Smoke rises after airstrikes on Aleppo's Castello road, Syria on June 2, 2016. 

© 2016 Reuters
(New York) – The Syrian government and allied forces should urgently allow access to aid to besieged eastern Aleppo. 

Residents of eastern Aleppo and aid workers told Human Rights Watch by phone that as the Syrian government siege has tightened since July 11, 2016, food prices have soared and medical supplies have decreased to alarming levels.

“Syrian government forces are repeating the terrible siege tactics in densely populated eastern Aleppo that devastated civilian populations in other towns in Syria,” said Nadim Houry, deputy Middle East director. “Syrian authorities should allow aid in and permit civilians wishing to leave to do so safely.”

The United Nations Security Council has demanded that all parties to the conflict in Syria allow aid workers swift and safe access to people in need, as required under international humanitarian law. The International Syria Support Group, which includes the United States and Russia, should use its influence to press the Syrian government and other warring parties to allow unhindered access to aid, particularly to all hard-to-reach and besieged areas of the country, Human Rights Watch said.

The eastern part of the city of Aleppo, which is controlled by opposition armed groups, has been effectively under siege since government forces cut off the main supply road, known as the Castello Road, through constant shelling and airstrikes. Roads leading out of Aleppo city to the west have also been cut off by government airstrikes on towns such as Hreitan and Anadan.

The UN estimates that the eastern part of the city has a population of between 250,000 and 300,000, and aid agencies estimate that a third of them depend on aid delivered via the Castello Road. International aid workers told Human Rights Watch that some residents would face health and nutrition problems in two weeks, but it has been three weeks since aid has been delivered to the city.

Prices inside the city for basic food and household supplies have increased sharply since July 11, and availability has noticeably decreased. Residents said that a kilo of rice was now US$14, a kilo of sugar was $20, and olive oil was $44.

Residents said that some traders are hoarding food items because of the rising prices. Fresh fruit and vegetables have been off the shelves for months. Aid workers also said there was just enough fuel to keep generators, bakeries, and hospitals running for a month. On July 13, the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) released a statement saying the UN had food supplies for only 145,000 people for one month in east Aleppo.

Feras Badawi, a journalist in east Aleppo, told Human Rights Watch that the humanitarian situation inside the city was worsening by the day:

We have been under siege since at least July 11, and the shops are emptying very quickly. A liter of diesel is about $10 and if you can find gasoline for your car it is $20 a liter. We also only get four hours of electricity every 24 hours. We haven’t seen vegetables in weeks and the airstrikes are not giving us a break. Missiles even fell on the roof next to my house. The streets are very empty and people scurry outside only if they really need to go out. Most people are sleeping in shelters or basements under their homes and there is a lot of fear.

Ibrahim Abu al-Laith, who volunteers in Aleppo with Syrian Civil Defense, a search-and-rescue organization that operates in opposition-held Syria, said:

It is a crisis situation in our city. We don’t have any vegetables, a package of bread is $6 and gas stations are usually out of gasoline. The lines of people at shops to stock up on rations are extremely long. We are really expecting a famine in a few days. Also, any injured people who need specialized treatment and need to be taken out of Aleppo are now completely stuck.

According to the Syrian Network for Human Rights, Syrian and Russian military forces were responsible for the death of 278 civilians, including 154 children and 78 women, between June 1 and July 13. Opposition armed groups also continued to shell and rocket western Aleppo city, which is controlled by the government. According to the Syrian state news agency, opposition armed groups killed over 60 civilians between July 9 and 16.

On July 18, the Syrian-American Medical Society, which runs hospitals and clinics inside opposition-held areas of Syria, said that the closure of the Castello Road was affecting their ability to transport medical supplies and food to the city as well as to transfer patients and severely injured civilians out to safety for treatment. It said that 805 civilians, including 179 children, had been were killed in eastern Aleppo between April 22 and July 11, and that only 40 doctors and dentists remain in the eastern part of the city.

Dr. Abdelbassit al-Sheyoukhi, a doctor inside east Aleppo, told Human Rights Watch that the medical situation could deteriorate quickly:

While we have some medicines and supplies in our medical warehouses, there is a shortage of treatment for specialized illnesses like heart disease and chronic diseases and in surgical equipment. There is also a shortage on the staffing front. While there are some doctors, medics, and nurses, we are just not enough to meet the needs of the city. The situation will become a catastrophe if the siege lasts, and we are calling for a humanitarian channel out of the city to deliver our injured and sick people, be they civilian or military, out of the city.

Badawi, the journalist, said that civilians in the city “have to depend on smaller clinics to treat our children if they become sick because many of our hospitals have been rendered out of commission due to airstrikes. Most of the clinics are run by nurses, not doctors, and they are only able to give painkillers for whatever the illness.”

UN Security Council Resolution 2268, adopted on February 26, sets out the terms of the cessation of hostilities in Syria and calls on all parties to the conflict to allow humanitarian agencies “rapid, safe and unhindered access throughout Syria by most direct routes, allow immediate humanitarian assistance to reach all people in need, in particular besieged and hard-to-reach areas and immediately comply with their obligations under international law.”

Under international humanitarian law, all parties to the conflict must allow and facilitate rapid and unimpeded passage of humanitarian relief for civilians in need. The parties are obligated to grant humanitarian relief personnel freedom of movement, and protect them from attack, harassment, intimidation, and arbitrary detention. Using the starvation of civilians as a weapon is a war crime.

“Russia and the US should not wait for images of starving civilians before pressing Syria and other warring factions to allow aid to reach besieged civilians,” Houry said.