BEIRUT: In a civil conflict environment as complex as that in Syria, distribution of humanitarian aid has become a deeply divisive issue prone to politicization over access to territory held by competing sides.

The U.N. estimates that some 2.5 million people inside Syria are now internally displaced and in dire need of humanitarian aid.

Aid agencies, competing for funds from states and individual donors, are divided on which method of aid delivery should be used, and to what extent – if any – they should coordinate with a government that is party to a bloody civil war in order to gain access to rebel-held areas.

NGOs and the United Nations always need the host government’s permission to work in a country. But Syria has not allowed any new groups to legally operate inside the country since the uprising began in March 2011.

The UNHCR, which mainly works with the Syrian Arab Red Crescent, as well as other U.N. agencies and some 70 mostly Syrian government-approved bodies to coordinate and deliver humanitarian aid, last week championed a successful visit to rebel-held Azaz, near Aleppo.

The agency delivered some 200 tons of blankets, food and medical aid to the area by road convoy from Latakia, on the Syrian coast, after the supplies were flown in from Denmark.

The UNHCR’s chief spokeswoman Melissa Fleming heralded the trip as “precedent setting” and the UNHCR is understood to be preparing for more trips to rebel-held areas soon.

“We were very pleased with the delivery to the north because we managed to coordinate with the government and opposition parties. It was a new development that was encouraging,” she told The Daily Star.

But the agency has faced persistent criticism that its partnership with Syrian government agencies and NGOs, in addition to access restrictions, has led to a drastic imbalance in aid to Syrians in rebel-held areas.

Human Rights Watch issued a statement Monday calling for Syria and the U.N. to authorize cross-border missions to deliver aid into Syria, including from Turkey.

Turkey, which hosts some 200,000 Syrian refugees, has offered logistical support to Syria’s armed opposition. It shares a 822 km border with Syria, and large swathes of Syrian territory south of that frontier have fallen under opposition control.

HRW said that while Syria has allowed some aid deliveries of goods that have originated in Damascus to be taken to rebel held areas, it has not allowed assistance to be sent to opposition areas directly from neighboring states.

Under a General Assembly resolution, U.N. agencies are not allowed to work in Syria without Syria’s consent, unless the Security Council authorizes those efforts.

“The U.N. Security Council should also call for Syria to agree to cross-border aid, a step likely to be more palatable to Syria’s allies than a resolution authorizing such aid without Syria’s agreement,” HRW said.

Lama Fakih, a HRW Lebanon and Syria researcher who recently returned to Beirut from a field mission in Syria’s northern Latakia, Idlib and Aleppo provinces, said the team saw “extremely high levels of displacement.”

She said that while some NGOs – notably Turkey’s Humanitarian Relief Foundation, (IHH) and the British NGO Hand in Hand – were working in some rebel areas including Atme on the Turkish border, “It was clear that there was very limited assistance.”

“We are very happy to hear that the U.N. is reaching these areas now but they are doing so through government channels,” Fakih said.

“The obstacle is that the Syrian government has not given permission to access rebel held areas. Humanitarian organizations are not restricted in the same way [as the U.N.].”

Fakih said that one of the challenges was finding which opposition forces aid organizations can work with in a highly fluid conflict situation, adding that trust was also an issue in opposition areas where the U.N. was partnering with government agencies.

“[Another] of the challenges has also been a lack of transparency of understanding which organizations the U.N. is working with to distribute aid.”

Fakih noted that one of the opposition forces’ criticisms was the U.N.’s dealings with an umbrella group administering all NGO activity in Syria that is headed by the president’s wife, Asma Assad. Syria’s first lady is currently under U.N. and European sanctions for her role in suppressing protests.

“They should conduct a thorough vetting of the organizations they are working with and be transparent about that,” Fakih said.

“We have spoken to some SARC employees who have talked about a lack of trust, theft of government vehicles and being physically targeted by government soldiers.”

The UNHCR’s Fleming admitted access was a huge problem. “We need the cooperation of the government and all the parties in territories or occupying transit routes,” she said.

And while she would not comment on which opposition groups the UNHCR had successfully contacted to act as intermediaries in aid delivery, she said the agency operates according to a principle of impartiality and that “it is essential that all our partners have the same philosophy.”

“Our issue is lack of access due to fighting or restrictions that the U.N. has in place,” she said, specifically “those restrictions related to security routes that have to be authorized by the government of any country.”

One organization operating without government authorization in rebel held areas is Medicines Sans Frontiers (Doctors Without Borders).

After being denied humanitarian access from the Syrian government, MSF’s president Dr. Marie-Pierre Allié said the group opted to operate inside Syria illegally last June. By coordinating with opposition militia in the area, it has operated three field hospitals in rebel-held territory, surgically treating some 1,000 patients.

MSF last week issued a statement claiming areas under government control receive nearly all international aid, while opposition-held zones receive only a “tiny share.”

The group, which receives no government funding and relies entirely on private donations, criticized the lack of cross-border access as inefficient, following the announcement of a $1.5 billion humanitarian aid package for Syria from states attending a donors meeting in Kuwait City on Jan. 30.

Allié said working in rebel-held areas meant the group was unable to determine the percentage of those in need among internally displaced in opposing territories, but said the security obstacles in crossing front lines in Syria’s war highlighted the need for cross-border aid to be implemented.

“Our point is that since it is not possible to distribute aid across the lines, let’s be effective in distributing across borders and not from Damascus.”

Allié admitted that working solely with opposition groups was a challenge to the MSF’s charter, which states that the group “provides assistance to populations in distress, to victims of natural or man-made disasters and to victims of armed conflict ... irrespective of race, religion, creed or political convictions.”

“We want to be impartial,” she said. “That is exactly why we are requesting the ability to reach people on both sides. All our requests to intervene on the other side have not been fruitful.”

The UNHCR and the U.N. Office for Coordination for Humanitarian Affairs declined to comment on whether they would push for cross-border authorization, but in a Jan. 29 statement made after visiting Syria and Turkey, OCHA operations director John Ging said urgent agreement was needed to reach devastated communities in the north.

“Humanitarians must obtain access to all areas and by whatever routes are most effective,” Ging said. “Our experience of the past 22 months convinces us that cross-line access from within Syria, while vital, is just not enough to reach everyone, everywhere.

“We therefore need agreement to cross borders, irrespective of whose control they are under. This is particularly urgent in the north as without it we cannot reach the vast majority who are in need in the opposition-held areas there.”