Testimony of Acting Assistant Administrator Thomas H. Staal to the House Foreign Affairs Subcommittee on the Middle East and North Africa the Subcommittee on Africa, Global Health, Global Human Rights, and International Organizations

Thursday, February 12, 2015

The Syrian Humanitarian Crisis Four Years Later, No End in Sight


Chairman Ros-Lehtinen, Ranking Member Deutch, Chairman Smith, Ranking Member Bass, and Members of the Subcommittees, thank you for the opportunity to testify today on the humanitarian crisis in Syria.

The Syrian crisis is the largest and most complex humanitarian emergency of our time. The emergence of the Islamic State of Iraq and the Levant (ISIL) has exacerbated an already protracted crisis in Syria, where the Assad regime has waged an unrelenting campaign of bloodshed against its own people for four years.

The humanitarian situation grows more complex every day. There are more than 12.2 million Syrians in need of humanitarian assistance— more than half of Syria’s pre-war population, and equal to the combined populations of New York City and Los Angeles. According to the United Nations (UN), Syrians are now the largest refugee population in the world under the mandate of the UN High Commissioner for Refugees. One in five people displaced globally is Syrian.

The conflict has radically reshaped the demographics of a region with an already delicate ethnic and religious balance and scarce resources. According to UN estimates, refugees from Syria now account for one-quarter of Lebanon’s population and at least 10 percent of Jordan’s. Indeed, Lebanon now hosts the largest concentration of refugees in the world. This population bulge has overwhelmed basic infrastructure, including water systems, hospitals, and schools.

Last week in Jordan and Iraq, I visited Syrian partners and communities struggling to withstand another winter away from home and heard from families that had fled unspeakable horrors.

We are doing everything possible to save lives, alleviate human suffering, and restore dignity and resilience among the most vulnerable. The United States is the single largest donor of humanitarian assistance to people affected by the Syrian crisis, providing more than $3 billion to date. Our FY 2016 request of $735 million for International Disaster Assistance Overseas Contingency Operations resources for the Syrian humanitarian response demonstrates our continued commitment to the most vulnerable people and communities impacted by this tragic crisis.

Today, I’d like to cover three key areas: First, an update on the U.S. response in Syria; second, how we are building resilient systems so host communities can cope with the influx of refugees; and third, an outline of the key challenges that lie ahead.

The U.S. Response

This protracted and brutal war is testing the capacity of the humanitarian community at a time of immense global need. For the first time in USAID’s history, our Office of U.S. Foreign Disaster Assistance has deployed four Disaster Assistance Response Teams (DARTs) and activated three Response Management Teams (RMTs) concurrently. Our DART for Syria is working in collaboration with partners, the UN, and other donors to coordinate our response.

Four years into the conflict, Syrians see no end in sight to the violence. ISIL’s abuses, including the horrific murder of Jordanian pilot Captain Muath al-Kasasbeh last week, have been layered on top of the Assad regime’s indiscriminate killings and barrel bombings, which have displaced millions. There are 9.8 million Syrians who are food insecure—lacking reliable access to affordable, nutritious food. More than half of Syria’s hospitals and a quarter of its schools have been destroyed. Water availability in Syria has decreased to 50 percent of pre-crisis levels. While many internally displaced persons (IDPs) are hosted by friends or family, others are living in warehouses, poultry farms, or other structures that lack sanitation facilities and are not equipped for winter.

Our partners are heroically providing humanitarian assistance to Syrians who are most in need— including IDPs, host families, and other conflict-affected communities. Partners continue to work through all possible channels, including across international borders and conflict lines, to deliver food, medicine, relief supplies, and sanitation services in regime, opposition, and ISIL-controlled areas— wherever people are in need throughout Syria.

For over three years, the U.S. government has provided emergency care to those caught in the crossfire. Nearly two million patients have been treated for trauma wounds, received vaccines, and undergone more than 186,000 surgeries at over 300 U.S. supported hospitals, clinics, and mobile medical units across Syria this year. We have also trained 3,100 Syrian volunteers to provide emergency care. After a polio outbreak in Syria in 2013, USAID and its international partners mounted an aggressive response, supporting an unprecedented vaccination campaign across the war-torn country that helped bring polio cases down in Syria. January marked one year of no new cases.

