GENEVA — Deliveries of lifesaving aid to Syrian civilians trapped in besieged areas are at their lowest level in almost a year, despite a cease-fire that has curbed fighting across much of the country, the United Nations said on Thursday. In Idlib Province, residents of some towns are dying for want of medical care.
Armed opposition groups and government forces “are routinely doing what they can, all of them it seems, to avoid us helping women, children, wounded on the other side,” Jan Egeland, the United Nations adviser on humanitarian affairs, told reporters in Geneva.
The cease-fire, brokered by Russia and Turkey at the end of December, is still holding and saving lives in many parts of the country, Mr. Egeland said. But for many hundreds of thousands of exhausted civilians still trapped in besieged areas, this winter, the sixth since the fighting began, is proving to be the harshest since the conflict started.
“The way it is now, it cannot continue,” he added. “The government has to change the way it is blocking our humanitarian access to civilians, but also the armed opposition groups.”
His bleak assessment came days ahead of a new round of peace talks that Russia, Turkey and Iran will convene in Astana, the capital of Kazakhstan, in a bid to make the cease-fire work in more areas. President Bashar al-Assad of Syria has suggested that the talks could lead to “reconciliation deals” with opposition groups.
Every month, the United Nations submits to the Syrian government a list of locations it wishes to reach with supplies of food and medicine. For January, the government approved all but five of those locations, Mr. Egeland said.
But even so, aid agencies ended up in a “completely hopeless bureaucratic quagmire,” forced to obtain additional approvals from several layers of government, security committees and armed forces of both sides, which effectively prevented aid convoys from delivering supplies in areas controlled by opposing forces.
Aid agencies had managed to deliver some food and medicine and conduct medical evacuations last year in four fiercely contested towns in Idlib Province: Madaya and Zabadani, which are besieged by pro-government Hezbollah forces, and Fouaa and Kfarya, surrounded by opposition forces. But now, Mr. Egeland said, inhabitants of these towns are routinely dying for want of medical care.
Another worry is the plight of 93,000 civilians in Deir al-Zour, besieged by Islamic State forces. Its inhabitants have depended for months on United Nations airdrops of food, but the drops were suspended on Sunday because of a recent Islamic State offensive.
The United Nations mediator for Syria, Staffan de Mistura, is to attend the Astana meeting. He has proposed another round of talks on the political transition in Syria in Geneva starting on Feb. 8.
Few other details of the Astana talks have emerged, but Mr. Egeland said that Russia, Turkey and Iran pledged on Thursday to push the parties to end the obstruction of humanitarian aid deliveries.
They have an “immense responsibility,” he said.