Review of alternative modalities for the border crossing of Ya‘rubiyah - Report of the Secretary-General (S/2020/139) [EN/AR]

I. Introduction

1. The present review is submitted pursuant to paragraph 6 of Security Council resolution 2504 (2020), in which the Council requested the Secretary-General to report to the Council by the end of February 2020 on the feasibility of using alternative modalities for the border crossing of Ya‘rubiyah in order to ensure that humanitarian assistance, including medical and surgical supplies, reaches people in need throughout the Syrian Arab Republic through the most direct routes and in accordance with the humanitarian principles of humanity, neutrality, impartiality and independence.

2. The information contained herein is based on available data from the United Nations system and obtained from the Government of the Syrian Arab Republic and other relevant sources, including field visits and a desk review, up to 19 February 2020.

II. Humanitarian situation in the north-east of the Syrian Arab Republic

1. Civilians in the north-east of the Syrian Arab Republic are among the country’s most vulnerable. An estimated 1.9 million people are assessed to be in need of humanitarian assistance in that region, the vast majority of whom – 1.34 million people – are in areas not under government control. Some 70,000 people remain displaced in the north-east as a result of the launch of Operation Peace Spring on 9 October 2019. Prior to 9 October, the north-east already hosted approximately 710,000 displaced civilians. Children account for 42 per cent of the 710,000 displaced persons, most of whom are hosted by local communities. More than 480,000 of those displaced in the north-east are in areas not under government control, including more than 66,000 people who reside in Hawl camp, almost 44,000 of whom are children.
   More than 14,000 displaced persons are accommodated in collective shelters, almost all of which were previously schools.

2. Needs in the north-east are extremely high. As at the end of 2019, only 2 out of 16 public hospitals and 4 out of 279 primary health centres across the north-east were functioning at full capacity. The challenges to health care, combined with major gaps in the availability of safe water, have resulted in several outbreaks of infectious diseases in the past years across the north-east. Significant contamination from explosive weapons continues to limit movement, making access to services even more difficult.

3. Local actors report that, at current consumption rates, medical stocks are expected to run out in the coming months. Reproductive health kit stocks could be depleted by March. This means that, unless alternative modalities are found, items needed to undertake medical procedures related to maternal health, such as delivery by caesarian section, will not be available. By May, there is likely to be broader gaps in basic medicines in medical facilities previously supplied by the United Nations cross-border operation, should an alternative to Ya‘rubiyah not be found. The impact of such gaps would be significant, limiting the ability of medical providers to deliver a broad range of critical medical treatments to people in need. As detailed below, delivery capacity is also a major challenge.

4. On 15 October 2019, in a letter to United Nations entities in the Syrian Arab Republic, the Government of the Syrian Arab Republic requested “the United Nations humanitarian team to take immediate action by sending convoys of relief items, such as food and medical items”, to the north-east of the country. On 21 October, in a letter to the Secretary-General, the Government pledged to do everything possible to facilitate the delivery of such assistance, in coordination with the Syrian Arab Red Crescent and government agencies.