Syria Complex Emergency - Fact Sheet #3

Speeches Shim

May 5, 2016

International Syria Support Group (ISSG) representatives agree to a nationwide cessation of hostilities.

Relief agencies reach 778,000 people in hard-to-reach and besieged locations since January.

Intensified aerial attacks in and around the city of Aleppo cause civilian casualties and damage key infrastructure, including NGO-supported health facilities.

During a February 12 meeting in Munich, Germany, representatives of the International Syria Support Group (ISSG) agreed to a nationwide cessation of hostilities in Syria, which went into effect on February 27. As part of the agreement, ISSG members agreed to lobby for accelerated humanitarian access to priority besieged and hard-to-reach areas under the guidance of the Humanitarian Assistance Task Force.

Numbers At A Glance

13.5 million

People in Need of Humanitarian Assistance in Syria

6.5 million

IDPs in Syria

4 million

People Reached per Month by USG Assistance in Syria

4.8 million

Syrian Refugees in Neighboring Countries

2.7 million

Syrian Refugees in Turkey

1 million

Syrian Refugees in Lebanon


Syrian Refugees in Jordan


Syrian Refugees in Iraq

Humanitarian Funding

To Syria Humanitarian Response
FY 2012 - FY 2015

USAID/OFDA $871,555,850
USAID/FFP $1,782,602,164
State/PRM $2,475,866,537
TOTAL $5,130,024,551

The reduction in violence, following the cessation of hostilities agreement, has enabled the UN, in collaboration with the Syrian Arab Red Crescent (SARC) and the International Committee of the Red Cross (ICRC), to conduct increased cross-line humanitarian assistance deliveries to hard-to-reach and besieged locations in Syria. As of May 3, the deliveries had provided life-saving assistance, including emergency food rations, nutritional supplements, water, sanitation, and hygiene (WASH) items, medical supplies, and other emergency relief commodities, to an estimated 778,000 people in such areas.

As of May 3, USAID/FFP partner the UN World Food Program (WFP) had conducted 22 successful high-altitude humanitarian airdrops to the besieged city of Dayr az Zawr, delivering 380 metric tons (MT) of food assistance for approximately 110,000 people.

On March 17, U.S. Secretary of State John Kerry declared that the Islamic State of Iraq and the Levant (ISIL) had committed acts of genocide against groups in areas under ISIL control, including Christians, Shia Muslims, and Yezidis. Secretary Kerry called on local populations to ensure that ISIL-persecuted groups can safely return and reintegrate into communities.

Persistent armed conflict, compounded by Syrian Arab Republic Government (SARG) and Government of the Russian Federation (GoRF) aerial attacks, continues to negatively affect millions of Syrians, particularly in Aleppo Governorate, despite the nationwide cessation of hostilities agreement that went into effect on February 27.

The conflict in Syria resulted in approximately 1,040 civilian deaths in April and 623 civilian deaths in March, according to the Syrian Network for Human Rights. Of the total deaths in March and April, SARG forces killed approximately 1,100 civilians, including 226 women and children. During the same period, ISIL forces killed an estimated 165 civilians, and armed opposition groups killed approximately 170 civilians. The UN estimates that up to 400,000 people have died as a result of the conflict in Syria since 2011.

Intensified fighting and aerial bombardment in multiple areas of the city of Aleppo killed more than 250 civilians between April 22 and April 30, according to the Syrian Observatory for Human Rights. Overall, the increased attacks in the city killed nearly 860 civilians in April, including approximately 140 children. Additionally, airstrikes hit two hospitals in Aleppo on April 27 and 29.

The alleged SARG and GoRF airstrike on Al Quds Field Hospital in the Alsukkari neighborhood of eastern Aleppo city on April 27 destroyed the facility and killed at least 55 civilians and two doctors, including the only remaining pediatrician in the area, according to Médecins Sans Frontières. Al Quds was one of only 10 hospitals offering health care services to the population of eastern Aleppo city.

On April 29, a series of SARG and GoRF airstrikes targeted the Bustan al-Kasser neighborhood in the city of Aleppo, hitting another relief agency-supported primary health care facility. While the attack did not result in any casualties at the hospital, damage to the structure prompted the facility to close temporarily.

