The problem of aid delivery in Syria has become so grave that the UN is pressing the Syrian government to allow more aid to pass through Turkey to reach what it estimates to be 3.5 million people who have been isolated and cut off from any form of humanitarian relief.
The crisis has intensified as the warring parties have reached a stalemate. In the north, the population of internally displaced persons residing in camps has increased by 20 percent to around 129,500 between January and May this year, according to the Assessment Capacities Project. Polio and measles, diseases that had previously all but been eradicated, have now made a reappearance, not to mention a recent study that accuses the Syrian government of targeting health infrastructure inside the country. The channels between donors, delivery partners and beneficiaries have broken down and humanitarian organizations are now looking for alternative solutions.
Currently, UN agencies and many NGOs are bound by their own charters to deliver aid through the Syrian government. This aid is distributed by government partners, often the Syrian Arab Red Crescent (SARC). There are widespread concerns that SARC's aid delivery is politicized, with aid only reaching government-held areas. According to a report by Syrian state news agency SANA, the Minister for Syrian Arab Red Crescent Affairs, Joseph Sweid, said the organization is linked to the prime ministry. SARC President Abdul Rahman Attar has denied these claims, stating the organization operates independently of government. Attar himself, along with other top-ranking figures, has been accused of having close ties with President Bashar Al-Assad's government.
Syrian surgeon Dr. Safi Dabdoub, who used to run a private hospital in Hama until it was seized by the government, says that "aid to SARC actually props up the regime." Saleh Muslim, head of the Kurdish Democratic Union Party (PYD), told Asharq Al-Awsat last May that SARC was highly selective in its aid delivery, favoring Arabs over Kurds. While it is hard to establish the truth of these accusations, concerns over impartiality have contributed to a breakdown in trust between SARC and donors. Dr. Sharif Al-Ghazal, a member of the Syrian Parliamentary Affairs Group, says he believes "the vast majority of aid delivered through SARC goes to government-held areas." He asks: "Would the government help people in Homs? If the government has thrown chemical weapons on the civilian population would they also deliver aid? We simply cannot trust the government."
Similarly, the Syrian government is suspicious of aid delivered by NGOs, fearing it could strengthen the rebel position. The rebels have been accused of redirecting aid intended for civilians; the problem is compounded further by the fact that the line between civilian and fighter is blurred. A recent report accuses all sides of politicized aid delivery: "The obstruction of humanitarian assistance to Syria continues to be used as a political tactic by parties to the conflict, further compromising the humanitarian community's ability to reach the most vulnerable communities."
The result is that civilians suffer. In many instances aid delivery has actually decreased; in the first three months of 2013 the World Health Organization delivered emergency medical kits to 914,000 beneficiaries, but in April to June of the same year that number dropped to a paltry 270,500 after the government restricted medical aid delivery to opposition areas.
Unconventional aid delivery
In reaction to these obstacles, unconventional models of aid delivery are being considered. Among others, Human Rights Watch and a coalition of the world's leading lawyers have called for cross-border aid delivery even when the Syrian government fails to give its consent. Cross-border aid has been carried out before without government approval and has legal precedents in Ethiopia, Nigeria and Iraq.
In northern Syria, cross-border aid from Turkey is already a de facto reality. Organizations such as Médecins Sans Frontières assist civilians across the border, as do several Syrian diaspora NGOs. The vast majority of northern Syria relies on aid delivered through these smaller NGOs, which are often run by Syrians who know the ins and outs of their country. Volunteers for Hand in Hand for Syria talk of delivering aid to Homs when it was under siege, thanks to their knowledge of the city's sewage system. Dr. Wael Kurdi, one of the directors of charity Sanabel Al-Sham, says: "We have men inside Yarmouk camp, where we have soup kitchens, who move their locations daily so the government can't target us." This is in stark contrast to the oft-thwarted efforts of the UN Relief and Works Agency to access Yarmouk camp. Dr. Kurdi explains that the aid from 13 different international organizations is delivered through Sanabel Al-Sham.
But there are problems with this model, too--not enough support has been given to these smaller organizations to ensure their work continues. A hospital in Aleppo run by Hand in Hand for Syria is facing closure due to lack of funding. Another charity, SKT Welfare, said it had to relocate to Idlib because its medical facilities were hit in Aleppo. What these organizations lack is the financial clout that the larger NGOs can bring to aid delivery.
Aid convoy risks
Several convoys organized by British charities have traveled from the UK to Syria to deliver ambulances and aid. Some of these charities, which are often largely amateurish outfits, have recently come under scrutiny for allegedly transporting foreign jihadists to Syria. One such charity, Children in Deen, is currently being investigated by the Charity Commission after reports emerged that it transported a British man who later blew himself up inside Syria.
An advisor to the UK's Department for International Development (DFID), Fred Robarts, said the DFID did not encourage aid convoys due to the risk associated with entering Syria, and instead suggested donating money to local charities. He also believed that buying ambulances in neighboring countries was far more effective than delivering ambulances to Syria. However, Robarts said that no one should be criminalized for wanting to help, and that there had to be a forum where interested parties could come and discuss their concerns with the British authorities.
While tough measures are needed to ensure donor money goes to the right places, some are worried that many more Syrians will suffer as fewer convoys cross the border. Syrian-British cardiothoracic surgeon Mohamed Fadel Moghrabi made an impassioned plea at a parliamentary meeting on Syria last week, stating how vital ambulances were to the aid effort. In a presentation accompanied by studies conducted by the British Medical Association, he demonstrated that 90 percent of attacks on hospitals and medical facilities were perpetrated by the regime and ambulances had not been spared. Thirty ambulances in Aleppo alone have been destroyed; only fifty doctors now cater for a population of 5 million, according to Dr. Moghrabi.
After the recent Al-Anfal Operation conducted by opposition forces in Latakia, the difference the ambulances donated by the people of Nottingham made on the operation of hospitals in northern Syria became clear. One British aid worker who asked to remain anonymous said that instead of cracking down on aid convoys, the solution for cross-border aid delivery was to make them more professional and transparent, while at the same time those organizing aid convoys needed to take effective steps to vet participants. With the situation in Syria set to get worse, the argument for cross-border delivery is an option the UN and other international aid organizations cannot resist for much longer.
This article was first published in The Majalla