Childhood Under Fire Correct_embargoed
Transcript of Childhood Under Fire Correct_embargoed
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Childhoodunder ire
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Childhood under ireT t t s ft S
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Save the Children works in more than 120 countries.
We save childrens lives. We fght or their rights.
We help them ulfl their potential.
Published by
Save the Children
1 St Johns Lane
London EC1M 4AR
UK
+44 (0)20 7012 6400
savethechildren.org.uk
First published 2013
The Save the Children Fund 2013
The Save the Children Fund is a charity registered in England and Wales (213890)
and Scotland (SC039570). Registered Company No. 178159
This publication is copyright, but may be reproduced by any method without ee or
prior permission or teaching purposes, but not or resale. For copying in any other
circumstances, prior written permission must be obtained rom the publisher, and a
ee may be payable.
Cover photo: Hanane, our, at a reugee camp near the Syrian border (Photo:
Jonathan Hyams/Save the Children)
Typeset by Grasshopper Design Company
Acknowledgements
This report was written by Nick Martlew, Senior Humanitarian Advocacy Adviser
at Save the Children. The research was supported by Nick Pope, with additional
assistance rom Misty Buswell.
Testimonies were collected by Mona Monzer, Cat Carter, Mohamad Al Asmar and
Farah Sayegh. Photos by Jonathan Hyams. (All are Save the Children sta.)
The report also includes fndings rom an unpublished study, the Bahcesehir Study
o Syrian Reugee Children in Turkey, conducted by a team o researchers or
Bahcesehir University in Istanbul, Turkey. The research team was led by Dr Serap
Ozer o Bahcesehir University, Dr Selcuk R Sirin o New York University, andDr Brit Oppedal o the Norwegian Institute o Public Health. The study fndings
are available rom the authors on request.
The childrens drawings in this report were gathered as part of the Bahcesehir study.
All names of children and parents who shared their stories have been
changed to protect identities.
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conTenTS
Executive summary i
Introduction 1
The impact o war on children 3Sheltering rom the storm 3
Staying alie, staying healthy 7
Danger on all sides 10
Education under attack 12
Going hungry 14
Humanitys best eorts? 16
Recommendations 19
Endnotes 22
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i
My message to the world? The war shouldstop in Syria so we could be able to go back toour country.
Nidal,* 6
From the ery beginning o the crisis in Syria, children
hae been its orgotten ictims acing death, trauma
and suering, and depried o basic humanitarian aid.
Sae the Children estimates that nearly 2 millionchildren are in need o assistance in Syria.
Through Sae the Childrens work in Syria and the
region, we are witnessing what is happening to
children and the misery and ear they are liing with
eery day. The only way to stop their suering is to
bring an end to the war. A larger humanitarian action
response is absolutely essential, but we also recognise
that, without peace, or children in Syria there will
only be more death, and more destruction.
We had to stay in one room, all of us Iwatched my father leave, and watched as myfather was shot outside our home I started tocry, I was so sad. We were living a normal life, wehad enough food Now, we depend on others.Everything changed for me that day.
Yasmine, 12
This report shows how the confict is aecting all
aspects o childrens lies. Families are struggling to
nd a sae place to stay, as nearly 3 million buildings
hae been damaged or destroyed. The lines oghting moe almost daily, so amilies oten do not
know i the place theye settled in today will be sae
tomorrow. Most displaced amilies share oercrowded
apartments and houses, but an estimated 80,000
internally displaced people are sleeping out in caes,
parks or barns.
With more than 5,000 people being killed each
month, the killing is touching eeryone: a new
study by a research team at Bahcesehir Uniersity
in Turkey ound that three in eery our Syrian
children interiewed had lost a loed one because
o the ghting. Children are being killed and maimed
too, including by the indiscriminate use o shells,
mortars and rockets. In one area o Damascus that
was ormerly home to almost 2 million people,
heay weapons were used in 247 separate recorded
incidents in January 2013 alone.
Children are increasingly being put directly in harmsway as they are being recruited by armed groups and
orces. There hae een been reports that children as
young as eight hae been used as human shields.
Confict is threatening childrens lies in Syria rom
their rst days o lie. Mothers and their newborns
are at greater risk o complications during childbirth.
Many hospitals and health workers are being
deliberately attacked, so people are reluctant to take
the risk o going to hospital; across the country, a
third o hospitals hae been put out o action. Thismeans more births are taking place at home, without
a skilled birth attendant. There is also a worrying
trend o attacks, mostly by Syrian goernment orces,
on hospitals in contested areas. We hae seen how
een hospitals that hae managed to stay open are
nding it dicult to proide a high standard o care,
with little or no heating, ehausted doctors, and
intermittent electricity supply.
Childrens access to healthcare is massiely reduced
while the risks to their health grow. In many areas,
water and sewage systems hae been destroyed or
made inaccessible by iolence or displacement; in one
area where Sae the Children works, almost eery
amily told us they did not hae sae access to clean
toilets. These unsanitary conditions are contributing
to the growing number o cases o children suering
diarrhoea the biggest killer o children globally.
Schools should be a sae haen or children. But
2,000 schools in Syria hae been damaged during
the confict, and many are closed because they hae
become temporary shelters or displaced people.
execuTive Summary
* All names o children and their amily members who shared their stories hae been changed to protect identities.
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Eperience in other confict settings where Sae the
Children works shows that the longer children are
out o school, the less likely they are to eer go back,
threatening their own utures and the uture o
the country.
I liked going to school We used to write andplay. When I want to remember something
happy, it is playing with my riends on the swings.We laughed. I miss them.
At the beginning there wasnt shelling at myschool, but ater some time the shelling started.I stopped going to school when the shellingstarted. It wasnt sae. I eel sad that my schoolwas burned because my school reminds me omy riends. I love going to school.
Noura, 10
Mills, actories and roads are also being damaged andarmland threatened by shelling. As a result, most
parts o the country are eperiencing shortages o
four, orcing ood prices beyond the reach o the
poorest amilies. Combined with an alarming drop in
the proportion o mothers breasteeding their inants,
this is leading to the rst signs o increasing leels o
child malnutrition in Syria.
It is not just Syrian citizens whose lies are being
aected by the war. Non-nationals who were liing as
reugees in Syria (including large numbers o Irais and
Palestinians) hae limited access to assistance and are
becoming eer more ulnerable.
Despite the eorts o the United Nations (UN) and
non-goernmental organisations (NGOs), millions o
people in desperate need in Syria are not receiing
enough humanitarian assistance. Some areas hae
had ery little aid or none at all. Insecurity is one
o the biggest constraints: 15 aid workers in Syria
hae lost their lies in the past two years. Access is
another huge obstacle, as control o access routes
shits continually with the ghting. This means that
agencies sometimes hae to negotiate more than
20 checkpoints or one journey, with each negotiation
taking time; and it only takes one checkpoint to reuse
passage or the entire aid deliery to be halted.
There are also ew organisations local or
international with the skills and systems in place
in Syria to respond to the massie scale o needs.
Some Syrian agencies deliering assistance hae strong
political aliations with one side o the confict,
representing a challenge to the principles o humanityand impartiality, which are essential to reach those
most in need.
Sae the Children is calling on the international
community to take urgent action to address some
o these challenges so that children and their amilies
can receie the assistance they so desperately need.
First and oremost, the UN Security Council must
unite behind a plan that will bring about an end
to the violence and ensure that humanitarian
aid reaches children throughout Syria.In addition:
Theinternationalcommunitymustpress
urgently and eplicitly or parties to the confict
to end the recruitment and use o children in
military actiities, and cooperate with the UN to
ensure that all iolations o childrens rights are
documented so that those responsible can be held
to account.
Internationaldonorsshouldquicklyturnpledges
into unding and delier assistance on the ground
in a way that is needs-based, sustained, feible,
and coordinated.
I wasnt thinking; I just wanted to protect mychildren. I didnt want anything else. I wasnt eventhinking; I just wanted to keep my children sae.I I die it is ne but not my children. I want tokeep them sae
Syria is our country and we want to go backthere. We dont know who is right and whois wrong, but I know we civilians are payingthe price.
Hiba
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I want to tell the world about the situation inSyria There is no uel, no electricity, no ood.This is the situation. There is shelling, explosions,
gunre violence, death. No one is working,there are no jobs. People are just surviving day today, living or the sake o living.
Every human being should act they should
stop this violence. It is killing women and children.People are feeing. We cannot bear this This,this is too much
I hope that you can tell the entire world whatI have said here, what I have seen. I am onlyone person, but every person will say the same.We are tired tired o this. It has been two
years killing, feeing. I wish the world could seethe truth. I wish you could.
