A child stands amid the rubble of what was once his home, after an aerial bombardment on the city of Idlib in northwestern Syria. Credit: Freedom House/CC-BY-2.0

By Kanya D'Almeida
UNITED NATIONS, Jul 9 2015 (IPS)

Barely 10 months ago, the United Nations Refugee Agency (UNHCR) said the refugee population from Syria had reached the three million mark. Today, the latest data from the field show that the number has passed four million.

“This is the biggest refugee population from a single conflict in a generation,” U.N. High Commissioner for Refugees António Guterres said in a statement on Jul. 9.

"I took [my son] to the field hospital in Tafas. They tried to help him but couldn't, since the appropriate equipment is not available in Syria. He needed to go to Jordan for treatment." -- Murad, the father of a 27-day-old baby injured in a barrel bomb attack in Syria
“It is a population that deserves the support of the world but is instead living in dire conditions and sinking deeper into abject poverty.”

Midway through its fifth year, the Syrian conflict that began in March 2011 has reached catastrophic heights, and yet shows no sign of abating.

What started out as mass demonstrations against long-time ruler Bashar al-Assad now involves multiple armed groups including fighters from the Islamic State in Iraq and Syria (ISIS).

A quarter of a million people are dead, according to estimates by the Syrian Observatory for Human Rights. A further 840,000 are injured, with many thousands maimed for life.

And as U.N. agencies struggle to cobble together the funds needed to heal, house and feed millions who have fled bullet-ridden towns and demolished cities, the exodus just keeps growing.

A UNHCR press release issued Thursday said Turkey is hosting 1.8 million Syrians, more than any other nation in the region. Over 250,000 of these refugees are living in 23 camps established and maintained by the Turkish government.

Other countries in the region that have opened their doors to scores of families fleeing the fighting include Lebanon (currently home to over 1.7 million Syrians), Jordan (hosting 629,000 refugees), Iraq (249,000) and Egypt (132,000).

In every single one of these countries, health and infrastructure facilities are quickly nearing breaking point as the hungry, sick and wounded arrive in droves.

On Jul. 9 Doctors Without Borders (MSF) warned that Jordanian hospitals are groaning under a huge patient burden, including numerous Syrians injured by barrel bombs.

In the last two weeks alone more than 65 war-wounded patients turned up at the emergency room of Al-Ramtha hospital in northern Jordan – less than three miles from the Syrian border – where MSF teams have been working with the Jordanian Ministry of Health to provide emergency care to refugees.

The medical humanitarian organisation has called repeatedly for an end to the use of these deadly, improvised weapons, which are typically constructed from oil drums, gas cylinders or water tanks filled with explosives and locally-sourced scrap metals dropped from high-altitude helicopters.

Due to the wide impact radius of barrel bomb attacks, victim often suffer wounds that are impossible to treat within Syria’s borders, where many health facilities have been reduced to rubble in the past five years.

“More than 70 percent of the wounded we receive suffer from blast injuries, and their multiple wounds tell their stories,” Renate Sinke, project coordinator of MSF’s emergency surgical programme in Ramtha, said in the statement released Thursday.

Dr. Muhammad Shoaib, MSF’s medical coordinator in Jordan, added, “A significant proportion of the patients we receive have suffered head injuries and other multiple injuries that cannot be treated inside southern Syria, as CT-scans and other treatment options are limited.”

One of the patients at Al-Ramtha Hospital, the father of a 27-day-old child who suffered head injuries as a result of shrapnel from a barrel bomb, recounted his family’s plight, which mirrors the experience of millions of civilians caught in the crossfire of the deadly conflict.

“At 9:00 a.m., a barrel bomb hit our house in Tafas […]. When I heard the news, I dropped what I was doing and I ran to the house as fast as I could […]. I saw my little boy. He was quiet and his head seemed to be injured. I took him to the field hospital in Tafas. They tried to help him but couldn’t, since the appropriate equipment is not available in Syria. He needed to go to Jordan for treatment,” Murad, the boy’s father, told MSF staff.

“It took us one-and-a-half hours from the time of injury until we arrived at the border, and some more before arriving in Ramtha. Now, all I want is for my baby to be better and go back to Syria.”

It is families like these that comprise the bulk of Syrian refugees, the highest recorded since 1992 when Afghan refugees reached an estimated 4.6 million, says the U.N. Refugee Agency.

Indeed, the figure from Syria could well be even higher than field reports suggest, and does not include the roughly 270,000 asylum applications by Syrians in Europe. A further 7.2 million people are displaced inside Syria itself, in remote or heavily embattled regions.

Worse, officials say, is the apparently inverse relationship between emergency needs and humanitarian funding: with the former constantly rising, while the latter shrinks.

UNHCR and its partners had requested 5.5 billion dollars for relief operations in 2015, but so far only a quarter of those funds have been received.

The World Food Programme (WFP), tasked with feeding about six million Syrians inside the country and in the surrounding region, is facing a massive shortfall, and warned last week that unless immediate funding became available, half a million people could starve.

There is also the very real possibility that over 1.7 million people will have to face the coming winter months without fuel or shelter.

