ISTANBUL - As the war inside Syria rages, aid organizations find themselves on the outside looking in -- fully aware of the daily destruction across the border, but unable to directly reach those in need because of the violence. That's where people like Mahmoud come in.
Mahmoud, who asked to be identified using a pseudonym, is a Syrian in his thirties who has worked with a Western-backed international aid organization operating on the Turkey-Syria border for the past six months. With security concerns and bureaucratic hurdles keeping most international aid workers from actually entering this war-torn country, NGOs rely on Syrians like Mahmoud to make the hazardous trek across the border to assess the needs for assistance and deliver aid to the local population.
Syrian "implementing partners" pick up the supplies at warehouses in southern Turkey, near the border, and drive them into Syria -- avoiding major highways to mitigate the risk of being attacked by a plane or helicopter. "The roads are bad because there are many parts of the road that are destroyed because of the shelling," Mahmoud said.
It's dangerous work. Mahmoud recounted a trip to opposition-held northern Syria this winter, when a military helicopter menaced the village he was visiting. The helicopter dropped barrels filled with TNT explosives onto the town. As Mahmoud sought shelter, running toward the relative safety of a basement, he saw two children and their mother standing on the roof of a house and watching the helicopter's deadly activity. The children and their mother did not hide, nor did they point or cry out.
"This is something horrible," he said. "I still have my feelings. I am afraid of the shelling. The people who stay inside [Syria] all the time, after all this, they are not afraid of anything."
Mahmoud's job is to help deliver aid, document how it is used, and gather data on the humanitarian needs inside Syria -- and then report back to his employer. It's not work that's going to be complete any time soon.
"What is going on in Syria...we will need aid for five years after the fall of the regime," he said. "It is not only the materials that you have to deal with, the destruction of buildings, the material damage. There is something else that has to do with the psychology of the people. Here there is big damage."
As the Syrian conflict approaches the two-year mark, it has left more than 60,000 dead -- and the devastation grows larger by the day. The U.N. Office for the Coordination of Humanitarian Affairs (OCHA) estimates that more than 850,000 people have become refugees. Inside Syria, the situation is even worse: There are 2 million people internally displaced and four million are in need of assistance. According to Melissa Fleming, spokeswoman for the U.N. Refugee Agency, some 7,000 Syrians are fleeing the country every day due to the worsening crisis.
About 15 international NGOs -- including big names such as Doctors Without Borders, Save the Children, and the Turkish IHH Humanitarian Relief Foundation -- operate in southern Turkey, sending supplies into Syria. Private donors fund most of the NGOs, said aid workers speaking on the condition of anonymity, though some receive funding from the United States and European governments. Mahmoud estimated that a total of 50 international aid workers have established themselves in the Turkey-Syria border area.
In addition to private organizations, the United Nations has stepped up its work in Syria. It appealed for $519 million to help Syrians inside the country, which it says would sustain its work through June. So far it has received just over 20 percent of the funds, or about $106 million, according to Jens Laerke, a Geneva-based spokesperson for OCHA. The United Nations has also appealed for an additional $1 billion to aid Syrian refugees in neighboring countries. But it has only received about 19 percent of the funds, or about $200 million.
There are some signs that the aid organizations are growing more effective. According to Mahmoud, one Western NGO is supporting 25 field hospitals in Syria with medical supplies. Two field hospitals receive all their supplies from this one NGO.
Field hospitals are, in general, better stocked with life-saving supplies than they were six months ago. But they remain ill-equipped to cope with the viciousness of the ongoing war: For instance, in many field hospitals, if 10 injured Syrians are brought in following an attack, there is not enough equipment to treat them all, Mahmoud said. A race to get the injured to a hospital in Turkey follows. But with the trip at times taking two to three hours, many patients die along the way.
The frequency of aid deliveries is still irregular. "Sometimes it is every week. Sometimes it is one time per month," Mahmoud said.
There are bureaucratic issues to bringing supplies into Turkey from abroad. Purchasing large quantities of certain medicines -- such as powerful sedatives necessary for operations -- can be problematic. Additional hold-ups, such as the temporary closure of the Bab al-Hawa border crossing after a car bombing on Feb. 11, slows the delivery of aid into the country.
"You can't describe it as an open border," Mahmoud said. "Because the Turkish government does not all the time allow the people work. Of course, they hide their eyes at times, but not all the time."
Mahmoud pointed out that there are clear benefits to relying on local Syrians for NGOs. Syrians know the situation and can move more easily in the country, and can be more attuned to the needs on the ground.
"As the volunteers are from the places in which they are working, they come from different backgrounds and have very good knowledge of their own communities," Stephanie Bunker, a U.N. spokesperson based in Amman, said in an e-mailed response to questions about the benefits of local implementing partners. "[O]f course, they speak the language as well."
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.
Western NGOs' safeguards, while understandable, also place them at a disadvantage in winning the hearts and minds of Syrians. Mahmoud agreed with recent reports that the al Qaeda affiliated group Jabhat al-Nusra is gaining support through its aid work.
"I am completely against Jabhat al-Nusra, but I have to tell the truth about what is going on," Mahmoud said. "If you go now to any village that is under the control of Jabhat al-Nusra you can find the bread there very cheap. If you go to any village that is close to the one under the control of Jabhat al-Nusra, the bread is very expensive."
"I think this is what makes people sympathize with [Jabhat al-Nusra] or at least respect them. How does al Qaeda have all this money, tell me?" he said.
As international aid agencies settle in for the long haul, however, there is a chance that this dynamic will change. Mahmoud said international NGOs are preparing to stay in southern Turkey for at least one or two years.
This means Mahmoud will continue traveling into Syria to aid his countrymen. He has been embarking on these dangerous journeys long enough now that he even knows the best weather conditions to make the trip.
"I am waiting all the time for the bad weather, when it is raining or when there are clouds," he said. "Because the aircraft don't go in this weather."
Even if the Syrian regime falls, the need for international aid to Syria will continue, he added.
"Until now, the doors to Syria are still closed. After the fall of Assad, these will open and...the Syrian people who escaped will all come back," he said. Only then can the real work of rebuilding Syria begin.