Testimony of Assistant Administrator Nancy Lindborg before the Senate Foreign Relations Committee

Thursday, October 31, 2013


Chairman Menendez, Ranking Member Corker, and Members of the Committee; thank you for inviting me to testify on the ongoing U.S. response to Syria’s humanitarian crisis. Thank you also for your continued support for our humanitarian programs around the world, which make a positive difference every day in the lives of millions.


I last testified on the Syria crisis for the Senate Foreign Relations Subcommittee on Near Eastern and South and Central Asian Affairs seven months ago and since then we have seen another 30,000 deaths, reflecting the staggering escalation of violence. In just the last year, the number of reported deaths has tripled from 26,000 to more than 100,000. The number in need inside Syria jumped from 2.5 million people to more than 6.8 million—roughly the equivalent of the combined populations of Vermont, New Hampshire, Maine, and Connecticut. And now with over two million refugees, a national crisis has fully evolved into a regional crisis, putting severe strains on vulnerable communities of neighboring countries.

According to a recent report released by the U.N., Syria has lost 35 years in human development as a result of two and a half years of this brutal conflict. And behind these jarring statistics is the very real toll on the people of Syria who survive—the women who continue to endure rape and violence; the ‘lost generation’ of Syrian children now out of school for two years; and the roughly five million people displaced inside Syria with neither enough to eat nor a safe way out.

As the crisis has escalated, the United States has accelerated our humanitarian response at every step. We have now contributed nearly $1.4 billion in humanitarian assistance to help meet the urgent needs of 4.2 million people across all 14 governorates inside Syria and the more than 2 million refugees.  

But the stubborn challenges of access, insecurity, and resources continue to prevent the international community from reaching all those who desperately need our help. Seized with the urgency of this crisis, in early October, and in the wake of concerted international action on securing chemical weapons, the U. N. Security Council unanimously adopted a Presidential Statement (PRST) on humanitarian access, urging all parties to the conflict to facilitate immediate humanitarian access to all those in need, importantly, across borders and conflict lines. To date, the PRST represents the first and most significant show of global political will to ensure humanitarian assistance reaches those who need it most. But now, we need this statement to translate into real action—and compliance—on the ground.

The urgency of real action is underscored by recent reports of serious food shortages and disease outbreaks among communities literally blockaded and made unreachable by the regime. And, as cold weather approaches, we anticipate increased reports of catastrophic needs. Coming on the heels of the U.N. Security Council resolution on the elimination of Syria’s chemical weapons program, the U.S. government is working with intensity to mobilize the international community to translate agreement into action on the ground to enable life-saving assistance to reach those Syrians desperately in need after two years of a brutal civil war.

Today, I’d like to update you on the U.S. government humanitarian response and the challenges we still face.

The U.S. Humanitarian Response

The United States continues to work through all possible channels—the United Nations, international and non-governmental organizations (NGOs), and local Syrian organizations—to reach those in need with life-saving supplies and services. Since this time last year, we have scaled up the number of our partners inside Syria from 12 to 26. To cope with a conflict with shifting lines, we have shored up systems and supply lines to increase our ability to reach all 14 governorates throughout the country.

U.S. humanitarian assistance in Syria is focused on four key areas: emergency medical care, food assistance, the provision of much-needed relief supplies, and the protection of vulnerable populations.

Medical Care

For almost two years, the U.S. government has provided emergency medical care to those caught in the crossfire. Today, we support 260 medical facilities across Syria. These field hospitals and makeshift clinics have treated more than 940,000 patients and performed more than 113,000 surgeries. We have trained over 1,500 Syrian volunteers to provide emergency first aid care.

With the onset of warmer weather and communicable diseases on the rise last spring, we worked with partners to establish an early warning system for communicable diseases, which require early detection and fast response to prevent devastating consequences. We note with great concern the 10 cases of polio affecting under-immunized children under two in Syria’s Dayr az Zawr Governorate that have been confirmed by the World Health Organization (WHO). WHO reports that immunizations have started in the area, but we remain concerned about the spread of this crippling and potentially deadly infectious disease.

The United States has also provided mental health support—such as operating child-friendly spaces, conducting emergency psychosocial first aid, and trainings in child protection—for more than 26,000 vulnerable people in internally displaced persons (IDP) camps and host communities. None of this vital medical assistance would be possible without the courage of the Syrian health workers who risk their lives on the front lines every day.

