The United Nations has issued a statement meant to convince the Syrian government to improve access for humanitarian workers. Organizations on the ground in Syria are skeptical the situation will improve any time soon.
The United Nations Security Council's demand was unambiguous: It wants "immediate action" to quell the humanitarian crisis in Syria, an increase in humanitarian activities, and called on the administration of Bashar al-Assad to "lift bureaucratic impediments and other obstacles" to delivering such assistance.
Aid workers at risk
Hassan Ahmed could only shake his head at the UN statement: Far too many people have already paid with their lives in efforts to help ordinary Syrians over the course of the civil war.
Ahmed, who was born in Syria and works for the German-Syrian Association for Freedom and Human Rights, based in Darmstadt, Germany, this week had renewed concern for his friends. They are trying to cross the Turkish border and reach Aleppo in a truck loaded with medicine and medical supplies.
"You never know if they'll be shot at. You don't know how the soldier at the checkpoint might be feeling. And then it may really be that the driver pays with his life," Ahmed said.
The al-Assad regime has until now has categorically denied access for international aid missions, arguing that they are providing assistance to rebels. Ahmed doesn't believe that the UN statement will change this.
"It all sounds well and good. We often hear such demands, but nothing changes," he said. In contrast to a UN resolution, a UN statement is completely non-binding. "Countries can take it or leave it. It does not constitute a concrete measure that will actually help Syrians," Ahmed said.
Medicine for underground clinic
The German-Syrian association has instead taken matters into its own hands, supported by the German medical relief organization Action Medeor, which contributed 190,000 euros ($258,000) to the transport of medicine and medical supplies.
These supplies are supposed to outfit an intensive care unit that has had to operate secretly for months. Doctors in Aleppo have been working in cellars since a long-range rocket destroyed the hospital that previously stood on this square in Aleppo.
Doctors Without Borders has been working under similar conditions in Syria. In 2012, the organization's chair Tankred Stöbe even set up an operating room in a cave in the Syrian province of Idlib. And in September, he spent four weeks on the Syrian border with Iraq where a tent was converted into a field hospital.
Difficult situation for the chronically ill
Hundreds of Syrian refugees arrived there from across the border every day, Stöbe said. And it is not just that their homes are being bombed, but also the lack of medical care that is driving them to leave their country, Stöbe added. More than half of all Syrian hospitals have been destroyed or damaged in the conflict.
"People reported to me that they hadn't had any medication for months, that they had no doctors anymore. Many doctors have also left the country," said Stöbe.
For the chronically ill - such as those with diabetes or high blood pressure - a lack of medication and care can be fatal.
Doctors Without Borders currently operates six clinics in rebel-controlled regions in northern Syria. But the group is also supporting dozens of other clinics in other areas with medicine and medical supplies. "We aren't officially allowed to enter the country," Stöbe said, referring to the regime's anti-aid policy.
But he reported that even where they are able to work, the security situation is abysmal: "We are constantly having to pull our workers out - daily, weekly. We're working in cellars, in civilian homes, in caves. We have to hide, otherwise we're attacked."
A Doctors Without Borders surgeon was shot this past September, and ambulances are also attacked. "Every moving vehicle is a target," Stöbe said. He and his team have taped over all the lights on their vehicles because anything seen as part of a medical effort "is declared the enemy."
Jens Laerke, Genevan spokesman of the Office for the Coordination of Humanitarian Affairs, has confirmed numerous attacks on humanitarian aid workers in Syria. As expected from a UN staffer, he welcomed the UN statement. But he admitted there's been nothing binding yet.
Laerke said the UN is promoting a "humanitarian pause" in the Syrian civil war, where fighting would stop for a certain period of time "to enable us to get in, reach people and provide the aid that they need."