19/01/2015 12:52 GMT | Updated 21/03/2015 05:59 GMT

Syria: From Bad to Worse

In 2014, the fourth year of the conflict in Syria, a bleak humanitarian situation deteriorated even further. To date, there have been over 200,000 fatalities and one million casualties. Three million people have sought refuge across borders and more than seven million people have been displaced. More than half of the country's population - including five million children - require some form of humanitarian aid. Not only has violence increased, but access to aid has also been restricted. Needs are greater than ever but the aid system is not meeting them. Today, Syria remains the most serious humanitarian crisis in the world.

In 2014, indiscriminate bombings have continued in many parts of the country, while in some cities, like Aleppo, they have been stepped up. There, barrel bombs have left the city practically deserted. The opposition-controlled area is unrecognisable, with many neighbourhoods suffering destruction comparable only to World War II or Grozny in the 1990s. Bombs have forced many Syrians to flee their homes, cross into neighbouring countries, or to relocate to areas controlled by the government or the Islamic State, which are less likely to be targeted.

In July 2014 alone, at least six hospitals in Aleppo were hit or affected by bombs. Some have been targeted several times; the Dar Al Shifa Hospital has been hit on four separate occasions and the Sakhur Hospital has been hit three times. On 2 August an airstrike completely obliterated Al Huda Hospital in west Aleppo, killing at least six doctors and nurses and injuring another 15 people, including patients. This hospital provided the only neurosurgical service in northern Syria. MSF facilities have not been spared the bombing: our medical centre near Aleppo has been damaged three times in recent months.

The Syrian health system has disintegrated. Outbreaks of measles and polio are having a cruel impact on children. Communicable and chronic diseases are leaving a trail of untold suffering, and women are giving birth in abject conditions. Even if the violence decreases in the medium term, basic needs are huge. Humanitarian organisations, including MSF, are unable to deliver basic services to communities that are struggling to survive.

Refugees are placing unprecedented social and economic pressure on the local communities that host them, and particularly on national health systems, social welfare and job markets. Not even a sprawling city like Istanbul, with nearly 18million inhabitants, can cope with the massive influx of Syrians. The situation in Jordan and Lebanon, where the proportion of refugees per capita is equivalent to 20% of the population, is worse. Refugees who have fled to Iraq have meanwhile found themselves caught up in the conflict there.

There now seems to be consensus that a victory by either side is neither possible nor desirable. Only despair and shame remain. It is shameful that in the four years of the conflict, Europe has given shelter to fewer refugees than Lebanon, Jordan and Turkey have in a single day. It is shameful to hear politicians speak about how maritime rescue services 'encourage' refugees and other vulnerable individuals to attempt perilous boat journeys across the Mediterranean. It is shameful to witness how the international community only reacts when its own interests are affected, such as the agreement to end chemical warfare or the threat of oil concessions in northern Iraq. With responsibility for their care having been passed on to humanitarian aid organisations, apparently Syrian civilians are not worthy of even the tiniest of gestures.

This article was originally published in Spanish by Vocento Group (Spain)