Food Assistance

The United States remains the single largest donor of emergency food assistance for the Syria crisis. Our partners, the U.N. World Food Program (WFP) and non-governmental organizations, now reach more than three million people inside Syria and over one million Syrian refugees in Jordan, Lebanon, Turkey, Iraq and Egypt each month—and U.S. food aid presently accounts for more than one-third of all food assistance received by conflict-affected Syrian families.

USAID’s Emergency Food Security Program enables us to deliver food assistance rapidly through a variety of flexible mechanisms—including local and regional purchase and voucher programs—that allow us to address food needs of Syrian refugees and invest in neighboring communities. Staying flexible is a central part of our approach and, without question, adds to our ability to help meet daily needs. Since January, for example, through partnerships with NGOs, we have supported delivery of approximately 18,000 metric tons of food to conflict-affected families in Aleppo governorate not reached by WFP, feeding over a quarter of a million people on a daily basis.

Relief Supplies

With millions more displaced this winter than last, fierce winter forecasts, and heightened vulnerability after another year of conflict, the United States is focused on mobilizing a significant winterization response. In addition to basic supplies—communal cooking kits, blankets, mattresses, clothing, plastic sheeting, hygiene kits, water jugs—we are also improving infrastructure and shelters in camp and non-camp areas.


All our humanitarian assistance programs seek to reach the most vulnerable populations—women, children, persons with disabilities, the elderly—who often face extraordinary levels of violence and abuse. Sadly, women and children often fare the worst in war, and the crisis in Syria is no exception. Gender-based violence (GBV) is a serious concern. U.S. government medical support includes services for GBV survivors through women’s health centers, mobile clinics, and outreach teams that provide health and psychosocial services to women who desperately need it. Simple solutions, like supporting all-purpose women’s washing and gathering spaces in camps for the internally displaced, can prove life-changing.

Building on the momentum of the U.S. National Action Plan on Women, Peace, and Security as well as the U.S. Strategy to Prevent and Respond to Gender Based Violence Globally, Secretary Kerry announced a new $10 million global initiative last month in New York, called Safe from the Start—a joint Bureau for Population, Refugees, and Migration/USAID commitment to elevate our focus on the scourge of GBV. In Syria, that means we have looked at all of our programs with the goal of prioritizing and incorporating protection for women and children.

Key Challenges

But the single-greatest factor limiting humanitarian aid remains the ongoing, intensifying conflict. Despite persistent pushing for greater humanitarian access, including across borders, the U.N. still estimates that 2.5 million people in need have not received help for almost a year. The regime continues to actively blockade whole communities.

This siege on civilians is unconscionable.  The recently passed PRST lays down markers for the Syrian regime regarding the world’s expectations that it will provide international humanitarian relief agencies with the immediate and unfettered access they have long been denied.  It outlines very specific steps that are essential to facilitate the expansion of humanitarian relief operations and address the obstacles that already exist on the ground. These steps include:

  • Immediately demilitarizing medical facilities, schools, and water stations and refraining from targeting all civilian objects;
  • Approving access for additional domestic and international NGOs;
  • Easing and expediting the operationalization of humanitarian hubs, the entry and movement of humanitarian personnel and convoys by granting necessary visas and permits;
  • Accelerating the importation of humanitarian goods and equipment like communications tools, protective armored vehicles, and medical and surgical equipment; and, most importantly,
  • Facilitating humanitarian workers’ immediate and unfettered access to people in need.

There are concrete steps that the Syrian regime can take to allow the international community to reach innocent civilians caught in the crossfire. For example, we have seen some instances of aid delivery across battle lines so we know such access is possible. Through delicate negotiations with the Syrian Government and opposition factions, and with the critical partnership of the Syrian Coalition, approximately 30 U.N.-sponsored convoys reached displaced Syrians through cross-line efforts from January to September 2013. But more help is urgently needed, and time is not on our side.

The U.S. Government is seized with this issue, but getting the Syrian regime to comply will require coordinated diplomatic support from all sides. We were encouraged by Russia and China’s support for the PRST and now, this support must be followed with significant pressure.  U.S. diplomats are working with key international actors that have influence in Syria to convince all parties to the conflict to expand humanitarian access now.

