Equipo Nizkor - S/2016/714 - 30th Report of the Secretary-General on the Implementation of Security Council resolutions 2139 (2014), 2165 (2014), 2191 (2014) and 2258 (2015) (July 2016).

United Nations
Security Council

S/2016/714

Distr.: General
16 August 2016
Original: English

Implementation of Security Council resolutions 2139 (2014), 2165 (2014), 2191 (2014) and 2258 (2015)

Report of the Secretary-General

I. Introduction

1. The present thirtieth report is submitted pursuant to paragraph 17 of Security Council resolution 2139 (2014), paragraph 10 of Council resolution 2165 (2014), paragraph 5 of Council resolution 2191 (2014) and paragraph 5 of Council resolution 2258 (2015), in which the Council requested the Secretary-General to report, every 30 days, on the implementation of the resolutions by all parties to the conflict in the Syrian Arab Republic.

2. The information contained herein is based on the data available to United Nations agencies on the ground, from the Government of the Syrian Arab Republic, other Syrian sources and open sources. Data from United Nations agencies on their humanitarian deliveries have been reported for the period from 1 to 31 July 2016. More recent data has been included when available.

II. Major developments

A. Developments on the ground

3. During the reporting period, the deteriorating security environment had a significant impact on the humanitarian situation, including further damage to civilian infrastructure such as hospitals and schools, limiting the ability of United Nations agencies and their partners to deliver much-needed humanitarian support. Military activities, including airstrikes, continued in Aleppo, Dayr al-Zawr, Hasakah and Idlib, as well as in Rif Dimashq and other governorates. In line with resolution 2258 (2015), the following description of developments on the ground reports on the compliance by all parties in the Syrian Arab Republic with resolutions 2139 (2014), 2165 (2014) and 2191 (2014). This information is provided without prejudice to the work of the International Syria Support Group Task Force on the Ceasefire.

4. Military activity intensified in Aleppo governorate in July, including major military operations by both Government and non-State armed groups in Aleppo city. On 7 July, Government forces advanced north of Aleppo city, cutting the Castillo road, the only remaining supply route to non-State armed group-held areas in the eastern part of Aleppo city. On 11 July, airstrikes on a residential area in the old city area of Aleppo reportedly resulted in the killing of 18 civilians, including two children and one woman, and the injury of at least 30 others. On 16 July, various neighbourhoods in non-State armed group-held Aleppo including Firdaws, the old city of Aleppo and Ma'adi were hit by several airstrikes that reportedly resulted in the killing and injury of at least 22 civilians. Umar ibn Abdulaziz hospital in Ma'adi neighbourhood was also allegedly damaged and put out of service by airstrikes which hit in its vicinity. The next day, airstrikes on residential areas of Abu al -Zuhur reportedly killed 11 civilians from one family and injured five others. On 23 and 24 July, the Office of the United Nations High Commissioner for Human Rights (OHCHR) received reports of four makeshift hospitals, along with the central blood bank, being hit by airstrikes in eastern Aleppo city (see para. 42). On 25 July, airstrikes hit a residential area in Mashhad neighbourhood, reportedly killing at least six civilians. On 31 July, airstrikes on three non-State armed group-controlled neighbourhoods of Aleppo — Mashhad, Ansari and Sukkari — destroyed a number of residential structures and reportedly killed at least 15 civilians, including a child, and injured another 10 civilians. Moreover, following an opposition advance in the south-west of the city, 25,000 people were displaced. The United Nations Children's Fund (UNICEF) is providing assistance to these internally displaced persons in temporary shelters around the city.

5. Non-State armed groups significantly increased mortar and rocket attacks on Government forces-controlled areas in the western part of Aleppo city, causing significant casualties among civilians. During the Eid al-Fitr holidays, on 8 and 9 July, non-State armed groups reportedly increased the firing of mortars and rockets into Government-held areas of the city. At least 44 civilians were allegedly killed and dozens injured, including many women and children. Tens of civilians were reported as having been admitted to Razi and Jam'iy hospitals. The strikes continued throughout July, allegedly causing further civilian deaths and injuries. For example, on 22 July, six civilians, including a child, were reportedly killed in Government-controlled Aleppo when mortars fired from eastern Aleppo hit a public park. On 25 July, a civilian woman and her child were allegedly killed by a mortar that fell on Khalidiyah neighbourhood.

6. Attacks on civilian infrastructure in Aleppo city took their toll on civilians. They include attacks on 31 July and 1 August that reportedly damaged a transmission centre, resulting in an electricity blackout throughout western and eastern Aleppo. Consequently the two main water pumping stations, both located in eastern Aleppo and serving over 2 million people across the city, stopped functioning. In western Aleppo, humanitarian actors are scaling up alternative sources of water; however, these are not sufficient to meet the full needs of the population. In eastern Aleppo, public wells are serving a portion of the population but will require sustained access and supplies of fuel to continue operating.