I dont think there is a single child untouchedby this war. Everyone has seen death, everyonehas lost someone. I know no one who has notsuered as we have. It is on such a scale.
When the world nally sees what is happeningin Syria, when you go to villages beyond those youare allowed into you will not have the words.Everything is destroyed. A people is destroyed.
You will not be able to bear what you willsee in Syria. We know what is happening, but theworld is not listening.
Saa
i
PHOTO:JONATHANHYAMS/SAvETHECHILDREN
A reugee settlement near the Syrian border
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1
Once, armed men chased us. They shot at [thethree o] us and it hit the ground near my oot soI jumped. It hit below my oot and it touched myshoe but I kept running. We reached a wall andcouldnt run any more.
I was scared, very scared. I was scared and myriends too. We were surrounded by walls. Sowe chose to jump over one wall. When we ranthrough the garden, we saw men with guns. Theyasked us why we were running. We told them wewere being ollowed. They came with us and ranwith us and we reached another wall, and oneo them carried me over and my other riend
jumped by himsel. Another riend they caught,I dont know what happened to him.
My message to the world? The war should
stop in Syria so we could be able to go back toour country.
Nidal, 6
From the ery beginning, children hae been the
orgotten ictims o Syrias horrendous war. Today,
nearly 2 million children are in need o assistance.1
Si months into the confict, 1,000 people were dying
each month; now, it is 5,000 people each month.2 The
ghting is on such a scale that ew children hae been
spared eeling its eects. Three in eery our Syrian
reugee children interiewed as part o new research
by Bahcesehir Uniersity, Turkey, had eperienced the
death o a loed one due to the confict.3
This report bears testimony to the suering o Syrias
children. Depried o ood, water, healthcare; denied
saety; their homes and communities destroyed; in a
war being ought erociously throughout the country,
children aboe all are paying the price.
The chaotic reality o the confict makes it dicult to
gather comprehensie, denitie data. The inormation
on which this report is based has been gatheredthrough Sae the Childrens response to the crisis
on the ground, as well as the eperience o other
inTroducTion
PHOTO:JONATHANHYAMS/SAvETHECHILDREN
Sana, three. Her older sister
Yasmine explains what
happened to their amily
on page 4.
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CHILDHOODUNDERFIRE
2
agencies working in the country. The interiews
carried out with children and their parents all o
whose names hae been changed proide powerul
testimony to the deastating impact o the war on
eery aspect o childrens lies today.
Through our work in Syria and the region, Sae the
Children is witnessing rst-hand the misery being
inficted on children. They are telling us their stories
and they want them to be heard. We are working
tirelessly in Syria and with reugees in Ira, Jordan,
and Lebanon to meet the enormous humanitarian
needs o children and their amilies.
An estimated 4 million people are in need o
assistance within Syria, in addition to more than
1 million who hae fed to neighbouring countries.4
The United Nations (UN) and non-goernmental
organisations (NGOs) are doing what they can to
reach people in need by whateer channels aailable
to them, and millions o people hae already receied
ood or other orms o assistance. Despite these
eorts, children are not receiing the help they
need.5 This report is an urgent call to action: the
international community must take stronger action
to support humanitarian eorts, based solely on the
needs and rights o those aected by the confict,
and independent o any political interests. The scale
o the crisis demands a concerted, coordinated, and
large-scale response.
Stopping the war is the astest way to stop the
suering and start the process o reconciliation and
rebuilding. Humanitarian action is absolutely essential,
but we also recognise that without peace, or
children in Syria there will only be more death, more
destruction; the legacy o this confict grows more
painul and costly with eery day o ghting. The only
way to stop the suering is to bring an end to the war.
The rst part o this report sets out how Syrian
childrens lies are being aected by the confict,
rom the places they hae to lie to the iolence
they hae to ear; the impact on their education
and on their health. Children and parents describe
in their own words how the war has aected their
lies and the lies o their loed ones. The report
then gies an oeriew o the challenges inoled in
deliering a humanitarian response o the scale and
uality needed. Finally, we present Sae the Childrens
recommendations or how to oercome these
challenges to ensure that childrens needs or basic
surial and protection are met.*
* The report includes inormation rom dierent parts o Syria, but where that inormation could compromise the security
o children, their amilies and communities, or the agencies inoled in the humanitarian response, we do not cite a location.
Drawing by a Syrian reugee child
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3
As Saas story shows (see page vi), the civilwar raging throughout Syria is devastatingall aspects o childrens lives. This sectiondescribes some o the ways the ghting isaecting children, beginning with the desperateshelter conditions or the millions o peopleinside Syria who have had to fee their homes.
It then looks at the impact o the war onchildrens health, protection, education, andood security.
SHELTERING FROM THE STORM
The ghting has damaged or destroyed an estimated
2.9 million buildings.6 As a result o the destruction,
3 million people (one in seen Syrians) people like
Hiba and her amily hae had to fee their homes.7
A third o them hae sought reuge in neighbouringcountries (see bo on page 5), but 2 million people
remain displaced within Syria.
In some areas, the entire population o a town has
fed. In others, people who had held on or months
amid heay ghting nally had to fee as they could
no longer meet their basic needs. As Abu, a ather in
Damascus, told Sae the Children: Why did we leave?
We let because o the explosions, the constant shelling.
Everything was a struggle, nothing was available no ood,
no water.For many people, ongoing ghting makes ittoo risky to moe to the border. For others, especially
the poorest amilies, feeing the country is not an
option as they simply cannot aord the transport to
get to the border.8
The options open to amilies displaced within Syria
are bleak. The lines o ghting moe almost daily,
so people oten do not know i the place they hae
settled in today will be sae tomorrow. Most people
seek reuge with riends or relaties in whateer space
they can spare apartments, outhouses, een chickensheds. The result is oten etreme oercrowding, with
up to 50 children liing in one house.13 Thousands
o people either hae no etended amily to turn to
or cannot reach them. It is estimated that 80,000
internally displaced people (IDPs) are sleeping out in
caes, parks or barns.14
Displaced people are receiing some temporary
shelters and basic items proided by Syrian
or international humanitarian agencies, butimplementation challenges (described below) mean
the leel o assistance is ar below international
standards. Sae the Children is seeing how this
particularly aects girls: the shelters that thousands
o amilies are liing in are cramped, aording little
personal priacy; girls are oten araid to go outside,
especially at night, as the presence o armed men
contributes to a perasie ear o seual iolence.15
Families seeking reuge inside Syria hae had to
endure two winters that saw snow all across mucho the country, with temperatures as low as -8C.16
Families fed, oten without enough time to gather
winter clothing or children.17 This winter, rationing
o the power supply seerely limited electric heating.
Shortages o uel pushed the price o kerosene up by
as much as 500%, making it impossible or the poorest
amilies to heat their shelters; in one area, 80% o
households could not aord heating.18 This makes
warm shelters and blankets all the more important,
but in 2012 only 30% o those who needed blankets
or mattresses receied them.19
This lack o sae and protectie shelter is putting
childrens health at risk. In the depths o this winter,
children aged 5 to 14 suered the largest proportion
o fu-like illness 38% o all registered cases in
Syria.20 In some cases, childrens lies hae been put
directly at risk: some shelters hae accidentally caught
re, killing seeral children, because people made open
res as the only way o keeping warm.21
The net section shows in more detail the many
ways in which the health o Syrias children is under
constant assault.
The impacT o waron children
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4
Most o the houses were being hit.We had to stay in one room, all o
us. The other rooms were being hitThe shelling was constant, I wasvery scared.
I elt so araid. I knew we could notmove rom that one room. Therewere 13 o us crammed into oneroom. We did not leave that room ortwo weeks. It was always so loud.
My ather let the room. I watched
my ather leave, and watched as myather was shot outside our homeI started to cry, I was so sad. Wewere living a normal lie, we hadenough ood. Now, we dependon others. Everything changedor me that day.
yaSmine, 12
PHOTO:JONATHANHYAMS/SAv
ETHECHILDREN
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THEIMPACTOF
WARONCHILDREN
5
This report ocuses on the situation or children
inside Syria, but the humanitarian crisis has
spilled oer the countrys borders as more and
more people fee their homes and seek reuge in
neighbouring countries. As o March 2013, there
were more than 1 million people 52% o them
children registered as reugees or awaiting
registration, with nearly 5,000 more eery day.9
The real number o reugees is likely to be much
higher, as around 4050% o reugees outside the
established camps hae not registered with the
United Nations Reugee Agency, UNHCR oten
in order to protect their identities.10
Jordan and Lebanon are home to the largest
number o reugees, each with more than a uarter
o a million Syrian people registered or awaiting
registration. More than 180,000 Syrians hae sought
reuge in Turkey and more than 100,000 in Ira,
nearly 10% o whom are in Anbar proince, where
agencies like Sae the Children hae to manage the
insecurity to try to meet reugees basic needs.11
The reugee crisis is most isible at Zaatari camp
in Jordan, where the goernment and humanitarian
agencies are working hard to epand the proision
o essential serices like shelter and water. Howeer,
across the region, 70% o reugees are not in camps
but are instead liing in inormal settlements or
with etended amily and riends, many o whom
are themseles ery ulnerable.12
Sae the Children is working with UNHCR and
other UN agencies, and the host goernments
in Jordan, Lebanon, and Ira, to ensure that all
ulnerable groups get the assistance and protection
they need. We are proiding support to reugees
(whether registered or unregistered) and host
communities, as well as non-Syrians feeing the
country, such as Palestinians and Irais. As o March
2013, we had proided much-needed assistance
to more than 240,000 people across the region,
including shelter, ood, and protection or children.