As aid supplies dwindle, desperate and impoverished families are sending their children out to earn a living – according to a joint report released this week by the United Nations Children’s Fund (UNICEF) and Save the Children, three quarters of all refugee households surveyed reported that children have become breadwinners.

Against the backdrop of soaring poverty rates, these findings are perhaps not unexpected. An estimated 86 percent of refugees outside of camps in Jordan, for instance, live below the poverty line, while a further 55 percent of refugees in Lebanon are living in “sub-standard” shelters, according to the refugee agency.

While world leaders oscillate between political and military solutions to the crisis, Syrians are faced with a choice: death by shrapnel at home or death by starvation abroad?

Edited by Kitty Stapp

The head of the United Nations agency for Palestinian refugees has described the situation inside the Syrian refugee camp of Yarmouk, under attack by Islamic State (IS) militants, as “one of the most severe ever” for the already spartan camp.

Fighters allegedly from the IS, and al-Qaeda affiliate al-Nusra, began their attack on the camp, on the outskirts of Damascus, on Apr. 1. By Apr. 4, the Syrian Observatory for Human Rights reported that 90 percent of the camp was controlled by militants.

Around 18,000 people, including 3,500 children, are believed to be trapped inside Yarmouk.

Pierre Krähenbühl, commissioner general for the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), told a press briefing Monday the current situation was among the most dire faced by refugees in the camp, already under siege for two years and suffering from a lack of food, water and medical help.

“The current escalation has made the hour more desperate than ever for civilians inside Yarmouk,” Krähenbühl said via videoconference from Jordan.

“Concerted action by [U.N. Security Council] members and U.N. members to uphold humanitarian law is required.”

He said UNRWA had been unable to render assistance to those trapped inside due to access issues, but that the agency was “ready at any time to resume humanitarian assistance.”

On Sunday, UNRWA released a statement demanding access to the camp. “The lives of civilians in Yarmouk have never been more profoundly threatened,” the statement read.

“The level of our aid has been well below the minimum required. Potable water is now unavailable inside Yarmouk and the meagre health facilities that existed have been overrun by conflict.  The situation is extremely dire and threatens to deteriorate even further.”

Krähenbühl was unable to comment on how much of the camp may be under militant control, but conceded that affected areas did house the highest concentration of civilians.

Reports from Yarmouk include alleged beheadings by IS members, but Krähenbühl was again unable to comment, saying UNRWA had been “unable to independently verify” such reports.

Ongoing gun battles in the streets of Yarmouk further escalate an already bleak and miserable living situation for Palestinian refugees. Civilians are said to subsist on just 400 calories a day, with sparse access to food or water. Krähenbühl conceded UNRWA was only able to provide “meagre” assistance to Yarmouk residents, calling their living conditions “unbearable.”

U.N. Secretary-General Ban Ki-moon and the Security Council have been briefed on the situation. While it is unclear what, if any, action the U.N. may take, Krähenbühl made several cryptic comments calling on the international community to “influence” armed groups to curtail their offensive.

“There are no easy solutions … messages have to be passed to all the parties and armed groups inside Yarmouk that respect for life is an element not only in international law, it is a fundamental human principle that is found in all religions,” he said.

“We call on states to act and influence parties on the ground … more concerted action could influence action on the ground.”

When asked whether UNRWA had any direct contact with IS, Krähenbühl said no.

“It is not up to me to give any indication on who may channel messages to different parties, including the armed groups inside Yarmouk,” he said.

Hezbollah clashes with Syrian rebels on the outskirts of Ersal seem to be widening the divide between residents of the Eastern Bekaa town – increasingly dominated by Syrian rebels, including the radical Nusra Front – and other regions as well as the Lebanese state. 

At the bottom of the rugged Syrian Qalamoun mountain chain lies the predominantly Sunni town of Ersal. The region is known historically as a smuggling route between Syria and Lebanon.

Since the beginning of the Syria revolution, politics have pushed its people away from their Bekaa neighbours, who mostly belong to the Shiite community. Ersal largely sympathises with the Sunni-led uprising against Syrian President Bashar Assad, while Bekaa Shiites support the Lebanese Hezbollah, which is currently fighting alongside Syrian regime forces.“Clashes between Hezbollah and Syrian rebels have aggravated tensions between local residents and their neighbours, and every incident is causing a backlash on the village [Ersal]” – deputy mayor of Ersal, Ahmad Fleety

Despite the fall of Qalamoun to Hezbollah and Assad regime troops in March, fighting has resumed in the Syrian region as well as the barren valley and rocky tops of Ersal in Lebanon, where rebels are also present.

“The clout of Syrian insurgents over the town has become an unavoidable reality,” says a Lebanese army officer speaking on condition of anonymity.

This week, seven members of Hezbollah died and 31 others were wounded, according to the Syrian Observatory for Human Rights. The fighters were killed in an ambush in the hills above Ersal. The rugged area is also used a rocket launch pad by rebels who frequently target Hezbollah villages in Bekaa.

“The Syrian-Lebanese border there is the soft belly of Hezbollah’s stronghold as it overlooks the Bekaa and more importantly the city of Baalbeck, which is the birthplace of the militant organisation,” says Professor Hilal Khashan from the American University of Beirut.

