In a world gripped by a pandemic, it can be difficult to remember that the war in Syria is still happening. AP

Syria's brutal conflict enters its 10th year Sunday with President Bashar Al Assad's regime consolidating its hold over a war-wracked country with a decimated economy where foreign powers flex their muscles.

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When Syrians took to the streets on March 15, 2011, they could scarcely have imagined their anti-government protests would turn into a complex war entangling rebels, jihadists and outside forces.

Syrian army soldiers fire their weapons during a battle with rebel fighters near Aleppo, Syria. File/AP

At least 384,000 people have since died, including more than 116,000 civilians, the Syrian Observatory for Human Rights war monitor said Saturday.

The conflict has displaced more than 11 million people internally and abroad.

"Nine years of revolution illustrate the extent of the suffering we have known, between exile, bombings and deaths," said Hala Ibrahim, a rights activist who now lives in the town of Dana, in Idlib province.

Civilians cut off a section of highway which links the northern Syrian provinces of Aleppo and Latakia. File/AFP

"I left my university, my house which was bombed," the woman in her 30s said. "We've lost everything."

Originally from the northern city of Aleppo, Ibrahim left in late 2016 after the regime retook rebel-held areas and she sought refuge in Idlib.

The northwestern region — Syria's last rebel stronghold — is the regime's latest target.

Thanks to the military support of Russia, Iran and Lebanese militant group Hezbollah, Assad has clawed back control of over 70 per cent of the war-torn country.

A Syrian refugee woman puts a face mask on a boy in Al Wazzani area, in Lebanon. Reuters

A fragile ceasefire came into effect in the northwest earlier this month, and Turkish and Russian officials have agreed to start joint patrols in Idlib.

Syrian forces and Russian warplanes have heavily bombarded the region since December, killing nearly 500 civilians, the Observatory says, and forcing nearly a million to flee, according to the United Nations.

Agence France-Presse