The cautionary graffiti – "It's your turn, doctor" – written by children on a wall in the southern city of Deraa a decade ago, sparked a chain of events that at one time looked ready to bring a Syrian dictator down and end his family's near-40-year rule. <br/> Against the backdrop of the uprisings that were toppling governments in neighbouring Egypt, Libya and Tunisia, there was hope for change in Syria. But, instead, <a href="https://www.thenationalnews.com/world/mena/syrian-protests-escalate-at-funerals-1.418125">it sparked a deadly war</a> that is raging a decade on and has turned the country into a charnel house. Bashar Al Assad – the doctor – still clings tenuously to power but has re-asserted control over most of the major cities his government once lost. Since then, the president's survival guide centred on a catalogue of repressive tactics to crush any form of dissent, counting on the loyalty of his fellow Alawite clan members, who make up the backbone of the army and security forces. Sham parliamentary elections and Cabinet reshuffles that portray the president as a progressive reformer are also part of this playbook. But the civil conflict quickly became a geopolitical flashpoint, as Russia and Iran helped to tilt the balance in favour of Mr Assad, whose forces defeated the sharply divided rebels and extremists, cornering them today in the north-western province of Idlib, along with up to three million civilians. The conflict has drawn in not only the two main backers of the Assad regime, but also western and regional countries that acted to strengthen their rebel allies on the ground. "From the get-go, the Assad regime understood that this was going to be a war of attrition, one that it waged while sparing no thought for civilians," Michael A Horowitz, head of intelligence at the Bahrain-based Le Beck International, a Middle East and North Africa security consultancy group, told <em>The National.</em> “This was always a slow and deadly war. Urban combat is difficult, even when you don’t shy away from using barrel bombs or chemical weapons, or when using tunnels and car bombs. Both sides were and are still suffering from extensive attrition, making it very difficult to mobilise for extended periods of time and carry out swiping offensives.” In 2015, Russia sent weapons, military advisers and mercenaries to prop up the Iran-backed government forces. This intervention was a game changer for Mr Al Assad. Russian air power helped the regime to regain control over most of the country. By mid 2018, the regime had retaken major cities and other areas, chiefly Aleppo and large patches of the countryside and suburbs of Damascus, then Deraa, the birthplace of the Syrian revolution-turned-war. The regime established a point of strength during UN and western-backed peace talks, with continuing hostilities on the ground making them futile. As western-backed forces – including the US and its allies in Europe – shifted focus from toppling Mr Al Assad to fighting ISIS, the embattled president played the long game. First, he decided to give up control of areas he knew he would not be able to keep, while defending areas that were central to the regime's survival. “Russian air power, as well as the continued influx of Iran-backed foreign fighters, slowly broke the rebels, while also forcing those backing the opposition to review their positions," Mr Horowitz said. “I would say that this last part was Moscow’s simplest and perhaps most efficient tool: making it clear that, while Assad may not win, the regime also wouldn’t fall, which eventually forced backers of the rebels to slowly move away from what is now perceived as an unrealistic objective," he said. Adding to the geopolitical aspect of the conflict, the UN Security Council's permanent members were also divided, with Russia and China consistently supportive of the Assad regime, whereas the US, the UK and France endorsed change. As for the winners and losers of the conflict so far, observers are beginning to see where the chips are falling. "Russia, to me, is one of the main winners of the conflict. With a limited intervention, a relatively small number of air assets, as well as ground forces [mostly in the form of private mercenaries], Moscow successfully prevented the fall of Assad and positioned itself as an essential interlocutor for most Middle Eastern countries," Mr Horowitz said. “Strongmen around the world will also get the message that having a Russian base on their soil is kind of like having a get-out-of-jail card." The Syrians on both sides have lost. The rebels are now almost fully co-opted by Turkey, to the point that some of them are acting as mercenaries in Ankara's regional wars. But a lack of progress caused Turkey to rethink its strategy and goals, from pushing for regime change in Damascus, to a policy strictly focused on "protecting its fence" through costly ground operations. In 2018, Russia and Turkey reached an agreement to avert a full-scale regime operation to recapture Idlib, the last main stronghold for rebels and extremist factions. Mr Horowitz said the Assad regime and its supporters have also lost the war. "Despite Assad's ability to survive, Syria will never be the same, and the centralised regime that we knew prior to the conflict no longer exists, replaced by a set of foreign-backed warlords," he said. The war leaves Syria in ruins and the cost of reconstruction is mind-boggling. Neither the Syrians nor the Iranians nor Russians can afford such a daunting undertaking. The reconstruction process is tied to geopolitical factors in a war dictated by foreign rivalries and US sanctions that might scare off key players in the region and despite recent rapprochement with Damascus. “At the end of the day, the keys to bringing Syria back to the Arab fold lies in Arab capitals: Abu Dhabi, Riyadh and Cairo. "More so, the Gulf countries are expected to shoulder a major load in Syria's reconstruction, which appears to be a common consensus if and when it happens. To do so, there will be a price to be paid and those Arab capitals will surely not want to prop up Assad while Iran still enjoys a lot of sway over the regime,” said Bachar Al Halabi, Mena geopolitical analyst for the New York-based ClipperData. In March 2011, “Assad or we burn the country” was one the slogans pro-regime supporters often used. The grim story of Syria continues.