Trapped in Syria

Earlier this month, a doctor in northern Syria asked that a message be sent out to the world via Widney Brown, director of programs at Physicians for Human Rights (PHR). "I don’t know how much longer I can hang on," the doctor, a woman, said in the message, which Brown relayed to me in an interview. (Doctors have been the targets of violence in the country and are wary of being named.) Every day, children die in her hospital from a treatable form of anemia because the facility lacks the resources to perform basic procedures, such as blood transfusions or iron injections. "It’s horrific," the doctor said. The international community, and the United Nations in particular, "have got to do a better job of getting supplies in or letting people out."

The doctor is like many people in Syria who are on their last emotional or physical legs as they face a complex, brutal, seemingly endless crisis. And now, according to a new report from the International Rescue Committee (IRC), published Thursday, those who want to leave Syria are increasingly finding themselves trapped.

U.N. High Commissioner for Refugees António Guterres has called the outflow of Syrian people from their war-ravaged country "the biggest humanitarian emergency of our era." This week, UNHCR announced the latest numbers: Approximately 7.2 million people have been forced to flee their homes within Syria, and 3.3 million have become refugees abroad. (UNHCR estimates that, in total, 13.6 million people have been displaced by fighting in both Syria and Iraq.) The IRC’s report adds a startling dimension to these statistics: UNHCR registered an average of 150,000 refugees leaving Syria each month in 2013. For the first three-quarters of 2014, however, the number fell to about 78,000 per month. Then, the kicker: In October 2014, the number of people registered by the U.N. as leaving Syria fell to just 18,453. That’s an 88 percent drop from the 2013 monthly average.

The number isn’t shrinking because fewer people are trying to flee. Rather, according to the IRC, people are either unable to leave cities under siege — there were high levels of conflict in Syria in October — or they are being turned away at the borders of neighboring countries as tighter restrictions are put into place.

Lebanon, which already hosts 1.1 million Syrian refugees, announced in October that it would suddenly and severely limit the human influx: "No more refugees will be allowed to cross the border except for extreme humanitarian cases," Information Minister Ramzi Joreige said after a cabinet session. Since then, Lebanon has turned away as many as 60 percent of people attempting to cross the border, according to the IRC. In that same timeframe, in Turkey, the IRC found that "just two border crossings remained formally open for refugees, while two other crossings offer restricted access only." Iraqi borders, meanwhile, open and close intermittently, and Jordan put restrictions in place in 2013 that led to the drop in incoming refugees — from an average of 60,000 at the start of the year to just 10,000 in September.

There are a "large number of people along the Syrian side of some of the border crossings," says Sarah Case, senior policy and advocacy advisor at IRC. For many people deeper inside the country, "it is too risky to get to the border areas," even though the consequences of remaining are grave. "Those that can’t seek safe haven in neighboring countries or who cannot afford to take the chance of leaving risk a reality of daily violence and a dramatic deterioration in living standards," Case says.

How did it come to this? It’s true that Turkey, Jordan, Lebanon, and Iraq are strapped for resources and bearing an enormous burden. The rest of the world, however, is doing little to help, including wealthy Western countries.

Overall, only 7,000 refugees in total had been resettled worldwide through UNHCR-facilitated programs from the start of the war through August of this year. The United States is currently processing 4,000 refugees for resettlement, the IRC reports, yet it had only physically resettled 166 Syrians since the start of the war as of the end of September. Canada has only pledged to take in 200. And only 50 people have been formally resettled so far in the United Kingdom, according to BBC. 

Countries not sharing borders with Syria, the IRC says in its report, "have shown a remarkable lack of solidarity both with Syria’s civilian population seeking to escape violence and with the neighboring countries that host the overwhelming majority of refugees."

Amin Awad, UNHCR’s director for the Middle East and North Africa, told Reuters on Tuesday, "Other countries in the world, especially the Europeans and beyond, should open their borders and share the burden." Similarly, IRC’s Case says that it is time for the international community to "substantially increase developmental and humanitarian assistance in the region, to enable them to keep their borders open to men, women, and children fleeing the war in Syria." Countries outside the Middle East have only agreed to receive "a token 50,000 quota refugees from Syria," she says. That’s less than 2 percent of the total refugee population. "It is our collective responsibility to step up."

The obstacles of getting countries to step up are myriad: PHR’s Brown explains that some states cite "national security" in explaining why they won’t take more refugees, while others say they already pledge money to UNHCR, so their hands are washed of the refugee burden. (Humanitarian efforts at the U.N. are only half funded, or worse.)

Additionally, the United States and some other countries cherry-pick whom they let enter.

"What you would want to do is prioritize the people who have the least ability to survive in the temporary situation," Brown says. In practice, however, what often happens "is really just the opposite. They’ll take people who are the best educated or have family ties in the country." (This way, she says, "you won’t become dependent on the state.")

Brown and some other human rights workers closely following air strikes in Syria maintain that the United States may even be adding to the refugee crisis. Take Aleppo, for instance. "People are dodging barrel bombs by day and U.S. bombs by night," Brown says, arguing that the United States hasn’t sufficiently planned for the humanitarian consequences of the strikes. "You should be assessing where the civilians are, their mobility, where it’s safe for them to flee to." With the strikes creating further insecurity inside the country, Syrians who are able to do so will likely continue to head to borders with neighboring countries — where they might not be able to cross over. "You don’t create a refugee flow and say, ‘Oops, sorry, you guys take care of the mess,’" Brown adds.

The doctor who spoke to Brown, pleading for the world to help, described a nightmare in progress in northern Syria. "You can take really, really emergency cases across the border into Turkey if literally the person is dying and immediate surgical intervention can save them," the doctor said. "But if you have people who are still in desperate need of treatment, are in pain, all that stuff — in fact, dying, but in a longer-term way — they can’t get people in need of emergency care over."

With a prewar population of 22 million people and more than 3 million living abroad as refugees, that leaves nearly 19 million Syrians caught in a place without enough food and medical supplies, or even basic human rights. With too little aid and blocked borders, hope that things will get better is also rapidly depleting.