THE REGIONAL REFUGEE CRISIS
PHOTO:JONATHANH
YAMS/SAvETHECHIL
DREN
A reugee settlement near the Syrian border
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6
Hiba fed Syria with her daughter and seerely
disabled son.
Hospitals in Syria are being targeted with shelling. Theone I took my son to or physiotherapy sessions is not
operating any more. I couldnt put him in a car and take
him to a doctor, and then to which hospital? The roads
were too dicult.
I dont know why some hospitals were shut down. Some
were hit in the shelling, others were untouched; yet the
roads were too dangerous or us to travel anyway. Any
time I want to take him out, its dangerous or us. We stay
at home, we call the doctor, but we can never reach him.
How do I eel? Any mothers heart would break seeingher son in this state I am helpless. When I see him tired,
I wish its me instead. He gets sti and aints; his eyes
stare in vain, and this is very hard or me Sometimes
I cry, but I cant do anything.
Everyone is aected by this war. My daughter is 13 years
old and goes crazy every time she hears a noise. Once
the bombs started we ran I couldnt take my sons
wheelchair, so I had to carry him, and run. We thought it is
better or us to die in the street than under the rubble o
our house. We ran at 3 in the morning and we didnt know
where to go. We were just running because we didnt want
to die under the rubble.
I wasnt thinking; I just wanted to protect my children.
I didnt want anything else. I just wanted to keep my
children sae. I I die it is ne but not my children.
I want to keep them sae.
In the morning we came back to our home, but it was
ruined. Theres no place or us to go to, no sae space to go
to at all. I think there is no sae space in Syria. It is beyond
imagining.I cried and shouted but there was nothing else I could do.
What can we say? Nothing. There is no human being living
that wouldnt be sad. We worked all our lie to build our
home and suddenly we lose it all.
Syria is our country and we want to go back there. We
dont know who is right and who is wrong, but I know we
civilians are paying the price.
hiba
PHOTO:JONATHANHYAMS/SAvETHECHILDREN
Hiba with her
granddaughter
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THEIMPACTOF
WARONCHILDREN
7
STAYING ALIvE, STAYING HEALTHY
The ciil war is being waged in eery city in Syria,
aecting eeryones health and their ability to get
healthcare when they need it. Most o those injured
by gunshots are young men, oer the age o 18. But
across the country, rom being unable to nd or aordmedication to being injured by eplosie weapons,
children are eeling the eects. As Aras story shows,
some childrens health is at risk rom the moment
they are born.
Stories like Aras are ar rom uniue. Sae the
Children has ound that getting access to sae birthing
acilities can be a dangerous, sometimes impossible
struggle or mothers and midwies. The lack o
neo-natal care and specialist medics, as well as the
damage to health acilities, mean that many birthsare now taking place in peoples homes, temporary
homes or shelters, without a skilled birth attendant
who can assist with any complications. Gien the
dicult liing conditions and the huge challenge o
adeuate sanitation or displaced people and their
host amilies (described below), mothers and their
newborns are at greater risk.22
Young childrens health is also at greater risk now
because the ciil war has disrupted or completely
stopped routine accinations, including or measles
and polio. While UNICEF managed to conduct
a accination campaign that reached 1.4 million
children, oten in ery dicult circumstances, getting
accinations into Rural Damascus goernorate and
also into opposition-controlled areas o northern
Syria has proed immensely challenging. By January
2013, no more than a third o children had been
accinated in the north o Syria; with eery passingday, the potential or an epidemic increases.23
Ara has three children.
I was very sick during my pregnancy but there were
no doctors, no hospitals. It wasnt like my other
pregnancies I had no scans, no check-ups.
It was morning when the contractions started. They
carried on all day, I remember that I was so tired. Ive
always delivered in hospital beore, never at home. Ater
nightall, I told my amily that I must go to hospital, but
they knew there was no way we could get through saely,
shells were already alling. Men shoot at everything
they see at night, and there are so many checkpoints
we would never get past. Even i we did get through,
where would we go? There are no hospitals now, only a
makeshit clinic ar away.
Around 4am, I started to deliver, I was terried. I was in
so much pain, I thought I would die. There was a terrible
complication in my birth and I thank God some o my
neighbours helped a brave midwie to get through to me.
The cord was wrapped around my babys neck the
midwie saved my baby boys lie, and mine too I think.
My daughter was there or the birth, and she wasterried about the whole situation. She couldnt deal
with what happened all around her especially the
shelling, and the screaming.
Its because o these shells, the endless explosions,
that I let my home. I let a ew months ater this birth,
coming rom my home only three days ago. For the
journey, I carried my baby. I have other children and I
wished I could carry all o them, but I couldnt so they
had to run or themselves. People were dying all around
us, houses became rubble.
I you ever went into Syria you will see something
youve never seen beore. It is not something you can
believe
The children that are still in Syria they are dying. It
eels as though no one is helping, nothing is changing.
Why cant you help them?
ARA
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CHILDHOODUNDERFIRE
8
ATTACKS TARGETING HEALTH FACILITIES
AND HEALTH WORKERS
These growing threats to childrens health in Syria are
all the more alarming gien the increasing deastation
to health acilities and attacks on health workers, as
Hibas eperience (see case study) iidly shows.24
This destruction is all too oten the result o atargeted attack on health acilities: agencies working
in Syria report that they are seeing a continued trend
o attacks, mostly by Syrian goernment orces, on
hospitals in contested areas. This appalling trend is in
contraention o international humanitarian law, and
means people are araid to go to hospitals een when
they are in urgent need o treatment.25 In Deir ez
Zor goernorate, or eample, eery single hospital
has been damaged, while in Aleppo goernorate,
two-thirds o hospitals are no longer unctioning.
Across the country, more than hal o Syrias hospitals
hae been damaged, and nearly a third hae been put
completely out o action.26
Een hospitals that are still unctioning are not able
to deal with the growing numbers o people who
need treatment. In one area, Sae the Children ound
hospitals with little or no heating, ehausted doctors,
intermittent electricity supply, and woeul conditions
or paediatric patients despite the best eorts o
courageous and committed sta who were continuing
to work in such dicult conditions.27
The ghting in cities and reports o targeted attacks
on doctors mean that many medical sta ear or
their lies when they trael to work. Understandably,
many decide they simply cannot take the risk: 50%
o doctors are reported to hae fed Homs, and
according to one account, the number o medics
practising in and around Aleppo has allen rom 5,000
to just 36.28
TRAPPED IN WAR AND POvERTY
The ghting has made it much more dicult orpeople to get to hospitals and other health acilities
or treatment, and it has also led to a major shortage
o medicines in many areas, as Sae the Children
has witnessed. Beore the confict began, almost all
drugs used in Syria were produced in-country.29
PHOTO:JO
NATHANHYAMS/SAvETHECHILDREN
Souha, three, at a reugee settlement near the Syrian border
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Now, shortage o uel and hard currency, disruption
to supply chains and damage to actories hae all
massiely slowed production o medical supplies.
Wealthier Syrians are reportedly traelling to
neighbouring countries or healthcare; but, as with
heating and ood, the medicines that are aailable are
priced beyond the reach o the poorest amilies.30
The poorest amilies health is also at greater
risk, because they are more likely to be liing in
oercrowded communal shelters with little or no
access to clean water and adeuate sanitation. More
and more children are suering rom diarrhoea,
hepatitis A, upper respiratory tract inections, and
skin rashes because o the deterioration in sanitation
conditions.31 In one rural area where Sae the
Children is responding to the crisis, almost eery
displaced amily said they lacked sae access to cleantoilets. In many cases, parents eared or the saety o
their daughters with the presence o so many men
carrying weapons.32
Een in cities, children now hae to go to the toilet
in public spaces because damage to the water and
sewage system means that toilet fushes no longer
work. In addition, the proportion o sewage being
treated in Syria has haled since the confict began.
