The UN Failed to Save Hospitals in Syria

The charred remains of a tent after the Syrian government bombardment of a makeshift camp, which included a maternity hospital, last month in the village of Qah near the Turkish border in the northwestern Idlib province. © Omar Haj Kadour/Agence France-Presse — Getty Images
The charred remains of a tent after the Syrian government bombardment of a makeshift camp, which included a maternity hospital, last month in the village of Qah near the Turkish border in the northwestern Idlib province. © Omar Haj Kadour/Agence France-Presse — Getty Images
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The UN Failed to Save Hospitals in Syria

The charred remains of a tent after the Syrian government bombardment of a makeshift camp, which included a maternity hospital, last month in the village of Qah near the Turkish border in the northwestern Idlib province. © Omar Haj Kadour/Agence France-Presse — Getty Images
The charred remains of a tent after the Syrian government bombardment of a makeshift camp, which included a maternity hospital, last month in the village of Qah near the Turkish border in the northwestern Idlib province. © Omar Haj Kadour/Agence France-Presse — Getty Images

A United Nations system to prevent attacks on hospitals and other humanitarian sites in insurgent-held areas of Syria has been ignored by Russian and Syrian forces and marred by internal errors, a New York Times investigation has found.

The repeated bombing and shelling of these sites has led relief group leaders to openly criticize the United Nations over the system, which is meant to provide warring parties with the precise locations of humanitarian sites that under international law are exempt from attack. Some of these groups have described the system of identifying and sharing sites, known as the “humanitarian deconfliction mechanism,” as effectively useless.

A new offensive by Syrian and Russian forces that began in late December has devastated what remains of several towns in northwestern Syria and caused tens of thousands of civilians to flee.

United Nations officials only recently created a unit to verify locations provided by relief groups that managed the exempt sites, some of which had been submitted incorrectly, The Times found. Such instances of misinformation give credibility to Russian criticisms that the system cannot be trusted and is vulnerable to misuse.

“The level and scale of attacks has not really decreased,” said Dr. Mufaddal Hamadeh, the president of the Syrian American Medical Society, which supports more than 40 hospitals and other sites in insurgent-held areas of northwestern Syria. “We can say categorically that in terms of accountability, in terms of deterrence, that doesn’t work.”

The Times compiled a list of 182 no-strike sites by using data provided by five relief groups and compiling public statements from others. Of those facilities, 27 were damaged by Russian or Syrian attacks since April. All were hospitals or clinics. Such a list is likely to represent only a small portion of the exempt sites struck during the Syrian war, now almost nine years old.

Under international law, intentionally or recklessly bombing hospitals is a war crime.

The deconfliction system works by sharing the location of humanitarian sites with Russian, Turkish and United States-led coalition forces operating in Syria, on the understanding that they will not target those sites. The system is voluntary, but relief groups said they felt intense pressure from donors and United Nations officials to participate. The groups give locations of their own choosing to the United Nations Office for the Coordination of Humanitarian Affairs, the agency that runs the system.

A document prepared by the agency warned that participation in the system “does not guarantee” the safety of the sites or their personnel. The document also stated that the United Nations would not verify information provided by participating groups. The system also does not require the Russians, Turks or Americans to acknowledge receipt of no-strike locations.

Whether such an arrangement can ever be successful in the brutal Syria conflict, where laws of war are disregarded on a daily basis, is an open question.

The forces of President Bashar al-Assad of Syria, alongside their Russian allies, have acted as if the deconfliction system does not exist. Local journalists and relief groups have recorded at least 69 attacks on no-strike sites since the Russian military intervention to help Mr. Assad began in October 2015, all but a few of them most likely committed by Russian or Syrian forces.

Jan Egeland, a Norwegian diplomat who was an adviser to the United Nations on Syria from 2015 to 2018, said the United Nations had failed to impose sufficient repercussions on those responsible.

“In general, deconfliction can work if there is a very loud, very noisy, very reliable investigation follow-up, accountability-oriented mechanism around it,” Mr. Egeland said, “so that the men who sit with their finger on the trigger understand there will be consequences if they don’t check the list or if they even deliberately target deconflicted places.”

But Russia has repeatedly blocked action in the United Nations Security Council meant to strengthen accountability and humanitarian access in the Syria war, casting 14 vetoes since the conflict began, including for a resolution that would have referred Syria to the International Criminal Court. Russia’s latest veto, on Dec. 20, could halt deliveries of humanitarian aid into Syria from Turkey and Iraq starting next month.

