Testimony of Assistant Administrator Nancy Lindborg before the Senate Judiciary Subcommittee on Constitution, Civil Rights and Human Rights

Tuesday, January 7, 2014

The Syrian Refugee Crisis

Chairman Durbin, Ranking Member Cruz, and Members of the Subcommittee; thank you for inviting me to testify on the ongoing U.S. response to Syria’s humanitarian crisis and for your interest in this critical issue.


As we celebrate the start of 2014, and a new year, the Syrian people find themselves in their third year of an escalating war. In just the last year, the number of people displaced inside Syria has quadrupled from 1.5 million to more than 6.5 million. More Syrians are now internally displaced from their homes than anywhere else in the world. An additional 2.3 million Syrians have fled to neighboring countries in search of safety. More than 9.3 million people—over 40 percent of Syria’s population—are now in need of humanitarian assistance.

Behind each of these numbers is a name. In my own visits to the region, I have heard firsthand the heartbreaking stories of lives destroyed; of women who have endured rape and violence; of families separated; and of a generation of Syrian children who have not been able to attend school for two years now, many of them traumatized by daily bombings and subject to the recruitment efforts of extremists.

We know that even tougher months lie ahead as the Middle East faces one of the worst winters in 100 years. And the latest United Nations appeal for Syria and the region was just released at $6.5 billion—more than four times what it was a year ago. This appeal marks the largest-ever request for a single humanitarian emergency and nearly half of the United Nations’ global humanitarian request.

Working in partnership with the international community, the U.S. humanitarian response has reached millions of people with life-saving medical assistance, food aid, relief supplies, and vital protection programs. Yet, the needs continue to escalate faster than the international community can respond.

Today, I'd like to cover three key areas for you: first, to directly address the challenges that continue to inhibit our ability to meet the full scope of humanitarian need; second, a brief update on the significant, life-saving U.S. government humanitarian response, including an important focus on women and children who are especially vulnerable. With more than 4 million children in Syria at risk and 2.25 million out of school, many for more than two years now, we have a humanitarian and protection challenge as well as the risk of losing a generation of Syrians to hopelessness in an already volatile region. Finally, a quick review of how we have reoriented our U.S. development programs to support a comprehensive response to the growing burden of refugees in neighboring states.

Key Challenges

With so many people in need, the humanitarian response has been constrained by the challenges of insecurity, blocked access, and insufficient resources. Despite a massive mobilization of assistance and funding, international aid has not reached some 2.5 million people inside Syria. The intense insecurity of a war zone complicates efforts every day. Roads closed due to fighting and hundreds of checkpoints make aid delivery across conflict lines dangerous, complicated, and unreliable.

Most concerning, an estimated 250,000 people have been completely and deliberately cut off from humanitarian assistance for many months, the majority of whom are in areas besieged by the regime in an unconscionable campaign of starvation.

In October, the United Nations Security Council unanimously adopted a Presidential Statement urging all parties to the conflict to facilitate immediate humanitarian access—across both borders and conflict lines. This statement is the first and most significant demonstration of global political will to ensure humanitarian assistance reaches those who need it most. It lays down clear markers for the Syrian regime regarding the world’s expectations that it will provide the immediate and unfettered access it has long denied, including the call to:

  1. Immediately demilitarize medical facilities, schools and water stations;
  2. Approve access for additional domestic and international NGOs;
  3. Grant visas to ease and expedite the operationalization of humanitarian hubs and the movement of humanitarian personnel;
  4. Accelerate the entry of humanitarian goods and equipment, and;
  5. Facilitate humanitarian workers’ immediate and unfettered access to people in need.

The Syrian regime has the power to enable life-saving assistance to reach more than 200,000 people in need—and all international pressure must be applied toward this end. We have seen slight shifts in rhetoric that have signaled regime approval for new humanitarian hubs for the United Nation, increased visa approvals for international staff, and several approved flights from Iraq. But these remain for the most part rhetorical shifts, with little additional, substantial access on the ground and a continued assault on civilians.

My colleague Anne Richard and I traveled to Geneva several weeks ago for a high-level meeting of the 22 core countries working to push forward implementation of the Security Council’s Presidential Statement and increase humanitarian access. This process, led by the United Nations, is focused on applying full diplomatic pressure to improve humanitarian access. The United Nations’ Under Secretary General for Humanitarian Affairs and Emergency Relief Coordinator provides regular public reports on the status of this process.

Finally, resources remain a key constraint as we enter a third year of what is now a regional crisis with global implications. A donor’s conference is scheduled for January 15th in Kuwait, and we are working to urge all donors to give generously, including those that do not typically respond to these appeals.

