UN food distribution in Yarmouk on 24 February.(UNRWA)
The United Nations agency for Palestine refugees, UNRWA, was permitted to make a delivery of 300 food packages to Yarmouk camp near Damascus today, after 15 days of being denied access by the Syrian government.
However, the delivery is a drop in the ocean of what is needed in in the besieged refugee camp, where an estimated 18,000 civilians remain trapped. The camp was once the largest population center of Palestine refugees in Syria, as well as home to thousands of Syrians.
UNRWA says it needs to deliver 700 food parcels per day to prevent starvation in the camp, where many residents have already died of hunger, the Guardian reported last weekend. However, an average of only 100 parcels per day have been delivered since the beginning of the year, despite the UN Security Council’s adoption of Resolution 2139 on 22 February requiring all parties in Syria’s civil war to allow unfettered humanitarian assistance.
According to a joint statement issued yesterday by UN agencies attempting to alleviate the humanitarian catastrophe in Syria, there are “at least one million people [who] are now in need of urgent humanitarian assistance in Aleppo alone.”
“Starvation as weapon”
Neil Sammonds, Syria researcher with Amnesty International, said that the “Main problem is the Syrian government,” which is not allowing food aid to come through its borders. He added that the government is “using starvation as a weapon of war to achieve its ends.”
Abeer Etefa of the World Food Program said that communities in Aleppo, Syria’s most populous city, are being completely cut off by both government and opposition forces. However, the agency was able to reach four million people in Syria in March.
Christopher Gunness of UNRWA emphasized that if it was within the UN Security Council’s power to implement an agreement to rid Syria of its chemical weapons stockpile, “with thousands of people possibly facing the risk of starvation, surely the Council can adopt an equally robust approach in getting Resolution 2130 implemented …”
Gunness added that the UN charter states: “the organization is there to save succeeding generations from the scourge of war and the fact is that tonight the people of Yarmouk are not being saved from the scourge of war and the credibility of all of us in the UN is at grave danger as are the lives of those poor, besieged civilians trapped in Yarmouk.”
Months of siege
A report published by Amnesty International last month details the events leading up to the Syrian government’s siege on Yarmouk in December 2012 and its impact on its residents.
Titled “Squeezing the Life Out of Yarmouk: War Crimes Against Besieged Civlians,” the 37-page report states:
Scores of civilians are reported to have died in Yarmouk as a direct result of the siege or have been killed in attacks by Syrian government forces. Amnesty International has obtained information about 194 individuals, all said to be civilians, who have lost their lives since government forces tightened the siege in July 2013. Starvation, lack of adequate medical care and shooting by snipers are the three main causes of death reported to Amnesty International.
Many other Yarmouk civilians have been wounded or maimed, or have fallen victim to illnesses caused by the severe conditions to which they have been exposed for so long. Yarmouk’s civilians have been brought to the brink of starvation, forced to forage for any food that they can find. They have few and diminishing medical facilities available to treat their sick and wounded. Every day they face uncertainty about their future and what the Syrian government forces may do to them if and when the siege ends. Elsewhere, other communities in Syria remain under siege by government troops and face similar privations and fears. Within the context of the siege, Syrian security forces have also arrested scores of Yarmouk residents, many of whom they have subjected to enforced disappearance. Some have died in custody in suspicious circumstances. Those arrested include at least 12 medical workers; six of whom were subjected to enforced disappearance and remain unaccounted for and another who died in the custody of Syrian security forces. All appear to have been targeted by the Syrian security forces on account of their activities as medical workers. Other medical and health workers have been killed and injured in apparently targeted or indiscriminate attacks by the Syrian government forces besieging Yarmouk.
The plight of the Palestinian refugees of Syria is a catastrophe within the wider catastrophe of Syria. Almost two thirds of Syria’s 530,000 Palestinian refugees have once again been displaced. Approximately 270,000 Palestinians are internally displaced in Syria. More than 50,000 are reported to have fled to Lebanon, 11,000 to Jordan, 6,000 to Egypt, 1,000 to Libya, 1,000 to Gaza and others to Turkey, Malaysia, Thailand and Indonesia and other countries. As early as July 2013, the United Nations Relief and Works Agency for Palestine Refugees (UNRWA), which provides protection and assistance to some 5 million Palestinian refugees across Syria, Lebanon, Jordan, the West Bank and Gaza Strip, described the community as “unravelling and in acute distress”.
