Humanitarian aid workers in Syria are struggling to provide emergency relief to civilians in some of the most brutal areas of conflict, owing to mass evacuations ordered by the Syrian government, an aid agency has said.
The advocacy officer for Syria, Iraq, and Lebanon at Christian Aid, Máiréad Collins, said this week that some staff members of its NGO partners on the ground in Eastern Ghouta, on the outskirts of Damascus, have been forced to evacuate to government-run IDP camps, which are miles outside of the region.
The aid workers fear that they might be perceived as being "enemies of the Government" because of their NGO status, she said. All men over the age of 15 are unable to leave the camps because their identification has been seized by government security forces.
Hundreds of civilians, including children, have been killed by air strikes conducted by Syrian government forces on the city of Eastern Ghouta over the past month (News, 29 March, 2 March). Some were aided by Russian fighter jets.
But while shelling has lulled in the area in recent weeks, residents have been unable to remain in their homes, Ms Collins warned.
"The people are not being given a choice -- it has been described as a humanitarian situation but many people wanted to stay. The option to stay safely has not been given to them.
"[It is] not just the fighting between various groups, and the shelling, but what situation they would face them when the Syrian Government and Russia security forces do come in. It is very uncertain."
Some residents of Eastern Ghouta have gone to Damascus to stay with family, she said, but "these families are already struggling, so they are not going into a good situation".
Most of the people of Eastern Ghouta have been sent to Idlib, in northwestern Syria, which remains in the control of rebel groups. Ms Collins fears that this evacuation might cause a "secondary crisis" because of displacement, overcrowding, and outbreaks of violence.
A further 137,000 civilians have been displaced to Idlib from Afrin, an area in the north of the country which has recently been infiltrated by Turkey. Idlib has been referred to as a "perfect kill box" by those who fear that it might become the "next Aleppo", Ms Colins said.
World Vision have also called on world leaders to recognise the escalating crisis in the city. Its Syria crisis response director, Wynn Flaten, said: "Idlib is extremely overloaded -- medical services, clean water and sanitation are becoming more scarce. There are very few schools, and shelter is inadequate. As the crisis goes on, children are facing greater and greater devastation.
"We are calling on the international community to ensure an end to the violence, and a peaceful future for Syria's children. Humanitarian organisations urgently need access to some of the worst-affected areas, and their safety must be guaranteed by all parties to the conflict."
The leaders of Russia, Iran, and Turkey met in Ankara this week, without the United States, to discuss a new constitution for Syria, including increasing security in "de-escalation" zones across the country, it has been reported.
The summit on Wednesday brought together the most forceful supporters of President Bashar al-Assad -- the President of Russia, Vladimir Putin, and the Supreme Leader of Iran, Ali Khamenei -- with its strongest opponent, the President of Turkey, Recep Erdogan.
It came after the President of the United States, Donald Trump, announced that he would be suspending funds for a planned $200-million stabilisation project in Syria. President Trump also hinted this week that US troops would be withdrawn from the country. There are about 2000 US troops fighting the Islamic State in Syria.
Ms Collins said of the meeting: "The fact that the talks do not include the opposition is problematic; without them it will be very hard to reach a negotiated peace.
"With Syria, there are so many hands in the game and at no point are any of them interested in the protection of the Syrian people. The Syrian people are never at the heart of any of the decisions that leaders are making or have made in the past."
She concluded: "Civilian protection has to be at the heart of any talks and agreements made."
The seventh anniversary of the Syrian uprising fell last month. More than 400,000 people have since been killed, including nearly 20,000 children. More than six million Syrians have been internally displaced, and a further six million have crossed the borders into neighbouring countries.
In an interview last week with the Roman Catholic charity Aid to the Church in Need, the Syriac Orthodox Archbishop of Homs and Hama, Selwanos Petros Al-Nemeh, lamented the exodus of about half of Christians from Syria since 2011.
"Christians would love to stay and be bound to their country because this is their land," he said. "What is preventing them from staying is the instability in their work, the insecurity and vulnerability that they are facing, economic difficulties, and dreadful living conditions."
Residents of the city of Homs were "bewildered by the immensity of the damage" there, and the struggle to get help, he said. "We need a lot of support to rebuild and allow people to return."