Chairman Risch, Ranking Member Menendez and distinguished Senators, thank you for your important decision to hold this full Committee hearing on the continuing humanitarian impact of the Syrian civil war. Since I last spoke to this Committee just over two years ago, battle lines have moved, Syrian territory has changed hands, ISIS, or Daesh, has been driven from its territory, and Syria has largely dropped off the front pages – but human suffering has been constant and in some ways growing. Last year 1.5 million Syrians were newly displaced by the fighting, including a period of civilian displacement at the beginning of 2018 higher than any other since the war began.

Throughout the conflict humanitarian concerns have come too low down the priorities of key decision-makers, with devastating consequences for well over half the Syrian population. It is heartening that this Committee has not forgotten their plight and is ready to hear the arguments for urgent international leadership to ease the situation. That leadership needs to focus on four priorities: preventing humanitarian meltdown as the Assad government, with its Russian and Iranian allies, seeks to capture territory in the North West and North East currently out of its hands; promoting livelihoods, education and dignity for refugees in the neighboring states by renewing support for them and for the states hosting them; re-establishing multilateral (UN-led) engagement with the parties to the conflict and the Syrian people to promote sustainable peace; and helping the most vulnerable refugees with resettlement to third countries, including the U.S.

These priorities and my testimony are based on what my colleagues see on the ground. The International Rescue Committee operates across the arc of crisis—directly in the midst of conflict in Syria, in refugee hosting nations like Lebanon, Jordan and Iraq, on refugee transit routes like Serbia and Greece, and in 26 cities across the United States where we have assisted over 400,000 refugees to rebuild their lives since our founding by Albert Einstein in the 1930s. There are currently 2,190 dedicated IRC staff working in Syria and neighboring states. In 2018 we provided emergency aid and long-term services to 1.25 million uprooted Syrians and within the communities that host them - including 954,000 inside Syria. In total we have reached more than 5 million people in the region since 2012.

None of this would be possible without the support of the international donor community, including the United States. For example, IRC’s enduring partnership with USAID’s Office of Foreign Disaster Assistance (OFDA) allowed us to provide lifesaving services to more than 300,000 conflict-affected men, women, and children across Syria and Iraq in FY 2018. In the region, the IRC has partnered with the U.S. Department of State’s Bureau for Population, Refugees, and Migration (PRM) to reach millions of Syrian refugees. We are grateful for USAID and the State Department’s continued commitment to assist Syrians in need, and their continued confidence in IRC’s ability to provide effective and efficient programming that helps Syrians in Syria and the wider region to survive, recover, and gain control of their futures. We know that Congress has played an absolutely pivotal role in appropriating funds for these purposes, and on behalf of our clients we express our sincere gratitude. Independent assessments give us high confidence in the value and quality of these programs.

More aid, better delivered, remains a pressing priority. But so does a surge of diplomacy that brings the needs of civilians to the forefront in the conduct of the war and the making of peace. The Syrian conflict has been a poster child for a new Age of Impunity, where war crimes go unpunished and the laws of war become optional. A recent report has revealed that chemical weapons, expressly forbidden by international law, were used over 330 times against civilians over the eight years of the conflict.

There have been 355 attacks on hospitals during the war, including at least 13 bombings of IRC-supported hospitals in the country. Just last year, 102 people were killed in attacks on medical facilities. The number of attacks on hospitals in Syria has actually gone up since 2016 when a UN Security Council resolution called for them to cease. These attacks on healthcare come at a time when civilians account for at least 85% of all war casualties.

The statistics suggest a terrible new normal: civilians fair game, humanitarian aid workers unfortunate collateral, investigations and accountability an optional extra. Even the limited mechanisms that do exist for accountability in Syria, the Independent International Commission of Inquiry (COI) and the International Impartial and Independent Mechanism (IIIM) can merely bear witness to the violations, but cannot hold those responsible to account without the political will of UN Security Council.

The U.S. Government, and Congress, therefore face important choices not just about humanitarian aid but also about diplomatic and military engagement. Our plea is to put civilian needs at the center of those decisions, in the name of humanitarian need but also in the interest of geopolitical stability in a vital region of the world.