7. On 10 July, airstrikes on a residential area of Kafr Ibbin reportedly killed at least 19 civilians, including 11 children and two women. The same day, seven civilians were allegedly killed by airstrikes in Shantarah. Another airstrike, on 18 July, in Tukhar Taymu allegedly killed eight civilians from a single family, including women and children. In the early morning hours of 19 July, numerous airstrikes again hit residential areas in Tukhar Taymu, allegedly killing at least 70 civilians from nine families, including at least 20 children. A medical unit in Atarib was also allegedly hit by airstrikes on 24 July. On 30 July, a makeshift hospital was allegedly hit by an airstrike in north-western Huraytan and put out of service. No casualties were reported. On 30 July, four ground strikes hit the village of Kafr Naha reportedly killing five civilians and injuring 10 others. On 31 July, a ground strike hit a residential home in Anadan allegedly killing at least three civilians and injuring seven others.

8. Fierce fighting continued between Islamic State in Iraq and the Levant (ISIL) and Syrian Democratic Forces and their allies in and around the town of Manbij in the eastern countryside of Aleppo. On 18 July, at least 15 civilians from one family, including women and children, were reportedly killed when an airstrike hit their home in the Hazawnah neighbourhood of Manbij. On 28 July, airstrikes hit residential buildings in the ISIL-controlled town of Ghandurah located north-west of Manbij, and allegedly killed at least 28 civilians and injured dozens more, including a number of children. On 2 August, OHCHR received a note verbale from the Government of the Syrian Arab Republic which stated that those airstrikes killed 45 civilians. Hazawnah neighbourhood and the nearby village of Shuwayhah were also struck, and an unknown number of civilians were reportedly killed in Shuwayhah. Also on 28 July, an airstrike hit the Sharia Al-Rabita neighbourhood of Manbij and reportedly killed five civilians and injured dozens of others. On 28 July, ISIL allegedly executed at least 25 civilians, including a number of women and children, when they temporarily took over Buwayr village to the north of Manbij. Approximately 13,000 civilians were reportedly displaced from the town of Manbij because of ongoing infighting.

9. Fighting continued throughout the reporting period in Damascus and Rif Dimashq governorates, including the first attacks reported in recent months against Damascus city. On 2 July, airstrikes and artillery fire on Jayrud reportedly killed at least 35 civilians, including three children, four women and a doctor. On 4 July, airstrikes on a residential area in Khan al-Shih allegedly killed two civilians and injured five others. Airstrikes on a residential area of Marj on 12 July reportedly killed three civilians, including a woman, and injured at least six others. A woman and a child were allegedly killed in airstrikes in Hammurah on 23 July. The next day, artillery fire reportedly killed at least six civilians in the same town. On 24 July, at least five civilians were allegedly killed, including one woman and three children, when airstrikes hit a local market and houses in Irbin. Also on 24 July, at least seven civilians were reportedly killed, including three women and one child, and at least 19 others injured when ground strikes hit the old city of Damascus, damaging houses and restaurants. On 25 July, further ground strikes in Damascus hit the Ush al-Wurur area and reportedly injured at least six civilians. On the same day mortars landed in a residential area of Qaymariyah neighbourhood in the old city of Damascus and allegedly injured at least four civilians.

10. A number of strikes were also reported in the towns of Duma and Darayya during the reporting period. On 2 July, airstrikes on residential areas in Duma reportedly killed three civilians, including a child, and injured two other civilians. On 22 July, airstrikes and artillery fire which hit commercial and residential areas in Duma reportedly killed three civilians. Also on 22 July, an airstrike allegedly killed a woman and her two -month-old baby in a residential area of Darayya. On 25 July, three civilians including a child were reportedly killed and at least another two injured as a result of artillery fire and airstrikes which hit a residential area of the town.

11. In Idlib governorate, on 8 July, airstrikes struck a local market in Darkush allegedly killing at least 22 civilians, including nine women, and injuring 20 others. The town is reported to be densely populated with internally displaced persons from other areas in the governorate. The incident, which took place during the Eid al-Fitr holiday, coincided with the last day of a 72 -hour ceasefire agreement. On 11 July, airstrikes hit the town of Ihsim in close proximity to Shifa' hospital and allegedly killed three civilians, including one child, and injured at least three others. The hospital was severely damaged and put out of service. On 13 July, airstrikes hit a local market in Ariha and reportedly killed at least 13 civilians and injured several others. On 21 July, an airstrike hit a residential area in Tallmannis and reportedly killed at least nine civilians, including two children. At least 10 other civilians were injured. On 29 July, a maternity hospital in the village of Kafr Takharim in Idlib was hit by an airstrike. Two civilians were allegedly killed in the incident and the facility put out of service.

12. In Homs governorate, on 13 July airstrikes hit a number of civilian facilities in Rastan, including a Syrian Arab Red Crescent medical unit. As a result of the strikes, at least 17 civilians, including three women, were reportedly killed and approximately 48 others injured.

