The humanitarian crisis in Syria has reached a "horrifying new level," according to a U.N. official.
That's how Mark Lowcock, the United Nations under-secretary-general for humanitarian affairs and emergency relief coordinator, described conditions in northwest Syria, based on eyewitness accounts from U.N. staff in and around Idlib province.
Idlib has been under air attack for years, but the intensity of those attacks is now worse and there are new ground attacks as well, says Robert Ford, former ambassador to Syria under the Obama administration and now a senior fellow at the Middle East Institute in Washington, D.C. As the last opposition stronghold, the province is home to about 3 million people, half of them refugees from other parts of Syria.
This latest humanitarian crisis in the 9-year-old conflict was brought on by fighting that has escalated since December, with Syrian and Russian troops attacking opposition forces. Idlib has seen airstrikes as well as shelling from artillery and ground-based missiles.
What's more, temperatures have dropped below freezing many nights since December, and heavy snow has fallen, most recently in mid-February.
Lowcock's report said the vast majority of those displaced are women and children, many of whom are sleeping outside because the refugee camps are full. "Mothers burn plastic to keep children warm. Babies and small children are dying because of the cold," wrote Lowcock.
Zaher Sahloul, a physician and president and co-founder of aid organization MedGlobal, was last in Idlib in January and said that with so little room, people are sleeping anywhere they can, including tents in a refugee camp set up in a soccer field and tiny classrooms in schools. Many children had respiratory illnesses because of the overcrowding and cold. When there is no space in indoor structures set up as shelter, families pitch tents, of varying strength and quality, often in the mud that accumulates when rain hits the snow. More rain is expected this week.
Sahloul, a critical care physician, says among the people he met in refugee camps was a girl, Ahlam, whosaid she was 12, collecting branches that her family would burn to heat their tent. Another 12-year-old, who said her name was Asma, told him she had been displaced seven times and was walking 2 miles to school each way. "I wish I could walk not in the mud," Asma told Sahloul.
Many of the newly displaced have had to move to new locations in Idlib. Others are headed north toward to the Turkish border, though Turkey is not accepting new refugees.
Aid organizations are on the ground, but many local aid workers, and their families, face the same harsh conditions as those they are trying to help, says Christy Delafield, spokeswoman for aid group . Like the refugees, they are living in tents or are on the move because of the fighting.
In his report,Lowcock said that equipment and facilities of aid workers were being destroyed and that the aid workers themselves were among those injured and killed.
Adding to the difficulty for aid organizations, says Robert Ford, is that the Syrian government has taken over two main highways so the aid groups now depend on slower back roads to deliver supplies.
The numbers of displaced people have grown — from hundreds a day before December to thousands a day now, according to U.N. spokesman Farhan Haq.
"The sheer number of displaced families is challenging, and our size and level of funding just cannot cope with [sometimes] 50,000 people a day who are fleeing," said Erin Taylor, senior communications director for Save the Children. "In addition, humanitarian workers are being displaced themselves and had to leave behind programs and equipment in areas that are now too close to the front lines to return to."
Juliette Touma, chief of communications at UNICEF's Middle East and North Africa Regional Office, told NPR by phone from Amman, Jordan, that "this mass displacement is an exodus of people that we have not witnessed before in Syria."
Suzanne Meriden, executive director of the , which advocates for a secular democracy in Syria, agrees. "Before this most recent wave, there were already 6.2 million internally displaced persons in Syria, including 2.5 million children, according to the U.N. High Commissioner for Refugees," she says. "When we hear from people inside Syria, they tell us this is like nothing anyone has ever seen before. The fear and the chaos – people are fleeing, but they don't even know where to go."
Aid workers say one challenge is that supplies, including blankets and tents, are often put in place in cities, but those who are fleeing from the fighting often change direction. "Logistically, it's extremely hard to even know where to go to deliver aid," says Meriden.
Current funding is "simply not enough," says Touma of UNICEF: In January, the U.N. released a new Humanitarian Readiness and Response Plan for northwest Syria requesting $336 million to help 800,000 refugees. Just last week, the U.N. upped that amount to $500 million — for the next six months to address the massive displacement since December, which it now pegs at 1.1 million.
"We will be working with member nations to secure that funding," said Farhan Haq.
Mona Yacoubian, senior adviser for Syria, Middle East and North Africa at the U.S. Institute of Peace in Washington, D.C., says an added element of despair is that the areas that are now relatively safe are so small that there is significant overcrowding. Even if a family receives a tent, there may not be room to pitch it.
Yacoubian says aid organizations just can't scale up quickly enough.
She notes that many of those on the run have been refugees for almost a decade: "It is a very vulnerable and traumatized population, which adds a layer of complexity to their needs."
On Feb. 18, the U.N. Secretary-General called for an immediate cease-fire. The next day, the Security Council was told by Geir Pedersen, special envoy of the Secretary-General for Syria, that there had been no progress in stopping military actions in Syria since his previous briefing two weeks before.
"We join the U.N. in calling for an immediate ceasefire and for a halt to indiscriminate violence against the people of northwest Syria," a U.S. State Department spokesman told NPR.
More than a dozen aid organizations held a press conference on Capitol Hill on Thursday to ask for help in securing more aid and a halt to the fighting. At that event, former Ambassador Ford called the current situation in northwest Syria "the worst-case scenario."
Speaking to NPR on Monday, Ford said the scale of what is happening in Idlib is, "even by Syrian standards," unprecedented in terms of numbers displaced and killed at one time.
The very cold weather — which is likely to last, at least in the evenings, for a few more weeks — adds its own harshness. According to a field report last week from Western Aleppo Countryside by physicians from Doctors Without Borders, a refugee family of four, including two children, all died of carbon monoxide poisoning from a faulty heater they were using in their tent.
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