This presents a huge risk o disease outbreak,
especially as clean water becomes more and morescarce. In some areas, water supply is now down to a
third o pre-crisis leels; in some parts o Aleppo, or
instance, water is only pumped or our hours a day.33
AN UNSAFE REFUGE
Beore the confict began, thousands o people
feeing confict rom elsewhere in the region had
sought reuge in Syria. These people are particularly
ulnerable now (see bo). For eample, beore the
confict, an estimated 10,000 Palestinian reugees were
liing in Dera camp in south-west Syria. Water and
sanitation proision was poor een then; now, the
acilities hae closed altogether.34
Not all those aected by the confict are Syrians.
Hundreds o thousands o Palestinians, Irais,
Aghans and others are in Syria haing sought reuge
rom iolence and insecurity back home. There
are belieed to be more than 500,000 Palestinian
reugees and 480,000 Irai reugees in Syria.35
Approimately 40% o these are children though
children under e are oten not registered, so this
is probably an underestimate.36
Reugees in Syria were particularly ulnerable een
beore the confict. For eample, children born toPalestinian reugee amilies were less likely to be
enrolled in school than Syrian children, and more
likely to die beore their th birthday.37 Also, a
high proportion o Irai reugees two in eery
e had special protection or medical needs that
reuired targeted support.38
The outbreak o confict in the country these
reugees originally came to or protection means
they are now much more ulnerable and ace new
risks. For instance, Yarmouk camp, a Palestinianreugee settlement in Damascus, has become a
battleground; there is ghting almost eery day
in or around the camp. Three-uarters o the
150,000 residents hae once again had to fee, and
because some borders to neighbouring countries
are closed to Palestinians, they remain trapped
inside Syria.39 The United Nations Relie and Works
Agency (UNRWA) proides essential assistance
to Palestinian reugees, but insecurity has orced it
to halt its operations in many camps in Syria. As a
result, only 40% o its clinics are still open, and more
than 80% o school-age Palestinian reugee childrenare unable to attend school.40
Tens o thousands o Irais hae already fed Syria,
and UNHCR estimates that a third o those still
in Syria will leae during 2013.41 Most o them will
probably go back to Ira, despite the continuing
insecurity there and the lack o jobs and basic
social serices.42
Reugees in Syria already aced dicult and
uncertain utures. Now, nding themseles enguled
in confict once again, their options are een morelimited, their situation een more desperate.
PALESTINIAN AND IRAqI REFUGEES IN SYRIA
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DANGER ON ALL SIDES
The confict in Syria has had terrible repercussions
or childrens lies and health. When the confict is
isited directly on children, the conseuences are
truly harrowing. These threats to children are what
the net section describes.When we ask parents how their children are coping
with their eperiences, the most common reply
is that it has let children with a perading and
persistent eeling o ear. When children are gien
the opportunity to draw pictures o their recent
eperiences, they ll the pages with iolent and
angry images o bloodshed, eplosions, and the
trappings o war. Parents also say that their children
are showing signs o signicant emotional distress,
such as nightmares, bed wetting, or becominguncharacteristically aggressie or withdrawn; any
loud noise reminds the children o the iolence
they fed rom.43
A new study by a research team rom Bahcesehir
Uniersity in Turkey, ound some chilling eidence o
what children are eperiencing. Two-thirds o those
interiewed had been in a terriying situation where
they elt they were in great danger; one child in three
had been hit, kicked, or shot at. And three in eery
our children interiewed children like nine-year-old
Ibrahim had eperienced the death o at least one
loed one.44
As documented in the UN Secretary-Generals 2012
report on children and armed confict, some abuses
in Syria are so heinous that they represent grae
iolations o childrens rights under UN Security
Council Resolution 1612.45 Children are being
killed and maimed eery day in Syria. The confict
has claimed the lies o some 70,000 people and an
estimated 300,000 are belieed to hae been injured.46
While we do not know just how many o these
casualties are children, hospital reports show that an
increasing number o children are being admitted with
burns, gunshot wounds, and injuries rom eplosions.47
Eery day, children remain at risk o death and injury,
including permanent disability. Children are not being
spared rom the iolence.
The use o eplosie weapons in populated areas has
killed and maimed children as well as adults. In January
2013 alone, there were more than 3,000 recorded
security incidents clashes or attacks in Syria;
80% o them inoled heay weapons such as mortars,
shells and rockets. This ghting was concentrated
in urban areas; in Damascus, 247 incidents were
recorded in just two communities that were ormerly
home to 1.8 million people.48
The blast and ragmentation eects o eplosie
weapons coer a wide area, and do not discriminate
between ciilians and military targets. All parties
to the confict are using these kinds o weapons in
built-up areas where many amilies remain trapped,
with goernment orces in particular using air strikes
and Scud missiles.49 There are multiple reports rom
across Syria o blasts rom eplosie weapons killingseeral children at once sometimes rom the same
amily, sometimes inants less than three months old.50
NOOR, 8
We were all scared. Because o the shelling, we
were hiding in the bathroom and the kitchen. The
shelling happened every day or a while Every day,
in the evening.
This is what I remember o Syria. No, nothing good,
no good memories. I remember how my uncle and
my grandmother died, because I saw it What do I
remember o Syria? Blood. This is it.
IBRAHIM, 9
Ibrahims mother and two older brothers died
when their home came under attack.
When I heard shelling in Syria at night, it always
woke me up. Sometimes I stood outside to see wherethe noise was coming rom and sometimes it made
me really araid, so I just stayed inside. I used to
tell my siblings they better stay inside because o
the shelling.
I miss the days my mum took me to the playground
in Syria. My mum is dead, and my two older brothers
too They died rom the shelling o our home.
Nadeem was my brother and my best riend. I wish
I can have un with him and go to school with him
again.I just wish they were still alive. It makes me want to
go back to Syria. When I return, I want to visit their
graves and say I miss you.
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Aside rom their deastating immediate impact,
eplosie weapons also leae a potentially atal legacy.
As much as 11% o eplosie ordinance does not
eplode on impact; these eplosie remnants o war
are now scattered across Syria, a country where
people hae had no preious eperience o dealing
with such hazards. Children ace the risk o death orserious injury either rom playing with uneploded
shells or simply through being orced to lie and moe
around in a landscape scattered with uneploded
remnants. Een ghters hae been killed rom trying
to deal with uneploded grenades.51
THE THREAT OF SExUAL vIOLENCE
Seual iolence is another grae iolation o childrens
rights. There is some eidence that girls and boys as
young as 12 are being subjected to seual iolence,
including physical torture o their genitals, and rape.52
The prealence o such abuses is hard to establish, as
suriors oten do not report the attacks or ear o
dishonouring their amily or bringing about reprisals.
But ear o seual iolence is repeatedly cited to Sae
the Children as one o the main reasons or amilies
feeing their homes.
There are also reports that early marriage o young
girls is increasing. This can be understood as desperate
amilies like Um Alis struggling with ever-narrowing
options to survive. They may be trying to reduce the
number o mouths they have to eed or hoping that
a husband will be able to provide greater security
or their daughter rom the threat o sexual violence.
However, anecdotal reports rom organisations working
inside Syria indicate that early marriage is sometimes
being used as a cover or sexual exploitation, where
girls are divorced ater a short time and sent back
to their amilies.53 In such a chaotic and dangerous
environment, children and young girls in particular
are at much greater risk o abduction and tracking,especially or purposes o sexual exploitation.
DISPLACEMENT AND SEPARATION
Faced with appalling and indiscriminate iolence, the
only choice let to millions o people has been to
fee their homes. These displaced people may nd
shelter, but they may not nd security: once they
hae let their homes, amilies may be repeatedly
displaced as the ghting spreads, each time carrying
with them harrowing memories and ewer and ewer
possessions. According to one surey o Syrians who
fed to Mara goernorate in Jordan, more than 60%
had been displaced twice or more beore crossing the
border, each time settling or a week or more beore
being orced to fee again.54 In some situations, people
hae no time to pick up een a coat or proper shoes;
they literally hae to run or their lies.
In the panic o escape, many children become
separated rom their amilies. In other cases,
parents make the tough decision to send children
away to relaties in areas deemed less insecure.
This is why, in one area o Syria where Sae the
Children is responding to the crisis, a uarter o
amilies are hosting other peoples children. As the
situation deteriorates urther, many oster amilies
will no longer be able to cope, increasing the risk
that children may be handed oer to institutionsor abandoned to lie on the street and end or
themseles in a country at war.55
THE RECRUITMENT OF CHILDREN
BY ARMED GROUPS OR FORCES
There is a growing pattern o armed groups on both
sides o the confict recruiting children under 18
as porters, guards, inormers or ghters. For many
children and their amilies, this is seen as a source o
pride. But some children are orcibly recruited into
military actiities, and in some cases children as young
as eight hae been used as human shields.56
Drawings by Syrian reugee children
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The use o children in combat is a grae iolation
o their rights; it contraenes international law and
commitments made by both parties to the confict.
