The latest chemical attack, which allegedly killed hundreds in Damascus, will worsen the humanitarian disaster in Syria. Last week, the UN registered the one millionth Syrian child refugee. Earlier in the month, the UN also confirmed what many already suspected—that over 100,000 people have now died in the battle for Syria. Paulo Sérgio Pinheiro, chair of the International Commission of Inquiry on Syria, responded with a phrase which could encapsulate the conflict, stating that “it is not enough to be appalled.”
As international intervention looms, the humanitarian crisis worsens and the boundaries of civilized behavior continue to crumble, it is important to understand that it is not just the Syrian regime’s tanks, aircraft, or possible use of chemical weapons, nor the opposition’s motley array, of weaponry that are killing people. Bureaucracy, both inside and outside the country, is increasingly acting to accentuate the fallout from the conflict, with a host of deadly consequences. It has become a weapon of war, manifested through paperwork, checkpoints and sieges, which are resulting in the denial of access to lifesaving medical care.

Long before the 2011 uprising began, the regime in Damascus oversaw an Orwellian bureaucratic state characterized by a lethargic, bloated civil service and an enormously opaque set of repressive laws. Despite the retreat of the regime’s control, this bureaucracy continues to underpin what remains, and often undermines and obstructs, the humanitarian response to the conflict. Learning from their enemy on a far smaller, but equally worrying, scale, opposition fighters are beginning to restrict aid within their zones of control, in Aleppo in particular.

Outside the country, regional players struggle to mitigate the consequences of hundreds of thousands of Syrians crossing their borders. While their generosity is widely acknowledged, there are politics at play, with border crossing closures and registration issues that need to be addressed. Meanwhile, the international response to the conflict continues to be typified by division, even while some Western actors prepare for armed intervention. Those professing to support the relief effort are finding themselves bogged down in legislative and legal delays.

A staggering challenge

It is always important to put into context the scale of the challenge at hand. Syria’s population numbers around 22.5 million—and today a staggering 4.25 million, almost one in five Syrians, are estimated to be internally displaced. As for external refugees, around 6,000 people flee the country on an average day according to the UN. Those who have fled their homes continue to live a precarious existence, as most aid agencies cannot get to them. War Child surmised the two challenges providers of aid face: “The government won’t allow it and the security situation is too unstable.” With the humanitarian situation becoming ever more desperate and half the population is estimated to become dependent on aid by the end of the year, government restrictions on aid and persistent insecurity could spell death for many Syrians.

Hugh Fenton, chair of the Syrian INGO Regional Forum, lamented the state of humanitarian aid in Syria: “The Syrian crisis is our largest challenge as humanitarian agencies worldwide. We are trying to help millions of people. The frustrations of knowing that many people are unable to access the aid they need is indescribable. Many people are trapped by violence or such insecurity that we cannot reach them.” According to the European Humanitarian Aid and Civil Protection department (ECHO), only one new International Non-Governmental Organization (INGO) has been validated by the Syrian authorities in recent months, bringing the total number of INGOs formally allowed to operate in the country to a paltry twelve. Moreover, ECHO also revealed that the list of 110 local NGOs authorized by the Syrian government to support the work of international aid agencies had been cut down to sixty by the Ministry of Social Affairs. Some aid agencies continue to work unofficially inside the country but its workers are vulnerable to kidnapping and, of course, the rampant insecurity that comes from a conflict typified by the firing of unguided missiles into built-up urban areas.

Syria’s international borders have become more theoretical than real, yet inside the country the checkpoint has become the oppressive manifestation of sovereignty. The aid that is allowed to enter the country must run a gauntlet of paperwork and these ubiquitous checkpoints. In June, the UN reported that their agencies were increasingly facing obstacles and delays in gaining approval to dispatch medical supplies across the country. They blamed lengthy customs procedures for the import of humanitarian goods and equipment for undermining the efficiency of the aid operation.

The UN is unable to cross borders into Syria without the regime’s permission, and has only been able to secure approval for a handful of convoys, as each requires a Syrian minister to grant permission. In April, a UN inter-agency mission delivered urgent humanitarian assistance across the front lines. On their way from Damascus to Aleppo, normally about a four-hour drive, the convoy encountered more than fifty checkpoints. In July, UN spokesperson Martin Nesirky told reporters in New York that the “proliferation of checkpoints are slowing down movement of humanitarian goods, and bureaucratic processes continue to delay aid delivery and impede the efficiency of the emergency response.” Access constraints and bureaucracy slow down aid delivery while violence continues unabated in many parts of the country. As a result, access is further limited across many locations known to have considerable needs, especially in the eastern governorates, as well as in rural Damascus and Dera’a.