Two-thirds of the fatalities identified by Amnesty were the cause of starvation. The group also noted cases of residents, including a child, foraging for edible plants being shot and killed by snipers.
Because of the depletion of stocks of food, the cost of a kilogram of rice skyrocketed to $70-100 in late 2013, according to the report.
One resident told Amnesty: “The last time I ate vegetables was more than eight months ago.”
Food poisoning and disease has resulted from residents being “forced to exist on a diet of leaves and weeds.”
The camp’s medical infrastructure has been badly impacted by the siege and medical workers killed and arrested.
The main hospital currently functioning in the camp, the Palestine Hospital run by the Palestine Red Crescent Society (PRCS), has been damaged by bombing and lost many of its staff and thus its capacity has reduced, according to Amnesty:
One health worker at the hospital told Amnesty International that it has been bombed a number of times by Syrian government forces: “On one occasion, a rocket hit the fourth floor and destroyed the generator. Another time a bomb fell at the front entrance.” He said that rockets had also struck the area surrounding the hospital several times, including one that hit a nearby building, causing damage to the door of the hospital and wounding one of the hospital’s staff. By February 2014, the Palestine Hospital’s capacity and services had been severely diminished by the months of siege; it had only two doctors, depended for its electricity on generators that were kept going using diesel fuel provided by residents from their own diminishing stocks, and was running low on medicines and other medical supplies, including fluids for intravenous therapy, locally referred to as “serum”. Yet the hospital continued to receive casualties – victims of shooting by government snipers and people suffering from a wide range of siege-related injuries and illnesses as well as others whose existing ailments have been exacerbated by the shortages of food, water, electricity and medicines arising from the siege.
Before the siege, the Palestine Hospital carried out around 600 surgical operations each month, including plastic surgery, ear, nose, throat and eye operations. Today, however, after months of siege, no surgeons remain and the hospital lacks proper medication for surgery patients; even so, according to a PRCS medical worker in Yarmouk who spoke to Amnesty International, “any necessary surgery is carried out by nurses who are learning by experience and study.” Unsurprisingly, another medical worker said “many have already died here due to a lack of serum and other medication.”
A PRCS-S volunteer told Amnesty International: “People are dying from injuries sustained from being shot by snipers, or in explosions, particularly if they were hit in the head or chest, since there is no one able to treat them. Other civilians are dying specifically due to the lack of medical equipment and supplies such as defibrillators, incubators, blood bags and serum. We also lack gauze and simple sterilizers.” A PRCS worker added that “babies are dying because there is no milk, neither powder nor from their mothers” and that hospital staff were trying to remedy this by arranging for other mothers who were successfully lactating to breastfeed several children in addition to their own.
According to one PRCS health worker, three women and five newborn babies died due to complications during pregnancy and childbirth in December 2013 and January 2014 because the hospital was unable to give them the medical treatment they required. There has been an increase in miscarriages due to food shortages and poor nutrition for pregnant women, and due to the collapse of antenatal facilities and care under the siege. A medical worker told Amnesty International that the hospital possesses an aged ultrasound machine but has no doctor to operate it; consequently, it cannot be used to identify potential foetal problems prior to birth. The lack of gynaecologists and surgeons means that the hospital cannot carry out Caesarean births; at least one pregnant woman is reported to have haemorrhaged to death. The hospital has just two midwives to advise and assist women during pregnancy and birth.
The Palestine Hospital’s two remaining doctors continue to treat patients with internal illnesses or injuries, to provide anaesthetics and first aid, but they have virtually no medical supplies. One of the hospital’s two stores of medical supplies has been exhausted while the other was seized, apparently for their own use, by armed men believed to be members of Suqour al-Jolan, an FSA-linked armed opposition group.
One medical worker told Amnesty International that he witnessed the armed men removing the store of medical supplies provided by the PRCS: “I saw their van full of our medical supplies stamped with ‘Ramallah’ on them.” The same armed opposition group is also reported to have been responsible for seizing the Palestine Hospital’s entire fleet of five ambulances.