It also puts the children inoled at enormous risk
o death, injury or torture. One monitoring group
aliated with the opposition, the Syria violations
Documenting Center, has documented the deathso at least 17 children associated with armed groups
since the start o the confict. Many other children in
armed groups hae been seerely injured; some hae
been permanently disabled.57
Thousands, i not millions o children in Syria hae
eperienced appalling abuses during the war. In ront
o high-leel representaties o the international
community in Kuwait in June 2012, the UNs Under-
Secretary General or Humanitarian Aairs, valerie
Amos, highlighted the urgent need or psychosocialsupport or inants and children like Hammas
youngest daughter to deal with what they are
going through.
EDUCATION UNDER ATTACK
It is dicult to know the ull etent o the disruption
to childrens education caused by the war in Syria,
gien the relatie scarcity o data. But the illustratie
data that do eist, and the inormation Sae theChildren has been able to gather, are deeply worrying.
It is clear that education is part o the ront line
o the war on children. Schools are protected by
international human rights law; they should be sae
places or children to play, learn and deelop. But in
Syria, schools hae come under direct attack, denying
children their right to education in a sae learning
enironment. An eight-year-old boy rom Aleppo
reused to talk or more than two weeks ater feeing
Syria. When he eentually did speak, his rst wordswere, They burned my school. 58
Children like Noura, feeing rom the ghting, just
want to be back at school, back to normality, learning
and playing with their riends.
I liked going to school in Syria. We used to write and play.
When I want to remember something happy, it is playing
with my riends on the swings. We laughed. I miss them.
At the beginning there wasnt shelling at my school, but
ater some time the shelling started. I stopped going to
school when the shelling started. It wasnt sae. I eel sad
that my school was burned because my school reminds
me o my riends. I love going to school.
I would hear the shelling I would get scared and try
to hide. One day I was with my riends playing in the sun
and sand. We were collecting the sand, and putting it in
a bucket, then we fipped it. We made a castle like that,
always. Then a sound rom the mosque shouted RUN,RUN. We ran away to our houses, and sat inside because
we knew the shelling started. We ran very ast. I was
araid that shrapnel would hit me.
We were terried, and cried a lot when this happened.
The mosque speaker sounds the alarm on the incoming
shelling, so we can seek shelter and hide. Sometimes we
heard the mosque alarms and sometimes we didnt.
I came home, we hid in the living room and we prayed.
I prayed that my brother and sisters will stay sae. I also
prayed or my school not to be destroyed.Noura, 10
In Syria, beore the confict, access to basic education
was ree and more than 90% o primary school-aged
children were enrolled one o the highest rates in
the Middle East.59 But the confict is undoing all those
achieements, denying children the right to education,
depriing them o a sae learning enironment, and
threatening their utures as well as that o the country.
In other confict settings where Sae the Children
works, once children hae been orced to drop outo school, their aspirations and aith in the education
system (especially state schools) are seerely dashed.
The longer children are out o school, the less likely
they are eer to return. Millions o children and young
people in Syria may neer regain the chance to ull
their true potential.
Some schools hae closed because displaced amilies
are liing in them, as they had nowhere else to stay.
An estimated 1 million people are liing in schools
and public buildings not designed to be lied in, and so
lacking proper heating and sanitation.60 In one area o
Syria where Sae the Children is responding, during
HAMMA
My other daughter, Sham, is one year and seven
months. Do you know what her rst word was?
Enjar [Explosion]. Her rst word! Thats why we
let, thats why we ran. My daughters rst word is
explosion. It is a tragedy. We elt constantly as i we
were about to die.
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um ali
Um Ali has three children.
There has been no school or two
years. Because o this, my son missedhis baccalaureate, and my daughtermissed her 11th grade. Its too dangerous
to go to school they are being shelled,and even i they are still there, you getshot at i you try to get there.
My daughter, she is 16 and she loved school.She was the rst in her class, and she wantedto become an architect. But this war
we were too worried or her. We could notprotect her, so we had to marry her. I knowthat men are hurting women, old women,single women everyone. We needed her tohave a protector.
We couldnt let her go outside at all. And isomeone comes inside your house, you cannotdeend yoursel as just a woman. I theycome in, what will her ather do? Sit asideand watch? They were attacking women.
Her ather told her this is the only solution.There are no schools. One year, two years, noschools. What about marriage? Your cousinis a good man, take him, he is good. So shesaid As you wish. But she did not want to getmarried, she wanted to study. But there wereno more schools. So she was married. Thisis happening a lot within Syria, many womenI know are marrying their daughters even
younger than 16 to protect them.
What do people need most? People in Syrianeed everything. They need help, they needto be saved. People are dying. People aredying and there is slaughter and the rest othe world is just watching. There is no helprom outside. They keep holding meetings andthats it. They are just watching. We arecalling or them, but no one is listening.
PHOTO:JONATHANHYAMS/SAvETHECHILDREN
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the bitter winter months, school benches were stolen
or rewood; desperate, understandable measures
to stay warm, but urther erosion o childrens
opportunities to learn and play.
Thousands more schools hae been put out o use
by the ghting. Attacks on schools represent grae
iolations o childrens rights because o their direct
and lasting impact on children. Yet according to the
Syrian goernment, 2,000 schools hae been damaged
in the confict; one UN surey ound that a uarter o
schools in one area had been damaged or destroyed.61
This not only makes childrens place o learning
unsae or unusable; it can also make children araid
o returning to school een when the ghting is oer.
There hae also been reports o parents not allowing
their children especially girls, like 13-year-old Saba
to go to school or ear o being attacked, caught incrossre, or directly shot at.62 As a result, attendance
rates, particularly or displaced children, ary widely.
According to one estimate, more than 200,000
children displaced by the ghting in Syria are missing
out on education.63
In one area, Sae the Children has witnessed
incredible dedication on the part o teachers who
hae no materials to work with, but teach what they
can remember by heart. Despite threats against
them, displacement, and the destruction o schools,
do not lessen their coniction that children need to
continue their education. These dedicated eorts are
enough to keep education going or 200 children.64
But they are not able to proide the standard o basic
education that the children hae a right to, and there
are hundreds o thousands more who are getting no
ormal education at all.
The net section describes how the war is
depriing children and their amilies o enough ood
to surie on.
GOING HUNGRY
What we struggled or the most in Syria was to get ood.
Even the water tanks were shot at to leave houses without
water. We almost starved to death.
During the confict, bread supplies were completely cut
o rom my town. I saw it with my own eyes a truckcarrying four into the town to supply the bakeries, and the
truck was orced to turn back, and this is how our bread
supply was cut.
They cut our water, they cut our electricity, our ood and
our bread. We managed to make it through, by uniting. I
one o the neighbours was able to get bread, they shared it
with the rest This is reality.Faris, ather o si
Beore the confict began, although Syria was
considered a middle-income country, it had
relatiely high leels o stunting a result o chronic
malnutrition.65 Acute malnutrition was rare, and
remains so.66 Howeer, as the ghting continues and
amilies are nding that accessing nutritious ood
becomes eer more dicult, epensie, and een
dangerous, there are the rst signs o an increase in
the number o children suering malnutrition.67
According to the United Nations Oce or the
Coordination o Humanitarian Aairs (OCHA),
2.5 million Syrians are in need o emergency oodassistance.68 Howeer, one recent assessment in
the north o the country estimated that 3.2 million
people need ood assistance in 58 sub-districts alone,
suggesting that the situation may be much worse than
preiously thought.69
The ghting has drastically curtailed ood production
in the country. Jamal, like 20% o armers, reports
that it was too unsae to harest any o his crops.
Insecurity has also hampered cross-border trade
We let Syria because there were lots o explosions but
we didnt want to leave our house. We were injured and
we got scared, thats why we let. What do I remember?
People being hurt. People dying In ront o my eyes.
They were hitting schools. Many children would die, so
we got scared and stopped going to school. No childrenwould go to school, it was too dangerous. It makes me
sad that Im not going to school.
Beore the crisis we used to play outside. We werent
scared. Now? We stay inside and be araid. That is it.
We should stop the shelling. For me, explosions lead
to destruction. And more than that the shelling makes
people get injured, and it makes people die. The only
eect is destruction, death and wounded people. Myhome has been destroyed. We were in it when it was
hit, and when it ell. I eel as though all o Syria has
been destroyed.
