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Syria's Human Crisis: What is to be Done?

September 25, 2013

J. Stephen Morrison, Senior Vice President, and Director, Global Health Policy Center, CSIS; and

Matt Fisher, Program Manager, Global Health Policy Center, CSIS

The August 21 chemical weapon attack in the Damascus suburb of Ghouta set off a turbulent train of events.  Initially, attention was fixed on the Assad regime’s use of chemical weapons, the ghastly videos of the victims' suffering, the threat of retaliatory cruise missile strikes, and whether the U.S., UK, and French governments had the will to act, sufficient legislative endorsement at home, and broad enough international support. Attention then pivoted to the diplomatic scramble by the United States and Russia that resulted in the September 14 Geneva framework agreement to dismantle Syria’s chemical weapons arsenal, in record time in the midst of a full blown civil war. More recently, a divisive debate opened at the UN over a draft Security Council resolution that seeks to verify Assad's compliance and hold his regime accountable.

Before and during this topsy-turvy chemical weapons drama, we lost sight of the full humanitarian story, both inside Syria itself and spilling into neighboring countries. There has been woefully scant reference to Syria's colossal human crisis, its scale and ferocity, its root causes, and its likely future trajectory. High-level political leadership has been missing. There has also been little serious consideration of the potentially dire humanitarian ramifications of a widening war, the questionable long-term goals, sustainability and effectiveness of the international response, and the accelerating changes to the region's demography, stability and development. There is today an evolving debate between optimists and pessimists over whether or not the Geneva framework agreement on chemical weapons creates a slight diplomatic opening – or in fact diminishes the odds – to address the human crisis at a new, more serious level. That debate is potentially quite important. But far more vital is that world leaders -- Presidents Obama and Hollande, UN Secretary General Moon, Pope Francis, World Bank President  Kim, UK Prime Minister Cameron -- focus on the big picture: Syria's burgeoning human crisis, its strategic long-term consequences, and key steps to contain and reverse it.

The human crisis

In the two and a half years since Syria’s civil war commenced in March 2011, almost one of every three of Syria’s 21.4 million citizens has paid a huge personal price in suffering and loss: 100,000 dead, the vast majority from highly explosive weapons in populated cities; almost 30,000 gone missing; an untold number wounded; 4.25 million forcibly displaced from their homes but struggling still inside Syria; and 2 million who reached the wrenching personal decision, under distress, to leave their home country behind to flee to an uncertain and risky future in another country. A year ago, Syrian refugees numbered less than a quarter million. Over the first 8 months of 2013, more than 200,000 Syrians fled to neighboring countries each month. That staggering pace has not slackened.

By the official UN count, over 6.8 million Syrians are today in need of urgent humanitarian assistance. The true number, most observers agree, is far higher. UN High Commissioner for Refugees António Guterres recently summarized the crisis in Syria as “a disgraceful humanitarian calamity with suffering and displacement unparalleled in recent history.” Aggregate humanitarian demand has reached unprecedented levels: the two UN appeals that run through calendar year 2013 amount to $4.4 billion; pledges have met slightly more than 40 percent of that estimated need. New massive appeals for 2014 are forthcoming soon.

There are unsung heroes.


As grim as this situation is, courageous individuals and institutions do struggle to contain it. Commendably in this turbulent period, Syria's neighbors, most notably Jordan, Turkey, Lebanon, Egypt, and Iraq, have at considerable cost and risk allowed hundreds of thousands of Syrians to enter and take refuge in their countries. Turkey has expended an estimated $1.5 billion toward the care of Syrian refugees.

UN agencies – most notably the Office for the Coordination of Humanitarian Affairs (UNOCHA) the UNHCR, the World Food Program (WFP), the World Health Organization (WHO) and UNICEF -- have persevered under exceptionally trying, dangerous operational conditions. The same is true for the International Committee of the Red Cross (ICRC), the Syrian Arab Red Crescent (SARC), Médecins Sans Frontières (MSF), and many other non-governmental organizations that prefer to remain anonymous and habitually do not receive adequate recognition.

