Earlier this year, the UN Special Envoy for Syria estimated that 400,000 people have died in the country’s conflict since it began in 2011. With the number of dead so vast, it has become an immense challenge to find space in which to bury them. And because the majority of the deceased practiced Islam, a religion whose funerary rites include burial rather than cremation, the need for enough ground in which to lay thousands upon thousands to rest is even more acute.

Syria’s residents have been forced to come up with makeshift solutions. In the opposition-held city of Douma, northeast of Damascus, for instance, locals buried people outside the city when the cemeteries filled. As the number of dead increased, they began to create tiered plots. One worker told Turkey’s Anadolu Agency that he is helping to dig one with three layers, each able to hold a thousand graves.

In eastern Aleppo, currently under siege as opposition groups try to repel Syrian government and Russian forces, the cemeteries have been at capacity for several years. Even the public parks that had been turned into crude burial grounds are now overflowing, forcing people to inter their loved ones in empty lots or in fields.

In Damascus, residents are selling their burial plots on the black market for huge sums in order to survive. “People are hungry and desperate,” Abu Salah al-Maydani, a Syrian activist, told Syria Direct. “[They] are trading in death to preserve life.”

Establishing burial plots for Syrians in neighboring countries is also a challenge. While the refugees have escaped direct violence, most are living in extreme poverty and have higher death rates than the host population. In the Bekaa Valley of Lebanon, for example, where more than a third of the country’s 1 million Syrian refugees live, many towns’ cemeteries were already close to full before the influx of new residents. When turned away by Lebanese authorities or asked to pay high fees that they cannot afford, refugees have confessed to burying their dead in cemeteries or elsewhere in secret, under the cover of night.

Many Syrians fleeing by unsound boats to Europe have perished at sea, their bodies washing ashore at such places as the Greek island of Lesbos. An activist on the island, Efi Matsoudi, has established a Muslim cemetery for those who have drowned. Such efforts both in and out of Syria have given some a more dignified burial than might be expected in such chaotic times.

For those who are still living, Hasan Monir Jakal, a gravedigger in Aleppo, perhaps most aptly describes their incalculable suffering. “I dream of when my time will come, where, and how,” he told Middle East Eye. “Am I going to be buried in rubble, suffocating? These are the questions the living in east Aleppo ask themselves every day. I’d rather be buried than see this.”