We have improved water and sanitation for 1.3 million Syrians in all 14 governorates. Partners have organized hygiene awareness sessions and trucked water to ensure access to clean water. We are carrying out emergency repairs of water networks as well as repairs and upgrades to water sources and bathrooms in communal shelters. We are supporting solid waste collection and upgrades to temporary shelters and camps, including constructing latrines to help prevent the spread of disease. In times of crisis, clean water and sanitation are critical to survival; these programs have prevented countless illnesses and deaths.

Harsh winter weather can exacerbate already tough living conditions, but we can predict and prepare for this, given sufficient resources and access to those in need. For the third year, we are working tirelessly to support Syrians enduring another harsh winter away from home, especially those living in informal shelters. Preparations for winter began last spring. In October 2014, 18 partners began distributing supplies to prepare for the cold weather, along with other relief items. Our partners have reached almost half a million people so far this winter, through distributions that included 58,400 winter kits, 193,500 blankets and bedding kits, and 203,400 clothing kits. We have also distributed 13,900 relief vouchers so that families can buy much-needed fuel. We are providing plastic sheeting and other supplies to weather-proof makeshift homes and tents. One partner is putting up windows, doors, and glass to insulate the homes of more than 500 families in Aleppo.

We are also taking measures to prevent disease outbreaks that can arise from cold, wet weather. With our support, health facilities received 300,000 flu vaccines and antibiotics to treat common winter infections. The UN World Health Organization and other partners have provided water heaters to hospitals in eight governorates, serving more than two million people, and distributed air heaters to 800,000 people in nine governorates in Syria.

Food Assistance

The United States is the largest food donor in the Syrian crisis, providing more than $1.1 billion to date. With our help, more than 4.8 million people in Syria and 1.7 million refugees have food to eat. We take a locally appropriate and cost-effective approach to meet the diverse needs of Syrians in and out of Syria. Through the UN World Food Program (WFP) and other partners, we support family rations and flour-to-bakery programs inside Syria. In neighboring countries, WFP issues food voucher debit cards, which help restore some normalcy to refugees’ lives, by allowing refugees, including many female-headed households, to buy groceries in local supermarkets. These efforts not only feed Syrian refugees, easing the pressure on host countries, but also support local economies. According to the WFP, its voucher program has injected approximately $1 billion into the economies of Lebanon, Jordan, Turkey, Egypt, and Iraq since the program began. In Jordan, the program has injected several hundred million dollars into the economy, and in Lebanon, it has created 1,300 new jobs.

WFP is taking steps to make its operations more sustainable and cost-effective through increased targeting of assistance to the most vulnerable and reducing operational costs. We applaud these efforts, and urge other donors to continue their support for the program, which provides a lifeline to so many Syrians in need, and to the economies of the region.

Women and Children

Protecting women and children is a priority for the U.S. government in all humanitarian settings, and nowhere is this more important than in the Syrian crisis. In ISIL-held areas, the group has sanctioned barbaric tactics such as stoning women and selling girls as young as 12 into sex slavery. Eighty five percent of those killed in the Syrian crisis have been men, leaving behind women heads of households struggling to keep their families alive. Nearly three million Syrian children are out of school. Behind these statistics is a generation of girls and boys yearning to shed the trauma of conflict and build a more prosperous and peaceful future.

We have provided $26 million in humanitarian protection activities to ensure maximum safety and dignity for women. Partners distribute hygiene and infant supplies; install separate toilets and showers for women with inside locks; and build latrines near tents. We are supporting mobile clinics to increase access to reproductive health services and clinical care for survivors of Gender Based Violence (GBV) and have trained 360 healthcare workers to respond to GBV cases throughout Syria. We support safe spaces for young women to talk about the challenges they face, including early marriages, which are on the rise.

The U.S. is also expanding educational and recreational opportunities to restore a sense of normalcy for Syrian girls and boys. We provide psychosocial support and recreational opportunities for Syrian children who have suffered or are at high risk of abuse. In neighboring countries, we are ensuring that all children can keep thriving, especially in schools absorbing refugee children. In Lebanon, we are rehabilitating 259 public schools, including 131 schools in areas with a high number of Syrian refugees; providing equipment; and training teachers to improve learning outcomes. In Jordan, USAID has trained 12,700 teachers to integrate refugee children recovering from war.

