

Among them is Marwan, the former prisoner, who says the post-Assad situation in Syria is “far better” than before. But he is struggling economically.

Sometimes he picks up labor that pays only 50,000 or 60,000 Syrian pounds daily, the equivalent of about $5.

Once he finishes his tuberculosis treatment, he said, he plans to leave to Lebanon in search of better-paid work.

Sewell reported from Beirut. Associated Press journalist Omar Albam in Damascus contributed to this report.

FILE - A man breaks the lock of a cell in the infamous Saydnaya military prison, just north of Damascus, Syria, Monday, Dec. 9, 2024. (AP Photo/Hussein Malla, File)

Former detainee Mohammad Marwan walks down a street on his way to the Homs Recovery Center in the village of Tell Dahab in the Homs countryside, Syria, Tuesday, Dec. 2, 2025. (AP Photo/Ghaith Alsayed)

A girl sits on a machine gun as visitors tour the "Syrian Revolution Military Exhibition," which opened last week ahead of the first anniversary of the ousting of the Bashar Assad regime in Damascus, Syria, Sunday, Dec. 7, 2025. (AP Photo/Ghaith Alsayed)

A boy checks out military equipment as visitors tour the "Syrian Revolution Military Exhibition," which opened last week ahead of the first anniversary of the ousting of the Bashar Assad regime in Damascus, Syria, Sunday, Dec. 7, 2025. (AP Photo/Ghaith Alsayed)

A Syrian man silhouetted by a digital billboard showing the date of the ousting of the Bashar Assad regime during celebrations marking the first anniversary, in Damascus , Syria, Sunday, Dec. 7, 2025. The Arabic words read: "A history retold and a bond renewed." (AP Photo/Hussein Malla)

Wanted portraits of former Syrian president Bashar Assad are displayed in the window of a coffeeshop, in Damascus Sunday, Dec. 7, 2025, as Syrians celebrate marking the first anniversary of the ousting of the Bashar Assad regime. (AP Photo/Hussein Malla)

Syrian men wearing anonymous masks flash victory signs, as they stand on top of their car with its front window covered by an Islamic flag, during celebrations marking the first anniversary of the ousting of the Bashar Assad regime in Damascus, Sunday, Dec. 7, 2025. (AP Photo/Hussein Malla)

LOS ANGELES--(BUSINESS WIRE)--Dec 8, 2025--

A new study led by Children’s Hospital Los Angeles (CHLA) has linked specific molecular markers at birth to future childhood leukemia risk. The study—the largest of its kind in pediatric leukemia—identified distinct DNA methylation signatures in newborns who later developed acute lymphoblastic leukemia (ALL). The findings could pave the way for understanding why certain children develop ALL.

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Eric Nickels, MD, MS, a pediatric oncologist in the Cancer and Blood Disease Institute at CHLA, presented the results Dec. 6 in an oral presentation at the 2025 American Society of Hematology (ASH) meeting in Orlando, Florida.

“This study gives us a window into the earliest molecular changes that precede childhood leukemia,” Dr. Nickels says. “It’s exciting because it moves us closer to understanding which children may be at risk for this cancer.”

Early clues at birth

Scientists have long suspected that pediatric ALL begins before birth, with early genetic changes arising during fetal development. But until now, researchers had limited ability to examine epigenetic features that could contribute to a child’s risk. One of those features is DNA methylation—chemical tags that regulate which genes are turned on or off. “If you think of DNA as a textbook, methylation tells the cell which pages to read,” Dr. Nickels explains.

To study these markers at birth, he and his collaborators at the Keck School of Medicine of USC accessed an extraordinary resource: nearly 1,700 archived newborn blood spots collected across California during routine newborn screenings.

A clear pattern

When the team compared methylation patterns across these samples, a striking signal emerged. Babies who developed ALL in childhood showed consistent differences in DNA methylation at birth compared with healthy controls.

Researchers found one of the strongest associations at a site in ARID5B, a gene already linked to ALL—making this finding especially compelling.

The team also identified more than 100 regions where methylation patterns differed between newborns who developed ALL as children and those who did not. Many of these regions were located in genes involved in blood cell development or previously linked to leukemia biology, including FLI1 and LAX1.

Together, these findings suggest that measurable epigenetic differences are present at birth in children who later develop ALL.

“Seeing these differences in newborns tells us that important biological changes are happening far earlier than we can usually detect,” Dr. Nickels says.

Future directions

The team is now studying how these early patterns influence gene activity and how they compare with changes seen at diagnosis. That knowledge could help reveal which molecular pathways are disrupted first—and which might be targets for intervention.

Because some methylation changes are shaped by maternal nutrition and environmental exposures, the study opens the door to exploring whether certain risks could eventually be reduced—preventing leukemia from ever developing.

“This is a first step toward that long-term goal, but it’s an important one,” Dr. Nickels says. “The more we learn about how leukemia begins, the closer we will be to finding ways to predict—and potentially prevent—this disease.”

About Children’s Hospital Los Angeles

Children’s Hospital Los Angeles is at the forefront of pediatric medicine and is the largest provider of hospital care for children in California. Since its founding in 1901, CHLA has delivered a level of pediatric care that is among the best in the world. Ranked one of the top 10 children’s hospitals in the nation by U.S. News & World Report, Children’s Hospital Los Angeles provides comprehensive and compassionate care to one of the largest and most diverse pediatric patient populations in the country. The hospital is the top-ranked children’s hospital in California and the Pacific U.S. region for 2025-26. A leader in pediatric research, CHLA is among the top 10 children’s hospitals for research funding from the National Institutes of Health. The Saban Research Institute of Children's Hospital Los Angeles supports the full continuum of research, translating scientific discoveries into life-changing treatments for patients around the globe. As a pediatric academic medical center, CHLA is also home to one of the largest graduate education programs for pediatricians in the United States. The hospital’s commitment to building stronger, healthier communities is evident in CHLA’s efforts to enhance health education and literacy, introduce more people to careers in health care, and fight food insecurity. To learn more, follow CHLA on Facebook, Instagram, LinkedIn, YouTube, and X, and visit CHLA.org.

Eric Nickels, MD, MS pediatric oncologist in the Cancer and Blood Disease Institute at Children's Hospital Los Angeles, presented the study results Dec. 6 in an oral presentation at the 2025 American Society of Hematology (ASH) meeting in Orlando, Florida.