-OpEd-

GAZIANTEP — On Feb. 15, 2014, the medical staff in the Syrian region of eastern Ghouta, my home, decided to close the unit housing incubators for premature babies because the hospital ran out of fuel for the electricity generators. The siege made my neighborhood inaccessible and deprived the hospital of supplies. Incubators need round-the-clock electricity and, at the time, we were hardly able to save enough fuel for critical cases. I took part in making that decision, and I will never forgive myself. A little girl died that night. She was two days old.

Eastern Ghouta has been under siege by pro-government forces since early 2013. Between November and December of that year, 33 children died because of the lack of fuel and medical supplies. The inaction of Damascus-based humanitarian organizations since then has only compounded this suffering. Three U.N. and partner agency convoys delivered supplies to our area in 2014, but each of them carried few items of value and they failed to stop the siege-related deaths.

I am now based in Gaziantep, Turkey, and work for the Syrian American Medical Society (SAMS), a medical relief organization. I can attest that being a beneficiary of aid in Syria is completely different from working from outside to deliver supplies. Working in a hospital whose services are needed at all times is different from working to send supplies, fuel and salaries to that hospital. Advocating for protecting health workers in Syria is completely different from defending your own life under barrel bombs.

When I was living in besieged eastern Ghouta, I did not read the humanitarian agencies' frequent reports on the latest aid delivery statistics. I was concerned with different numbers — the hospital's last liter of serum, the last liter of fuel, the last orthopedic external fixation.

I arrived in Gaziantep in June 2014, determined to continue supporting Syrian hospitals from the outside. I explored the "humanitarian community" and tried to learn the "humanitarian language." At first, I ignored statistics. Whenever I heard someone talk about Syrians as numbers, I told them, "We are not numbers. Every single casualty is a family member: a father, a brother, a sister or a son."

Numbers tell the story of our failure as humanitarian activists.

Yet, slowly, I became aware of the importance of numbers. Numbers tell the story of our failure as humanitarian activists. Numbers tell the story of how funding is dispersed. Numbers prove that donors also pay for military operations that exacerbate the crisis — much more than the amount they invest in humanitarian causes.

This is the story of Syria's failed humanitarian response, told by numbers.

According to Fueling the Fire, a March 2016 SAMS report by a group of international and Syrian NGOs on the response of the UN Security Council's permanent members to the Syria crisis:

- Syria's poverty rate was 35% before the crisis. It was 85% in 2015.

- The monthly income of a Syrian family was $600 before the war. It was just $100 in 2015.

- Syria's unemployment rate before 2011 was 8%. It was 52% in 2015.

- Life expectancy at birth in Syria was 70 years in 2011. It was 55 years in 2015.

According to the global nonprofit Physicians for Human Rights, there were 382 attacks on medical facilities and 757 health workers were killed between March 2011 and June 2016. In May 2016, the UN Security Council adopted a resolution to protect health workers and infrastructure in Syria, but that same month, PHR documented eight attacks on medical facilities. There were nine in June.

Every six months, the Security Council renews the resolution that enables cross-border aid deliveries. The International Syria Support Group (ISSG), a group of countries working on the crisis, created a humanitarian task force to follow up on aid deliveries in Syria. Despite these diplomatic efforts, the UN's Office for the Coordination of Humanitarian Affairs (OCHA) reported that in June convoys had reached only 341,400 people in besieged and hard-to-reach areas — roughly half the total of delivery approvals received and much lower than OCHA's target of 1.1 million people.

Many of Syria's 18 besieged areas were left critically underserved, with convoys lacking medical aid and carrying insufficient supplies. In Madaya, a town of 40,000 people located 30 miles (45km) from the humanitarian warehouses in Damascus, help came far too late. Eighty-six people died due to siege, starvation and the long wait for permission for medical evacuations.

The majority of aid has been going to hard-to-reach areas, and the Syrian government has had significant control over who receives help, and what supplies convoys carry. The UN said in January that of the 4.6 million people in besieged or hard-to-reach areas, only 620,000 received aid in 2015.

Failure to obtain the proper permission was the most severe factor that contributed to this discrepancy: 75% of the entry requests submitted in 2015 never received a government reply, 10% were approved and another 10% were granted but not carried out.

Even after the ISSG's humanitarian task force started working, only 30% of deliveries to besieged areas were approved, and the Syrian government still had significant influence over the contents.

While there is no doubt that decision-makers are aware of what needs to be done to protect civilians and guarantee that humanitarian aid is able to reach those in need, there's little appetite in the international community to make this happen.

However, a look at the numbers in Syria's story highlights the one thing that has so far proven to be the most effective tool at decreasing suffering: accountability.

Between September 2013 and December 2015, the Security Council passed three resolutions on the use of chemical weapons in Syria. Despite this, 69 of 161 verified chemical attacks during the war took place in 2015. However, after the UN launched an investigation, tasked with identifying individuals, entities, groups or governments involved in the use of chemical weapons, in October 2015, SAMS reported that the number of chemical attacks dropped to seven in the past six months.

The Syrian government would think twice before blocking aid if it were to be held accountable for these actions. It would rethink the use of unconventional weapons if an international tribunal was investigating war crimes in the country. However, the current inaction of the international community encourages the government and other parties to continue to commit the same crimes.