“Rebels, including the Nusra Front, are using Ersal to launch attacks on Hezbollah, which is self-compelled to retake the region, at a very high cost,” he adds.

The military source underlines that an estimated 6,000 Syrian fighters have found refuge in Ersal. Hundreds of opposition militants are believed to be hiding in the hills and caves above the town. Dirt tracks connecting Ersal to the Bekaa mountain tops are also used by residents to ferry aid, gasoline and supplies to insurgents.

Deputy mayor Ahmad Fleety admits that Ersal is paying a high price for backing the Syrian revolution.  “Clashes between Hezbollah and Syrian rebels have aggravated tensions between local residents and their neighbours, and every incident is causing a backlash on the village,” he says.

The official points out that an Ersal resident, Khaled Hujairi, was wounded in nearby Laboueh after the funeral of one of the Hezbollah fighters who died in the recent battles.

However, the divide separating Ersal residents from those residing in surrounding villages dates back to the beginning of the uprising and a spate of tit-for-tat kidnappings between Sunnis and Shiites.

Relations between the two communities took a turn for the worse after four Shiites were killed in June last year near Ersal.  The trend was only exacerbated when the town remained under siege for several weeks early this year, after the village became a transit point from Syria into Lebanon for booby-trapped cars targeting Shiite areas.

Ersal’s grim reality is only compounded by the town’s isolation. A small asphalt road connects it to the rest of Bekaa, and from there onward to the capital Beirut. Syrian planes frequently fly over, firing missiles into the village and the mountain tops above it. An attack this week led to the injury of seven Ersal residents.

These repetitive incidents rarely draw any complaints from Lebanon.

“Ersal is an outlying territory neglected by the government, which can explain the rise of extremism there. If Ersal residents felt they belonged to the Lebanese state, they would not be so supportive of Syrian rebels,” points out Khashan.

In addition, relations with the state have been strained by a series of incidents, the most recent leading last year to clashes between an army patrol and local residents, claiming the lives of two Lebanese armed forces members as well as one suspect who was being pursued.

The presence of over 120,000 Syrian refugees – which exceeds the local population threefold – is further straining relations with the state and other villages. “Ersal people have chosen to support the Syrian revolution, they won’t back down,” says local activist Abu Mohamad Oueid.

The deepening feeling of distrust between old neighbours now turned foes seems to be here to stay, and the fates of Ersal residents to be intertwined with that of Syrian rebels.

Syrian activists claim that government forces have carried out a “poisonous gas” attack in suburbs of the capital, Damascus, leaving hundreds of people dead.

Activists said regime forces fired “rockets with poisonous gas heads” in the alleged attack early on Wednesday.

The Britain-based Syrian Observatory for Human Rights said the shelling was intense and hit the eastern suburbs of Zamalka, Arbeen and Ein Tarma.

It said at least 100 were killed, while the Local Coordination Committees said hundreds of people were killed or injured in the shelling.

The attack coincided with the visit by a 20-member U.N. chemical weapons team to Syria to investigate three sites where chemical weapons attacks allegedly occurred over the past year.

Syrian authorities dismissed reports of a chemical attack on Wednesday as “baseless”, and said the reports were intended to hinder the mission of U.N. inspectors.

The main opposition group, the Syrian National Coalition, accused the regime of killing more than 650 people on Wednesday.

“Over 650 confirmed dead result of deadly chemical weapon attack in Syria,” the National Coalition said on Twitter.

The reports could not be independently confirmed.

Al Jazeera’s Nisreen El-Shamayleh, reporting from neighbouring Jordan, said there were videos allegedly showing both children and adults in field hospitals, some of them suffocating, coughing and sweating.

“We have been receiving reports that the doctors in the field hospitals do not have the right medication to treat these cases and that they were treating people with vinegar and water,” she said.

Call for U.N. probe

The head of the U.N. chemical weapons inspectors in Syria said that reports of the gas attack should be investigated.

Swedish scientist Ake Sellstrom told news agency TT that while he had only seen TV footage, from which nothing could be determined, the high number of casualties reported sounded “suspicious”.

The Syrian National Coalition has called for an urgent U.N. Security Council meeting after the deadly attack.

“I call on the Security Council to convene urgently,” National Coalition leader Ahmed al-Jarba told Al-Arabiya news channel, condemning the Syrian army’s bombardment of the suburbs of Damascus as a “massacre.”

He urged the U.N. team now in Syria to visit the site.

In Cairo, the Arab League also urged the U.N. inspectors to visit the site of the alleged attack immediately. And Saudi Arabia as well urged the U.N. and EU ministers to immediately address the “massacre”.

UK said it would raise the reported chemical weapons attack at the U.N. Security Council and called on Damascus to give U.N. inspectors access to the site.

“I am deeply concerned by reports that hundreds of people, including children, have been killed in airstrikes and a chemical weapons attack on rebel-held areas near Damascus,” British Foreign Secretary William Hague said in a statement.

France will also ask U.N. experts to visit the site of the alleged chemical attack in Syria, a French government spokesman said.

Published under an agreement with Al Jazeera.