Between February 1 and 22, escalated conflict in Aleppo displaced approximately 75,000 people from and within the governorate, according to the Camp Coordination and Camp Management (CCCM) Cluster—the coordinating body for humanitarian CCCM activities, comprising UN agencies, non-governmental organizations (NGOs), and other stakeholders. In addition, ISIL—who is not party to the cessation of hostilities agreement—launched an offensive against several opposition-held towns and villages east of northern Aleppo’s town of Azaz on April 14, prompting the displacement of an estimated 40,000 people from eastern Azaz toward internally displaced person (IDP) settlements near the Bab al-Salam border crossing point along the Turkey–Syria border, according to the UN.

Humanitarian organizations are providing multi-sector services for the estimated 75,000 people in Azaz displaced by February clashes, as well as new IDPs, under the coordination of the CCCM Cluster. As of April 15, relief agencies, including USAID partners, had delivered approximately 7,000 blankets, 3,900 food baskets, and 11,500 kits containing hygiene, household, and shelter items to IDPs in Azaz. A USAID partner also distributed 9,000 food baskets in Azaz District and is providing an additional 900 food parcels, each sufficient to meet basic needs of a household for 15 days.

In southern Syria, conflict displaced more than 86,600 people in Dar’a and Al Qunaytirah governorates between November 2015 and February 2016, including approximately 53,500 people displaced from the Dar’a town of Sheikh Miskine, according to the UN. Relief agencies responded to new displacement from southern Dar’a and pre-positioned critical relief commodities. On February 11, an NGO delivered 12,000 boxes of medical supplies to health facilities in southern Syria. In addition, relief agency members of the Food Security Sector in Amman, Jordan, including WFP, had reached more than 13,000 new IDPs in southern Syria with a one-month supply of food assistance as of February 12, supplementing ongoing operations to reach at least 300,000 people with food assistance in southern Syria every month. As of mid-March, approximately 23,000 people displaced from Sheikh Miskine had returned to their areas of origin following a halt in fighting, according to the UN.

Late-March advances by the Yarmouk Martyrs Brigade and affiliated groups had prompted the displacement of more than 12,000 people from southwestern Dar’a Governorate as of April 27, according to the UN. The majority of new IDPs originated from the towns of Hit, Jlein, Sahm al-Golan, and Sheikh Saed and fled north to the Dar’a town of Nawa and south toward the Jordanian border. In response, humanitarian partners increased flour allotments to areas hosting the new IDPs.

Between late February and mid-March, spurred by the efforts of the ISSG, the SARG approved an increased number of cross-line convoys. The reduction in violence enabled the UN, in collaboration with SARC and ICRC, to conduct approximately 63 humanitarian assistance convoys and 22 airdrops in priority locations as of May 3. The deliveries have provided lifesaving assistance, including emergency food, nutrition and medical supplies, and other relief items, to an estimated 778,000 people, including 255,250 people in besieged locations and 472,925 people in hard-to-reach locations. By contrast, the UN was unable to provide aid to any people in besieged areas during the same timeframe in 2015. USAID is the largest humanitarian donor to the agencies participating in the delivery of emergency relief assistance through the humanitarian convoys.  During a synchronized operation on April 20, the UN and the SARC successfully evacuated 515 critically ill and injured civilians from the SARG-besieged towns of Madaya and Al Zabadani in Rif Damascus Governorate and the opposition-besieged towns of Al Fu’ah and Kafrayya in Idlib Governorate. Relief staff transported 265 evacuees from Madaya and Al Zabadani to the city of Damascus and opposition-controlled areas of Idlib for life-saving medical treatment, while 250 evacuees from Al Fu’ah and Kafrayya received treatment in SARG-controlled areas of Latakia Governorate. In Madaya, clearly marked SARC vehicles came under small-arms fire, with at least one vehicle sustaining minor damage, the SARC reported. The incident did not result in any casualties or significant disruption to the operation.  On May 2, State/PRM partner the UN Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) delivered lifesaving humanitarian aid in Yalda, an area adjoining the besieged Yarmouk neighborhood in the Damascus suburbs, providing 900 households with food parcels and hygiene kits. The agency also provided dental care via mobile clinic to 50 people. Between April 7 and May 2, intense clashes between armed groups inside Yarmouk had interrupted the relief operations in Yalda, and civilians trapped in Yarmouk had run out of food and safe drinking water.  Prior to the April surge in violence, UNRWA had completed 21 cross-line missions into Yalda and distributed 11,700 food parcels, 11,600 hygiene kits, and 19,160 blankets to families in need of assistance since resuming aid deliveries in February. UNRWA staff also provided primary health services to nearly 1,450 people and dental care to nearly 120 people. A joint SARC–ICRC convoy delivered humanitarian assistance to Damascus neighborhoods of Babella, Beit Saham, and Yalda, on March 25 to supplement UNRWA’s ongoing relief efforts in Yalda.  As of May 3, the SARG had not approved UN access requests for convoys to the besieged town of Darayya, Rif Damascus, which has not received humanitarian aid since the siege began in November 2012, and is facing severe shortages of food, medicines, medical equipment and supplies, and health facilities and personnel. On April 16, the Office for the UN Special Envoy for Syria led an assessment mission to Darayya, where an estimated 4,000 people remain besieged by SARG forces; however, the mission did not include humanitarian supplies.