The Situation Inside Syria

Since I last addressed the Committee, the Assad government has retaken control of large swathes of the country, and ISIS has been driven from its centers of power. However the conflict continues in significant parts of the country, and civilians pay the price, with 6.2 million people currently internally displaced. Our priorities are to see the U.S. use its diplomatic muscle to prevent a resurgence of fighting with devastating impact, to increase and extend the impartial provision of humanitarian aid, including for those who suffered under ISIS rule, and to see the international system re-establish a multilateral basis for planning a sustainable future for Syria and its people.

In Northwest Syria, in Idlib province, currently home to 2.7 million Syrians, IRC has more than 300 people working to help people access vital healthcare, to protect vulnerable women and children, and promote economic livelihoods opportunities, while also responding to emergencies driven by the conflict. In this part of the country, an agreement between Turkey and Russia averted a humanitarian crisis by halting an impending military offensive last September. Since then, ongoing and increasing violence in areas of the so-called “demilitarized zone” has undermined the fragile standoff. Shelling has risen steadily since November, with over 120,000 people displaced since February. While the Brussels Conference was underway earlier this spring, Russian airstrikes on March 14th killed 10 civilians and injured 45 others. At least 90 civilians were killed in March, half of them children. Two weeks ago, we saw the highest number of people killed in one week since this zone was agreed to. Just last week, one of our sister NGOs reported attacks on two schools they support and the deaths of three more children. In total, more than 200 civilians have been reportedly killed in Idlib since February, and we continue to fear a major offensive on the province. Estimates suggest as many as 800,000 people could be displaced – two to three times the number of people who were displaced during fighting in Southern Syria in mid-2018.

In Northeast Syria, more than 450 IRC staff work to provide healthcare, protection, and economic recovery and development across three governorates via cross border access from Iraq. This is clearly an area of high political tension, with Syrian, Kurdish, Turkish, Russian and US troops in close proximity, plus the remnants of ISIS. ISIS lost its last zone of territorial control in Syria on March 23. The brutal impact of its tactics and ideology have yet to be fully addressed, as have the grievances and disempowerment of local communities. In addition there are very difficult questions about how to identify former ISIS fighters, how to bring them to justice, and how to deal with their families, including large numbers of children.

The aftermath of the fight against ISIS has led to a burgeoning humanitarian crisis. At al Hol Camp, catering to people previously living under ISIS rule in Baghouz and other parts of Deir-ez-Zour , the population has risen since December from 11,000 to more than 73,000 people. Most of them have arrived highly vulnerable – with trauma, malnutrition and disease common. As of April 11, 249 people died on the journey to al Hol or soon after arriving at the camp. According to an analysis in March of the first 123 reported deaths, a quarter of those deaths were of newborns under one month old, two thirds of deaths were of babies under one year old, and 80% of deaths were children under five years old.

The population in al Hol is diverse. There are more than 30,000 Syrians, 30,000 Iraqis, and more than 11,000 people with foreign citizenship across 30 countries. Of the camp population, 93% are women and children, 65% are children under 12. Most are in desperate need of basic services, education and psychosocial support to recover from the horrors they’ve experienced. These children are innocent victims of conflict and should not be held responsible for any crimes that may have been committed by their parents. But we also recognize the concern about the status and position of former ISIS fighters, and the need to address, and prevent, radicalization. We support the initiative of a number of countries, with U.S. support, to take back their own citizens, including children born under ISIS rule and call for other states to follow suit. We welcome the support the U.S. recently provided to Kosovo as it repatriated 110 of their citizens, mostly children and their mothers. In the education and health programs we run in Syria, we see what a difference mental health support and safe learning spaces for children can make even in a short time. The children we work with who get this support are less aggressive, less violent, and are more successful in school.

The humanitarian crisis persists in and around Raqqa as well. When Raqqa City was retaken, IRC was the first organization to undertake emergency cash distributions for vulnerable households and treat more than 65,000 people through mobile medical units. Since that time, tens of thousands of people have returned to a city where their homes have been destroyed, water and electricity are scarce, and functioning health facilities and schools are few and far between. Raqqa is so heavily contaminated with mines and other unexploded ordnance that it could take years to fully clear the city so people can be safe. The city’s infrastructure has been decimated, with major bridges vital to traffic and transportation of goods destroyed or unusable.

In Rukban, an arid remote area in southern Syria near the northeast border of Jordan, some 40,000 people remain stranded, isolated from humanitarian aid deliveries that are rare and intermittent, in a desperate state without regular access to food and medical care. Rukban is an example of a place in Syria where it is not “hard to reach” civilians with humanitarian aid, but rather, where aid is regularly denied. Out of hunger and desperation, some people are beginning to take their chances by leaving Rukban.  But although it appears that several thousand people left the enclave over the last few weeks, there have been concerning reports that some have been detained and even executed.

