Hunger under siege: How UNICEF is tackling malnutrition in Syria

By Annie Harrison-Dunn

- Last updated on GMT

UNICEF: “80% of the world’s aid is delivered in war zones, but sadly [in Syria] we have to negotiate a level of complexity I’m not sure has ever been seen before.” © / RadekProcyk
UNICEF: “80% of the world’s aid is delivered in war zones, but sadly [in Syria] we have to negotiate a level of complexity I’m not sure has ever been seen before.” © / RadekProcyk
Political neutrality, besieged communities and an escalating amount of mouths to feed. The United Nations Children’s Fund (UNICEF) has a lot to contend with if it is to reach the two million children and mothers it intends to with nutrition products this year. 

UNICEF is seeking $19m (€16.96m) in funding for its nutrition programme in Syria. 

The international charity hopes the funds – yet to be fully secured – will help it reach 700,000 children under the age of five and pregnant women and lactating women with multi-micronutrient supplementation, 1.3 million children with vitamin A,  680,000 children screened and 6,000 under-5s treated for acute malnutrition in 2016. 

But how easy is this in a crippling war zone.

“Besiegement as a tactic has become a terrible aspect of this conflict, which is against international law completely.”

Speaking with us from Syria’s capital Damascus, UNICEF Syria’s chief of communications Kieran Dwyer said the conflict was unprecedented in the efforts needed to get the nutrition supplies to those most in need.

“80% of the world’s aid is delivered in war zones, but sadly [in Syria] we have to negotiate a level of complexity I’m not sure has ever been seen before.”

He added: “Besiegement as a tactic has become a terrible aspect of this conflict, which is against international law completely.”

Broadly speaking the conflict is between the government of Bashar al-Assad and opposition groups. But in 2013 it was estimated this umbrella term of ‘opposition’ covered as many as a 1000 different armed rebel groups. 

Walking a thin line​ 

The groups UNICEF had to seek permission from before crossing military lines and entering besieged areas changed from week to week.   

“It’s not easy and it’s no secret that we’ve not always been able to get the approvals we need.”​ 

UNICEF Syrian Arab Republic 2015
A severely malnourished baby is given a RUTF product at a Syrian Family Planning Association nutrition centre in Damascus.Image © UNICEF Syrian Arab Republic / 2015

In January this year images emerged of starving residents of the Syrian town of Madaya – just a few dozen miles from the capital Damascus but cut off from services and food supplies during months of sieges led by forces loyal to the Assad government.

The photos of emaciated children and adolescents forced nutrition to the forefront of the Syrian crisis response and increased pressure to lift sieges. 

“For adolescent boys to reach that stage of malnutrition, it is shocking,” ​Dwyer said. 

A UNICEF health worker based in Damascus told us it was vital the charity gained greater access to these areas as a onetime convoy of nutritional products was not enough to save young children from acute malnutrition.

A break in treatment – typically involving Ready-to-Use Therapeutic Food (RUTF) Plumpy'nut products manufactured by French firm Nutrise – will see them quickly return to acute malnutrition status.

“Children can deteriorate so easily and the younger the child is, the more fragile their health is,” ​said the health worker, who preferred to remain unnamed.  

The charity got information from local contacts, but without access itself it was hard to judge the needs of a besieged community. 

The ultimate solution 

“We’re calling to have all sieges lifted. The whole idea is unacceptable. All people should be able to come and go and have access to food markets. That’s the ultimate solution,” ​Dwyer said. 

In the meantime it was working towards increased access to these areas, in which there had been a complete breakdown of health and education services. “We need more than a few hours.”

The different parties involved were tired, frustrated and did not know who to trust, Dwyer said, and UNICEF and the wider UN humanitarian community had to work hard to show it was not taking sides. 

“We are health workers not soldiers,” ​he told us.

Be that as it may, since the beginning of the conflict in March 2011, nearly 80 staff members of the UN, Syrian Arab Red Crescent and Palestinian Red Crescent Society have lost their lives as well as hundreds of medical workers in the course of duty.

Soaring food prices have followed food shortages and exacerbated nutrition issues. Between March 2011 and March 2015, the price of wheat flour increased by 197%, the price of rice by 403% and the price of bread by 180%. 

An estimated 55 NGO workers have died since January 2015 alone, reports suggest.

But the Syrian’s themselves are paying a far greater price. 

According to a UNICEF report, one in three people in Syria are unable to meet their basic food needs, with an estimated 8.7m people in need of a range of food security-related assistance. 

Escalating crisis, escalating needs 

The charity said it reached over 1.6m people with nutrition interventions in Syria last year. 

But greater funds were required if these continuing needs were to be met. 

“The Syrian humanitarian crisis is relatively well funded compared to other crises but the needs just keep escalating and so the funds needed keep escalating.”​ 

Dwyer said with so much focus on the migrant crisis, which directly effects the West, it is often forgotten the majority of Syrian children effected remain within the country's borders.

“At times the Western media has been tied up with the migrant crisis, as a Western crisis. So much of what is happening to Syrian families inside Syria is not being covered.”​ 

There are over 4m refugees in neighbouring countries alone as a result of the conflict, around half are children. 

A significant figure, Dwyer said, but there are also 8m children still living in Syria itself. 

Action on getting nutrition products to these children couldn't wait, he said. 

“You can’t tell a 5-year-old to put their life on hold.” 

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