Beneath the buzzing sound of fighter jets, a physician named Ahmed works in a tiny clinic with few medical supplies and empty shelves in the northern countryside of the Aleppo governorate, which has been torn apart by the Syrian war. He used to be able to provide some treatment to patients with conditions such as diabetes, chronic anemia, and cancer — but not anymore. A drug shortage became even more acute after the United Nations Security Council failed to reauthorize a crucial border crossing in July.
That decision prohibited U.N. agencies from delivering humanitarian aid through Bab al-Salam, the nearest crossing between Turkey and northern Aleppo. Aid operations have since shifted to Bab al-Hawa, a crossing between Turkey and Syria’s rebel-held stronghold of Idlib. However, Bab al-Hawa doesn’t have the capacity to let through hundreds of additional convoys, resulting in long lines, long delays, and less relief into Syria.
“Since Bab al-Salam closed, we have received aid once every two months, but we used to see a convoy every two to three weeks,” said Ahmed, 44, who asked Devex to withhold his last name to protect his relatives in government-controlled areas from reprisal.
The crisis in northern Aleppo encapsulates the shortcomings of international diplomacy in maintaining aid to Syria's beleaguered civilians. In 2014, the Security Council established a cross-border mechanism that allowed U.N. agencies and partners to deliver large quantities of aid via four crossings to areas that were then not under Syrian government control. But since December 2019, Russia and China have wielded their vetoes to strong-arm the U.N. Security Council into not renewing three of them.
“The remaining NGOs won’t have the structure to procure supplies or do outreach like the U.N. does. You can’t even imagine the consequences of a closure.”— Sara Kayyali, Syria researcher, Human Rights Watch
The only one of those four that remains, Bab al-Hawa, allows aid to reach some 4 million people in northwestern Syria. If it’s not reauthorized by July 10 — and the cross-border mechanism is effectively shut down — U.N. agencies will have to reroute all their operations through Damascus.
Aid groups and NGOs warn that would enable the Syrian government to weaponize relief by keeping it from civilians in northwestern Syria, cutting the region off from the world and exacerbating a humanitarian catastrophe.
All eyes are on Moscow, a key backer of Damascus arguing that the cross-border operations undermine Syria’s sovereignty. Throughout the war, Russia and the Syrian government have targeted humanitarian workers, aid convoys, and hospitals in rebel-held areas. On March 21, airstrikes near Bab al-Hawa damaged or destroyed 24 trucks used for transporting humanitarian supplies, along with a warehouse storing food.
U.S. Secretary of State Antony Blinken condemned the attacks and other government abuses last month and urged the U.N. Security Council to reopen the crossings.
“Sovereignty was never intended to ensure the right of any government to starve people, deprive them of lifesaving medicine, bomb hospitals, or commit any other human rights abuse against citizens,” he said.
With reauthorization talks in the Security Council expected to pick up in the coming weeks, Russia could threaten to veto the renewal of Bab al-Hawa crossing or insist that members agree to a new, amended resolution. In the past, for example, Russia has demanded that the duration of resolutions be reduced from 12 months to six.
In the event of a Russian veto, Sara Kayyali, a Syria researcher for Human Rights Watch, warned that local and international NGOs wouldn’t be able to fill the gap left by U.N. agencies. The World Food Programme aids more than 1 million people per month in the northwest. Without its presence, only one-tenth of that number would receive food baskets, she estimated.
“The remaining NGOs won’t have the structure to procure supplies or do outreach like the U.N. does. You can’t even imagine the consequences of a closure,” Kayyali said.
Roadblocks for aid
Assessing what happened in Syria’s northeast when another crossing was closed gives a sense of the misery that could befall the northwest. In January 2020, a Security Council resolution terminated cross-border U.N. aid from al-Yarubiyah, which borders Iraq. Shortly afterward, Western diplomats said that U.N. medical aid declined by 40%, later resulting in an acute shortage of drugs and COVID-19 testing kits.
Some NGOs have continued supplying aid — without the Syrian government’s permission and outside the U.N. mechanism — through Faysh Khabur, a small crossing straddling northern Iraq. However, the Kurdistan Regional Government in Iraqi Kurdistan, citing a shortage of its own, has banned medical supplies purchased in its territory from export to Syria. Compounding the issue, Faysh Khabur’s limited capacity allows for few convoys into the northeast each day, increasing the leverage of the Syrian government.
“Some U.N. agencies have attempted to reach the northeast from Damascus, but they were turned around at government checkpoints,” Kayyali said. “This happens frequently until they can renegotiate permission.”
Reaching the northwest from Damascus would be even more difficult — or even impossible. Unlike with the Kurdish-led administration in the northeast, there are no lines of communication between the Syrian government and Hay’at Tahrir al-Sham, an internationally designated terrorist organization that controls most of Idlib in the northwest.
“There is no alternative to replace the current U.N.-supported cross-border operations in the northwest. If the U.N. Security Council resolution is not renewed in July, major gaps will hamper an effective response to areas not reachable from the … [Syrian government-controlled] areas,” said Christy Delafield, managing director of communications at Mercy Corps.
The rollout of COVID-19 vaccines would also be hampered. Global vaccine sharing platform COVAX plans to provide 336,000 doses to local cross-border partners in the northwest. But U.N. Secretary-General António Guterres has warned that the plan won’t be possible without the renewal of Bab al-Hawa. The first COVAX batch arrived Wednesday in Idlib through Bab al-Hawa.
Amid the uncertainty, Kasper Engborg, deputy head of office for the U.N. Office for the Coordination of Humanitarian Affairs, stressed that the U.N. won’t abandon its partners or its humanitarian mandate in Syria. He told Devex that if the cross-border resolution is not renewed, the U.N. will look for alternative ways to meet the growing needs in northwest Syria.
“The U.N. won’t close their doors and walk away,” he said. “It will continue to do its jobs to the extent that is absolutely possible.”
Still, NGOs fear that dozens of local aid groups that depend on U.N. funds will have to close. The OCHA-administered Syria Cross-Border Humanitarian Fund allocated $104.1 million to 40 local partners last year, Engborg told Devex. Losing that support would force many NGOs to find new funding sources. For example, they may turn to state donors such as Canada, Germany, or the United States. However, sprawling U.S. sanctions could dissuade smaller donors from financing Syrian NGOs directly.
Yakzan Shishakly, CEO at the Maram Foundation for Relief and Development, which provides housing assistance and education to Syrians in need, said his organization relies on the U.N. for about 80% of its funding. Without that support, he will need to lay off hundreds of employees in the northwest.
“If U.N. agencies leave, then we’re going to scale back operations,” he said. “We will lose a large amount of money, employees, and beneficiaries.”
Dr. Mazen Kewara, Turkey director for the Syrian American Medical Society Foundation, has another fear: Local aid workers could be increasingly targeted by all actors in the war if they lose the legitimacy the Security Council resolution bestows on them, he said.
“We already have experienced security issues and violations against hospitals and humanitarian centers from government forces and Hay’at Tahrir al-Sham,” Kewara said. “But the U.N.’s presence still gives us some sort of legitimacy, and that is important.”