SABA, 13
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o ood and other essentials like cooking oil; and in
some cases, road closures and ghting hae disrupted
delieries o ood relie (this is discussed urther in
the net section).70 Shortages o four a key staple
hae been reported in most parts o the country due
to damage to mills, closure o actories, lack o uel or
deliery, road closures, and insecurity.71
We stopped leaving our houses because o the danger,
which meant no work and no more income. It was
impossible to go to the eld and check on my crops.
Beore the confict, we harvested our olives and grapes, but
or the past year, I swear to you not one armer harvested
a single olive. Not one human being. Whoever decided to
visit his crops, knows he is going to die.Jamal, ather o eight
The scarcity o ood has contributed to soaring
ood prices, eacerbated by the closure o manyood markets due to insecurity. This has ended up
centralising supply in priate bakeries and leaing
price-setting in ewer hands.72 In Aleppo, which has
seen heay ghting, the price o bread is now up to
ten times what it was when the confict began two
years ago.73
For many people, the price rises mean they are unable
to eed their amilies. Een or those who hae enough
money to buy ood, the risk o being caught up in the
ghting makes joining the long ueues at bakeriestoo dangerous to attempt. As we see through Sae
the Childrens response to the crisis, ew displaced
amilies hae any ood stocks at all. They are haing
to cut down on the number o meals they and their
children eat each day.74We were living rom the ood
we had stored away jam, a little bread,Hamma told
us. She was heaily pregnant when she fed Syria with
her one-year-old daughter. Prices are so high ood is
ten times as much as it was. All I want or my baby is a
sae lie. That is my only hope.
Access to aordable ood is a daily challenge or
amilies in Syria, but malnutrition in inants and ery
young children can be staed o i they get the right
ood and micronutrients, or which breasteeding
is essential. Traditionally in Syria, the majority o
mothers do not breasteed their inants, but Sae the
Children has seen indications o a urther reduction
between 15% and 50% in the proportion o mothers
breasteeding.75 This is because o a widespread
perception that the stress women are under reducestheir ability to produce enough breast milk. Another
actor is that there has been uncontrolled distribution
o breast milk substitutes such as inant ormula.76
Gien the poor sanitation conditions many amilies
are liing under, described earlier in the report, we
hae seen how this is contributing to more inants
and children suering diarrhoea.77
This is just one small indication o the compleity o
the situation acing children and their amilies in Syria.
The net section outlines some o the main challenges
that Sae the Children and other agencies ace in
trying to help children in Syria in the contet o the
confict raging around them.
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The enormous humanitarian needs in Syriaand the widespread iolations o childrensrights demand action. Humanitarian agencies,including Syrian and international NGOs andUN agencies, hae already mobilised to helpall those people they can reach.
But the challenges inoled in the humanitarian
response in Syria are immense. Some o the biggestissues concern ongoing insecurity, limited access,
constraints on implementation capacity, challenges to
coordination, and insucient unding, which are all
described in more detail below.
While it is impossible to say with any certainty, there
are belieed to be millions o people in Syria who
need assistance and who are not receiing enough,
i any at all.78 There hae been recent breakthroughs
in humanitarian access, with some UN agencies
succeeding in negotiating access across confict linesto delier essentials such as ood and blankets.79
While these are much-needed positie signs, the
oerall picture remains bleak. It is likely that millions
o children are not getting the help and protection
they need.
Insecurity: The most eident constraint to reaching
the millions who need assistance is insecurity.
Crossre, indiscriminate use o orce, eplosie
weapons, landmines, uneploded remnants o war,
kidnapping; the list o threats to aid workers goeson, and the threats are real 15 aid workers in Syria
hae lost their lies in the past two years, trying to
get assistance to ciilians caught up in the confict.80
Some o them were directly targeted despite wearing
internationally recognised humanitarian emblems.81
Ambulances hae been directly attacked too: our out
o e Syrian ambulances hae been damaged during
the confict.82
Whether indiscriminate or targeted, attacks on
aid workers and aid conoys make some areas toorisky to operate in. For instance, the UN agency
responsible or proiding assistance or hal a million
Palestinian reugees in Syria (UNRWA) had to close
most o its operations in Yarmouk, where 150,000
Palestinians had been liing.83 Crossre, shelling
and aerial bombardment mean agencies are taking
signicant risks to reach those in need.
Assent o parties to the conict: The confict in
Syria has created a comple patchwork, with dierent
armed groups and orces actie in dierent areas.
There are some large areas where control is relatielyunied, and where large numbers o people can
gain assistance, i security allows. In other areas, the
situation is much more ragmented and dynamic, so
aid agencies must negotiate with numerous actions
to moe around and reach people aected by the
crisis. Sometimes more than 20 checkpoints must
be negotiated or one journey, with each negotiation
taking time; it only takes one checkpoint to reuse
passage to mean that the agency has to halt an aid
deliery, with no one gaining assistance.
For Sae the Children, humanitarian impartiality
is our only passport to respond in Syria, meaning
we hae already been able to proide assistance to
thousands o children. Denying children their right to
receie humanitarian assistance by denying agencies
access to them is a grae iolation o childrens rights
and contraenes international humanitarian law.
Eperience tells us that negotiations to secure access
based on humanitarian principles will continue to be
dicult, and necessary.
Capacity to deliver: Prior to the confict there
were ery ew organisations local or international
with sucient technical and operational capacity
or a humanitarian response in Syria. As the confict
has escalated, the UN and NGOs hae been trying
to increase the scale o their operations, within the
constraints o access and insecurity. To complement
direct operations, many agencies, including Sae
the Children, work with Syrian partners who are
able to delier a humanitarian response on a large
scale. Howeer, there are not enough eperiencedlocal organisations working in accordance with
humanitarian principles o impartiality and neutrality
to match the enormous needs.
humaniTyS beST eorTS?
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naziha, 17
One evening I was at my house with myhusband and I was holding my daughter inmy arms, breasteeding. We heard a noiseoutside. Something hit the house and I dontremember anything ater that All I knowis that ater, I became disabled I cantmove my arm or my leg. Now I cant standor sit without help.
There were many people who wereinjured or who became disabled in Syrialike this. This cannot go on. Someone shouldput an end to it. People are losing their
children, brothers, parents. Some peopleare getting shot. Others are unable to leavethe country. Children in Syria are dying, orbecoming disabled like I was. Until whenwill this keep going?
PHOTO:JONATHANHYAMS/SAvETHECHILDREN
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CHILDHOODUNDERFIRE
18
For most agencies international and Syrian getting
hold o the commodities needed to delier lie-saing
assistance can be etremely challenging. Whether it
is medicines, ood, blankets and tents, or people with
the necessary epertise and isas, there are signicant
obstacles to increasing the scale o operations in Syria
to meet the immense and urgent needs.
Humanitarian principles and coordination:
Due to the diculties o access and insecurity, there
is no central ocus in the country or ensuring that
humanitarian community has a clear, impartial, national
picture o the needs and the response. For eample,
many o the humanitarian organisations operating
in Syria are not present in Damascus. Conersely, o
those organisations operating rom Damascus, many
are not present in places like Aleppo, in the north.
The UN Oce or the Coordination o HumanitarianAairs (OCHA) has been proactiely working with
non-goernmental partners to nd creatie solutions
to this dilemma. It is not simply an issue o aoiding
duplication and lling the gaps, important though
this is. It is also about ensuring that the response is
based on humanitarian need, rather than political
considerations.
Some Syrian diaspora groups with strong political
aliations have given substantial nancial and technical
support to groups on whichever is their side o theconfict. In addition, the Syrian confict has deeply
divided the international community, with some
individuals, groups or governments unding only
one side or the other, regardless o what is best or
children and their amilies in need. The humanitarian
imperative is that the priority or the fow o essential
aid to Syria must be to reach those who need it most.
Acting on that imperative gives agencies best chance o
security in what is a complex and ast-moving confict.
Operating in this context requires constant vigilance
and negotiation. Given the access challenges described
earlier, all sides to the confict want to have a role in
the targeting o aid into the country. However, it is
vital that agencies delivering humanitarian assistance
remain impartial.
Funding: In 2012, unding or the international
humanitarian appeal or Syria ell $130 million short
o the reuirements identied by the UN a shortall
o more than a third.84 As the humanitarian needs
escalated throughout the year, this not only meant
that agencies in Syria could not proide much o the
necessary assistance; it also meant that they were still
trying to increase the scale o their operations.