As of May 3, USAID/FFP partner WFP had completed 22 high-altitude airdrops containing approximately 380 MT of food rations for conflict-affected populations in SARG-controlled, ISIL-besieged areas of Dayr az Zawr city. The food rations delivered to date are sufficient to provide partial monthly food rations to approximately 110,000 people currently registered by the SARC in Dayr az Zawr, according to WFP.

Between February 17 and April 30, humanitarian convoys accessed the besieged towns of Al Fu’ah, Kafrayya, Madaya and Al Zabadani on three occasions. On April 30, a 70-truck convoy delivered emergency relief items to more than 60,000 people in the four towns, including 180 MT of wheat flour and 8.9 MT of nutrition supplies to prevent and treat acute malnutrition for more than 6,800 children, according to WFP. Relief agencies participating in the most recent deliveries reported visible improvements in the food security situation compared to the first delivery in January 2016; however humanitarian aid remains the only source of food in the towns. A joint humanitarian convoy had last reached the four towns on March 17, delivering food rations, health and nutrition supplies, and WASH items for approximately 61,000 people.

More than five years of sustained violence has eroded health care capacity in Syria and increased the number of preventable deaths, according to the UN World Health Organization (WHO). Conflict has damaged or destroyed at least 70 percent of public hospitals, generated ambulance and health supply shortages throughout the country, and resulted in the death of at least 730 health care workers as of March, according to the NGO Physicians for Human Rights. The fleeing of qualified health care workers and price spikes in medicines has further disrupted the provision of essential health services, increasing risks among people who require specialized care or treatment for chronic diseases. Limited access to safe drinking water and deteriorated sanitation services has also rendered conflict-affected populations more vulnerable to disease outbreaks.

WHO published a 2016 health sector Humanitarian Response Plan (HRP) for Syria on April 4, requesting more than $141 million in funding to support the health needs of 11.5 million people in the country. The health HRP prioritizes interventions that build local response capacity, provide life-saving assistance, and strengthen health sector coordination. The plan also requests nearly $12.3 million in funding to provide health assistance to Syrian refugees in Jordan and Turkey.

A UN- and relief agency-led national polio vaccination campaign reached approximately 2.5 million children younger than five years of age across all 14 governorates in March, according to the UN Children’s Fund (UNICEF). In northern Syria, health actors also conducted a measles campaign that vaccinated more than 927,800 children—or approximately 91 percent of the target population. In addition, emergency health programs helped at least 50,200 children and mothers to access primary health care and essential medical supplies in 10 hard-to-reach locations in March. Since January 2016, approximately 125,400 children and mothers have benefitted from medical consultations in 11 governorates, and an estimated 432,000 people have received UNICEF-provided health supplies through internal and cross-border programs.