Assistance to Neighboring Countries and Host Communities

With more than two million Syrian refugees in neighboring countries, this crisis is now truly regional, threatening the stability of nations struggling to support this massive influx. As these countries host growing refugee communities, our commitment is to continue to support both refugees and those host communities bearing much of the brunt.

Beyond food, medical care, and other traditional relief supplies, U.S. government assistance for refugees includes innovative methods to meet the needs of refugees living in urban populations, such as food vouchers and debit cards for use in local markets, and cash assistance to help refugees pay rent. On my last visit to the region in August, I met with Syrian refugees now living in the outskirts of Amman, who named the cost of rent as their greatest concern.

With the majority of Syrian refugees now living outside camps, U.S. government support for food vouchers and other emergency food assistance to Syrian refugees now totals more than $177 million, injecting cash into local economies and alleviating pressures on communities that are hosting refugees.

U.S. assistance for host communities was a major focus of my travel in August to Jordan and Lebanon, where in some cases Syrian refugees now outnumber the Jordanian or Lebanese people in villages, and vital resources like water are already scarce. In both countries, we see that the poorest communities clearly overlap with the greatest concentration of refugees. Tensions between locals and refugees over resources exist in both countries, so we are paying close attention to key infrastructure, health, and education programming and ramping up efforts to help ensure delivery of essential services at the local level so host communities directly benefit from our assistance.

In Jordan, where domestic water supply is among the lowest in the world, USAID’s Complex Crises Fund (CCF) not only helps communities withstanding mass influxes of refugees to access clean water themselves but also to improve water use efficiency, meaning they can provide water for their livestock and sustain their livelihoods. More recently, we launched a $21 million Community Engagement Project that works closely with communities to identify their most pressing challenges and meet growing community needs: school infrastructure, public parks preservation, lighting, medical equipment, and youth clubs. These programs are helping the Jordanian people and their communities cope with the influx and continue to welcome the influx and continue to welcome Syrian refugees. 

In Lebanon, where an estimated one quarter of the population is now Syrian refugees and the spillover effects of the crisis appear the most acute, we are similarly focused on water and education as well as a value-chain development program to advance agriculture in heavily affected areas like the Bekaa Valley in Lebanon’s northeast.

Providing support to host communities will be an ongoing challenge for the international community. We are partnering with host country governments and the international donor community to prioritize development assistance needs, including in Jordan where the Government of Jordan, along with UNHCR and UNDP, is developing a Host Community Coordination Platform to coordinate direct humanitarian and development support to host communities. At the request of the Government of Lebanon, the World Bank recently released a “Roadmap” identifying priority assistance areas to help Lebanon manage the impact of the Syrian crisis and develop the public service infrastructure needed to sustain the dramatic increases in its population.

These partnerships and assessments are vital to charting an effective way forward as we work to address the long-term effects of Syria’s protracted conflict. Well aware that Syria’s humanitarian crisis now presents a fundamental development challenge for the region, international humanitarian and development donors will reconvene in Amman next week to continue mapping coordinated efforts essential to alleviating immediate pressures on neighboring populations—and ensuring the stability and long-term development of countries in the region.


Humanitarian assistance will not end the bloodshed in Syria, but it is saving lives and helping alleviate the very real pressures this protracted conflict has put on the lives of everyday people throughout the region.  The United States remains fully committed to a strong humanitarian response—and to coordinating closely with our international development partners—to help the Syrian people and Syria’s neighbors endure this crisis. Your Congressional support has been vital in enabling life-saving humanitarian assistance work throughout the region.

The breakthrough agreement among members of the United Nations Security Council on the elimination of Syria’s chemical weapons program, followed closely by the issuance of a statement endorsing emergency assistance to Syrians, has given new hope to aid workers inside Syria. These aid workers, most of them Syrian, have risked their lives daily to ensure help reaches those most in need, but effective humanitarian action will require cooperation from the Assad regime, opposition groups, and the foreign governments that until now have allowed their Syrian allies to stand in the way of or undermine relief operations.

Thank you for your time, and I look forward to your questions.

Foreign Relations

Last updated: December 03, 2013

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