BEIRUT:Its hospitals are battered, residents heavily dependent on aid and escape routes to neighboring Turkey sealed. If attacked by regime forces, Syria’s opposition-held Idlib is poised for a humanitarian calamity.
The northwestern province, which lies along the border with Turkey, has been held since 2015 by the extremist-led Hayat Tahrir Al-Sham alliance and other rival rebels.
Idlib and slivers of adjacent provinces form the largest remaining block of rebel territory — and the next expected target of Syrian President Bashar Assad’s troops and their Russian allies.
But a military assault could overwhelm already struggling health facilities, cut off food and medical supplies to desperate civilians, and prompt massive levels of displacement, the UN has warned.
UN chief Antonio Guterres said on Wednesday he was “deeply concerned about the growing risks of a humanitarian catastrophe in the event of a full-scale military operation in Idlib.”
“A worst-case scenario in Idlib will overwhelm capacities and has the potential to create a humanitarian emergency at a scale not yet seen through this crisis,” John Ging, who heads operations and advocacy for the UN’s humanitarian coordination office told the Security Council this week.
Moscow and Ankara are in talks to try to thrash out a solution that would spare the three million people living in rebel territory.
They include tens of thousands of rebels and civilians evacuated to Idlib from other areas recaptured by government troops.
Since Syria’s conflict erupted in 2011, more than 350,000 people have been killed, more than 11 million have fled their homes and medical infrastructure has been systematically targeted.
In the first six months of this year, there were 38 attacks on medical infrastructure in the province, most of them blamed on the government or its Russian ally, according to the UN’s Office for the Coordination of Humanitarian Affairs. (OCHA).
The World Health Organization warned that less than half of Idlib’s health facilities were still functioning “across areas that may soon witness increased violence.”
“The remaining facilities are neither properly equipped nor prepared for a massive influx of patients,” said Pawel Krzysiek, spokesman for the International Committee of the Red Cross (ICRC) in Syria. “Any offensive will make an already precarious situation even worse,” he said.
In the event of a chemical attack on the densely populated province, hospitals will likely struggle to cope.
Western powers have warned Syrian troops could use toxic substances against the civilian population as they seek to recapture Idlib.
Earlier this year, the UN began sharing the GPS coordinates of health facilities with Russia and the US in a bid to protect them but four have been struck since.
The UN and humanitarian groups are also deeply worried about the food, medicine and other aid they truck in through the Bab Al-Hawa and Bab Al-Salam crossings to some 2 million people in need in Idlib and adjacent areas.
“Cross-border operations provided a lifeline for civilians in regard to food supplies and other daily life products needed,” said Krzysiek. “If border crossings with Turkey are to shut down, hundreds of thousands of people will be affected.”
Aid operations could also be disrupted if key staff are caught up in the offensive, said OCHA’s spokeswoman in Damascus, Linda Tom.
“The potential displacement of humanitarian staff would further contribute to gaps in the response,” she said.
She said violence could force as many as 800,000 people to flee in one of the Syrian war’s largest displacements yet. The question, aid groups have warned, is where to.
US Secretary of State Mike Pompeo accused his Russian counterpart Sergei Lavrov of “defending the assault.”
“Sergey Lavrov is defending Syrian and Russian assault on #Idlib,” Pompeo tweeted.
“The Russians and Assad agreed not to permit this. The US sees this as an escalation of an already dangerous conflict.”
He added: “The 3 million Syrians, who have already been forced out of their homes and are now in #Idlib, will suffer from this aggression. Not good. The world is watching.”
An uptick in violence is likely to push residents to the frontier en masse in the hope that warplanes will not strike there.
“People from Aleppo, Eastern Ghouta, Homs, Daraa — they used to be brought to Idlib,” said Zedoun Alzoubi, who heads the Union of Medical Care and Relief Organizations.
Those areas were handed over to regime forces in surrender deals, with many opposition fighters and civilians bussed to Idlib.
“But now people who are in Idlib — where to go?” asked Alzoubi.