For Alfredo Malgarejo of the Red Cross, the mission of his aid convoy in northern Syria is clearly defined under international humanitarian law. Rule 56 states that all parties involved in a conflict must ensure freedom of movement for authorized humanitarian relief personnel.

"We had eight trucks packed with relief goods," he recalled. "Everything was agreed in writing with the conflict parties and then it all suddenly stopped."

A local commander refused to accept the mission. Days of negotiations followed before the food and medicine moved on.

Killed while helping

"It is becoming increasingly different and dangerous to make binding agreements in the midst of conflicts," said Malgarejo, who has more than 17 years of Red Cross experience.

Syria, he said, is no exception. It's a bitter example of how hard it has become to offer help.

Lack of clarity in the combat scene often makes it difficult for the Red Cross to help

"Eight employees of the Red Crescent were killed in one year, two others are still missing," said Malgarejo.

The rules for the work of the Red Cross and other humanitarian organizations in conflict areas were established at a time when military forces fought each other in clear structures.

In February 1863, Swiss businessman Henry Dunant seized the initiative to negotiate an international agreement for the treatment and care of war victims. It was the birth of the Red Cross Movement.

Private combat forces

The convention, adopted in 1864 in Geneva, regulates the scope of the relief organization in the classical form of negotiating between two clearly structured military forces. The convention was expanded through further agreements and additional protocols for non-international armed scenarios, which extended into the 1970s. But the conflicts have also changed since then.

"There are also now smaller wars," political scientist Herfried Münkler said of the current situation. "In the past 20 years, private combat forces have played a greater role and - if I can put it boldly - armed NGOs like Al Qaeda as well."

Indeed, today's conflicts tend to be more confusing - as recent history has shown. That has also had an impact on applying international law, according to Münkler.

Herfried Münkler points to innovations such as private combat forces and armed NGOs

"One of the most sensitive issues is the distinction between combatants and non-combatants," he said. Who is fighting and against whom? These are questions that classic warfare didn't have to puzzle over, but answers, he argued, are vital for the work of relief organizations.

"The lack of clarity in the combat scene makes it increasingly difficult to reach agreements over what we do," said Johannes Richter, who is in charge of German Red Cross relief efforts abroad. "This is not a problem of international law but of conducting operations."

Intensive security management

It's not just that the work of the Red Cross is affected: employees often become targets, as reports of killed and kidnapped members show. The German Red Cross has responded to this development with intensive security management. Two years ago, the organization established its own security officer who is responsible for analyzing and preventing risks.

Over the decades, the mission of the Red Cross has not changed - its main task is still to gain access to victims of conflicts. The Red Cross and its sister organizations such as the Red Crescent are required to be neutral and peaceful and bare no arms.

"How an opponent perceives neutrality is something you must always calculate," said Richert.

Johannes Richert says it's sometimes difficult to appear neutral

The work of the Red Cross is also complicated by relief organizations that have interests in conflict areas other than humanitarian aid, such as missionary objectives. These interests can confuse militias, which then become skeptical of the Red Cross too.

All parties in a conflict need to understand that aid for the needy brings no disadvantage to one side or the other, according to Richert. But that message is often difficult to convey, he said.

Establishing trust

In Syria, government troops are fighting against a variety of religious and secular militias, which are often regionally fragmented as well. In Yemen, terrorist and tribal groups are fighting against the central government and in Somalia, the government side is lacking altogether. These are diffuse conflicts that make it difficult to find the right person for the Red Cross to talk to.

"We always have to work discreetly to ensure that the conflict parties trust us," Richert said.

But the Red Cross has an advantage. The local national associations will already have their contacts established before it gets really serious.