Finally, it is important not to lose sight of the situation in areas that have been retaken by the Syrian government, such as Dara’a in southern Syria, where people are still struggling to recover. Before the government took control of this territory and the border crossings that served it, the IRC, with its network of Syrian partner organizations, was the largest health-care provider in southern Syria, supporting more than a quarter of a million Syrians. Now we are shut out, with no access to those people in need. Even before the government offensive to retake Southern Syria, the state of healthcare was dire: the area had 1,000 medical personnel in 2011, but just 150 in 2018. During the offensive, eight hospitals were hit by airstrikes. In March of this year, the UN reported that the majority of health facilities in Dara’a are either partially or completely destroyed and that there is a lack of health workers. The assurances from the Syrian government inspire little confidence in light of the conditions in other areas previously retaken by the state, such as Ghouta, east of Damascus.

Given these unrelenting realities inside Syria, there is a pressing need for the United States and other donors to fund the humanitarian response plan (HRP) to ensure that resources keep pace with the needs – yet only 65% of the $3.36 billion requested in the 2018 Humanitarian Response Plan was met. Within this shortfall, several sectors have been woefully underfunded, including just 10% of the request for protection services and just 30% for early recovery and livelihoods. In 2019, the HRP is almost the same as in 2018 at $3.32 billion – and needs to be fulfilled.

The international community also needs to ensure that humanitarian assistance is delivered in a principled manner via the most direct routes. More than 4.5 million Syrians, many in acute need, are reliant on life-saving cross-border assistance authorized by UN Security Council Resolution 2449, which was last renewed in December 2018. Cross-border access to Northwest and Northeast Syria is critical to meeting needs in these parts of the country, and the international architecture that supports that aid delivery should be maintained. Our experience in Southwest Syria has demonstrated what happens when this cross-border access is shut down – lack of access to hundreds of thousands in need, fears for the safety of our clients and staff, and little to no information on what aid is being provided in our absence.

The Strain in Neighboring States

The Committee will be aware that the Syrian humanitarian situation is part of a global trend: there are record numbers of refugees and displaced people around the world today. They are fleeing conflict and persecution that makes it unsafe to remain at home. This displacement is lasting longer than before —at least ten years for the average refugee. Once refugees are displaced for at least 5 years, as is the case for most Syrian refugees, the average rises to 21 years. Eight five percent of the world’s 24.5 million refugees live in low and middle-income countries, which already struggle to educate their populations and expand their economies. Just 10 countries, with 2.5% of global GDP, host over half the world’s refugees. Syria’s neighbors are all among these top 10, and the Syrian crisis epitomizes these challenges. However, the international community’s humanitarian efforts have remained short-term in nature, rather than offering a coherent, strategic, multi-year effort to promote self-reliance and resilience amidst a protracted crisis.

Syria’s neighbors in the region, namely Lebanon, Jordan, Turkey, and Iraq, are hosting 5.6 million Syrian refugees. Lebanon has taken in 1.5 million Syrians and Palestinian refugees from Syria, accounting for 30% of Lebanon's population, at a time when one-third of the Lebanese population already live in poverty. The Syrian war has disrupted cross-border trade and deterred foreign tourists, and GDP growth that reached double figures almost a decade ago is set to fall to 1-1.5% this year. Jordan has taken in 650,000 registered refugees, straining the country’s resources, especially scarce water and agricultural resources, at a time when the country is midway through an austerity program. And while Turkey has a greater size and economic capacity, it is host to 3.6 million refugees. These countries deserve significant support from the international community for the generosity they have shown Syrians fleeing violence and persecution even as they face their own domestic economic and social challenges.

The pressure on refugees in the region is severe, and all signs indicate there is no immediate hope of returning home. Refugees tell us that they are scared to return and are not ready to do so. Less than 6% believe they will return to Syria within the next year. Although the overwhelming majority hope to be able to return one day when it is safe and conditions are in place, just 19% think they will ever be able to return home. When asked what concerns they have related to returns, refugees cite the lack of security improvements, limited livelihood opportunities, lack of access to shelter, compulsory conscription and military service, limited access to basic services and education, fear of detention, and absence of a political solution.