In mid-April, health and nutrition sector organizations launched the first polio campaign covering all districts in southern Syria, including hard-to-reach Ash Shajarah and Lajat regions of Dar’a. The campaign reached 95 percent of targeted children younger than five years of age in Dar’a and Al Qunaytira governorates.

WASH Cluster members remain concerned about disruptions to water networks in northern Syria, despite the resumption of operations at the Al Khafsa Water Treatment Facility on March 3. To mitigate the risk of future disruptions, WASH Cluster members are supporting alternative water distribution systems and are pre-positioning 77,000 liters of fuel to support operation of the water distribution units. Cluster members plan to pre-position an additional 240,000 liters of fuel in northern Syria in the coming month to meet water needs in the event of future disruptions to water access.

From mid-February to March 11, UN agencies transported more than 500 truckloads of food and livelihood assistance, emergency relief commodities, and health and WASH items to Aleppo, Hama, Idlib, and Latakia governorates, exceeding the amount of cross-border aid delivered to northern Syria during the same period in 2015. The deliveries provided approximately 120,000 people with health support and 2,500 people with WASH supplies. Additionally, the International Organization for Migration (IOM) transported nearly 130 truckloads of emergency relief commodities, WASH items, and food and livelihood assistance into Syria from Turkey between March 4 and 11.

Turkey-based WASH Cluster members, including USAID/OFDA partners, are supporting the WASH needs of displaced populations in Aleppo Governorate. WASH Cluster members are providing services to approximately 120,000 IDPs across 50 informal settlements in northern Syria, including approximately 71,000 people displaced by airstrikes and clashes since September 2015. In southern Aleppo, relief agencies are providing WASH services for an estimated 12,000 IDPs living in approximately 21 informal settlements. WASH Cluster members are also improving IDP camp water networks, increasing access to latrines, providing access to safe drinking water, and working with health and nutrition experts to address health issues resulting from limited access to safe drinking water in Aleppo’s Azaz District.

The conflict continues to create an urgent need for shelter assistance among the 6.5 million IDPs in Syria, millions of who are living in overcrowded collective shelters and IDP camps, among other locations, particularly in Aleppo, Dar’a, Idlib, and Rif Damascus governorates. In some cases, the number of IDPs sheltering outside of camps in northern Syria exceeds the number of those living in CCCM-established shelters, according to the UN.

The UN Office for the Coordination of Humanitarian Affairs (OCHA) recently allocated funds to support increased needs resulting from intensified conflict in Aleppo Governorate. The funding, valued at $18.5 million, will enable humanitarian actors supporting the shelter needs of Syrians to provide nearly 85,000 individuals in Aleppo and Idlib with emergency shelter and other essential items. Additionally, the new funding will provide support for ambulance services, hospitals, mobile clinics, and primary health facilities in western Aleppo, eastern Aleppo city, and eastern Idlib, benefiting approximately 250,000 people.

During March, the Turkey-based Shelter/Non-Food Item (NFI) Cluster, whose members include USG partners, reached more than 395,000 people with cash, vouchers, and in-kind support, as well as more than 57,000 people with shelter interventions, across 45 sub-districts in northern Syria. The cluster notes that robust cross-border assistance via the Bab al-Hawa and Bab al-Salaam border crossing points continued in April. Between April 1 and 15, a total of 211 UN interagency trucks and 218 NGO trucks carrying humanitarian assistance crossed the two border posts, representing an increase relative to the 52 UN interagency and 154 NGO trucks that crossed into northern Syria between March 21 and 31.

Approximately 3.7 million Syrian children have been born since the conflict began in 2011, including more than 151,000 children born as refugees, according to a UNICEF report. The report estimates that the conflict is affecting 8.4 million children—more than 80 percent of all Syrian children—either within the country or as refugees. In addition to severe protection issues, UNICEF cites education as a primary concern for conflict-affected children, noting that more than 2.8 million Syrian children are not attending school.