Commendably also, the United States has been quick to respond generously and lead the humanitarian mobilization. From 2012 up to today, over the course of just 20 months, the United States committed $1 billion, roughly one third of all international humanitarian commitments. Over half of U.S. funding is directed to needs inside Syria, half to answering the needs of Syrian refugees now outside their home country. (An additional $250 million is dedicated to non-lethal assistance to opposition groups.) These commitments are striking and substantial, coming in the midst of worsening U.S budget constraints. Overall U.S diplomatic policy toward the Syrian crisis may be confusing or unstable; the U.S. humanitarian response has been fast, robust, and unwavering.

But these commitments stretch U.S. emergency budgets. If the human crisis in Syria continues to deepen, the United States will confront ever tougher budgetary tradeoffs as it strives to sustain its leadership. It is not clear that the United States will be able to carry a $1 billion dollar a year or higher commitment forward indefinitely. 

The human crisis threatens to overwhelm

The conflict in Syria and the resulting humanitarian crisis have exposed five disturbing realities.

First, Syria's human crisis – inside Syria and extending into Lebanon, Jordan, Turkey, Egypt and Iraq – conspicuously outstrips the financial and humanitarian response capacities of national governments, UN agencies, international organizations, local medical and relief societies, and international NGOs. That loose collection of humanitarian agencies simply cannot meet the burgeoning demand. Resources are insufficient, while operational capacities fall short.

Secondly, humanitarian access inside Syria is abysmal, getting worse, and stands at the very core of Syria’s human crisis. To a degree seldom seen in modern war, armed forces on both sides routinely obstruct the delivery of humanitarian aid, violate international humanitarian law and norms, and target and kill humanitarian workers from local and international NGOs. The Assad regime bears overwhelming responsibility, but it is not alone. The ever larger number of fragmented armed groups are also responsible. Inside Syria the regime has deliberately carried out the systematic destruction of infrastructure – of health, education, transport, housing, and communications – in over half a dozen major urban centers. That tragic choice leaves in its wake a wasteland that will require a decade or more to repair.

Third, worse things lie ahead, if, as expected, Syria's war intensifies. Unless and until the trajectory of the war is reversed and targeted attacks upon Syria’s civil society abate, we should assume an ever widening human crisis – whether the Geneva framework agreement on chemical weapons is or is not able to move ahead. Syrian refugees may exceed 3 million by year's end.

Fourth, Syria’s human crisis directly threatens the security of its neighbors, particularly Lebanon and Jordan. Region-wide, over 2 million Syrians are registered refugees or are awaiting registration, and many suspect the total number of refugees is much higher: over 700,000 Syrians have fled to Lebanon, over 500,000 to Jordan, over 450,000 to Turkey, over 150,000 to Iraq, and over 125,000 to Egypt. In Lebanon, Syrian refugees officially now comprise a sixth of the nation’s population; unofficially Syrians likely exceed one million and account for one in five persons on the ground inside Lebanon. Lebanon, Jordan and Turkey have become increasingly vocal that this rapid, massive, unsustainable refugee influx stresses their economies, support systems, and infrastructure to the breaking point.

Fifth, Syria's human crisis is fundamentally altering the region over the long-term. Large, insecure populations are being displaced over an indefinite period across a fragile region that will likely grow more, not less hostile. What began as an emergency just a short time ago is rapidly becoming a long-term political and development crisis for host countries themselves, with echoes to the Palestinian crisis of 1948. We need to prepare for a million or two million Syrians who do not desire to or cannot return home, cannot migrate elsewhere, and may not be welcome where they find themselves today.

What is to be done?

Syria's human crisis is bigger than all of us and getting bigger swiftly. Ending the war is essential to reversing course, but much more can and should be done now.  High-level leadership is however still missing. Whether the Geneva Agreement on chemical weapons moves ahead or not, President Obama and other world leaders need to take the conversation to a higher level, beyond pessimism and ad hoc humanitarian responses. They need to speak forcefully to the true magnitude of the worsening crisis and its strategic long-term consequences, and set immediate priorities. These should include accelerated high-level contingency planning; pressing Russia, Saudi Arabia, China and other wealthy states who have been absent to carry their weight in financing the response to this sprawling crisis; redoubling high-level pressure upon Assad and the armed opposition to respect unconditionally the neutrality of humanitarian norms, open the space for cross-border and cross-line relief, and permit expanded protection of humanitarian and health operations; and accelerating the introduction of development assistance to stabilize Lebanon and Jordan.

Media Queries

Contact H. Andrew Schwartz
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