The U.S. Humanitarian Response

Amidst these significant constraints, as the Syria crisis has escalated, the United States has accelerated our humanitarian response with a contribution of more than $1.3 billion in humanitarian aid since the conflict began. Our assistance has helped meet the urgent needs of 4.2 million people across all 14 governorates inside Syria as well as the more than two million refugees in neighboring countries.

To reach the greatest numbers of people in need, the U.S. government is working through all possible channels—the United Nations, international non-governmental organizations, and local Syrian organizations—to provide life-saving supplies and services. Since this time last year, we have scaled up the number of our partners inside Syria from 12 to 26.

U.S. humanitarian assistance in Syria is focused on four key areas: emergency medical care, food assistance, the provision of much-needed relief supplies, and the protection of vulnerable populations—particularly women and children.

Medical Care

In response to the brutal conflict, a key component of our humanitarian response for the last two years has been life-saving medical care, which currently reaches more than 2.7 million people inside Syria. Nearly one million patients have been treated at the 260 U.S. supported hospitals, field clinics, and medical facilities across the country. These field hospitals and makeshift clinics have performed more than 190,000 surgeries. Last spring, with the onset of warmer weather, we worked with partners to establish an early warning system for communicable diseases. This system enables early detection and fast response in areas where the medical system has collapsed to prevent devastating consequences. And recognizing the need for additional medical staff capable of saving lives, we have trained more than 1,500 Syrian volunteers to provide emergency first-aid care.

The doctors, nurses, and volunteer health workers on the front lines of these efforts are true humanitarian heroes, risking their lives daily to help others, as the regime has continually targeted health workers.

We are deeply concerned by Syria’s 17 confirmed cases of polio—a potentially deadly and crippling disease eradicated in the country more than a decade ago—and the chance that it could spread along with other infectious diseases. The United Nations is leading the largest-ever polio vaccination campaign in the region aimed at immunizing approximately 20 million children across the Middle East, including 2.2 million inside Syria, and the United States is in full support.

Food Assistance

The United States is the single-largest donor of emergency food aid for the Syria crisis, supporting the United Nations World Food Program (WFP) and other international humanitarian organizations and NGOs to feed 4.2 million people inside Syria and 1.3 million refugees in neighboring countries.

Widespread displacement, reductions in agricultural production, disruption of markets and transportation, elimination of bread subsidies, damage to infrastructure—including mills and bakeries—and loss of livelihoods are contributing to unprecedented food insecurity in Syria. In response to this complex crisis, USAID draws on its full array of flexible mechanisms to deliver emergency food, including family rations in all 14 governorates in Syria, supplementary nutritional food for children, flour-to-bakeries programs, food vouchers for refugees in neighboring countries, and meal-replacement bars for new refugee arrivals.

WFP assistance to Syrian refugees in Egypt, Iraq, Jordan, Lebanon, and Turkey, with support from the United States and other donors, consists primarily of a food voucher system, with hot meals, dry rations, and emergency food bars provided where necessary. This system enables Syrian refugees to use electronic voucher cards to shop for fresh food items at participating local markets, including more than 60 stores in Jordan alone. With direct benefits for the local economy of neighboring countries, the voucher system helps reduce the burden on our allies in the region. In Turkey, for example, the WFP food voucher program has injected nearly $40 million into the Turkish economy since October 2012.

Relief Supplies

The majority of Syrians are forced to flee with no more than the clothes on their backs. With severe winter weather forecasts for the region, we began preparing winter relief efforts last summer. In addition to providing basic relief supplies—communal cooking kits, water jugs, hygiene kits, and plastic sheeting—we have mobilized to provide specialized supplies to help Syrians cope with the harsh weather: thermal blankets, floor coverings, water heaters, and warm clothing, including winter coats, scarves, hats, socks and boots. We have increased the number of partners providing winter relief from six last year to 16, and they are also improving infrastructure in camp and non-camp areas to provide adequate shelter.


All U.S. humanitarian assistance programs seek to reach the most vulnerable populations—women, children, persons with disabilities, and the elderly—who are least able to survive the brutalities of conflict and deprivation.

Gender-based violence (GBV) is of particular concern. U.S. medical support includes psychosocial services through women’s health centers, mobile clinics, outreach teams, and home-based support for GBV survivors. The new $10 million State-USAID global initiative Safe from the Start aims to elevate our focus on GBV from the very onset of an emergency. In Syria, that means we prioritize and incorporate protection for women and girls into all programs.