Up to 250,000 children residing in besieged areas have inadequate access to education, food, health services, or safe drinking water, according to a recent report from Save the Children. The report notes that conditions have worsened in recent months and that children are dying due to a lack of food and medicine—which, in some cases, is stored in warehouses directly outside the besieged area. According to the report, more than 20 percent of aerial bombardments in 2015 occurred in areas now categorized by the UN as besieged and more barrel bombs are dropped in besieged areas than other locations. Save the Children has urged an immediate end to siege tactics by parties to the conflict and called for sustained humanitarian access, free movement of civilians, and medical evacuations. The NGO also called for the de-linking of access negotiations from cessation of hostilities negotiations.

In January and February, WoS Protection Sector members reached nearly 261,000 people, including nearly 90,000 people via cross-border operations from Turkey, with prevention, mitigation, response, and capacity building programs—such as case management services, frontline responder training, and psychosocial support. Gender-based violence interventions have reached 38,600 people, already exceeding the figure targeted in the 2016 HRP. The WoS Protection Sector aims to provide protection support to 7.2 million people within Syria in 2016.


On February 29, WFP announced that pledges made at the Supporting Syria and the Region Conference in London will enable the UN agency to meet 100 percent of the food needs of targeted beneficiaries in Syria, as well as Syrian refugees in Egypt, Iraq, Jordan, and Lebanon until nearly the end of 2016. During the conference, international donors pledged more than $11 billion in assistance for Syria-related activities, including $675 million, primarily from the Government of Germany, toward WFP operations.


State/PRM partner the Office of the UN High Commissioner for Refugees (UNHCR) is providing limited cash assistance to 34,200 of the 120,000 registered Syrian refugees in Egypt, which meets only 30 percent of refugee basic needs. The Egyptian government continues to balk on the request to extend residency permits to registered Syrians for up to one year, and has issued only 11 of 82 family reunification visas as of May 3.

Another State/PRM partner, assisting Palestinian refugees from Syria, reported that the deteriorating protection environment and pull of economic and educational opportunities in Europe has led to a decrease in Palestinian refugees from Syria in Egypt from 4,000 people to 3,000 people as of March 2016.


Iraqi Kurdish Regional Government (KRG) authorities closed the Fishkhabur border crossing point—the main commercial and humanitarian route from Iraq into Al Hasakah—to all commercial and humanitarian traffic in late March, with the exception of some life-saving assistance, including food items and medical supplies. Some humanitarian staff with permits previously issued by KRG authorities are reportedly permitted to cross the border in both directions; however, humanitarian agencies fear that the ongoing closure may negatively affect relief operations in Syria, as all border crossing points from Turkey into Al Hasakah also remain closed.


As of April 29, number of Syrian refugees stranded on the Jordanian side of the Syria–Jordan border, in an area known as the berm, had reached approximately 57,000 people, including nearly 50,000 people at the Rukban border crossing point and more than 7,000 people at the Hadalat crossing point, according to Jordanian officials. UNHCR had registered approximately 31,400 asylum seekers at Rukban and 7,680 asylum seekers at Hadalat as of late April, although insecurity at the border has hindered registration efforts. Humanitarian agencies are providing assistance to refugees stranded at the berm.

In coordination with the Government of the Hashemite Kingdom of Jordan (GoHKJ) Ministry of Health, several relief agencies initiated a vaccination campaign at the berm on April 16, reaching more than 9,200 children younger than 15 years of age with oral poliovirus vaccine; nearly 8,700 children from 6 months to 15 years of age with measles vaccine; and nearly 3,400 women of child-bearing age with tetanus vaccine. In addition, nearly 4,300 children younger than five years of age received vitamin A supplements.

On April 4, GoHKJ authorities implemented a directive permitting Syrian refugees in Jordan to apply for work permits at no cost for three months. The decision allows Syrian refugees to seek work permits in certain sectors, including construction and agriculture, and reduces barriers that previously limited livelihood opportunities for Syrian refugees.


In January, WFP provided emergency food assistance to nearly 595,000 Syrian refugees in Lebanon through monthly voucher support valued at nearly $22 per person. In February, WFP launched a nine-month school feeding pilot project, benefitting an estimated 10,000 vulnerable Lebanese and Syrian students.