13. On 3 July, armed clashes broke out between Kurdish forces and national defence forces in Hasakah city. OHCHR received reports that at least five civilians were killed and three others injured in the crossfire. On 5 July, a suicide bomber targeted a bakery in the Salihiyah neighbourhood of Hasakah city. OHCHR received the names of 21 people — 15 men and 6 children — believed to be civilians who were reported to have died in the attack. Six others were also allegedly killed, four of whom remain unidentified. In addition, 29 individuals including six women were reportedly injured in the attack. A car bomb on 27 July in Qamishli close to the offices of the Office of the United Nations High Commissioner for Refugees allegedly killed 48 civilians, including women and children, and injured 140 more, along with the destruction of civilian homes and buildings.

14. Fighting continued between ISIL and Government forces around Dayr al-Zawr and Raqqah governorates. On 8 July, ISIL fighters fired mortar rounds into Government-held areas of Dayr al-Zawr city and reportedly killed four children in the Tulaytulah public garden area of Jurah neighbourhood. In Raqqah governorate, on 12 July, airstrikes on residential areas in Raqqah city allegedly killed four children, all siblings. On 19 July, at least 57 civilians, including women and children, were reportedly injured by airstrikes on a residential area of Tabaqah.

15. OHCHR has received reports of airstrikes allegedly conducted by international actors which resulted in civilian deaths and injuries, but was unable to identify the parties responsible. The United States Department of Defense confirmed that in July the United States-led coalition carried out 366 strikes against ISIL targets in the governorates of Aleppo, Raqqah, Hasakah, Dayr al-Zawr and Homs, 80 per cent of them around the area of Manbij. During a press briefing on 27 July, the United States Department of Defense stated that a formal investigation had been launched into allegations of civilian casualties as a result of a coalition airstrike on 19 July in Manbij. The Ministry of Defence of the Russian Federation provided no information to OHCHR on its operations in July, although on 28 July the Russian Defence Minister stated that Russian aerospace forces were providing active support to Government troops in response to ISIL and Nusrah Front |1| offensives in June and July near Aleppo.

16. My Special Envoy for the Syrian Arab Republic continued to assess the environment across the country in order to determine the most opportune moment for the formal resumption of political negotiations and consistently called upon the co-Chairs of the International Syria Support Group, the United States of America and the Russian Federation, to strengthen the cessation of hostilities and take measures that enhance humanitarian access across the country for actors providing emergency support. Bilateral discussions between the United States and the Russian Federation in Moscow on 15 July paved the way for a trilateral meeting of the co-Chairs and the United Nations in Geneva on 26 July. All parties agreed at that meeting to prioritize political negotiations while the co-Chairs agreed to continue their bilateral engagement in order to strengthen the cessation of hostilities while pursuing counter-terrorism cooperation, and ensure the provision of humanitarian access and aid. In preparation for the resumption of formal political negotiations, my Special Envoy continued to engage the Government of the Syrian Arab Republic, regional States, and Syrian civil society on topics related to political transition throughout the month of July.

B. Human rights

17. OHCHR continued to receive reports of serious human rights violations in July. On 19 July, a video and photographs emerged of members of a non-State armed group in the Shi'ar district in the city of Aleppo taunting and mistreating a young male in the back of a pickup truck before one of the fighters beheaded him. The age of the male, who has the appearance of a child, was unknown. On 20 July, OHCHR received a note verbale from the Government of the Syrian Arab Republic in which it was stated that the boy was 12 years old. On the same day, the Nur al-Din al-Zanki movement issued a statement condemning the incident and indicating that those responsible had been detained and handed over to an investigation committee.

C. Humanitarian response

18. In July, United Nations humanitarian agencies and partners continued to reach millions of people in need through all modalities from within the Syrian Arab Republic and across borders pursuant to resolutions 2165 (2014), 2191 (2014) and 2258 (2015) (see table 1). Non-governmental organizations also continued to deliver assistance to people in need in line with previous months. The Government continued to provide basic services to areas under its control as well as in many areas beyond its control.

Table 1
Number of people reached by United Nations organizations, July 2016

Organization Number of people reached

Food and Agriculture Organization of the United Nations 2 613

International Organization for Migration 45 561

Office of the United Nations High Commissioner for Refugees 175 570

United Nations Children's Fund 1.4 million

United Nations Development Programme 878 091

United Nations Population Fund 384 507

United Nations Relief and Works Agency for Palestine Refugees in the Near East 450 000

World Food Programme 4.2 million

World Health Organization 746 334

19. Cross-border deliveries continued during the reporting period. In July, 10 consignments consisting of 335 trucks crossed from Turkey and Jordan to the Syrian Arab Republic under the terms of resolutions 2165 (2014), 2191 (2014) and 2258 (2015). Six of the consignments crossed from Bab al-Hawa (307 trucks), three from Bab al-Salam (13 trucks) and one from Ramtha (15 trucks). This brings the total number of trucks since the beginning of operations to 9,013 (6,582 through Bab al-Hawa, 716 through Bab al-Salam and 1,715 through Ramtha).

20. Shipments through the Ramtha crossing from Jordan resumed on 28 July after they were delayed by the Government of Jordan on 21 June because of the security situation along the Syrian-Jordan border. In Turkey, shipments were suspended for two days following the failed coup attempt of 15 July. They resumed without any problem on 18 July.

