US-Russia ceasefire may hit difficulties if aid fails to reach Aleppo, with Assad regime accused of using restrictions as war tactic

This article is more than 4 years old

This article is more than 4 years old

UN aid deliveries are consistently failing to reach the vast majority of the 590,200 Syrians living in besieged areas, and convoys have been stripped of almost 50 tonnes of potentially lifesaving medical equipment in the past eight months.

In some months this year, UN deliveries reached up to 204,000 of those in the most troubled towns and suburbs, but in others, the figure was as low as 20,000, the Guardian can reveal.

The lack of aid in besieged areas has been a driving factor in the reported evacuation of a second Damascus suburb and raises questions about the UN’s ability to provide aid to Aleppo during the ceasefire brokered by the US and Russia, which is due to begin on Monday evening.



Aid deliveries to Syria’s many besieged and “hard to reach” areas, particularly rebel-held east Aleppo, are set to begin when the ceasefire comes into effect at sunset.

Syria: fragile US-Russia ceasefire deal divides warring factions Read more

But even those convoys that have got through in recent months had medical supplies rejected or removed by Syrian government forces, UN agencies have confirmed.



The World Health Organisation (WHO) said “49.5 tonnes of medical supplies have been fully rejected by the government of Syria” and the removed items “go beyond trauma and surgical” equipment.

They included:

Antibiotics, anaesthetic and antibacterial medicines

Obstetric kits for midwives and other kits for treating burns

Vitamins, anti-allergy drugs, anti-epileptic drugs and analgesics

Mental health-related medicines

The Syrian regime has also removed kits for treating burns from 18 convoys.

The Guardian has learned that in a recent delivery to al-Waer, a suburb of Homs, government forces removed 5.3 tonnes of medical aid, allowing only 440kg to get through.

The UN said Bashar al-Assad’s regime approves about 60% of its applications to send help to besieged and hard to reach places.



Yet an approval does not guarantee a delivery: the UN has to jump through further hoops and confirmed that convoys only reach “on average 33% of people to whom access was requested”.



This has led to the Syrian government being accused of using starvation and restricting medical access as a tactic of war.



A lack of medical supplies was one of the key factors in an evacuation deal struck in August in Darayya, a suburb of Damascus that has been besieged since 2012.

On Saturday, the Syrian government reprimanded the UN for criticising the evacuation in a letter to the organisation’s humanitarian coordinator, Stephen O’Brien, according to the Syrian state news agency, Sana.



Darayya had received a single two-part aid delivery in the past four years. The final straw came when the area’s last surviving clinic was hit by an airstrike just before the deal was agreed.



The evacuation of the neighbouring suburb of Moadamiya, which had been prevented from receiving aid on a regular basis, was reported to have begun on Monday.



A resident of the area said a UN official explained that the community needed to “repair their differences with the government” before a humanitarian aid convoy would be sent.



The difficulties of getting aid and medical supplies to besieged areas is acute in Aleppo, where UN agencies are preparing to use the ceasefire to make deliveries.



The agreement included tentative plans to relieve the pressure on the city, which was again bombarded by Syrian government forces over the weekend.



Details of a proposed UN relief operation for Aleppo, leaked to the Guardian, underline the difficulties faced by its agencies, but also the concerns of those who believe the UN needs to push back harder against Assad.



Facebook Twitter Pinterest Syrian children watch a 48-truck convoy drive through the rebel-held village of Teir Maalah, to the north of Homs. Photograph: Mahmoud Taha/AFP

The plans, dated from August, explain that it is the “preference of the government of Syria” to send medical evacuees “cross-lines”, from the rebel-held east of Aleppo into government-held areas of the city to the west, rather than somewhere neutral, causing anger among some doctors in rebel areas.



The documents also divide residents in the east into three groups: not affiliated with “AOGs” (armed opposition groups) and cleared by the Syrian government, affiliated with AOGs (family member) and members of AOGs.



The designations have alarmed some in the aid community, who say they are in contravention of humanitarian norms: the groupings assume residents, including women and children, are connected with armed groups unless cleared by Syrian security services.



Critics say the plans provide none of the usual protections for civilians, aid workers and doctors operating in the besieged half of the city.



Though the wording was removed from a later version of the plan, it has fed mistrust of the UN and its perceived deference to the Syrian government’s view of people living in areas not controlled by the regime.

One medic said: “We will not accept evacuations to west Aleppo. If we are doing cross-line, why not to Turkey? Why can’t we send them somewhere they feel safe or they have their family or friends. This was our request from our staff in Aleppo. The UN have to do something; what is their role if they accept anything coming from regime and not taking our suggestions seriously?”



Currently, no medical evacuations are taking place from east Aleppo.



Clauses in the ceasefire deal could see two areas, Castello Road and the Ramouseh, designated to allow humanitarian access.



However, it remains unclear whether these corridors would be controlled by the Syrian government and Russian forces, or become neutral areas.



Last week, more than 70 NGOs withdrew information sharing cooperation from the UN because they believe that the Syrian government has too much influence over the UN’s £3bn relief effort. Those NGOs represent critical partners for the UN, as they rush to get aid into besieged Aleppo during the ceasefire, which may not hold for long.



The UN insists that it remains completely impartial and has to work with all actors in Syria, the most costly and complex relief operation it has undertaken. But the organisation admitted that the Syrian government was exerting control over the delivery of aid.



A spokesman for the WHO said: “Lifesaving treatments and medical items urgently needed by patients across the country continue to be removed or rejected by government security forces.



“For example, from April to July this year, security forces removed medical items from 17 out of 24 convoys destined for the Aleppo governorate, Homs governorate, and rural Damascus governorate.”



Between January and August, the WHO said it had been involved in 49 aid convoys and burn kits had been removed from 18 of them.



The World Food Programme said it had called for “access to besieged locations to be able to deliver lifesaving assistance” for the estimated 9.4 million people who require food.



“Unfortunately, the parties to the conflict, in particular the Syrian government, have often failed to respond positively to such requests for access,” a WFP spokesman said. “This is in violation of its obligations under international humanitarian law.”



One senior western diplomat, who asked not be named, said: “The blocking of humanitarian aid by the regime is unbearable and seriously undermines the credibility of the international system and humanitarian norms. International pressure for access needs to be sustained.



“However, it is the Syrian regime and not the UN that has made it impossible to uphold humanitarian principles. Over the past five years, the UN has worked hard under very awkward political conditions. They have had to strike a very difficult balance, but have delivered humanitarian assistance to millions in both regime and opposition controlled areas, cross line and cross border.”