NEW YORK - The Syrian government should honor its commitments and cease unlawfully hindering the delivery of food and medical aid throughout Syria.

In his March 23, 2016 report to the United Nations Security Council, the UN secretary-general said that the Syrian government has blocked aid to at least six out of 18 besieged areas since the cessation of hostilities began on February 26. The government denied aid access to Eastern Ghouta – including Douma, Harasta, Arbin, Zamalka, and Zabadin – and Daraya, affecting over 250,000 civilians. Local council officials and aid workers in Daraya and Douma told Human Rights Watch in phone interviews that civilians are suffering from severe shortages of food and medicine as well as debilitating poverty.

“While aid delivery has improved in the last month, it’s still not nearly enough and too many Syrians are still not receiving the aid they need,” said Nadim Houry, deputy Middle East director. “The Syrian government should stop using aid as a pressure tactic and immediately allow it to reach all besieged civilians.”

While aid delivery has improved in the last month, it’s still not nearly enough and too many Syrians are still not receiving the aid they need.
—Nadim Houry, Deputy Middle East Director

The Syrian authorities have yet to give permission to impartial humanitarian agencies to enter parts of Eastern Ghouta and Daraya, where the conditions are “dire,” the UN said. Government forces have besieged the town of Daraya, eight kilometers southwest of the capital, Damascus, since 2012, affecting about 4,000 civilians, according to the UN. Local activists say that number could be as high as 8,300. They said the last time an aid convoy was allowed into Daraya was in October 2012, before the government began its siege.

Mohamed Shehateh, a member of the local council in Daraya, said the siege had left the city without running water and electricity. “Food is very scarce here,” Shehateh said from inside Daraya. “We used to depend on reserves and we could bring food in from the neighboring town but since the government tightened the siege we cannot bring in any food or medicine.” He said that most people have been growing food like spinach and beans in their gardens to survive.

Shehateh said the medical situation gets worse by the day. “Medicine is lacking and many times we have to use expired medicine,” he said. “There is only one field hospital to serve the whole city and they can’t perform many operations because of a lack of equipment.”

The government has besieged the town of Douma since October 2013. No aid convoys have been allowed to enter since that time. Local residents said about 140,000 people still live there. A local aid worker, Abdullah al-Shami, told Human Rights Watch from inside Douma that while there were options to buy food that entered through smuggling routes, most residents couldn’t afford the high prices.

“The level of poverty in Douma is devastating,” al-Shami said. “People in Douma aren’t able to buy the basics like bread and rice because we can’t afford it. Medicine is also scarce and finding the right treatment for sick people is almost impossible because there are no hospitals here.”

Firas Abdullah, another local activist in Douma, said that the siege has made life harder for Douma’s citizens. “Local residents are begging in the street to find a way to survive,” he said. “The depression in the town is really high because we have lost hope that the world will stand with us, especially when other areas of Syria received aid and we didn’t.”

The secretary-general reported that the UN delivered assistance to 150,000 people in 10 of the 18 besieged areas and to tens of thousands in other hard-to-reach areas in February and early March 2016. Some 486,700 people were under siege as of March, the UN said. The independent project Siege Watch puts the number of people living under siege at 1 million.

The secretary-general said that even in areas where aid was allowed in, the Syrian government has removed life-saving items from convoys. In February alone, convoys with 80,000 medical treatments were not allowed to go on or were removed from aid convoys to besieged areas, the UN said. The government removed life-saving items such as diarrhea kits, emergency health kits, antibiotics, and other medicines. Out of 17 requests submitted in 2016 by the World Health Organization (WHO) to the Syrian government to send medicines and medical supplies to hard-to-reach and besieged locations, the UN reported, only two requests had been approved as of March 27. The UN was not able to reach an estimated 720,000 people in areas such as Deir al-Zour and Raqqa that are under siege by forces of the Islamic State, also known as ISIS.

The Syrian government requires UN and other aid agencies to obtain the government’s approval to enter the areas under government siege before the agencies can deliver humanitarian aid. This approval process was made simpler in early March, when the government agreed to approve a monthly plan for UN convoys to besieged areas within seven working days and to approve all documents required for the movement of the convoys within three days, replacing an eight-tiered bureaucratic approval system. However, an international aid worker told Human Rights Watch that aid had still not reached about 60 to 70 percent of besieged areas and that the government was still picking and choosing where the convoys are allowed to go.

Evacuation of wounded civilians from besieged areas remains an issue, Human Rights Watch said. The aid worker said that only 15 people from Zabadani and Ma`ret Mesreen, which are under government siege, and from Foua and Kefraya, which are under siege by antigovernment armed groups, had been evacuated in the past week for medical reasons. There were some medical evacuations in March from Madaya, a town besieged by the government that drew global attention earlier this year because its people were starving, but the aid worker said that 300 civilians who needed urgent medical evacuation were still stuck in Madaya.

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 are obligated to grant humanitarian relief personnel freedom of movement, and protect them 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. The use of starvation of civilians as a weapon is a war crime.

The International Syria Support Group (ISSG), which includes the United States and Russia, should use its influence to press the Syrian government and other parties to the conflict to allow unhindered access to aid particularly to all hard-to-reach and besieged areas of the country, Human Rights Watch said.

“The Syrian government cannot justify its ongoing starvation tactic of areas around Damascus or its removal of basic medicines from aid convoys.” Houry said. “It shouldn’t take another media sensation like Madaya to remind the world and make the government comply with its obligations.”