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January 14, 2013 —  Nearly two years into ���������’s civil war, the region faces a staggering humanitarian disaster, requiring the international community to urgently scale up planning and funding for what is certain to be a long-term regional crisis, says the ̽����ѡ’s Commission on Syrian Refugees.

“The Middle East is once again facing a human displacement tragedy,” the commission states in its new report, Syria: A Regional Crisis. “Current assistance levels are drastically insufficient to address existing needs, let alone the barest requirements to respond to a lengthy humanitarian emergency and post-conflict recovery.”

As of today, more than 600,000 Syrians have fled to over-burdened neighbouring countries and the UN anticipates that number could soon exceed 1million if the exodus continues at its current pace of about 3,000 refugees a day. Inside Syria, more than 2 million civilians are displaced and the UN estimates that 4 million are in dire need of assistance.

Inside Syria: Struggling to Survive

Based on interviews with refugees, the ̽����ѡ report says Syrian civilians are struggling to survive in communities besieged by violence, chaos and destruction. Entire neighbourhoods have been reduced to rubble. Fleeing families face recurring displacement amid a moving frontline. Supplies of food, water and electricity have sharply dwindled, sanitation in many areas has halted, increasing the threat of disease, yet medical care has become scarce.

Partner organisations that provide emergency medical services and supplies inside Syria say the health care system has been decimated.  Syrian physicians described to the ̽����ѡ “a systematic campaign to restrict access to lifesaving care through the strategic bombing and forced closure of medical facilities” and “intimidation, torture and the targeted killing of doctors in retribution for treating the wounded.”

The report also details horrific levels of sexual violence, describing “rape as a significant and disturbing feature of the Syrian civil war.” In the course of three ̽����ѡ assessments in Lebanon and Jordan, Syrians identified rape as a primary reason their families fled the country. “Many women and girls relayed accounts of being attacked in public or in their homes, primarily by armed men. These rapes, sometimes by multiple perpetrators, often occur in front of family members,” the report states. The ̽����ѡ was also told of attacks in which women and girls were kidnapped, raped, tortured and killed.

Because of the stigma and social norms around the “dishonor” that rape brings to women and girls and their families, Syrian survivors rarely report rape. Many interviewed by the ̽����ѡ also said survivors fear retribution by their assailants, being killed by “shamed” family members, or in the case of girls, being married off at an early age “to safeguard their honor.” For survivors who manage to flee, there is a shortage of medical and counseling services to help them recover in the communities where they have settled and even there, challenges continue. Many women and girls face unsafe conditions in refugee camps as well as elevated levels of domestic violence.

The Refugee Crisis

Every day, thousands of Syrians who can no longer bear the violence and hardship at home stream into Iraq, Jordan, Lebanon, Turkey and increasingly North Africa to find safe haven. About 30 percent settle in refugee camps.  And while the international community allocates the bulk of its limited resources to these camps, many remain overcrowded, overstretched and unprepared for the brutal winter.

The vast majority of Syrians who have fled (100 percent in Lebanon and about 80 percent in Jordan, 50 percent in Iraq and 30 percent in Turkey) are now “urban refugees”. “Even though 70 percent of ���������’s refugees live outside of camps in urban and rural areas, there is a dearth of funding for programmes to assist them,” says George Rupp, the ̽����ѡ’s president, who led the commission visit to the region in November. “As a result, Syrian refugees not living in camps are grossly underserved and growing increasingly destitute and desperate.”

Multiple families crowd into small rented rooms and apartments in disrepair or schools and other spaces provided by host governments. Others squat in unused spaces in poor districts that lack the capacity to assist them. Many refugees arrive with war wounds and illnesses, yet struggle to access health care. Most flee with few belongings and little money, have seen their finances dwindle and can no longer afford food, clothing and other basics. Unable to work legally in most host countries, many have taken loans and are in deepening debt. The ̽����ѡ heard accounts of desperate women trading sex for food, children being forced to work in exploitative or dangerous jobs and families selling girls into early marriage to reduce household numbers or pay rent. The ̽����ѡ is stepping up cash assistance programmes for non-camp refugees in Jordan and Lebanon to help pay for daily expenses, but the needs remain immense.

