However, putting the delivery of aid in the hands of Syrians increases the risk that it becomes politicized. Last week, for instance, Syrians living in a camp near the Turkish border refused to accept the first shipment of aid to northern Syria since the outbreak of civil war. The U.N. aid was delivered by the Syrian Arab Red Crescent, an organization affiliated with the Syrian regime that the opposition views as a regime collaborator. "We don't need your aid ... not from the Assad's killers," the residents of the camp reportedly shouted.
Since then, two additional shipments of U.N. aid to northern Syrian have been successfully delivered. But the regime still refuses to allow the delivery of aid from across the rebel-controlled border with Turkey, requiring that all aid convoys make the treacherous journey north from Damascus. The United Nations has refused to defy the Syrian government, worried that such a decision could jeopardize its work in the capital.
NGO workers who spoke with Foreign Policy on the condition of anonymity are only too aware of the limitations of delivering aid while not being on the ground themselves.
Identifying trustworthy implementing partners is the first challenge: Aid organizations must constantly ensure that elements in Syria's fractured opposition, or groups affiliated with the regime, are not diverting the aid to support their political agenda.
It's no easy task to verify that aid is being used properly when NGOs can't send their staff to see for themselves. Aid workers try to overcome this hurdle by maintaining contact with networks of activists and local councils inside Syria, and heavily crosschecking and verifying the information provided to them by their Syrian implementing partners.
For instance, 30 Syrian data gatherers spread out across the north of the country in January 2013 to produce a report on humanitarian needs in the area. The report was organized by the opposition's Assistance Coordination Unit (ACU), which is designed to disburse aid in rebel-held regions, and international NGOs. The organization is headed by Wissam Tarif, a Lebanese activist who formerly worked with the advocacy group Avaaz.
"Basically, the data was collected by teams where we paired up ACU enumerators with NGO enumerators," said a British consultant to the ACU. "The data gatherers were interviewed extensively themselves on their return by the international assessment experts who designed the method."
Western aid organizations also demand receipts and documentation that funds and materials are used for the specific task for which they were allotted. For example, Mahmoud said that doctors at Western-supported field hospitals must sign for all materials that they receive. One copy of the receipt is left with the doctor and the other is brought back to the organization supporting the field hospital. Gulf donors, meanwhile, tend to be nowhere near as stringent with their reporting requirements.