By the end o January 2013, the appeal receied a
huge boost: international donors pledged $1.5 billion
to support the aid eort, including substantialamounts rom the European Commission, Kuwait,
the United Arab Emirates, the United Kingdom, and
the United States.85
These promises o unding are ery welcome, but
they need to be urgently translated into real unds or
agencies on the ground. At the time o writing this
report, UN gures showed only 2.9% o the reuired
unding or the emergency education response had
been proided, only 2.6% or community serices
(which includes programmes to improe childprotection), and a shortall o $72 million or health
88% o the reuested unds.86
While sucient unding is ital or an eectie
humanitarian response in Syria, the challenges set
out here make one thing clear: unding alone is not
sucient. The net section sets out what Sae the
Children beliees needs to happen to help address
the humanitarian suering.
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19
As the confict continues, so does theimpact o the war on children. Aboeall else, Save the Children calls on theUN Security Council to overcome itsdivisions and urgently unite behind aplan that will bring about an end tothe violence in Syria.
Ending the pain that this report sets out will not be
easy, but it is possible. Just as the waging o this war
is a result o human actions and decisions, so can be
its end. The appalling suering o Yasmine and Ibrahim
and Naziha and the thousands like them demands an
end to the confict now.
Tragically, but realistically, peace will take some time to
realise, and many more lies will be lost or destroyed
in the meantime. The international community
must press urgently and explicitly or parties
to the conict to take specifc measures toimprove and secure humanitarian access and
to ensure the protection o children. Other
recommendations addressed to specic actors are
detailed below.
PARTIES TO THE CONFLICT
Sae the Children takes no side in this confict. All
those who are ghting in Syria hae a responsibility
under national and international humanitarian and
human rights law to protect ciilians and specically
children, who are entitled to special protection. All
parties to the conict should commit publicly,
and take immediate measures, to:
allowunfettered,safeaccessbyhumanitarian
agencies trying to proide assistance to those
in need, including access across the lines o
the confict
easeanybureaucraticconstraintsonagencies
increasing their capacity to respond, allowinghumanitarian agencies, their sta and supplies
to reach those in need. This should apply to
all sectors o humanitarian actiity, including
protection, and clearance o uneploded remnants
o war
ensurethatchildrenandallciviliansandcivilian
objects are not targeted by armed action.
This should include targeting, occupation, or
military use o medical acilities and personnel,
schools, sites or internally displaced people, and
humanitarian agencies and workers. Ciilians
should be allowed sae passage out o areas o
actie military engagement
endtheuseofexplosiveweaponsinpopulated
areas
ceasetherecruitmentanduseofchildrenunder
the age o 18 in armed groups and orces, release
all children currently associated with armed groups
and orces, and cooperate with the return o these
children to their amilies, as well as necessary
systems or recoery and reintegration
cooperatewiththeUNtoensurethatalliolations o childrens rights are documented so
that those responsible can be held to account.
THE UNITED NATIONS
The UN has classied the Syria response as a leel 3
the highest category possible. This is a clear
recognition o the scale and urgency o humanitarian
need in Syria. This categorisation reuires the
appointment o a Super Humanitarian Coordinator,actiation o Clusters or coordination, and the
agreement o a strategic approach. The UN should
take action on the ollowing areas:
The UN Secretary-General, the UN-LAS
(League o Arab States) Joint Special
Representative or Syria, the Special
Representative o the Secretary-General or
Children and Armed Conict, and OCHA
should epressly urge parties to the confict to end
iolations o childrens rights and to take the specicsteps outlined aboe with utmost urgency to ensure
that children are protected rom the confict.
recommendaTionS
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CHILDHOODUNDERFIRE
20
OCHA should:
worktowardsasustainedstaffpresence,where
security allows, in its coordination hubs outside o
Damascus to work with goernment and non-
goernment actors to improe humanitarian access
useitspresenceintheregiontocomplementthe
work o the Damascus Humanitarian CountryTeam to deelop a whole o Syria picture o the
humanitarian needs and response. This is a means
to identiying gaps in coerage and pressing or
humanitarian access through all channels to reach
those people
pressforactivationofallClusters,including
education and protection
prioritise,atthehighestlevels,strengthening
coordination with donors and all aid actors rom
the Gul and the Middle East. This should also
promote decision-making based on impartial needsassessments, as well as aoiding duplication, and
maimising coerage by all actors in the response
undertake contingency planning or humanitarian
needs in Syria with all relevant partners, ensuring
that this inorms planning or the reugee response,
emergency preparedness, and post-confict planning.
INTERNATIONAL DONORS,
INCLUDING THOSE FROMTHE GULF REGION
The pledges made at the Kuwait donor conerence in
January 2013 or the Syria response and the reugee
crisis will allow a signicant increase in lie-saing
assistance. The crisis will be prolonged, howeer: the
need or emergency relie and help with recoery will
continue long beyond any cessation o hostilities. With
this and the wider contet in mind, all donors should:
committosupportingagenciesthataredelivering
assistance on the ground, with support that is: needs-based: in line with the principles o
Good Humanitarian Donorship, prioritisation
should not be linked to any political agenda but
rather according to greatest need, including or
Syrians, Irais, Palestinians, or any other group.87
To acilitate this, donors should strengthen
implementing partners capacity to undertake
needs assessments inside Syria
quickly disbursed: recent pledges should
be turned into committed unding as soon as
possible and disbursed to agencies deliering
assistance on the ground
sustained: humanitarian needs will continue
to increase as long as the confict lasts, and
people will need assistance long ater theconfict is oer
exible, including supporting humanitarian
preparedness to respond i the situation
changes and access improes
coordinated: donors should ensure that their
humanitarian unding is coordinated with other
donors unding
advocateforincreasedhumanitarianaccessby
any possible channel, and or greater humanitarian
presence on the ground
fundintegratedapproachesacrossallsectorsforan eectie holistic response, including:
protection: children need psychosocial
support; mapping and clearing eplosie
remnants o war is essential; and protection
rom all abuses, including grae iolations o
childrens rights, must be supported
education: this is to protect children now,
but also to protect their deelopment and that
o Syria once the confict is oer
continuetosupportthehumanitarianresponse
reaching reugees in neighbouring countries and
work with regional goernments to ensure that
borders are kept open or reugees.
ACTORS DELIvERING
HUMANITARIAN ASSISTANCE
There is a range o actors deliering humanitarian
assistance in Syria, rom established international
NGOs to relatiely new community groups that mayhae strong aliations with one side to the confict.
We urge all these groups to:
committosharinginformationregularlywithother
humanitarian partners, including OCHA, to ensure
that a ull picture o needs and responses can be
deeloped, notwithstanding the need to manage
risks to the security o programme sta and
beneciaries
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RECOMMENDAT
IONS
21
committoupholdingtheRedCross/RedCrescent
and NGO Code o Conduct, ensuring that
assistance is not linked to any political agenda
but is deliered according to where there is
greatest need88
conductjointneedsassessments,coordinatingwith
other agencies to ensure that the methodologyis compatible with that used in other areas o
the country. All assessments should include child
protection elements
workwithcommunitiestohaveIDPcamps,
schools, and hospitals declared as zones o peace,
agreed with armed groups and orces (learning
rom eperience in other countries such as Nepal,
or instance).
NEIGHBOURING COUNTRIES
As o March 2013, more than 1 million Syrians had
fed to neighbouring countries, along with thousands
o Palestinian and Irai reugees who had been liing in
Syria. Those goernments who hae maintained open
borders and are generously acilitating the responseto reugees needs are perorming an essential
humanitarian serice. Neighbouring countries should:
keepbordersopenforhumanitarianpurposes,
including allowing entry or all those feeing Syria
to nd sae reuge
continuetoworkwithhumanitarianagenciesto
ensure a reliable humanitarian supply chain or
reugee response and or operations in Syria.
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22
1 UNICEF (2013) Syria Crisis UNICEF Response and Needs, http://
relieweb.int/map/syrian-arab-republic/syria-crisis-unice-response-and-
needs-enar, last accessed 1 March 2013
2 UN News Serice (2013) UN ocials alarmed by eect o systematic
iolence on ciilians in Syria, 18 January, http://relieweb.int/report/syrian-
arab-republic/un-ocials-alarmed-eect-systematic-iolence-ciilians-syria,
last accessed 1 March 2013
3 S Ozer, SR Sirin and B Oppedal (2012) Bahcesehir Study o Syrian
Reugee Children in Turkey, Bahcesehir Uniersity, Istanbul, Turkey. This
report, Childhood Under Fire, cites statistics rom the Bahcesehir study,
which is aailable rom the authors on reuest.4 OCHA (2013) Humanitarian Bulletin: Syria, Issue 18, 22 January
4 February 2013, p 1; UNHCR (2013) Syria Regional Reugee Response:
Inormation Sharing Portal, http://data.unhcr.org/syrianreugees/regional.
php, last accessed 1 March 2013
5 This is an estimate based on dierent indications o a) need, and
b) response. According to the Syria Humanitarian Assistance Response
Plan (SHARP), 4 million people are in need across Syria. Howeer, the joint
assessment oerseen by the Assistance Coordination Unit (ACU) in 58 o
Syrias 128 sub-districts ound that 3.2 million people in these areas alone
needed assistance, suggesting that the true gure may be much higher than
the SHARP estimate. Food assistance has reportedly reached 1.5 million
people out o the 2.5 million identied by the SHARP as in need o ood
assistance. Distributions o non-ood items hae reached only 30% o the
1.5 million people identied as in need o such items. OCHA (2013) SyriaHumanitarian Assistance Response Plan (SHARP, 1 January30 June 2013).
www.unocha.org/cap/appeals/humanitarian-assistance-response-plan-syria-
1-january-30-june-2013, last iewed 1 March 2013
6 Syrian Network or Human Rights, cited in Syria Needs Analysis Project
(SNAP) (2013) Regional Analysis or Syria, 28 January 2013, Assessment
Capacities Project (ACAPS), www.acaps.org/disaster-needs-analysis, p 7,
last accessed 1 March 2013. This gure could not be conrmed without
etensie satellite sureys.