Supporting Resilience in Syria’s Neighbors

Many Syrian families have been uprooted more than once over the past four years. The seemingly endless flow of Syrian refugees into neighboring countries has put a massive strain on households and economies across the region. Many Jordanian and Lebanese towns along the Syrian border have doubled or tripled in size due to the influx of Syrian refugees. We commend the generosity of the Lebanese, Turkish, Jordanian, Egyptian, and Iraqi people with their Syrian neighbors. However, we are concerned with recent restrictions by Jordan and Lebanon to close or tightly manage their borders. The U.S. government continues to urge countries to keep borders open, but we understand that host communities are stretched beyond capacity and need our help. That is why we are investing more resources, in close coordination with the State Department’s Bureau of Population, Refugees, and Migration, into helping these communities build resilient systems that can withstand the shocks of refugee flows. We are working with host communities across the region to improve water, healthcare, and education systems to cope with the increased demand.

Jordan is one of the most water-scarce countries in the world. Now more than ever its water system is stretched beyond capacity. Through the Complex Crises Fund, USAID is working with communities in Mafraq and Irbid— two northern towns with the heaviest concentration of refugees— to conserve water. In more than 90 schools, we have organized plays to teach children about conservation and built cisterns to collect rainwater. We have provided more than 2,200 no-interest loans to community-based cooperatives so that families can afford to install rainwater harvesting systems in their homes. These efforts saved almost 200,000 cubic meters of water— equal to 5.5 million showers. We are also helping to alleviate the strain on water and basic services in Lebanon, especially after last year’s drought. As a result, over 220,000 Lebanese and Syrians had access to better waste management systems and over 265,000 had increased access to water.

We are also helping host communities to improve the delivery of basic services. In Irbid, we helped facilitate a town hall meeting where people voted on activities to improve their town, such as trash collection and road improvements. After the voting, we provided uniforms, equipment, and trash receptacles to help residents clean up the town. By involving both Jordanian and Syrian residents in these decisions, people were able to voice their frustrations and find workable solutions to make their town more livable for everyone.

We are also assisting heath facilities that are overwhelmed by the influx of patients. We are the largest donor to Jordan’s health sector, where 70 percent of all deliveries now take place in public hospitals largely renovated by our partners. We have expanded access to care at more than 30 facilities.

In Lebanon, we are working to mitigate increased sectarian and host community-refugee tensions and to counter the rise of violent extremism. For example, following clashes in October between militants and Lebanese Armed Forces in Tripoli, the U.S. worked with civil society groups to rehabilitate the Old City, including a vegetable market. These efforts revived the economy in a previously marginalized and impoverished area. By talking to youth and involving them in our efforts, we sought to reduce the appeal of extremism.

Fifty-three percent of registered refugees from Syria in Lebanon are under 18, and in desperate need of educational and employment opportunities. The donor community must help Lebanon expand opportunities for its refugees, and alleviate the pressure on Lebanese host communities in order to counter the dangerous tensions that could ensnare the country in a downward spiral of insecurity and conflict.


The U.S. government has been leading the charge to meet the overwhelming needs of those affected by the ongoing conflict in Syria, including those who have been displaced by the violence and host communities in and out of Syria. Despite our best efforts, important challenges remain, underscoring the need for increased commitments and coordination among foreign donors and humanitarian partners.

Access Constrained access and insecurity remain the primary constraint to providing urgently needed humanitarian assistance to those in need inside Syria. The U.S. government continues to work through all possible channels— including more than 50 UN, international, and Syrian NGO partners— to meet the urgent humanitarian needs of the Syrian people. However, violence continues to hinder the delivery of assistance, including in regime-held, opposition-held, and ISIL-held areas. An estimated 4.8 million Syrians in need reside in UN-identified hard-to-reach areas, including 2.7 million residing in areas under ISIL control. At least 150 NGO, Syrian Arab Red Crescent, and UN staff members have lost their lives providing life-saving assistance in Syria.

Host Communities

Donors must continue to work together to relieve the strain on host communities, and ensure their security. Donors, the UN, and humanitarian NGO partners must find a way forward and bolster funding commitments to support host communities across the region to build resilience, mitigate sectarian tensions, and counter violent extremism.


The U.S. government remains committed to keeping the lines of assistance open to save lives in Syria. And as part of our mission to ending extreme poverty and promoting resilient, democratic societies, we are committed to helping Syria’s neighbors build resilient systems to cope with the strain of refugee flows, recognizing this is a long-term crisis with regional impact.

We know that humanitarian assistance cannot solve the conflict, but it is vital to keeping civilians alive. Forging strong partnerships will be crucial to the immense needs ahead. We must also find a political solution to the crisis that can ultimately stop the bloodshed, destruction, and displacement.

USAID is deeply appreciative of Congressional support that makes our work possible in Syria. Thank you for your interest, and we look forward to your questions.