Jean-Hervé Bradol has just returned from an exploratory mission in northern Syria.
Interview by Olivier Tallés - La Croix.
LA CROIX: What are the humanitarian needs of people living near Alep?
Jean-Hervé Bradol: The priority remains treating the uninterrupted flow of the wounded. To date, Syrian medical staff have been providing their care through a network of private hospitals. These semi-clandestine centres treat fighters of the opposition who'd be arrested if they sought care in state-run medical facilities.
But after two months of fighting, these doctors have little left to give. They're short of staff and fuel, and are almost out of surgical supplies. The longer the war lasts, the higher the prices rise. Newborn milk powder has tripled in cost, it's so hard to find. Another pressing concern: the future of the hundreds of thousands of people uprooted from their homes. They're scattered everywhere, sleeping under trees. But winters are hard in this region - it often snows.
Dozens of foreign journalists have been travelling around northern Syria these last few weeks, but they haven't come across many humanitarian workers.
How do you explain the near-absence of foreign aid in the region?
The Syrian people have already been let down twice by the international community. On the first occasion, the country hoped for diplomatic aid through a negotiated settlement to the conflict. It didn't happen. As the violence escalated, each party called for military aid to wipe out its adversary. Again, the support given was too indecisive to sway things either way.
Now that the war's in full swing, Syrians are calling for humanitarian aid. People have used up all their savings. They're getting poorer and poorer. They're increasingly dependent on external aid. But the operational conditions and lack of security means it' really a huge challenge matching assistance to the needs. The Syrians were disappointed with the diplomatic and military aid. They'll be disappointed with the humanitarian aid too.
Yet it's not the first time that humanitarian workers are confronted with war.
The Syrian war is both highly violent and dispersed. Even in the north, no one can claim control of any given area. Territorial gains swing from one side to the other. The front shifts all the time. It's impossible to predict what will happen next. It's a constant game of hide and seek with army checkpoints.
How can a supply line be set up in these conditions? Food trucks can get through one day but not the next. Political constraints add to the security issues. In the areas under Damascus control, the World Food Programme or Red Cross distribute food as directed by the authorities. These latter select recipients according to political and military considerations. There's no leeway for developing real coverage of the needs.
MSF has opened a hospital near to the Turkish border. Why not multiply projects along this model's lines?
Everyone's betting that the border belt with Turkey will be sufficiently stable to set up rear bases, distribute food and treat patients. Yet there are pockets in the area still held by government troops. Health services are attacked by regular army planes as soon as they're spotted. In this type of setting, humanitarian operations are costly, low impact and highly frustrating. We can criticise the various actors involved, improve things here and there, but I just cannot see how we can distribute massive-scale aid.
How should assistance be organised in neighbouring countries?
There's a lot of work to be done in the refugee camps in Jordan, Lebanon, Turkey and Iraq, especially as winter approaches. The Syrians haven't yet crossed over their national borders en masse. People move from village to village, avoiding the fighting. When they've had enough of being tossed from pillar to post, they'll opt for exile. Once the exodus starts, reception capacities will be overwhelmed.