Humanitarian Deadlock in Northeastern Syria ?

Residents of the Sahlat al Banat camp lining up in front of the tent. © Juliette Elie

Under the already heavy sun of a September morning, about fifty people wait among the dusty tents of the Sahlat al Banat camp in northeastern Syria. As the vehicle arrives, a murmur rises in front of the tent: everyone pleads their case, hoping to be registered on the list of one hundred medical consultations scheduled for the coming days.

Since 2018, more than 2,000 families have taken refuge on the outskirts of the vast landfill site of Raqqa. From the towns of Deir ez-Zor or Maadan, they fled successive offensives that put an end to several years of Islamic State control. Over time, shelters have multiplied: as far as the eye can see, sheets of fabric, blankets, and tarpaulins—sometimes marked with the UNHCR logo—bear witness to the gradual withdrawal of humanitarian aid. A heavy odor hangs over the camp, a mix of waste and burning plastic that clings to the air and to the clothes. Here, children sort through mountains of garbage, searching for pieces of metal they can sell for a few cents. For many, it is the only means of survival.

Naji Al Matrood, teacher with the NGO Solinfo. © Juliette Elie

For several years now, we at SOLINFO have been running psychosocial support workshops for about a hundred children every month. For an hour or two, they can escape their daily lives and simply be children again—no longer worrying about how many scraps of metal they collected or how many Syrian pounds they managed to earn. Under this tent, teacher Naji Al Matrood constantly imagines new ways to capture the children’s attention and restore to them the lightness of their age.

My role as a doctor and the association’s medical coordinator strengthens this support by providing both medical care and preventive action, including hygiene awareness sessions and the distribution of kits containing essential items: toothbrush, toothpaste, soap, nail clippers, and disinfectant solution.

These moments spent with the children also reveal the daily lives of the men and women living in an extremely degraded environment. The dust and the smell permeate everything. The children often arrive barefoot, their clothes dirty or torn. The most common diseases tell their own story: scabies, diarrhea, and malnutrition are almost constant.

We conducted a nutritional survey of one hundred children in the camp, and the results are alarming: more than half show signs of undernutrition—53%, one third of them severely malnourished and two thirds moderately. In concrete terms, this means that most of the children examined are not growing normally: their weight is insufficient for their height or age, which can lead to bone fragility, developmental delays, edema, and greater vulnerability to infections. These data confirm the seriousness of the situation and illustrate the lack of sustainable nutritional programs in the region.

Children of the Sahlat al Banat camp © Juliette Elie

Dangerous Budget Cuts for Relief Efforts

These figures are not an exception; they reflect a broader reality—the humanitarian deadlock in northeastern Syria. Since early 2025, budget restrictions decided by Washington have led to the suspension of many USAID-funded programs. In practice, numerous international NGOs have seen their funding cut by 40%, forcing them to reduce staff and scale down their projects in the region.

On the ground, the consequences are visible: many NGOs have withdrawn, projects have been halted, and staff remain in limbo. Local NGOs are trying to compensate for the absence of international actors, but they lack the logistical and financial means that previously gave strength to the humanitarian apparatus. This paradigm shift now highlights the responsibility of the Autonomous Administration of North and East Syria (AANES), which finds itself alone in front of camps it can neither manage nor close.

In this fragmented humanitarian landscape, Damascus is gradually regaining control, starting with the administrative level: from now on, all UN agencies must submit their project proposals to the Syrian government before any field action. At the same time, international NGOs wishing to collaborate with the United Nations must register with the Ministry of Foreign Affairs, an obligatory step to obtain legal authorization to operate. This ministry imposes long, redundant, and sometimes arbitrary procedures.

Local NGOs, for their part, are subject to a similar process: they must obtain registration with the Ministry of Social Affairs, which reviews their statutes and funding sources. This supervision allows the government to filter and channel aid toward the areas it deems a priority.

Despite these constraints, the Health Authority Office (HAO)—the AANES’s health body—tries to maintain a parallel coordination system. Acting as a “Ministry of Health,” it manages hospitals, primary health centers, and coordinates humanitarian activities of both international and local NGOs to best respond to the population’s needs.

Beyond the humanitarian emergency, northeastern Syria has for several months been awaiting negotiations between the new government led by Ahmed Al Charaa and the Autonomous Administration of North and East Syria. In early October, several meetings took place, driven by U.S. efforts to maintain a fragile balance between their Kurdish allies and a Syrian regime seeking regional normalization.

