Subject: Syria deteriorating
From: "CARE Emergency Response" <[email-masked]>
To: "R. Biden" <[email-masked]>
Date: Sat, 24 Feb 2018 11:02:32 -0600

Dear R.,

"Extreme suffering".

That's the distressing headline from Syria, as a massive surge in violence since late December has forced 300,000 civilians to flee. Another 2 million are at risk.

As the carnage escalates, we've received new updates from CARE staff on the ground, and what they report is unimaginable:

- People wearing only a single layer of clothes are fleeing airstrikes and seeking refuge in open fields.
- Some are seeking shelter from the harsh winter under olive trees.
- Those living in Idlib and eastern Ghouta have resorted to drinking dirty, unsafe water, and eating hay to sustain themselves.
- Intense airstrikes and bombs are falling in densely populated areas, even in regions designated "de-escalation zones."

I wish I could report that we've been able to reach all of those who are suffering. But access has been limited, and some besieged areas haven't received aid from U.N. convoys since December.

I know you're concerned about the fate of innocent civilians there. Below is an internal update from our staff that provides more firsthand details into what's happening right now in Syria.  

Thank you for all you've done. If you'd like to renew your support of our work to protect vulnerable families in Syria and around the world, please consider donating to CARE's lifesaving work today. 

With gratitude,

Michelle Nunn 
President and CEO, CARE

Donate: http://my.care.org/site/R?i=N5nMyTcPQoZf0vk9ExOdHA

Q&A on Surging Violence in Syria
 
Can you describe the situation on the ground?

Idlib
Intense airstrikes and shelling continue to be reported daily in Idlib, resulting in civilian deaths and injuries, as well as the destruction of civilian infrastructure. The lives of two million men, women and children living in the governorate are in grave danger, as the space for civilians to access safety is rapidly shrinking. In the past few days, there have been reports of airstrikes in towns and villages across the governorate of Idlib that resulted in civilian death and injury, and damaged medical facilities, schools and other civilian infrastructure. Ground-based strikes have reportedly hit an IDP camp in Atma, near the Syrian-Turkish border, where some 60,000 displaced people are sheltered, causing several deaths and injuries, including among women and children. A blood bank has reportedly been destroyed and several hospitals damaged or temporarily closed. Over 1,200 schools in Idlib remain closed for more than six weeks now, due to the ongoing hostilities, impacting thousands of students. The current IDP camps cannot absorb the sheer number of new arrivals, forcing many families to erect their tents on muddy farmland. Newly-displaced families tell us that they have already been displaced multiple times over the course of the conflict, only to pick up and flee for their lives once again.
 
Eastern Ghouta
The escalating fighting in Eastern Ghouta continues to impact civilians and civilian infrastructure in the besieged enclave. In the last 48 hours, intense airstrikes and shelling have reportedly resulted in dozens of civilian deaths and many more injuries. A health facility and a kindergarten have reportedly been damaged by airstrikes. A sharp increase of mortars and shelling was also reported in several Damascus city neighborhoods and suburbs resulting in civilian deaths and injuries. After more than five years of besiegement, people in Eastern Ghouta are living in dire circumstances. Several medical cases are still waiting to be evacuated. Twenty-four people have passed away according to the UN.
 
Which groups of civilians are the most vulnerable currently?

In all conflicts, women and girls are particularly vulnerable. They often lack access to services and need support to secure essential items for family survival. Female-headed households are among the most vulnerable and often isolated as cultural restrictions as well as safety concerns restrict them from being able to circulate freely in the communities they have been displaced to; hence, they often have difficulties finding assistance and are reluctant to leave their shelters. 

Women often prioritize the health and well-being of their children and husbands over their own; they are often the last ones to ask for health or psychological support. Inside Syria, over three million children under five and pregnant and lactating women are in need of emergency nutrition services. At least two million children in Syria have dropped out of school due to the conflict. With the latest escalation in Ghouta and Idlib, they are again amongst the most vulnerable groups. It's been reported that pregnant women in Eastern Ghouta have suffered from falling hair and teeth, and even miscarriage because of lack of nutritious food. 

In our response to the Syria crisis, CARE is working to address those needs by ensuring that women have access to basic services, providing emergency cash to pay for food and accommodation, and psychosocial support.
 
Aren't the de-escalation zones supposed to be safe?

While the designated "de-escalation zones" are ostensibly meant to provide more security and assistance to people, the opposite has happened in most of these areas. Recent developments in Idlib and Ghouta, two so call "de-escalation zones", have clearly illustrated the level of insecurity in them. The increase of violence and shelling in Idlib has resulted in the displacement of over 270,000 people in very harsh weather conditions. This is the largest displacement the governorate has witnessed since the beginning of the conflict in 2011. For many of these people, this is their second or third displacement. In besieged Eastern Ghouta, we are also witnessing how the misery of the nearly half million Syrians living there has been taken to another, unimaginable level with intense air strikes, increased shelling and tightening of the siege. 
 
While parties to the various de-escalation efforts have made commitments to decrease hostilities and increase humanitarian access and service provision, no concrete action appears to have been taken by the guarantor states to prevent the ongoing and increasing violence in Idlib or improve the dire humanitarian situation in Eastern Ghouta.
 
How is the current violence in Idlib going to affect current displacement trends?

We have already seen how the current shelling and violence have resulted in the displacement of more than a quarter million people in Idlib, many having to move for the second or third time. CARE has increased aid distribution to civilians who have been displaced and aims to reach 25,000 people with emergency help, through our partners present in the area, but the rate at which displacement is happening makes it impossible for humanitarian agencies to cover the needs of the most vulnerable people. If violence continues, civilians will have no safe place to go.
 
Have you received information about the recent chemical attacks?

We are aware of reports that bombs allegedly containing weaponized chlorine have been used in the town of Saraqeb in Idlib and in Douma in Eastern Ghouta. Though we are not in a position to verify the nature of the attacks, we call on all warring parties to respect international humanitarian law, to stop targeting civilians and civilian infrastructures and to allow for urgent humanitarian aid to reach the most vulnerable, as well as the evacuation of medical cases.

Donate: http://my.care.org/site/R?i=QjlZqiTqkaNtwEFI2A4JLA

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