The Syrian city of Idlib is separated from the Bab al-Hawa crossing at the Turkish border by about 40 kilometers (25 miles). Huda Khayti, director of the Women Support and Empowerment Center Idlib, travels there several times each week to check on people in refugee camps along the border and bring them aid. Millions of internally displaced Syrians have been living there under extremely difficult humanitarian circumstances for years, and Khayti is worried about their fate.

"These people are extremely dependent on aid," she told DW by phone. "They don't have a voice. The world doesn't see them. If the assistance stops, they will quietly begin dying — either from starvation or illness."

The threat that aid could be cut off is real. The UN mandate that is the foundation for all aid delivery in the region of Idlib is about to expire.

Crossing's closure imminent

In 2014, the UN Security Council passed a resolution to open four border crossings into northwest Syria to supply essential aid to people living in the country's last rebel stronghold. But the mandate must be renewed each year, and Syria and its closest ally, Russia — which has veto power on the Security Council — have increasingly objected.

Last year, negotiations produced a tediously achieved compromise that closed all but one crossing: Bab al-Hawa, about 50 kilometers west of Aleppo. But the mandate for that crossing is set to expire on July 10.

Various estimates put the number of people living in Idlib at about 4 million, with more than a million of them in refugee camps. Many have repeatedly been forced to flee within Syria. In the time since the Security Council passed its resolution, it has become increasingly difficult for aid organizations to deliver food and medicine to people in the region.

'True humanitarian catastrophe'

According to the United Nations, about 1,000 truckloads of aid roll through the Bab al-Hawa border crossing each month. Human Rights Watch (HRW) estimates that about three-quarters of Idlib's 4 million inhabitants depend on humanitarian assistance.

Only three hospitals are currently operational in Idlib, and COVID-19 infections are rising. The region has so far received very few vaccine doses, and both HRW and the UN fear the worst should the Bab al-Hawa crossing be closed.

"If the aid doesn't come this will end in a true humanitarian catastrophe, because then medicine won't come," Khayti said. "We are being bombed. How are we supposed to treat the wounded, the sick, those infected with COVID-19? How can our humanitarian assistance be up for debate?"

Russia obstructing extension

For weeks, Syrian President Bashar Assad and his Russian backers have been stepping up attacks in southern parts of the province — especially the area around Jabal Zawiya — despite an official cease-fire.

At a Security Council meeting in late May, Russia indicated it was unlikely to agree to an extension of the mandate to keep the border open. US Secretary of State Antony Blinken, on the other hand, urged the opening of a second border crossing to allow for more aid to reach the last rebel stronghold.

"The discussion about the one checkpoint is the bare minimum," said Till Küster, Middle East coordinator for the aid organization Medico International. "In reality, we should actually be reopening more checkpoints."

Medico International supports the women's center run by Khayti, and sends materials to refugee camps to help slow the spread of the coronavirus. Independent organizations such as Medico are also using unofficial routes to transport their aid to Idlib, Küster said. But that means they must forgo UN security and customs exemptions.

"If fewer and fewer goods enter the country, prices here will explode," Khayti said. Thanks to the devaluation of the Syrian currency, prices for food, fuel and other essential goods have already skyrocketed.

Assad receives benefit

In principle, the United Nations can only be active in a member country with the consent of the government. As Assad's protecting power, Russia has long urged that all aid go through Damascus. "Russia is playing power games with the West," said Bente Scheller, a Syria expert at the Heinrich Böll Foundation in Berlin.

The regime, which only provides aid to populations loyal to Assad, would gain further leverage by closing the Bab al-Hawa crossing. The move could help it to recapture the last rebel stronghold by increasing pressure on the local population.

It's not just Assad who would benefit from the closure of the Bab al-Hawa border crossing. "It would also enhance Turkey's role," Scheller said. "It would then be in Turkey's hands how much aid it wants to allow in the first place — and to whom it goes. Humanitarian interests play only an indirect role here: When Turkey allows aid deliveries, it's to prevent even more people from fleeing Syria to Turkey."

Syria's long conflict

The country has been at war for more than a decade. Hundreds of thousands of people have been killed and more than 13 million people have been displaced, according to the United Nations, about half of them within Syria. The country has been split into zones under government, rebel and Kurdish control.

Khayti has been running the women's center in Idlib since spring 2018. She came to the area when the democratic opposition and rebel groups alike were brought to the province, which is controlled by the militant Islamist group Hayat Tahrir al-Sham, among others.

"I experienced in Ghouta what it means when the regime starves people," she said. "They sealed off everything at that time and didn't let anything or anyone into the city. It was almost worse than the bombs we had to endure. I don't want to experience that again. It's a terrible feeling, and it scares me that this is what we are facing."

Khayti is afraid that people will be forced to flee once again. But, with most of Syria not an option and Turkey keeping its border shut, there are few alternatives.

"What do you expect from 4 million people? That we sit here and wait for our deaths?" she said. "The international community only acts when a catastrophe is already underway, or over. We want you to know that we need help now."

This article has been translated from German.