We have seen the power of effective aid combined with policy reforms to make a real difference in the lives of Syrian refugees. For example, Lebanon has instituted a second shift for Syrian children to attend school, and Jordan has opened up its health care system to refugees. In Lebanon, World Food Program cash-based interventions between 2012 and 2017 injected around $965 million into the Lebanese economy. In Jordan, revisions to work permit restrictions have allowed vulnerable Syrian refugees to register their home-based and micro businesses and through work permits in construction, agriculture and manufacturing without employer sponsorship given refugees more control over their lives. But overall this effort has not been sufficiently strategic or comprehensive.

The economic situation for Syrian refugees in neighboring states remains precarious, which exacerbates challenges for the most vulnerable refugees: women and children. More than half of Syrian refugees in Lebanon are unable to meet the “survival needs” of food, health, and shelter. Fifty eight percent of refugees in Lebanon live in extreme poverty, and many are falling deeper into debt without consistent financial resources to meet their needs. In Jordan, despite the commitments and good will of governments to make some work permits available to Syrian refugees, many refugees lack documentation or the means to pay the costs associated with obtaining a work permit, and while 139,000 of the target goal of 200,000 work permits have been issued, just 40,000 are in active use. As a result 85% of Syrians in Jordan remain below the poverty line.

These impacts are felt hardest by women and children in these refugee communities. In conflict situations, there is often an increase in female-headed households and these are often the most impoverished as women face unique barriers to entering the workforce. In Lebanon, 93% of refugee women are not working, significantly higher than the 44% unemployment rate among refugee men. Even when governments take steps to bring refugees into the formal economy, women are often left behind. In Jordan, only around 4% of work permits have gone to women despite 22% of refugee households being headed by a woman.

As poverty rates rise and refugee families remain excluded from the formal economy, child labor and marriage has become all too common. Forty three percent of the 1.7 million school-age Syrian refugee children were out-of-school in 2018, an increase from 34% in 2017. This is a particular challenge in Lebanon, where a recent IRC survey in Lebanon found that children as young as six years old were working, and 79% of all working children surveyed were not accessing any form of education. Child marriage is another negative coping strategy for impoverished families. The percentage of married 15 to 19-year-old girls among Syrian refugees in Lebanon increased to 30% last year. Compared to the Middle East more broadly Syrian refugee girls face an increased risk of gender-based violence, higher rates of child marriage, and are more likely to drop out of school.

The priorities in the neighboring states therefore fall into three categories: economic support to address poverty; expansion of education and protection services to help children, especially girls; and macroeconomic support for the neighboring states to contain tension arising from the challenge of hosting refugees for nearly a decade. The more this is addressed as a short-term issue, the less effective it will be. Acute humanitarian needs and medium-term development challenges need to be addressed together. The Committee could usefully engage with the continued evolution of the Regional Response Plan as a basis for intelligent accountability for donors and implementers and partnership with host governments.

IRC has argued from the beginning of the Syrian civil war that the strain on the neighbors should not be seen only through the lens of short-term need. We were convinced this would be a protracted crisis that needed tools of development as well as humanitarian aid. We welcome the fact that the World Bank took important steps to change its financing models through the Jordan and Lebanon compact agreements. The Bank along with other donors used levers beyond aid, such as trade concessions, to incentivize host countries to reform their policies to allow refugees to work, move freely, and attend school. These are the types of changes we need to see in host countries in order to ensure a sustainable response, as well as enable refugees to become self-reliant and become net contributors to their local economies. While some of the initial experimentation has shown mixed results, the international community and international financial institutions should continue to innovate in their response. Even the small step of providing multi-year financing, rather than the short-term grants typically provided in humanitarian response, could have a big impact given the protracted nature of this crisis.

The U.S. can be a voice for four steps to further improve on these approaches:

Aid, trade, and other incentives for policy reform: International actors, including the U.S. government, World Bank and other donors, should align their aid and “beyond aid” support, such as trade and other concessions, to enable host governments to make necessary policy reforms that open up pathways for refugee self-reliance. Restrictive policies are often one of most significant barriers that refugees face in being able to support themselves. Host governments often need the right international support to implement more progressive policies, such as allowing refugees freedom of movement, the right to work and the right to attend school. This is where the U.S. government in particular could lean in with its diplomatic and financial weight to drive real, sustainable change.