Between November 30, 2015, and March 23, 2016, UNHCR distributed seasonal cash assistance to approximately 148,500 Syrian refugee households in Lebanon to address increased winter needs. With USG support, UNHCR and partners distributed $173 per month to approximately 73,000 Syrian refugee households residing in higher elevations and $100 per month to 75,500 households residing in lower elevations—nearly double the amount of winter cash assistance provided during the previous year. UNHCR also provided shelter support to nearly 27,000 Syrian refugee households in Lebanon, and 2,400 households benefitted from improvements to informal settlements that reduced flooding due to rain and snow. In addition, more than 27,000 vulnerable Lebanese people received $30 monthly for six months via WFP vouchers for food purchases.


On April 6, the Government of Turkey adopted a provision granting temporary protection status to Syrian migrants returning from the Greek islands in the Aegean Sea, fulfilling an obligation stipulated in the EU–Turkey Joint Action Plan.

On March 15, the European Commission’s Directorate-General for Humanitarian Aid and Civil Protection (ECHO) announced an additional €445 million—nearly $500 million—in humanitarian assistance for individuals affected by conflict in Syria. The funding will support life-saving projects, including emergency food assistance and health care services, implemented by response organizations in Jordan, Lebanon, Turkey, and Syria. Since 2012, ECHO has contributed more than $2 billion toward response activities benefitting individuals affected by the conflict.

Following the commencement of peaceful demonstrations against the SARG in March 2011, President Bashar alAsad pledged legislative reforms. However, reforms failed to materialize, and SARG forces loyal to President alAsad began responding to demonstrations with violence, leading armed opposition groups to retaliate.

At a November 2012 meeting in Doha, Qatar, Syrian opposition factions formed an umbrella organization—the National Coalition for Syrian Revolutionary and Opposition Forces, also known as the Syrian Coalition (SC). The USG recognized the coalition as the legitimate representative of the Syrian people on December 11, 2012. On March 19, 2013, the SC established the Syrian Interim Government, which opposes the SARG and is based in decentralized locations throughout opposition-held areas of Syria.

The UN Security Council (UNSC) adopted UNSC Resolution (UNSCR) 2139 on February 22, 2014, pressing the SARG and other armed actors to allow unfettered humanitarian access for relief aid workers in Syria. The resolution identified priority areas for emergency relief aid, and the UN is releasing monthly reports tracking progress on implementing the resolution’s objectives and access gains, as well as persistent access impediments.

On July 14, 2014, the UNSC unanimously adopted UNSCR 2165, authorizing UN cross-border and cross-line delivery of humanitarian aid to conflict-affected populations without SARG approval. The resolution permits the UN’s use of four border crossings from Turkey, Jordan, and Iraq—in addition to other crossings already in use by UN agencies—for delivery of humanitarian assistance into Syria. The resolution also establishes a monitoring mechanism under the authority of UN Secretary-General Ban Ki-moon and with the consent of the neighboring countries to ensure that deliveries across these border points contain only humanitarian items. In December 2015, the UNSC unanimously adopted UNSCR 2258, which renewed the mandate of UNSCR 2191 and will remain active until January 10, 2017.

UNRWA has registered approximately 560,000 Palestinian refugees in Syria, with more than 80 percent living in and around Damascus. Intense fighting in and around Palestinian camps and neighborhoods has significantly affected Palestinian refugees in Syria. UNRWA estimates that approximately 60 percent of Palestinian refugees are displaced within Syria, with a further 110,000 Palestinian refugees are displaced to neighboring countries. Syria also hosts an estimated 24,000 Iraqi refugees and asylum seekers, primarily in the greater Damascus area, as well as more than 3,200 refugee persons of concern from other countries.

The most effective way people can assist relief efforts is by making cash contributions to humanitarian organizations that are conducting relief operations. A list of humanitarian organizations that are accepting cash donations for disaster responses around the world can be found at

The USG encourages cash donations because they allow aid professionals to procure the exact items needed (often in the affected region); reduce the burden on scarce resources (such as transportation routes, staff time, and warehouse space); can be transferred very quickly and without transportation costs; support the economy of the disaster-stricken region; and ensure culturally, dietary, and environmentally appropriate assistance.

Last updated: May 10, 2016

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