The U.S. government’s protection strategy for children concentrates specifically on key areas of concern, including physical and sexual violence, psychosocial well-being, and child separation. Our programs focus on identifying children at risk and offering safe, stable, and nurturing environments for children to play, learn, and maintain some semblance of normal life. We have witnessed only a small increase in the percentage of Syrian girls marrying under the age of 18 since the start of the conflict, with only four percent of families turning to child marriage in response to sexual violence, but these concerns are on our radar. We also know that, despite the scale and recurrent nature of displacement in country, the numbers of children separated from their families is relatively low. We are supporting efforts to monitor these trends so we can address risk factors through our prevention efforts.

No Lost Generation

We have special concern for Syria’s children, who have experienced the trauma of war and had their lives upended, often losing their homes, family members, and friends. The majority of them have been out of school for two years and become more vulnerable with each classroom destroyed. This is a region that can ill afford to lose a generation to despair; rather, it needs children who can help drive forward a future of peace, not continual spirals of conflict.

The U.S. government is working closely with the international community to support a “No Lost Generation” strategy throughout the region with the goal of helping Syrian children access education and some sense of normalcy through both our humanitarian and development efforts.

Development Assistance to Host Communities in Neighboring Countries

The more than two million Syrians now living in neighboring countries threaten the stability of an already fragile region. And as this crisis enters its third year, the warm welcome first extended to those fleeing the violence is running thin. Host countries and communities find themselves strained and under pressure to accommodate the needs of their own people in addition to millions of new refugees.

U.S. assistance for host communities was a major focus of my travel last August to Lebanon and Jordan, where in some cases Syrian refugees now outnumber local populations in villages already struggling with scarce resources and poor infrastructure. In both countries, we see that the greatest concentration of refugees overlaps with the poorest communities, and tensions between locals and refugees over resources are prevalent. In addition to providing humanitarian assistance to these countries, we have reoriented part of our development assistance to focus on key infrastructure, health, and education programming as well as the provision of essential services at the local level.

In Lebanon, where Syrians now make up more than 20 percent of the total population, the spillover effects of the crisis appear most acute. Our assistance is focused on water and education as well as a value-chain development program to advance agriculture in heavily affected areas like the Bekaa Valley in Lebanon’s northeast. In addition to $254 million in humanitarian assistance for Syrian refugees and their host communities in Lebanon, the United States is working with Lebanon to identify additional ways we can help address deteriorating economic conditions and gaps in the delivery of important services, particularly in the health and education sectors.

In Jordan, where domestic water supply is among the lowest in the world, USAID is providing $20 million through our Complex Crises Fund (CCF) to help communities with a large refugee population improve water efficiency, allowing them to provide water for their livestock and sustain their livelihoods. Last summer, we launched a multi-year $21 million Community Engagement Project that works closely with communities to identify their most pressing challenges and meet growing needs: school infrastructure, public parks preservation, lighting, medical equipment, and youth clubs. In addition to our longstanding support for health, education, water, democracy, and economic development, we are providing support for host communities specifically to help reduce early marriage, human trafficking, child labor, and gender-based violence as well as $300 million in extra budget support to offset Jordan’s spending on services for refugees over the last two years.

By helping these communities cope, these programs are essential to the Government of both Jordan and Lebanon’s ability to keep their borders open to Syrians in need.

A report issued by the United Nations last summer found that Syria has lost 35 years of development as a result of two years of conflict. This crisis is also now affecting the development of the wider region, necessitating that donors bring their relief and development assistance together for the most effective response. We are partnering with host governments and the international donor community to prioritize development assistance needs, including in Jordan where the Government of Jordan, along with the United Nations Development Program (UNDP), is developing a Host Community Coordination Platform to coordinate direct humanitarian and development support to host communities.

At the request of the Government of Lebanon, the World Bank released a ‘roadmap’ which identifies priority assistance areas to help Lebanon manage the shock of the influx of Syrians and develop the public service infrastructure needed to sustain such dramatic increases in its population. The additional $30 million in direct assistance and development support for Lebanon’s host communities, announced by Secretary Kerry at the United Nations’ International Support Group for Lebanon this fall, will allow for a relatively quick, high-impact response to needs laid out in the roadmap as well as in the United Nations’ Regional Response Plan for the Syrian crisis. These assessments and partnerships are essential to paving an effective way forward and addressing the effects of a crisis unlikely to end soon.


Humanitarian assistance is not the solution to the horrific crisis in the Middle East, nor can it end the bloodshed. But it is saving countless lives and helping to protect the most vulnerable from this devastating conflict. The U.S. government remains committed to using every possible tool and avenue to reach those who need our help at this critical time—and to bringing our full diplomatic weight to bear to attain the access we need to do so.

Thank you for your time today and for the vital Congressional support that makes our life-saving work possible. I look forward to your questions.

The Syrian Refugee Crisis
Judiciary Committee