Breadcrumb
At midnight on Sunday, a UN mandate to deliver cross-border aid to opposition northwest Syria ended after Russia refused to accept an extension.
Overnight, Idlib was plunged into a nightmare scenario that could see millions starved of food and medicine.
Aid groups say that around three million Syrians, including one million children, reliant on the UN lifeline are now being held hostage by Russia's maximalist demands for the Assad regime to take full control over the distribution of aid to opposition areas.
This is the same regime that has mercilessly bombed, starved, and gassed these territories for the past 11-year war and weaponised aid, human rights groups say.
"The impact of the veto on the ground will be catastrophic, there are just too many people who rely on cross border aid for this to be even negotiable"
Starved of aid
At the time of writing, the UN is no longer able to send lifesaving supplies to northwestern Syria, a move that has completely upturned the vital humanitarian mechanism in Idlib.
Aid groups have painted an apocalyptic vision of northwest Syria for the coming months where due to Russia’s weaponising of aid, many Syrians could starve or perish to easily treatable diseases.
"The consequences will be devastating - that area of northwest Syria is almost completely reliant on aid and the vast majority is accessed via this UN cross-border mechanism," said Mark Kaye, Director of Policy, Advocacy & Communications for the Middle East and North Africa at the International Rescue Committee (IRC).
"The UN have the trucks to bring in that amount of aid on the scale that is needed, and we just don't - they are also able to bring in things more easily and quicker. We have been talking about how the aid mechanism is a lifeline, but the other side of the coin is that if you take it away it's a death sentence."
The IRC says it can likely provide food assistance to only 300,000 people due to the veto, meaning that one million people who were getting food aid will be without support.
Even if an agreement can be reached in the coming days, aid groups say that conditions for people in northwest Syria have never been so bad.
"For ordinary Syrians, the reason why things are so bad now is that you have an emerging hunger crisis. The Ukraine crisis has pushed up the price of wheat and fuel, and families are struggling to put food on their table," Kaye said.
Almost 90 percent of families in northwest Syria have seen their expenditures exceed their incomes by 50 percent, due in part to the Turkish lira crisis and escalating food prices.
"We are seeing children dropping out of school to work, an increase in child marriage, and a significant increase in mental health issues, including suicides, particularly among adolescent girls," said Kaye.
"People are eating less, and the quality of the food they eat is lower. There are families we have spoken to who haven't eaten a vegetable for months. The impact of this is just reverberating everywhere and felt by everyone."
One Syrian woman the IRC team spoke to said her three children had never tasted fruit.
"We are seeing adults missing meals so their children can eat, but this becomes a horrible cycle because if you're hungry then it makes it more difficult for you to find work or be productive. The tragedy is that there is food out there, it's just people aren't able to access it," Kaye added.
Russian veto
Russia's repeated threats to veto the aid mechanism have drained the time, energy, and resources of aid agencies. It also makes long-term planning difficult, not knowing if the border will be open in six months' time.
"Good early recovery work takes multiple years to enact and having to refight this [border vote] almost every six months takes up so much resources and time," Kaye said.
"We're now in year 12 of this crisis and a large part of that is because the international community failed in its obligation to protect Syrians and bring an end to this crisis."
Where there is hunger there is also disease. Kaye warned that without vital drugs and medical supplies medics will struggle to cope and the WHO's job of monitoring for disease outbreaks will become infinitely more difficult.
"There will be outbreaks because that is what happens where sanitation has been damaged, when people are living in crowded spaces and unhygienic conditions, when people aren't healthy and so they can't fight off illnesses as you and I can. So what will happen is that not only will diseases spread, but we will find out too late," Kaye said.
"It is harder to treat these things once they're out of the bag. What you want to do is treat them early when it comes to contagious and communicable diseases. We are very, very concerned about the impact this [veto] may have, particularly given that you have a health system that is already crumbling."
Hospitals have been decimated by years of targeted bombing and underfunding, which aid agencies say will take years to rebuild, as demand for health services grows by the year with Idlib's fast-growing population.
Amany Qaddour, Regional Director at Syria Relief & Development, which provides vital medical support to people in Idlib, said that aid workers fear a cataclysm.
"The impact of the veto on the ground will be catastrophic, there are just too many people who rely on cross-border aid for this to be even negotiable and I just think that given the collateral damage from attacks on healthcare facilities then the infrastructure in Idlib is not just able to respond at the scale that is needed," said Qaddour.
"With the uncertainty of the vote and funding shortages in the northwest, plus winterisation needs compounding things, then all these combined factors will be an issue in northwest Syria."
"We have been talking about how the aid mechanism is a lifeline, but the other side of the coin is that if you take it away it's a death sentence"
Dire moment
Aid groups have sounded the alarm over funding cuts before. NGO Forum warned in May that NGOs were experiencing funding cuts of $21.5 million s0-far in 2022 compared to last year, potentially leaving millions without healthcare and food and thousands of aid workers out of a job.
The Covid-19 epidemic and war in Ukraine have led some international donors, including the UK, to cut financial support to Syria at perhaps its darkest moment.
Qaddour said that there are one million more people in need of aid than there was a year ago, despite cuts of up to 40 percent from some donors. Women and children will be the biggest collateral from these funding gaps.
"We are unable to meet some of the targets we have set because the needs keep increasing. We also saw a trend where a lot of countries, because of Covid, are looking inward and responding to their own needs so that obviously affected funding across the board, and the war in Ukraine has not helped," Qaddour said.
"If the mechanism is approved for another six months, then we are going to have to go through this whole process once again and the uncertainty and timing of it is only going to cause more suffering for people."
Editor's note: Since this article was published, the UN has voted to pass a six-month extension to the cross-border mechanism mandate, a proposal put forward by Russia that was vociferously opposed by aid groups.
Paul McLoughlin is a senior news editor at The New Arab.
Follow him on Twitter: @PaullMcLoughlin