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(New York) – Syria should urgently agree that humanitarian aid may be brought into the country across all of its borders, including from Turkey. Syria’s allies, including Russia, should press Syria to consent to such transfers, Human Rights Watch said. Donors should not wait for Syria’s go-ahead, but instead should immediately expand support to non-governmental organizations already able to deliver aid from Turkey into opposition-held areas of Syria.

While there have been obstacles to delivering aid throughout Syria, reaching areas held by the opposition has been particularly difficult. On January 31, 2013, the UN Office for the Coordination of Humanitarian Aid said publicly that it was unable “to reach the vast majority who are in need in the opposition-held areas,” and called urgently for agreement to allow cross-border transfers, noting that “there is no time to lose.”

“Thousands of Syrians face horrendous living conditions because aid is simply not reaching them,” said Sarah Leah Whitson, Middle East director at Human Rights Watch.“A simple word from the Syrian government could make reaching those in need much easier – but even without it there is more donors can do.”

Syria has permitted some “cross-line” aid deliveries that originate in Damascus and then are taken to opposition-held areas, but it has not agreed that humanitarian assistance may be sent to opposition areas directly from neighboring countries. While independent organizations are delivering some aid from Turkey to northern Syria, under a UN General Assembly resolution, UN agencies are not allowed to work across borders without Syria’s consent, unless the UN Security Council authorizes such efforts. UN involvement in the cross-border deliveries would help ensure a more effective and coordinated aid effort, humanitarian officials have said.

The UN Security Council should also call for Syria to agree to cross-border aid, a step likely to be more palatable to Syria’s allies than a resolution authorizing such aid without Syria’s agreement, Human Rights Watch said.

“How do you explain to suffering families that aid is delayed because it can’t take the quickest route?” Whitson said. “Syria’s friends, including Russia, shouldn’t be silent in the face of this humanitarian crisis.”

Turkey should take immediate steps to make it easier to deliver aid, including food and fuel, across its border, Human Rights Watch said.

There are many obstacles to effective aid delivery throughout Syria, Human Rights Watch said. Syria has created administrative obstacles for international agencies, such as limiting the number of visas for expatriate personnel, and has harassed, targeted, and sometimes arbitrarily detained aid providers for doing their job, as Human Rights Watch has documented on several occasions. Human Rights Watch has also documented attacks by Syrian government forces on health facilities and personnel.

The Syrian government has also insisted that all aid be delivered under its supervision or through organizations on an approved list. UN agencies are vetting the organizations Syria has put forward but opposition supporters have strongly criticized dealings with some groups, including the Syria Trust, founded by Asma Assad, President Bashar al-Assad’s wife. The UN should conduct thorough vetting of the organizations it works with, and should be transparent about the organizations it is using as partners, Human Rights Watch said.

Under international humanitarian law, civilian humanitarian relief personnel must be granted freedom of movement by all parties to the conflict, and be protected from attack, harassment, intimidation, and arbitrary detention.  The parties to the conflict must allow and facilitate rapid and unimpeded passage of humanitarian relief for civilians in need.

Humanitarian aid to opposition-held areas is also undermined by the multiplicity of armed groups and the absence of security guarantees. The Syrian National Council should encourage armed opposition groups to grant safe passage to relief convoys and personnel into the territories within their control. The council should also rapidly expand the capacity of its assistance-coordination unit so that it can provide more help to people in need in opposition-held areas. Donors and international organizations should support these efforts, and should make deliveries in coordination with civilian governance structures that have been created in opposition-held areas.

During field investigations in northern Syria in December, Human Rights Watch documented increasingly dire humanitarian conditions affecting the civilian population in opposition-held areas. In many of the 18 villages visited in Idlib, Latakia and Aleppo governorates, residents told Human Rights Watch that humanitarian conditions had deteriorated significantly. Some villages only had electricity for a few hours during the night, while many no longer had any electricity. The price of fuel and gas had increased significantly, they said, prompting many to install wood-burning furnaces in their homes, although the price of wood had also increased. In Latakia, dozens of internally displaced people were living in tents that were not well-suited to the winter conditions.  

The main worry for local residents interviewed by Human Rights Watch, however, was the increasing shortage of food, and in particular of bread. Repeated government attacks on bread lines and bakeries have caused many bakeries to close, or operate with limited hours. A shortage of flour, and of fuel to power the granaries, has exacerbated the situation. A resident of a town in the Aleppo countryside told Human Rights Watch:

There used to be six bakeries here, but now only one is left. Because of the attacks people are afraid to stand in line and the bakery delivers instead. But we only get one or two breads per day. The bakery does not have enough flour.

Human Rights Watch also documented the limited access to medical help in the areas visited. In three places, residents said that government forces had struck health facilities, some several times, leaving them unusable. In most of the towns, opposition authorities would evacuate severely wounded people to Turkey for treatment because of the limited treatment available in their area.

The situation was most dire in Latakia governorate, where a combination of government attacks, fear of sectarian violence and harsh humanitarian conditions had prompted local residents to flee, sometimes leaving towns and villages virtually abandoned, other residents told Human Rights Watch.

In Jdeideh, in Latakia governorate, a resident who spoke to Human Rights Watch said that of the 1,300 residents typically living in the village only 375 remained. The others had left for fear of the shelling and because of the dire humanitarian situation in the village. The village had electricity outages, inadequate water supplies, no or limited diesel for heating and generators, inadequate flour supplies or access to functioning bakeries, and no access or limited access to doctors and hospitals. 

With the exception of two Turkish non-governmental organizations that were providing medical supplies to a field hospital in the area and the operations of one international agency, no humanitarian organizations appeared to be operating in the area. 

In Homs, the World Health Organization estimates that 550,000 people live in dire humanitarian conditions, while hospitals and health center staff said they are overwhelmed and understaffed, and that they lack adequate resources to treat patients in need.

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