In August, the United Nations Secretary-General António Guterres established a board of inquiry to investigate strikes on deconflicted sites, as well as other locations supported by the United Nations. But the investigators are currently planning to examine only seven of the dozens of attacks since April, and may not identify the perpetrators or even make their report public, a limited scope that has further angered humanitarian groups.

Growing frustration over the failure of the deconfliction system led to a June meeting between an association of relief groups and Trond Jensen, a top United Nations humanitarian official in Turkey who has since moved to a new position in Gaza.

A summary of the meeting that was sent to participants afterward by Mr. Jensen and that was obtained by The Times acknowledged “a huge trust deficit in the process and with those who manage it.”

Relief groups felt they were putting the lives of their colleagues and other civilians at risk by participating, Mr. Jensen’s summary said.

Fadi al-Dairi, chairman of the association that met with Mr. Jensen, said that the United Nations and humanitarian groups had acted in “good faith” when they began using the system but that “we’ve not achieved anything.”

“There is a sense of frustration, lack of trust in everyone,” said Mr. al-Dairi, who is a co-founder of Hand in Hand for Aid and Development, which supports 53 deconflicted sites in Syria.

Though the deconfliction system has existed for years, Mr. al-Dairi and others involved in relief efforts said that the United Nations humanitarian agency had only recently hired dedicated deconfliction staff in southern Turkey and Amman, Jordan, to verify locations of deconflicted sites so that false information was not sent to the warring parties.

Previously, United Nations officials had told the groups that they did not have the capacity to hire more people, Mr. al-Dairi said.

“Some NGOs might lack the skills when it comes to reporting the coordinates,” Mr. al-Dairi said of the groups, “but it’s up to the U.N. to confirm it.”

“It is a matter of life and death,” he added, “so that’s why they should have been more proactive, like they are now.”

United Nations humanitarian officials privately told The Times that some relief groups had previously submitted incorrect locations and that, although rare, in a few cases misinformation had been shared with Russia, Turkey and the American-led coalition.

The United Nations humanitarian agency has taken steps to improve the system in recent months, including the creation of a “centralized entity” to run it, according to Zoe Paxton, a spokeswoman for the agency. It also is now giving participant organizations a second opportunity to confirm submitted locations. United Nations officials emphasize that under international law, the warring parties are responsible for verifying targets and minimizing harm.

Mr. Assad’s government, which has effectively criminalized the providing of health care in opposition-held areas, has repeatedly bombed humanitarian sites. Russian officials claim their Air Force carries out only precision strikes on “accurately researched targets,” and they have attacked the integrity of the deconfliction system.

Vassily Nebenzia, Russia’s ambassador to the United Nations, said at a news conference in September that Russian military reconnaissance had discovered “lots of instances of deliberate disinformation” in the system.

One site listed as a hospital was actually being used to store firearms, Mr. Nebenzia claimed, while other sites had been submitted with coordinates sometimes up to 10 kilometers from their real locations.

“To get you a sense of an ‘iceberg’ size here, I will just say that only in July alone we were provided with 12 false coordinates,” he said. “And that is only about what we had capacity and time to check.”

While some of Mr. Nebenzia’s claims were shown to be false, at least three relief groups did submit incorrect coordinates to the United Nations on various occasions, The Times found.

While investigating an airstrike in November, The Times discovered that a relief group had provided coordinates for its health center that were around 240 meters away. When another hospital was bombed in May, The Times found that the coordinates submitted by its supporting organization pointed to an unrelated structure around 765 meters north.

After questions from The Times prompted the organization to review its deconfliction list, a staff member discovered that it had provided the United Nations with incorrect locations for 14 of its 19 deconflicted sites. The original locations had been logged by a pharmacist. The list had been with the United Nations humanitarian agency for eight months, and no one had contacted the organization to correct the locations, a member of the organization’s staff said.

Mr. al-Dairi and others involved in relief work said they assumed Russian and Syrian forces could find and target hospitals and other humanitarian sites without using the information shared by the United Nations. But they said they felt pressured to join the deconfliction system and had to convince skeptical Syrian doctors and aid workers to let them share their locations, knowing the information would go to the Russians and almost assuredly their Syrian government allies.

Dr. Munzer al-Khalil, the head of the Idlib Health Directorate, which oversees health care in Syria’s last opposition-held province, said many international donors would not support medical facilities unless they joined the UN’s deconfliction system.