Syrian children and youth have been gravely impacted by the violence and upheaval of their families.  Nearly every child will speak about witnessing family members attacked or killed and many children have been caught in the crossfire or targeted with violence. Many Syrian children have already missed up to two years of their education because of the unrest. And schooling for thousands of refugee children remains interrupted because classes in host communities are full and unable to absorb more refugee students. For those fortunate enough to attend school, most teachers are ill-equipped to assist such traumatised children and specialised services are largely unavailable. 

The influx of hundreds of thousands of Syrian refugees is seriously straining the limited resources of countries generously taking them in and tension between host and refugee communities is rising. Urban refugees, in particular, are saturating housing markets, leading to steep rent increases for both refugees and locals. Commodity prices are up and wages are down. Health, water, sanitation and education systems are struggling to cope. Countries in the region have been spending their own money to respond to the exodus and are now overtly asking for help. Iraq is also grappling with the return of 60,000 Iraqi refugees from Syria. “These countries feel neglected by the international community and saddled with an immense burden that has no end in sight,” the report says.

A Protracted Humanitarian Emergency

The ̽����ѡ report asserts that the Syria crisis will be a protracted humanitarian emergency: “An end to the civil war will not necessarily end sectarian violence; indeed the violence could well increase. Recovery, reconciliation and political transition will be fraught with challenges and could take years. Every country in the region is unsettled by the prospect of hostilities spilling over their borders. They fear continuing refugee influxes could create internal instability or exacerbate simmering or historical tensions.  Even if the conflict comes to a swift end, Syria will emerge in ruins—its social and civic fabric in shreds, its economic foundation and infrastructure devastated and its population scattered throughout the region—potentially unable for months if not years to return to shattered communities.”

“Donors need to step up, recognise the severity of the humanitarian crisis in and around Syria and face the virtual inevitability that this is going to get much worse and last much longer than initially anticipated,” says Sir John Holmes, commission member, Co-Chair of the ̽����ѡ-UK Board of Trustees and director of the Ditchley Foundation.

The ̽����ѡ’s Commission on Syrian refugees makes the following recommendations:

• Increase humanitarian aid: Donor governments must urgently meet the UN funding appeal for $1.5 billion to aid uprooted Syrians and significantly ramp up bilateral assistance to countries absorbing refugees to help offset the strain on their infrastructure and mitigate growing tension.
• Maintain open borders: Host countries must keep their borders open to endangered Syrian civilians and continue offering them safe haven. “Buffer zones,” which have a poor record of effectiveness, are difficult to protect and create a false sense of security for civilians living in them, should be discouraged.
• Expand international assistance inside Syria: The international community must expand partnerships with Syrian organisations that provide lifesaving assistance throughout Syria. Channeling aid to such groups is essential now and must be maintained in a post-conflict phase. Access must also be granted or improved for international aid groups that can provide emergency and recovery aid for Syrians and other vulnerable groups inside Syria, including Palestinian and Iraqi refugees.
• Prepare for a protracted humanitarian emergency: The international community must put financial diplomatic and logistical plans in place for a regional humanitarian crisis that could last years, given the scale of displacement and destruction and the risk of regional instability and increased sectarian violence. Preparations must be made for a mass exodus of refugees, should there be a sudden escalation of the crisis. UNHCR and donors should also discuss resettlement options for extremely vulnerable refugees.
• Scale up programmes for “urban refugees”: While camp-based Syrian refugees require improved and ongoing support, it is vital that international donors vastly increase resources for programmes that aid refugees living outside camps and bolster the infrastructure of over-extended host communities. Major investment is needed to help hospitals and clinics treat thousands of extra patients daily and to expand cash assistance programmes so that urban refugees can afford food, rent and other essentials for their survival. UNHCR should continue to expand registration sites to ensure that all refugees who want to register can, and that those who are afraid to register can still access available assistance.
• Address violence against Syrian women and girls: Funding must be increased for programmes that prevent and respond to violence against women and girls, inside and outside of camps. This includes clinical care and emotional support for survivors, improving safety in camps, minimising survival sex, forced marriage, and domestic violence and providing economic aid so that women do not revert to exploitative jobs.
• Invest in children’s safety and healing: Programmes must focus on identifying and providing tailored support for harmed or at risk children, including psychosocial support, aid for separated children and prevention of abuse, child labour and recruitment into armed groups. Local educators and health workers need special training in caring for violence-affected children. It is critical that Syrian refugee children are able to return to school and programmes meet the minimum standards for education in emergencies.