Aid as a weapon of war

Under international humanitarian law, belligerent parties are obliged to allow and facilitate rapid and unimpeded passage of humanitarian relief for civilians. They must also allow civilians in areas besieged by fighting to leave for safer areas should they wish to do so. Reports from Homs have revealed that the Syrian government has used access to aid as a bargaining chip in conjunction with the threat or reality of military attack. Human Rights Watch (HRW) has labeled such arbitrary denial of aid a “war crime.” According to interviews on Skype with opposition fighters and the US-based Institute for the Study of War, the regime offered considerable humanitarian aid deliveries, the resumption of basic services in the town, and the protection of civilians and surrendering fighters in return for a negotiated regime takeover:

The Syrian government was able to leverage its access to resources and supplies among a population in desperate need of humanitarian aid, and use its air superiority to play on fears of the destruction caused by aerial bombardment. In cases where civilians are desperate to get food and medical care, the Syrian government is able to use aid as an important negotiating tool.

The absence of ‘safe zones’ and ‘humanitarian corridors’ means that there is a steadily shrinking humanitarian space in the country. In July, Tamara Alrifai, the advocacy and communications director for the Middle East and North Africa division at HRW, wrote that the regime’s actions in denying humanitarian access to the town of Al-Qusayr “violates international humanitarian law, which requires fighting forces to spare civilians and allow them rapid access to medical care and other humanitarian relief.” In Al-Qusayr, Homs and Damascus, the Syrian government has not allowed the International Committee of the Red Cross (ICRC) to evacuate citizens, and the opposition has been using the same tactics in at least two cities. According to the ICRC, Aleppo’s central prison had been sealed off for months, and the ICRC and the Syrian Arab Red Crescent received reports of an acute shortage of food for prison inmates. The organization has revealed that “reaching people in areas encircled by government forces or the various armed opposition groups remains one of the toughest challenges the ICRC faces in Syria.”

The opposition appears to be getting in on the act of playing politics with aid as the conflict becomes more savage. In July, a resident of Aleppo told Al-Monitor that as a crippling, deadly siege was blighting the regime-controlled west of the city, “people braved danger and crossed over to the rebel side to buy groceries to feed their families. They were beaten and humiliated by the rebels manning the crossing there, the paltry bags of food they had with them taken away or thrown on the ground. ‘Let the regime feed you’ or ‘Go lift the siege on Homs first’ were some of the things shouted at them.” Toward the end of July, the opposition Syrian National Coalition was forced to issue a press release that stressed that “the Syrian Coalition stresses that Syrian people are all equal, and that discrimination in terms of humanitarian assistance is completely unacceptable. The Coalition rejects Assad’s policy of collective punishment and reiterates that the welfare of all citizens is one of the Coalition’s top priorities.”

The international approach

Regionally, so far all the neighboring states have kept borders more or less open, but there are increasing attempts to shut down refugee streams and close borders temporarily. NGOs are crossing the border from Turkey to Syria unofficially, but official registration by Turkey remains a problem. Far away from the battlefield, and despite the US and European governments donating hundreds of millions of dollars in aid, legislative hurdles continue to impede humanitarian efforts. In June, Foreign Policy magazine reported that half of the non-lethal US aid promised for Syria months ago has still not arrived: “Administration officials acknowledge that only some of the aid promised the Syrian opposition this spring has arrived in the country. They cite Congressional notifications, the need to vet recipients on the other end, and the more mundane necessity to obtain and then ship the supplies they plan to send as the hold up.”

Meanwhile, in July, Mary Kaldor, a Professor of Global Governance at the London School of Economics, told a conference on civil society that European anti-terrorism legislation was hampering relief efforts: “NGOs or humanitarian workers now have all kinds of restrictions on them if they are likely to work in areas where Islamists or jihadists might benefit,” adding that this has “made it very difficult for European NGOs to work in Syria.”

On the ground, international aid workers operating inside Syria face myriad challenges. Several aid workers recently told the UN’s humanitarian news and analysis service, IRIN, that the regime was refusing to approve medical deliveries, taking medical supplies out of aid convoys, and requiring case-by-case negotiations for the delivery of surgical kits. A humanitarian delegation that recently visited Iraq underscored the dangers that medical professionals are facing within Syria: “If you were found carrying blood bags or things that are clearly [for] palliative care that is just the same as if you had weapons in the eyes of the Syrian authorities.”

A growing diplomatic urgency is gaining pace as reports of the restrictions continue to worsen. Some imaginative responses to this state of affairs are in the works. A confidential document sent to the 15 UN Security Council members by UN aid chief Valerie Amos outlined thirty potential measures that could be taken to address current humanitarian challenges in Syria. This included an “agreement on modalities to implement humanitarian pauses to allow the passage of humanitarian convoys to the most affected areas, the provision of assistance to those in need and the evacuation of the sick and wounded.” Such thinking now needs to be translated into operational change.

The elephant in the room is whether the UN can take the cross-border assistance issue: this is the single biggest action that could alleviate the continued suffering in Syria. Questions remain as to what the likely US-led military response to reported chemical weapon use will look like. However, what is almost certain is that a Russian veto will mean that the UN will be further marginalized in its approach to Syria. This means that intervention could strike a double blow as far as the humanitarian situation is concerned, leading to more people fleeing their homes while simultaneously highlighting the impotence of the UN. This could allow Syria’s deadly bureaucracy, a machine that lacks the power to create the fleeting moments of terror of nerve gas attacks, to continue to operate unhindered—having a far more nefarious impact over the long term.