“Therefore, we did not have much of an option,” Dr. al-Khalil said. “We paid a price by sharing the coordinates of the medical facilities with the United Nations. And what we got lately, frankly, was more bombing of medical facilities, and more precise bombing, and more destructive than before.”

Relief group leaders said that their only remaining hope was that adding their sites to the deconfliction list had left Russia and the Syrian government with no deniability — important for theoretical war crimes trials decades in the future.

“We truly believe the world has abandoned us,” Dr. al-Khalil said.



Israel Cuts off Gaza’s Southern City of Rafah, Vows to ‘Vigorously’ Expand in the Territory

 Displaced Palestinians flee from east to west of Gaza City after the Israeli military issued evacuation orders in the area, Friday April 11, 2025. (AP)
Displaced Palestinians flee from east to west of Gaza City after the Israeli military issued evacuation orders in the area, Friday April 11, 2025. (AP)
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Israel Cuts off Gaza’s Southern City of Rafah, Vows to ‘Vigorously’ Expand in the Territory

 Displaced Palestinians flee from east to west of Gaza City after the Israeli military issued evacuation orders in the area, Friday April 11, 2025. (AP)
Displaced Palestinians flee from east to west of Gaza City after the Israeli military issued evacuation orders in the area, Friday April 11, 2025. (AP)

Israel announced Saturday it has completed construction of a new security corridor that cuts off the southern city of Rafah from the rest of Gaza, as the military said it would soon expand "vigorously" in most of the small coastal territory. Palestinians were further squeezed into shrinking areas of land.

"Soon, (military) activity will expand rapidly to additional locations throughout most of Gaza and you will have to evacuate the fighting zones," Defense Minister Israel Katz said in a statement, without saying where Palestinians were meant to go.

The statement urged Palestinians to stand up and remove Hamas and release the remaining hostages, saying: "This is the only way to stop the war." There was no immediate Hamas response.

Israeli troops were deployed last week to the new security corridor referred to as Morag, the name of a Jewish settlement that once stood between Rafah and Khan Younis, after the army ordered sweeping evacuations covering most of Rafah, indicating it could soon launch another major ground operation.

Israel has vowed to seize large parts of Gaza to pressure Hamas to release the remaining 59 hostages, 24 of them believed to be alive, and accept proposed new ceasefire terms.

Prime Minister Benjamin Netanyahu's government has also imposed a monthlong blockade on food, fuel and humanitarian aid that has left the territory’s roughly 2 million Palestinians facing acute shortages as supplies dwindle — a tactic that rights groups say is a war crime.

Israel has claimed that enough supplies entered Gaza during the two-month ceasefire that it shattered last month. Aid groups have disputed that.

Netanyahu has said Morag would be "a second Philadelphi corridor," referring to the Gaza side of the border with Egypt farther south, which has been under Israeli control since May 2024. Israel has also reasserted control of the Netzarim corridor, which cuts off Gaza's northern third from the rest of the territory.

The corridors, coupled with a buffer zone that Israel has razed and expanded, give it more than 50% control of the territory.

Katz said Palestinians interested in "voluntarily" relocating to other countries would be able to as part of a proposal by US President Donald Trump. Palestinians have rejected the proposal and expressed their determination to remain in their homeland.

Trump and Israeli officials have not said how they would respond if Palestinians refuse to leave Gaza. But Human Rights Watch and other groups say the plan would amount to "ethnic cleansing" — the forcible relocation of the civilian population of an ethnic group from a geographic area.

Many Palestinians have been crowding into squalid tent camps or the rubble of their previous homes, often displacing multiple times in response to Israel's evacuation orders since the Hamas-led attack on Oct. 7, 2023, killed some 1,200 people, many of them civilians, and sparked the war.

Israel on Saturday ordered the evacuation of areas east of Khan Younis ahead of an attack. Military spokesperson Avichay Adraee added that fighters had fired rockets into Israel from these areas.

Israeli strikes across Gaza continued, killing at least 21 people in the last 24 hours, according to Gaza’s Health Ministry, which doesn’t distinguish between civilians and combatants but says most of the over 50,000 Palestinians killed in the war have been women and children.

The ministry said at least 1,500 people have been killed since Israel's surprise bombardment resumed the war last month.

Israel says it has killed around 20,000 fighters in the war, without providing evidence.