The UN Security Council has an obligation under international humanitarian law to ensure that conflict-impacted populations are reached with aid by urgently renewing the authorization for Bab al-Hawa crossing in northwest Syria and reopen the Bab al-Salam and Yarubiyah crossings.

June 9, 2021

By Tlaleng-Mofokeng, United Nations Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health

Syria remains one of the world’s most complex humanitarian emergencies. Ten years of violence have resulted in more than 500,000 casualties, triggered one of the worst displacement crises of our time, and led to the widespread destruction of civilian infrastructure. Homes, schools, and health facilities have not been spared, and people have been deprived of essential services such as clean water and electricity. Despite the cessation of hostilities in many areas, the situation remains dire and is only worsening.

Few issues account more for the horrific toll of the violence in Syria than the impact of the conflict on health and access to health care. According to the United Nations, while 41 percent of Syrians suffer from non-communicable diseases, barely half of hospitals and primary health care centers in Syria are fully functional.

As the United Nations Special Rapporteur on the right to health, my responsibility is to assess the situation of this right throughout the world and contribute to its full enjoyment by all. The enjoyment of the right to health including the right of access to health facilities, goods, and services on a non-discriminatory basis under international human rights law as well as the norms on the protection of the wounded and the protection of medical facilities and personnel, which have been systematically violated throughout the conflict. Attacks on medical facilities, the killing and intimidation of medical personnel and obstruction of access to communities in need has decimated the health care system in Syria for a decade.

On July 10, Syria’s lone remaining UN-sanctioned international cross-border aid opening – through which life-saving medical and humanitarian supplies flows to civilians in dire need – is at risk of being closed, as a UN Security Council resolution permitting the crossing expires.

To avert an even greater humanitarian catastrophe in Syria, the Security Council must not only act to renew authorization for the existing Bab al-Hawa cross-border crossing, but also re-open two previously authorized crossings to ensure greater and urgently needed humanitarian access.

Despite the potentially catastrophic consequences, ongoing negotiations suggest that the Security Council will only re-authorize the lone existing channel rather than re-open the two previously closed crossings. And stunningly, the Security Council may only opt to extend authorization for the Bab al-Hawa crossing for a meager six months instead of the 12 months sought by many Syrian civilians, international aid groups, and some Member States. If only extended for six months, this would represent a callous and disastrous prioritization of political points over people’s lives in Syria.

The situation for women and girls is particularly dire. Since December 2019, 618,000 women and girls have been displaced due to ongoing hostilities, making their access to reproductive and other healthcare limited or impossible. Pregnant women may face unsafe procedures and even death due to complications if there are no hospitals nearby.

Since the beginning of the conflict, Physicians for Human Rights has documented 600 attacks affecting at least 350 medical facilities, as well as the killing of 930 medical personnel. These incidents, many of which may constitute violations of International Humanitarian Law, have devastated the capacity of the health system and deterred civilians from seeking health care. In March, the International Rescue Committee, together with the Syrian American Medical Society, released a report which found that 81 percent of Syrian health workers had a co-worker or patient who had been injured or killed due to an attack and 59 percent of civilians interviewed had been directly impacted by one during the course of the conflict.

The ongoing COVID-19 pandemic has further exacerbated the strain on the health system. Hospitals have been overwhelmed throughout the country, and there are ongoing shortages of PPE, ventilators, oxygen, and testing supplies. A vaccination campaign recently began and will expand in the coming months, making the need to increase the capacity of the health system even more important.

Despite the overwhelming humanitarian needs, the UN, NGOs, and their partners continue to provide lifesaving care to 4 million civilians in need in Northwest Syria. United Nations heads of agency have stated that a large-scale UN cross-border response for an additional 12 months remains essential to avert a humanitarian catastrophe in northwest Syria.

This resolution is a vital lifeline and is critical that it not only be renewed, but also expanded based on the humanitarian needs on the ground.

The closure of Yarubiyah border crossing into North Eastern Syria in January 2020 provides a window into what can be expected in other parts of Syria if the remaining crossing is closed, where medical supplies became even scarcer, and malnutrition rose. Overcrowded hospitals that struggle to provide care, rising malnutrition, no available post-rape treatment kits for survivors of sexual violence – these all characterize the current, and future, Syria, in the absence of continued humanitarian access.

The Security Council must urgently renew the authorization for Bab al-Hawa crossing in Northwest Syria for 12 months – not six – and, given the humanitarian needs on the ground, reopen the Bab al-Salam and Yarubiyah crossings. Greater humanitarian access is essential for providing life-saving humanitarian aid and increase the provision of COVID-19 vaccines. I further urge the continued engagement with all concerned parties to allow for cross-line aid convoys, which passes from Government of Syria-held territory into non-Government of Syria-held territory in the Northwest, while noting, as the UN has, that these convoys could not replicate the size and scope of the cross border operation.

Syrian people must remain our priority. For this, I urge the Security Council to renew the resolution and re-open the two previous crossings. Syrian civilians’ rights to enjoy the right to health, to have unhindered access to life-saving healthcare and to live free from violence has been egregiously violated for more than a decade — the Security Council must not fail them again.