21. In line with Security Council resolutions, the United Nations notified the Syrian authorities in advance of each shipment, including content, destination and number of beneficiaries. The United Nations Monitoring Mechanism for the Syrian Arab Republic continued its operations, monitoring 335 trucks in the 10 consignments in July, confirming the humanitarian nature of each, and notifying the Syrian authorities after each shipment. The Mechanism continued to benefit from excellent cooperation with the Governments of Jordan and Turkey.

22. The inter-agency convoys to the besieged and hard-to-reach locations listed in table 2 were completed in July. Moreover, the World Food Programme (WFP) completed 22 airdrops, dropping a total of 405 tons of food commodities and humanitarian assistance on behalf of other United Nations agencies over Dayr al-Zayr city. Overall, since April, WFP has completed 87 airdrop rotations, dispatching 1,552 tons of food, nutrition, shelter and water, sanitation and hygiene supplies. In addition, the WFP Logistics Cluster completed 39 airlifts to Qamishli from Damascus, airlifting 1,464 tons of mixed food commodities as well as water, sanitation and hygiene, nutrition and shelter assistance as at 2 August. United Nations agencies also undertook single agency deliveries to cross-line and hard-to-reach locations or reached those locations through their regular programmes during the reporting period.

Table 2
Inter-agency convoys, July 2016

Date Location Requested target (number of beneficiaries) Targeted people reached Type of assistance

2 July Eastern Harasta 21 000 10 000 Food, nutrition, water, sanitation and hygiene, education, health

12 July Shaykh Maqsud 27 000 27 000� Food, nutrition, water, sanitation and hygiene, education, non-food items, health

14 and 18 July Wa'r 75 000 75 000 Food, water, sanitation and hygiene, nutrition, non-food items, health

19 July Sirghaya 15 000 15 000 Food, nutrition, water, sanitation and hygiene, nonfood items, health

21 July Qal'at al-Madiq 32 000 32 000 Food, water, sanitation and hygiene, nutrition, education, non-food items, health

21 July Urum al-Kubra 70 000 50 000 Nutrition, non-food items, health, medical

24 July Mu'addamiyah al-Sham 45 000 40 000 Food, water, sanitation and hygiene, education, health

26 July Hajib and Banan 7 000 7 000 Food, water, sanitation and hygiene, nutrition, education, non-food items, health

26 July Talbisah 84 000 84 000 Food, nutrition, health

28 July Rastan 110 000 110 000 Food, water, sanitation and hygiene, non-food items, health

31 July Hulah 71 000 71 000 Food, water, sanitation and hygiene, nutrition, education, non-food items, health

� This was the third of three convoys that together reached 27,000 beneficiaries. The two previous convoys reached Shaykh Maqsud on 23 and 28 June.

Humanitarian access

23. The delivery of humanitarian assistance to people in need of assistance in the Syrian Arab Republic remained extremely challenging in many areas of the country as a result of active conflict, shifting conflict lines and deliberate restrictions by the parties to the conflict on the movement of people and goods.

24. In July, the number of people living in besieged and hard-to-reach areas stood at 5.47 million, an increase of some 900,000 people from the previous estimate of 4.6 million. As previously reported, this increase is based primarily on the inclusion of areas in parts of Aleppo, Raqqah and Hasakah governorates as a result of insecurity, as well as constrained access for humanitarian actors both from within the country and via cross-border operations. Moreover, the population in eastern Aleppo, where an estimated 250,000 to 275,000 people reside, is at serious risk of besiegement as the fighting closes in and basic necessities run out.

25. Access to the millions of people living in besieged and hard-to-reach locations remained of critical concern. Overall, the United Nations agencies and partners reached 39 of the 182 besieged and hard-to-reach areas (21 per cent) through either inter-agency convoys or single agency deliveries. Details of assistance to those areas by sector in July are shown in table 3. Meanwhile, non-governmental organizations continued to provide limited medical, education and protection services, as well as some support in other sectors, in hard-to-reach locations, under extremely challenging circumstances.

Table 3
United Nations deliveries to hard-to-reach, besieged and priority cross-line locations, July 2016

Sector (United Nations delivery only) Number of people reached (percentage of 5.47 million)

Food security 891 945 (16%)

Health (treatments) 402 433 (7.3%)

Non-food items 119 983 (2.1%)

Water, sanitation and hygiene 120 898 (2.2%)

26. Active conflict in several governorates hindered the effective delivery of humanitarian assistance, as well as people's access to essential services. Markets, schools, medical and other civilian infrastructures were damaged as a result of fighting in July, reducing the availability of basic and essential services in critical areas. For example, on 20 July, an airstrike reportedly hit the schoolyard of the Khalid Shaar examination centre in Idlib city, resulting in the death of a female student and one other adult. As a result of repeated airstrikes during the period, local education authorities decided to postpone all examinations, which resumed on 27 July. Further, an aerial bombardment on Saraqib city in Idlib, on 30 July, reportedly struck a university, resulting in partial structural damage. The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) was not able to conduct any mission in July to Yalda because of ongoing security concerns.