Like the Druze and Alawite communities, Kurdish representatives appear to be advocating for a federal modelguaranteeing administrative, cultural, and security autonomy. Damascus, on the other hand, favors the establishment of a centralized state and the integration of the various armed groups.

During my mission, clashes broke out in Aleppo’s Kurdish neighborhoods of Ashrafieh and Sheikh Maqsoud, opposing local units to pro-government factions. On October 8, a ceasefire was negotiated between the two parties, restoring a fragile calm to the city. These episodes reflect the fragility of coexistence between the regime and Kurdish forces and recall the community violence recently inflicted on the Druze and Alawites.

Even within Kurdish circles, opinions diverge. Some express cautious optimism, seeing a chance for recognition or even the promise of a federal state. Others, more disillusioned, fear renewed conflict, the disenchantment of a people exhausted by war. “Talks will never succeed as long as Damascus remains torn both internally and by its foreign sponsors,” says a local official in Qamishli.

Hope for Peace Above All

On the ground, this political stalemate is ever-present and translates into constant security fragility. Roads are closed or blocked by makeshift checkpoints; local partners tell rumors of attacks, kidnappings, and revenge killings—all of which contribute to the population’s sense of insecurity. The fear of the Islamic State still lingers in some villages where sporadic attacks occur.

Yet, we encountered no incidents during our mission. Movements took place without hindrance, and the region remains relatively stable. This observation reveals a fragile stability, where life continues despite everything.

Northeastern Syria today is a humanitarian gray zone, where neither war nor peace truly prevails. International attention has turned elsewhere, cameras have moved on, and displaced populations—now invisible—are rarely mentioned. Yet life here remains marked by extreme precariousness. In Raqqa, the national hospital still stands, supported almost entirely by NGOs. Care is provided free of charge, allowing the population to access a minimal level of healthcare.

Like many humanitarian actors in the region, we work exclusively with local NGOs—the only ones who truly know the realities on the ground. Mustapha, our country director, and Driss, our project manager, embody this quiet resistance and remain committed despite the uncertainty weighing on the current political situation.

I will return soon to continue this modest but essential work for those who have nothing left—except the hope of peace above all.

Juliette Elie.

 

Medical Consultations in Sahlat al Banat

Docteur Juliette ELIE : 

After earning a doctorate in medicine from Université Paris Diderot and a master’s degree in research on inflammation and inflammatory diseases, Dr. Juliette Elie works as an associate practitioner at Necker–Enfants Malades Hospital in Paris.

She currently serves as a volunteer humanitarian doctor within the NGO SOLINFO, chaired by Edouard Lagourgue, where she oversees medical projects, particularly in the fields of nutrition, community health, and support to displaced populations.

Her commitment reflects an approach that combines scientific rigor, field action, and support for local actors to sustainably strengthen health capacities in crisis zones

 

CALL TO READERS

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THE GLORIOUS YEARS – Interview with Bernard Kouchner

Bernard Kouchner in Hassakeh at the “International Forum on Water in Northeastern Syria,” September 27–28, 2021. Photo by Alain Boinet.

Alain Boinet: When one thinks of UN Security Council Resolution 688 of April 5, 1991, on Iraq, aimed at protecting civilians and the Kurds, how does it resonate with you in light of the geopolitical situation in 2025 and the ways conflicts are resolved? What is your assessment?

Bernard Kouchner: What is happening? We have all worked for human rights, development, humanitarian missions, anti-racism, and social justice. We continue to do so, but we must recognize that these values no longer hold the same allure. Is it a failure? No, I do not believe so, but it is at least an unfortunate pause.

The Kurds! A word about them: the largest stateless people, a remnant forgotten by colonialism, our discovery in Iraq at Hadj Omran, one night listening to the great Massoud Barzani, an old warrior who remained a democrat… It was in the early 1970s! And thirty years after Security Council Resolution 688, here we are unearthing it again, more than thirty years later—a major advancement in humanitarian law, once called “the mother of all resolutions.”

The world has changed. The Kurds are no longer unknown. They have fought hard; NGOs, the French, and Americans, among others, politically supported their efforts. Not enough. Here is a good example of the necessary mix of politics and humanitarian action. Certainly, the Kurds, trapped between Turkish, Iraqi, Syrian, and Iranian territories, are not united. They fight in different situations. Not to mention a significant, fragmented diaspora.