7 UNHCR (2013) Syria Regional Reugee Response: Inormation Sharing
Portal, http://data.unhcr.org/syrianreugees/regional.php, last accessed
7 March 2013
8 Obseration rom Sae the Childrens work; Al Jazeera (2012) Syrian
displaced seek shelter in ruins, 27 Noember, ideo clip, www.youtube.com/watch?=8N6ShEWPSZI&eature=youtu.be, last accessed 1 March
2013
9 UNHCR (2013) (see note 7)
10 Based on NGO assessment data, including rom Sae the Children
11 UNHCR (2013) (see note 7); also interiew with Sae the Children sta
12 IRC (2013) Syria: A Regional Crisis The IRC Commission on Syrian
Reugees, p 8, www.rescue.org/sites/deault/les/resource-le/
IRCReportMidEast20130114.pd last accessed 1 March 2013
13 Obseration rom Sae the Childrens work; SNAP (2013) (see note 6);
OCHA (2013) Humanitarian Bulletin: Syria, Issue 17, 821 January, http://
oodsecuritycluster.net/sites/deault/les/Syria%20Humanitarian%20
Bulletin%20Issue%2017.pd, last accessed 1 March 2013
14 SNAP (2013) (see note 6)
15 Obseration rom Sae the Childrens work; see also Reugees
International (2012) Syrian Women & Girls: No Sae Reuge,
16 Noember, http://reugeesinternational.org/sites/deault/les/Syrian%20
Women%20&%20Girls%20letterhead.pd last accessed 1 March 2013
16 WeatherSpark (2013) Historical weather or 2012 in Damascus, Syria,
http://weatherspark.com/history/32874/2012/Damascus-Ri-Dimash-
Goernorate-Syria, last accessed 1 March 2013
17 Obseration rom Sae the Childrens work
18 USAID (2013) Syria Comple Emergency, Fact Sheet #7, 17 January,
p 2, United States Agency or International Deelopment, http://transition.usaid.go/our_work/humanitarian_assistance/disaster_assistance/countries/
syria/template/s_sr/y2013/syria_ce_s07_01-17-2013.pd, last accessed
1 March 2013; Aaaz (2012) Suering Syria conronts another winter,
http://en.aaaz.org/1255/suering-syria-conronts-another-winter, last
accessed 4 February 2013; DFID (2012) Syrian reugees in Jordan,
podcast rom Liz Hughes, Humanitarian Adisor or Jordan and Ira, UK
Department or International Deelopment, www.dd.go.uk/Stories/
Case-Studies/2012/Syrian-reugees-in-Jordan/, last accessed 1 March 2013
19 OCHA (2013) Syrian Arab Republic: Non-ood items distribution
(1 Jan31 Dec 2012), distributed to Inter-Agency Standing Committee
(IASC) Emergency Directors meeting, 17 January 2013
20 OCHA (2013) Humanitarian Bulletin: Syria, Issue 17, 821 January, p 3,
http://oodsecuritycluster.net/sites/deault/les/Syria%20Humanitarian%20
Bulletin%20Issue%2017.pd, last accessed 1 March 201321 Obseration rom Sae the Childrens work
22 Obseration rom Sae the Childrens work
23 Obseration rom Sae the Childrens work; see also ACAPS (2012)
Disaster Needs Analysis: Update: Syria; 22 December 2012, p 19; OCHA
(2013) Syrian Arab Republic: Measles, Polio and vit. A vaccination Coerage
o 1,370,000 Children by Status o Location (as o 14 Jan 2013)
24 WHO (2012) Syria: Key Health Facts & Figures; Impact on public health
inrastructure & workorce, Monitoring Report, December 2012, World
Health Organization, p 2
25 ACU (2013) Joint Rapid Assessment o Northern Syria Interim
Report (drat), pp 18, 31; OHCHR (2013) Report o the independent
international commission o inuiry on the Syrian Arab Republic,
pp 2122, www.ohchr.org/EN/HRBodies/HRC/IICISyria/Pages/
IndependentInternationalCommission.asp last accessed 1 March 2013
26 WHO (2012), p 1 (see note 24)
27 Obseration rom Sae the Childrens work
28 WHO (2012) Health Situation in Syria and WHO Response,
26 Noember, p 2, World Health Organization Regional Oce
or the Eastern Mediterranean www.who.int/hac/crises/syr/Syria_
WCOreport_27No2012.pd last accessed 1 March 2013; see also IRC
(2013) Syria: A Regional Crisis, p 7 (see note 12)
29 WHO (2012) p 3 (see note 28)
30 Middle East Monitor (2013) Syria: A Modern Humanitarian Failure,
4 January, www.middleeastmonitor.com/articles/middle-east/4931-syria-a-
modern-humanitarian-ailure, last accessed 1 March 201331 ACU (2013) p 34 (see note 25)
32 Obseration rom Sae the Childrens work
endnoTeS
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ENDNOTES
23
33 ACU (2013) pp 412 (see note 25); see also SNAP (2013) (see note 6);
and UNICEF (2013) Running dry: water and sanitation crisis threatens
Syrian children, http://relieweb.int/sites/relieweb.int/les/resources/
Running%20dry%20Water%20and%20sanitation%20crisis%20threatens%20
Syrian%20children%20Eng_0.pd last accessed 1 March 2013
34 SNAP (2013) (see note 6)
35 UNRWA (2013) Syrian Arab Republic: Special Focus on the
Humanitarian Situation o Palestine Reugees in Syria, 4 February, http://
relieweb.int/report/occupied-palestinian-territory/syrian-arab-republic-special-ocus-humanitarian-situation last accessed 1 March 2013; see also
UNHCR (2013) 2013 UNHCR country operations prole Syrian Arab
Republic, www.unhcr.org/pages/49e486a76.html last accessed
1 March 2013
36 UNHCR (2012) UNHCR Syria Fact Sheet, December 2012, www.
unhcr.org/4ec630e09.html last accessed 1 March 2013; see also UNRWA
(2011) UNRWA Statistics 2010: selected indicators, p 6, www.unrwa.
org/userles/2011120434013.pd last accessed 1 March 2013
37 UNRWA (2012) Syria, www.unrwa.org/etemplate.php?id=55 last
accessed 1 March 2013
38 UNHCR (2012) (see note 36)
39 Amnesty International (2013) Reugees rom Syria ace urther suering
i Jordan closes border, 18 January, www.amnesty.org/en/news/reugees-
rom-syria-ace-urther-suering-i-jordan-closes-border-2013-01-18 last
accessed 1 March 2013
40 UNRWA (2013) (see note 35)
41 UNHCR (2013) UNHCR Global Appeal Update 2013 Update, p 168,
www.unhcr.org/50a9829a.html, last accessed 1 March 2013
42 UN News Centre (2012) violence in Syria orces more than 10,000
Irai reugees to leae country UN, www.un.org/apps/news/story.
asp?NewsID=42539 last accessed 1 March 2013; see also Reugees
International (2013) Ira, www.reugeesinternational.org/where-we-work/
middle-east/ira; last accessed 1 March 2013
43 Obseration rom Sae the Childrens work
44 Ozer et al (2012) (see note 3)45 UN Secretary-General (2012) Children and Armed Confict: Report
o the Secretary General, April 2012 www.un.org/ga/search/iew_doc.
asp?symbol=S/2012/261last accessed 4 March 2013. The si grae
iolations o childrens rights are: recruitment and use o children, killing
and maiming o children, rape and other grae seual iolence, abductions,
attacks on schools and hospitals, and denial o humanitarian access to
children.
46 N Pillay, UN High Commissioner or Human Rights, cited in UN News
Centre (2013) Security Council must unite to protect ciilians in co