27. Fighting also disrupted humanitarian supply lines to communities at risk. For example, no deliveries to eastern Aleppo could be made during the month of July, as the Castillo road, the only access route, has been cut off since 7 July. Prior to the interruption of access, WFP had pre-positioned food supplies for tens of thousands of people for July and partially for August. However, distributions are currently on hold, owing to ongoing fighting and volatile security conditions. Since access was cut, prices of essential supplies like fuel and fresh produce have increased. Some basic commodities are no longer available on the market. Further, UNICEF partners have identified over 170 cases of acute malnutrition in eastern Aleppo and provided essential nutrition treatments. As doctors and facilities are increasingly scarce, however, humanitarian partners are having difficulty in sustaining services. A lack of access to nutrition supplies has already disrupted services for 115 malnourished children who were, until recently, under treatment in eastern Aleppo.

28. On 28 July the Russian Federation announced the start of a large-scale operation to assist the civilian population of Aleppo and to ensure the exit of civilians through humanitarian corridors. The United Nations has been actively working on preparedness planning to assist all those in need, and held detailed discussions with Member States, including on the proposal of the Russian Federation, to ensure that key humanitarian principles would be strictly safeguarded in any possible initiative.

29. Deliberate interference and restrictions by the parties also continued to prevent aid delivery. For example, WFP continues to be unable to access populations in need in ISIL-controlled areas of the country, as all plans to deliver assistance to those areas have been suspended because of the inability to work independently and monitor activities. This is preventing WFP from reaching Raqqah governorate and most of Dayr al-Zawr governorate, except Dayr al-Zawr city where assistance is received via airdrops, as well as pockets of northern rural Aleppo, southern rural Hasakah and north-western rural Hama. Meanwhile, in July, more than 214,000 children, women and men in besieged and hard-to-reach areas were supported by UNICEF and partners with therapeutic foods, hygiene supplies and self-learning materials, as well as nutritional and psychosocial support.

30. The United Nations inter-agency convoy plan for July requested access to 1.2 million people in 35 besieged, hard-to-reach and priority cross-line locations. Of those 35 locations, 34 have been approved for access, representing approximately 75 per cent of total beneficiaries targeted, given the discrepancies between approved beneficiaries. Seventeen locations were approved in full for 502,500 people; 17 were partially approved with restrictions on the type of assistance and/or the number of approved beneficiaries for 354,000 people; and one location (Qabun) with 28,000 people was not approved. Overall, United Nations inter-agency convoys in July reached 484,000 |2| beneficiaries in nine locations (40 per cent of targeted people reached). Medical items continued to be removed from convoys (see para. 46). Increased insecurity, delays in administrative procedures at the national and local level, and lack of agreement of the parties to the Four Towns ceasefire agreement prevented the United Nations agencies and other partners from fully implementing the July plan. On 4 July, the Resident and Humanitarian Coordinator for the Syrian Arab Republic, Yacoub El Hillo, issued a statement expressing alarm over reports of deteriorating humanitarian conditions in the four towns (Fu'ah, Kafraya, Zabadani and Madaya), and calling on the parties to the agreement to allow for immediate humanitarian access to avoid starvation. The statement also highlighted the detrimental impact of the tit-for-tat approach on medical evacuations, and underlined the need for a principled approach to emergency lifesaving response. While there were a limited number of medical evacuations in July, several children are currently in need of immediate medical evacuation from the four towns.

31. The Nusaybin/Qamishli crossing in Hasakah governorate has been temporarily closed by the Turkish authorities because of security concerns since 27 December 2015. Hasakah governorate also remains largely inaccessible by road for United Nations agencies from within the Syrian Arab Republic. On 9 July, the United Nations commenced airlifts from Damascus to Qamishli airport. As at 2 August, the Logistics Cluster had completed 39 airlifts carrying 1,464 tons of mixed food commodities, nutrition, shelter and water, sanitation and hygiene assistance on behalf of other humanitarian agencies, including 24,300 food rations sufficient for 121,500 people for one month. During the month of July, 13,091 WFP food rations were dispatched to partners in Hasakah governorate for distribution, sufficient to support 65,455 people for one month. This is the first time food assistance has reached the governorate since December 2015.

32. A total of 31 new visa requests were submitted in July; 21 requests were approved, including older applications, and 10 remain pending. Moreover, a total of 43 visa renewal requests were submitted in July, 23 of which were approved (including older applications); 19 remain pending, while one visa renewal request was rejected.

33. A total of 17 international non-governmental organizations are registered with the Government of the Syrian Arab Republic to operate in the country. Four more international non-governmental organizations are in the process of completing registration. Those organizations continued to face a series of administrative hurdles and restrictions that affect their ability to operate, including in gaining permission to undertake independent needs assessments.

Besieged areas

34. The number of people living in areas designated by the United Nations as besieged currently stands at 590,200. Humanitarian conditions in besieged areas continue to be dire. In besieged areas, the flow of commercial supplies through official routes remained largely blocked, leading to high prices for commodities reaching besieged areas through unofficial and irregular supply lines. Freedom of movement remained heavily restricted, though limited numbers are sporadically allowed to exit and re-enter some besieged areas.