Whether humanitarian or political, we must continue alongside the Kurds. Everything has evolved, but the persistence of humanitarian commitments from NGOs was decisive. In Iran, repression remains perhaps the most violent; in Iraq, the Kurds are nearly autonomous. In Syria, the situation is unstable, and the new bearded leader inspires little confidence.

For the Kurds, is independence the next step? A single Kurdish state? Is this a shared desire? To achieve that, a common language and ideology would need to be built. It will take decades.

AB: In your view, what does Russia’s aggression against Ukraine and Donald Trump’s election signify for international relations, and what consequences might this have in the future?

BK: Let’s not confuse the two phenomena, even though they complement each other. We must consider the “rightward shift” of global public opinion, which exists and is strengthening. Do poor populations frighten the rich? The violent rejection of immigration points in this direction. The failure of socialist struggles and hopes reinforces this sentiment.

For Vladimir Putin, invading Ukraine is about forcibly reclaiming the borders of the former Soviet Empire. Let us recall that the Russians themselves (Yeltsin) authorized Ukraine’s independence and referendum. We had already followed the events in Georgia and Crimea. Will the Moscow army go further? Will they invade the Baltic states? Many French citizens believe so; many Europeans think the same. I personally do not believe in an immediate expansion of the war. The Russian economy is faltering, and the Ukrainians are not giving in. But undoubtedly, the risk exists.

We must strengthen our European defenses and persist in the old idea, this stubborn support for a “Europe of defense.” It should be noted that Donald Trump, in one of his oscillations, seemed to give in to Putin’s reasoning, and he does not seem to know the region’s history. Trump likes meeting Putin. Will the U.S. President add betrayal to diplomatic recklessness? He changes his mind often—a bad point—but when he persists, it is a good point. I do not yet know the outcome of this confrontation; what I understand regarding taxes and the economy frightens me. He has not finished shocking us. If Donald Trump does not appear as a great politician in the classical sense, he seems to be a top-level golfer.

Indeed, the century wavers.

Washington Summit on Ukraine, August 2025 ©The White House

AB: In his book Occident ennemi mondial numéro 1, Jean-François Colosimo emphasizes the conquering resurgence of former empires—Russian, Persian, Turkish, Chinese—and adds the United States. In this new context, what becomes of Europe, its countries, and democracy?

BK: Yes, the old empires are regaining ambition. Disputes over ideologies, capitalism and socialism, are rarer, but differences in living standards remain, and the poor and the rich are still with us. Europe—the one we wanted united—has become a target for other nations of all tendencies. Is it still an example, a hope, or a regret?

All of them, for different reasons, are irritated by these old democracies, by their convulsions, but even more so by their cultures and ways of life. And what is to become of Europe—should it make us despair? Not even a unanimous communiqué from all 27 European countries on the terrifying bombings of Moscow, which went on for many long months, despite the firm positions of President Macron and British Prime Minister Starmer. We maintained that Vladimir Putin was threatening all of Europe. The European countries remained vague.

And suddenly, thanks to the courage of Volodymyr Zelensky and the Ukrainian people, after a very forceful alliance between the British (who had left Europe) and the French, politics changed pace. Fear of a conflict spread, judgment of Vladimir Putin grew harsher. And the Washington conference finally gave a dimension that went beyond the first impressions of Trump’s alignment with the most harmful positions of Putin, supported by the very violent and deadly bombings on Ukraine. But very quickly, we fell back into vagueness.

Trump–Putin Meeting, Alaska 2025 ©The White House

AB: What becomes of the UN in all this? It seems paralyzed, marginalized, or submissive. Will it meet the fate of the League of Nations?

BK: The UN remains a disappointed hope. The UN is in a state of brain death. Not even a last resort. The UN does not move forward, but it still has some remnants of presence. For example, it remains stationed at the border between Lebanon and Israel. Yet it is a theoretical presence.

It is the Security Council that is paralyzed: Putin’s Russia, the invader of Ukraine, is the cause, and China supports it—softly, but supports it nonetheless. Two out of five permanent members of the United Nations Security Council: impossible to make a decision!