Define the right outcomes to identify the right solutions: Clear, measurable and context-specific outcomes will ensure that aid results in measurable improvements in refugee and host community lives. In Jordan, for example, a focus on jobs or increasing income levels—versus work permits—may have directed planning to more cost-effective solutions. The same is true for Lebanon, where a focus on improved socio-emotional and academic learning outcomes for refugees would have led to a refined focus on addressing the traumas faced by refugees that can impact learning, rather than primarily focusing on enrollment numbers.

Multi-year Financing: IRC has argued from the beginning of the Syrian conflict that the strain on the neighbors should not only be seen through the lens of short-term need. Our experience with conflict-driven displacement globally convinced us this would be a protracted crisis that needed tools of development as well as humanitarian aid. We welcome the fact that the World Bank took important steps to implement longer-term financing models through the Jordan and Lebanon compact agreements. Multi-year financing allows implementing partners to plan and staff against longer time horizons, reducing administrative costs and enabling organizations to create programs that put people on a path to self-reliance rather than more dependence on aid – like educational attainment and reduced poverty levels.

Refugee voices: It is vital systematically to include refugees and other affected populations when designing solutions. Early and periodic consultation, and inclusion in decision-making, are critical to making sure solutions defined by donors and the government meet the real needs of refugees and host communities. If refugees are left out of this process, there is a risk that solutions will not align with what refugees need nor help them overcome the barriers to self-reliance that they experience every day.

U.S. Leadership

The Syrian crisis has raised profound issues for geopolitics. The Committee will no doubt discuss how Russia, Iran and Turkey became the pivotal outside players in the course of the conflict, almost to the exclusion of other players, and what are the lessons.  From the point of view of the IRC, the growth in stature of the Astana process at the expense of the UN-led political process which started in Geneva in 2012 is a striking development. It carries considerable challenges for the future. Russia and Iran have filled the void, leaving Syrian civilians, humanitarian access, accountability for IHL violations, and civilian protection without effective champions.

At my last appearance before this committee in 2017, I warned there could be no effective foreign policy without effective humanitarian policy and urged this Committee and the Senate more broadly to push back against the administration’s proposed cuts to humanitarian assistance in its foreign aid budget. Since then, we have been grateful for the Senate’s enduring commitment to the people of Syria and to humanitarian assistance more broadly as you pushed back against proposed cuts to humanitarian aid. I hope you will do the same this year. Global contributions to respond to the humanitarian crisis in the region are not keeping pace with the needs. In 2018 only 52% of the $5.61 billion requested in the Regional Response Plan (3RP) was met. The proportion of the 3RP that has been met by international donors has steadily declined every year since 2013, when 73% of the 3RP appeal was met. In 2019, the 3RP is almost the same as in 2018 at $5.5 billion – and needs to be fulfilled. The United States has an important role to play as a donor in its own right as well as a catalyst for other donors to commit. Syria’s neighbors need to be provided the necessary resources to shoulder the burdens of hosting millions of refugees, but also incentivized to reform how they treat them.

Finally, U.S. leadership on Syria manifests itself in the resettlement of refugees, and in the lack thereof. In FY 2018, the United States resettled just 62 refugees from Syria, fewer than were killed in chemical gas attacks. So far in FY 2019 the figure is 285. Nothing has changed about this population except their vulnerability. As we have demonstrated in this testimony, eight years into the Syrian conflict, with all reserves depleted and with opportunities deeply constrained in countries of first refuge, the situation for Syrian families continues to worsen. The dramatic drop-off from the 12,587 Syrian refugees the U.S. resettled in FY 2016 is significant in and of itself, but also has contributed to a broader departure from international commitments by Western governments. In 2016, 25,000 of the most vulnerable refugees were resettled from Lebanon to third countries. In 2018, with the U.S. leading the retreat, just 8,500 were resettled globally. This is an unjustified rebuke to the generosity of countries like Lebanon and Jordan shouldering far more than their fair share.

I encourage you to work toward reversing this trend and fulfilling the Administration’s regional target of 9,000 refugees from the Near East and South Asia, which includes Syria, in FY 2019. Last year, the Administration failed to meet its own target, admitting just 22% of the regional total and less than half of the global total of 45,000 refugee admissions. The world’s greatest superpower should not reject the world’s most vulnerable in their greatest time of need. It is a symbolic show of solidarity with the neighboring countries, and a life-changing, lifesaving intervention for the individuals concerned.

I thank you and the members of the United States Senate for the opportunity to provide the IRC’s perspective on this defining humanitarian challenge. I look forward to addressing your questions.