35. In recent months, inter-agency convoys to besieged areas have highlighted numerous critical protection concerns beyond physical protection from ongoing fighting and lack of freedom of movement. A number of families have been separated, including children from their parents. Indications of severe trauma were observed, children being particularly affected. People in all locations expressed serious concerns about the unavailability of civil registration and documentation services. Access to education has been severely affected and significant numbers of children appear to have been recruited into armed groups, with many boys aged under 18 — in uniform and plain clothes — brandishing weapons. Child marriage has also been documented as widespread, as families are marrying their daughters at an increasingly younger age, often as a coping mechanism against poverty. The situation is further compounded by lack of opportunities for young people in besieged areas.

36. In July, the United Nations assisted approximately 224,000 people in besieged areas (37.9 per cent of the total besieged population) through inter-agency operations, including airdrops to Dayr al-Zawr city. Overall, since the beginning of the year, inter-agency and UNRWA operations have reached a net total of 401,650 people in besieged areas (68 per cent of the total besieged population), many more than once.

37. The following locations are besieged by Government forces: (a) in eastern Ghutah, in Rif Dimashq governorate, some 282,500 people remain besieged in Duma, eastern Harasta, Irbin, Zamalka, Ayn Tarma, Hammurah, Jisrayn, Kafr Batna and Saqba; (b) in Darayya, in Rif Dimashq, about 4,000 people remain besieged; (c) in Madaya and Buqayn, in Rif Dimashq, some 43,000 people remain besieged; (d) in Zabadani, Rif Dimashq, some 700 people remain besieged; (e) in Mu'addamiyah al-Sham, in Rif Dimashq, about 45,000 people remain besieged by; and (f) in the Wa'r neighbourhood in Homs governorate, about 75,000 people are besieged. Some locations, including Madaya and Buqayn, have not received United Nations assistance since 30 April.

38. In Fu'ah and Kafraya in Idlib governorate, some 20,000 people remain besieged by non-State armed groups and the Nusrah Front. These locations have not received United Nations assistance since 30 April.

39. In Yarmuk, in Damascus, some 10,000 people are besieged by Government forces and non-State armed groups.

40. In the Government-controlled western neighbourhoods of Dayr al-Zawr city, some 110,000 people are besieged by ISIL.

Attacks on medical facilities and free passage of medical supplies, personnel and equipment

41. Primary, secondary and tertiary health-care services continue to experience severe gaps in performance and service delivery, owing to the extensive damage caused to health facilities, the rapid turnover of health staff, and the lack of qualified professionals in the different medical specialties. Paediatric and maternal health services, including routine vaccinations, remain negatively affected, particularly in the governorates of Aleppo, Hama, Homs and Dar'a, as well as in the besieged areas of Rif Dimashq.

42. In blatant disregard for the special protected status of health-care facilities under international humanitarian law and Security Council resolution 2286 (2016), adopted on 3 May, medical facilities continued to be damaged or destroyed as a result of fighting in the Syrian Arab Republic. The United Nations and health partners received credible reports, which are in the process of being verified by the United Nations and partner organizations, of 44 attacks against health facilities in July alone. For example, in July, five out of nine hospitals in eastern Aleppo were repeatedly attacked, severely disrupting and limiting life-saving health services for children and their families. This includes attacks on Bayan, Hakim, Daqqaq, Sayidah al-Zahra' and Umar ibn Abdulaziz hospitals, in which patients were killed and medical staff reportedly injured. According to reports, a two-day-old baby died in his incubator as a result of oxygen interruptions following the attack. Three other babies reportedly died the next day because of respiratory problems caused by the fallout of the bombardment. Those medical facilities are severally damaged. The remaining hospitals in eastern Aleppo cannot cater to the needs of the approximately 250,000 to 275,000 people. The few staff that remain are overstretched and working in shifts. Lack of health workers is compounded by the fact that many health workers are no longer able to make the daily journey from their homes in the west of the city to the eastern area. Power and water shortages are severely affecting the delivery of health services.

43. Moreover, a hospital in Anadan, a blood bank in Atarib (both in Aleppo governorate) and a field hospital in Jasim (Dar'a governorate) were hit by airstrikes on 31 July. The previous day, a maternity hospital in Idlib was struck by airstrikes, putting the facility out of service and killing at least two people in addition to injuring a number of patients, including several babies and three female staff. This was the only maternity facility of its kind in the area, serving more than 1,000 women and children a month and delivering hundreds of newborns. Local health authorities reported that the facility was specifically targeted, as three out of six airstrikes on that morning were against the hospital. Dozens of casualties and injuries resulting from the strikes have been reported, including pregnant women and children as well as health staff. Prior to the reported strikes, these medical facilities provided life-saving health care to tens of thousands of people. Many of the locations are now inoperable. Moreover, according to verified reports, Raqqah National Hospital continues to be used by ISIL for military purposes with armed combatants, including children, posted outside as guards to control access to the facility.