What future for the United Nations? Dark. We must invent another machine for making peace. That big Washington meeting—was it useful? The UN was not even present. Your comparison with the League of Nations is accurate.

AB: The U.S. administration recently dismantled USAID, drastically cut budgets, and altered priorities and methods. Similarly, in Europe, the UK, Germany, France, and others are suddenly cutting humanitarian and development funding. How do you explain these choices, and what consequences might they have?

BK: Yes, it is an assassination, but why rely so heavily on the U.S.? Was this country our life insurance for nearly 70 years? We often criticized it while calling on it in serious situations. Military operations in Africa often received American material and financial support. Washington’s aid helped reinforce our social protection measures, allowing the French to reap the so-called “dividends of peace.” We paid little attention to others, unlike NGOs. None of our military operations could have happened without U.S. support. Our children attended schools overseas, music, sports—all influenced by the Americans.

It would be too easy to dwell on 1939–45 and D-Day. But let us remember: we cannot break with Americans simply because we doubt Trump’s stability.

AB: The drop in aid funding is accompanied by a weakening of international humanitarian law, protection of civilians, and access to relief, as seen in Sudan, Ukraine, and Gaza, where famine is used as a weapon of war killing innocents. Are we heading toward acceptance of the worst and the impotence of the law?

BK: Birth rates, capitalist success, poverty, disrespect for the law—multiple factors mix and clash. I regret this regression of commitments.

AB: Humanitarians feel less supported, even criticized. How can one speak to a public primarily concerned with purchasing power and insecurity about an uncertain future?

BK: Humanitarian action, thanks to NGOs, large and small, has been one of the major advances of political consciousness. It was about standing with others, with poor countries, requiring strong economies in rich countries.

Bernard Kouchner (right) in Afghanistan in 1985 with Commander Amin Wardak (left) and Alain Boinet. ©José Nicolas SIPA Press

You mention an uncertain future—is this a war against Putin’s army? The defeat or alleged betrayal of Putin, Trump, or both? The previous simplistic dichotomy of capitalism versus socialism was convenient but too simplistic. Society has evolved beyond those rigid labels. Yet France remains a country where, despite the crisis, life is still good.

AB: In L’heure des prédateurs, Giuliano Da Empoli writes: “In Libya, the Middle East, Ukraine: the edges of the continent that rebuilt itself on peace are now battlefields; war penetrates further into Europe’s borders.” Given this, should we prepare for possible war and arm ourselves accordingly?

BK: All indications point to a warlike reality. I do not know if conflict is imminent, but we must prepare. Again, despite illusions, we must build a “Europe of defense,” not a European army. The path is long, but the necessity is clear.

History forgets, so let us remember: it was Gorbachev and Yeltsin who granted Ukraine independence and accepted the referendum. Disturbances in 1984 marked conflict between Russian speakers and Ukrainians. Putin, after 20 years of dictatorship, launched a “special operation” and sent his army to seize power in Kyiv. Let us salute the courage of Ukrainians and the tenacity of President Zelensky.

AB: According to the UN (OCHA), $47.4 billion is needed this year to assist 189.5 million people in 72 countries. Forecasts suggest contributions may reach only a fifth, or less. The human consequences would be catastrophic. What message would you send to policymakers about this real risk?

BK: I advocate rescuing as many people in danger as possible. I have done so my entire life. But it is too easy to separate humanitarian action from politics. In these dangerous times, we must bring them closer without conflating them. With limited funds, we must innovate to continue emergency response and development aid.

We all dream of changing the world, and this is why we must closely follow political realities while addressing humanitarian needs. Is it possible? I believe so—it is not forbidden to dream.

AB: How would you like to conclude this interview?

BK: Current times try to make us despair; let us not despair and continue to believe in Humanitarianism. Politics will try to catch up.

Recently, Gérard Chaliand, a man of tenacity and loyalty, passed away. He had seen everything, understood everything, and, as they say, never flaunted his knowledge. I have remembered him since I was 20. He was a model of intellectual honesty and rare courage. He spoke with gentleness and gravity about what he observed, never speaking ill of others. A rare man who approached geopolitics with a poet’s eye—and friendship. Farewell, Gérard.

Bernard Kouchner

Co-founder of Doctors Without Borders and Doctors of the World. Former Minister of Health, former Minister of Foreign Affairs.

 

 

 

 

I invite you to read these interviews and articles published in the edition :