44. The World Health Organization (WHO) and UNICEF continued with the implementation of the nationwide vaccination campaign. To date, the first round of the cross-border component of the campaign has reached about 1,070,245 children, equivalent to a coverage rate of 86 per cent. Moreover, from Damascus, the United Nations has reached 1.2 million children, 476,000 of whom live in hard-to-reach and besieged locations. In July, WHO, UNICEF and partners launched the second round of the campaign from within the Syrian Arab Republic, targeting children under the age of 5, with a focus on hard-to-reach and besieged locations.

45. Since the beginning of 2016, WHO has filed with the Government of the Syrian Arab Republic 29 requests to access 93 locations in 11 governorates (four requests were submitted in July). The Government has approved 8 of the 29 requests. No approvals were received in July, and 21 requests remain unanswered, for which WHO has sent many reminders.

46. The removal of life-saving medicines and medical supplies from humanitarian aid convoys continued. Serum drugs, renewable items (razors, scalpel blades, gauzes) and surgical equipment (forceps, scissors, needles) are consistently removed from midwifery kits, inter-agency emergency health kits, paediatric kits, and diarrhoeal disease sets. The following treatments and supplies were removed from convoys during July: |3|

Location Number of treatments Type of treatments

Irbin 343 Burn kits, medicine for the treatment and prophylaxis of heart failure, angina, and reduction of the pneumonia kit B

Wa'r 2 104 Italian trauma A and B, steam sterilizer, psychotropic medicines, atropine and lidocaine, surgical items

Sirghaya 509 Psychotropic medications, burn kits, items removed from supplementary inter-agency emergency health kits and pneumonia kit B, in addition to reducing the quantities of kits

Qal'at al-Madiq 1 572 Pneumonia kit B, supplementary and basic inter-agency emergency health kits (intravenous fluid, psychotropic medicines, anaesthetic and life-saving medicines) and antiseptics

Talbisah 660 Antiseptics and intravenous sets

47. Fears about the targeting of health facilities remain a driver of home deliveries among pregnant women in the southern Syrian Arab Republic. This trend is further exacerbated by the desire to obtain proper notification documents that a birth has occurred — a service which is increasingly available only from Government-salaried midwives who are fearful of retaliation by the Government if they are detected as practising within unauthorized or unofficial health facilities. An assessment of civil documentation conducted by the International Rescue Committee from April to June 2016 reported that the proportion of births for which a birth notification was issued was only 35 per cent in Dar'a and 15 per cent in Qunaytirah. Furthermore, participants in Rif Dimashq, Qunaytirah and Dar'a ranked "lack or loss of personal civil documents" as their main protection threat.

Safety and security of staff and premises

48. A total of 27 United Nations staff members, 25 of whom are UNRWA area staff, one from the United Nations Development Programme, and one from UNICEF, are still detained or missing. Since the start of the conflict, dozens of humanitarian workers have been killed, including 18 staff members of the United Nations, 53 staff members and volunteers of the Syrian Arab Red Crescent, and eight volunteers and staff members of the Palestinian Red Crescent Society. This includes Yaser Mahmoud Shuaeeb, an UNRWA staff member, who died on 17 July after being struck by shrapnel fragments. In addition, scores of staff members of international and national non-governmental organizations are reported to have been killed.

III. Observations

49. There are few words left to convey the suffering being endured by Syrians, more than five years into the conflict. In addition to the ongoing civilian deaths and injuries, the destruction of property and cultural heritage and the displacement of tens of thousands of people, many Syrians are also facing severe water and fuel shortages, causing increased levels of disease and hardship, in particular in besieged and hard-to-reach areas.

50. In besieged areas, Syrian suffering continues largely unabated. In particular areas which are part of the Four Towns ceasefire agreement — Madaya, Zabadani, Fu'ah and Kafraya — Syrians in dire need of medical evacuation continue to be denied the right to access the necessary medical treatment owing to the tit-for-tat nature of the agreement. This includes children, mothers, the elderly, and other vulnerable people. Moreover, these areas have not received United Nations assistance since 30 April, raising concerns about cases of malnutrition possibly leading to starvation. These illegal practices of holding civilians hostage to the fighting must stop.

51. In Aleppo, more than 2 million people across the city are in fear of besiegement and in an uncertain and dangerous situation as fighting rages around them. The situation is growing worse for those 250,000 to 275,000 trapped in eastern Aleppo since 7 July, and it is extremely precarious for those in the west. The conduct of hostilities continues to be characterized by a prevailing disrespect for the fundamental rules of international humanitarian law. All parties to the conflict are failing to uphold their obligation to protect civilians. The fight for territory and resources is being undertaken through indiscriminate attacks on residential areas, including through the use of barrel bombs, killing hundreds of civilians, including dozens of children. In Aleppo we risk seeing a humanitarian catastrophe unprecedented in the more than five years of bloodshed and suffering in the Syrian conflict. I cannot stress strongly enough the need for a 48-hour pause in fighting, as well as safe and sustained humanitarian access in all areas of Aleppo. I also urge the co-Chairs of the International Syria Support Group, the United States and the Russian Federation, to rapidly reach agreement on a ceasefire in Aleppo and elsewhere. Not only would such an agreement ease the suffering of the Syrian people, it could also facilitate a more conducive environment for the resumption of the intra-Syrian talks.

52. In July, tens of thousands of people were forced from their homes in search of safety. Fighting continued to punish civilians across the country: in Aleppo, in Manbij, eastern Ghuta, in Dar'a and elsewhere. Attacks on hospitals, schools, basic services and humanitarian deliveries have continued unabated. The United Nations and health partners received credible reports, which are in the process of being verified by the United Nations and partner organizations, of 44 attacks against health facilities in July alone. What was inconceivable more than five years ago has become the norm for Syrian families and communities. The fighting must stop for humanitarians to be able to deliver aid and save lives. But most importantly the fighting must be halted to ease the suffering of those who already have lost so much.

53. As my Special Envoy prepares to convene the next round of political negotiations, I reiterate my call to the international community, and to the members of the International Syria Support Group in particular, to strengthen the cessation of hostilities and take measures that enhance humanitarian access across the Syrian Arab Republic. I commend the continued efforts by the Russian Federation and the United States to maintain the momentum and spearhead international support for the Syrian parties to work towards reaching a political agreement on the basis of Security Council resolution 2254 (2015). The people of the Syrian Arab Republic should not be forced to wait any longer for Syrian, regional and international parties to settle their scores. They have suffered enough and deserve our full attention, genuine effort, vision and leadership to end what has become one of the worst humanitarian tragedies of our times.

Notes:

1. On 28 July, the Nusrah Front announced that it would henceforth be known as Jabhat Fatah al-Sham, or Front for the Conquest of the Levant, and said it no longer owed allegiance to Al-Qaida. [Back]

2. The total does not reflect the 10,000 beneficiaries reached on 2 July in eastern Harasta as part of the June plan. [Back]

3. Medical, health and surgical items have also been removed from convoys to Rastan and Hulah. The number of removed items is currently being verified. [Back]

Information
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Organization	Number of people reached
Food and Agriculture Organization of the United Nations	2 613
International Organization for Migration	45 561
Office of the United Nations High Commissioner for Refugees	175 570
United Nations Children's Fund	1.4 million
United Nations Development Programme	878 091
United Nations Population Fund	384 507
United Nations Relief and Works Agency for Palestine Refugees in the Near East	450 000
World Food Programme	4.2 million
World Health Organization	746 334

Date	Location	Requested target (number of beneficiaries)	Targeted people reached	Type of assistance
2 July	Eastern Harasta	21 000	10 000	Food, nutrition, water, sanitation and hygiene, education, health
12 July	Shaykh Maqsud	27 000	27 000�	Food, nutrition, water, sanitation and hygiene, education, non-food items, health
14 and 18 July	Wa'r	75 000	75 000	Food, water, sanitation and hygiene, nutrition, non-food items, health
19 July	Sirghaya	15 000	15 000	Food, nutrition, water, sanitation and hygiene, nonfood items, health
21 July	Qal'at al-Madiq	32 000	32 000	Food, water, sanitation and hygiene, nutrition, education, non-food items, health
21 July	Urum al-Kubra	70 000	50 000	Nutrition, non-food items, health, medical
24 July	Mu'addamiyah al-Sham	45 000	40 000	Food, water, sanitation and hygiene, education, health
26 July	Hajib and Banan	7 000	7 000	Food, water, sanitation and hygiene, nutrition, education, non-food items, health
26 July	Talbisah	84 000	84 000	Food, nutrition, health
28 July	Rastan	110 000	110 000	Food, water, sanitation and hygiene, non-food items, health
31 July	Hulah	71 000	71 000	Food, water, sanitation and hygiene, nutrition, education, non-food items, health

Sector (United Nations delivery only)	Number of people reached (percentage of 5.47 million)
Food security	891 945 (16%)
Health (treatments)	402 433 (7.3%)
Non-food items	119 983 (2.1%)
Water, sanitation and hygiene	120 898 (2.2%)

Location	Number of treatments	Type of treatments
Irbin	343	Burn kits, medicine for the treatment and prophylaxis of heart failure, angina, and reduction of the pneumonia kit B
Wa'r	2 104	Italian trauma A and B, steam sterilizer, psychotropic medicines, atropine and lidocaine, surgical items
Sirghaya	509	Psychotropic medications, burn kits, items removed from supplementary inter-agency emergency health kits and pneumonia kit B, in addition to reducing the quantities of kits
Qal'at al-Madiq	1 572	Pneumonia kit B, supplementary and basic inter-agency emergency health kits (intravenous fluid, psychotropic medicines, anaesthetic and life-saving medicines) and antiseptics
Talbisah	660	Antiseptics and intravenous sets

16Aug16

30th Report of the Secretary-General on the Implementation of Security Council resolutions 2139 (2014), 2165 (2014), 2191 (2014) and 2258 (2015) (July 2016)

I. Introduction

II. Major developments

III. Observations