GENEVA (AP) — Doctors Without Borders said on Thursday that it took the wrenching decision not to formally inform Syria's government or its Russian allies about the location of some medical facilities such as the one hit by a deadly airstrike this week, amid concerns that doing so could open them up to targeting amid recent violence that has killed many civilians.
The charity, also known by its French acronym MSF, says repeated attacks against health facilities during Syria's five-year civil war have led medical staffers to ask the group not to provide the GPS coordinates of some sites. This was the case of the makeshift clinic run by the charity in the Syrian town of Maaret al-Numan, which was hit four times in attacks on Monday, killing at least 25 people.
"Deliberate attacks against civilian infrastructures, including hospitals struggling to provide life-saving assistance are routine," MSF International President Joanne Liu told reporters in Geneva. "Health care in Syria is in the crosshair of bombs and missiles. It has collapsed. Let me be clear: Attacks on civilians and hospitals must stop. The normalization of such attacks is intolerable."
Liu's comments came as the U.N. made new aid deliveries to five besieged towns and said it plans additional deliveries, hopefully to the 4.6 million Syrians living in hard-to-reach and besieged areas, as called for in an agreement by 18 key nations in Munich on Feb. 12. That agreement also called for a cessation of hostilities within a week — which would mean Thursday — but there was no sign of a halt to fighting.
U.N. spokesman Stephane Dujarric said Secretary-General Ban Ki-moon wants to see movement toward a de-escalation of violence and a cessation of hostilities as soon as possible.
"What we've seen recently goes against that," he said. "We see very worrying escalation of military developments."
MSF's Liu said the group has no certainty about who was responsible for the strikes, but the "probability" was that Syrian or Russian air power was to blame. She said MSF's policy of not informing Syrian or Russian officials about the location of health facilities has become a "hot topic" inside the organization.
Also Thursday, the head of a U.N. task force on humanitarian aid for Syria said that 114 "big trucks" delivered life-saving supplies over the past 24 hours for 80,000 people in five besieged areas of the country. Jan Egeland called the deliveries a "first step" by the task force that was set up last week following a meeting of world and regional powers known as the International Syria Support Group. He said the supplies are enough to last about a month.
Egeland said the aim is to reach other main besieged areas, or areas surrounded by government or opposition forces, and "hard-to-reach" places within the next week. He also expressed hopes for progress in air-dropping aid to Deir Ezzor, a city which is currently under siege by the extremist Islamic State group.
The U.N. special envoy to Syria, Staffan de Mistura, said from Damascus that the International Syria Support Group is "very encouraged by the fact" that the 114 trucks were able to reach 82,000 people in need and appealed for more such action.
"I must say that this was a difficult test for the United Nations to show they could do it, for the government and for the armed opposition," de Mistura was quoted as saying in a statement. "Of course, we should go beyond that, we should go far beyond that in order to be able to reach everyone in Syria who is either besieged or in need of being assisted."
He added that the idea of air drops in areas besieged by the Islamic State group and other factions has become a concrete proposal that the U.N. wants to work on.
In New York, U.N. spokesman Dujarric told reporters Thursday that the World Food Program is considering using a Russian civilian contractor that has been used in the past in South Sudan, and that the contractor would be expected to seek instructions only from the United Nations.
Russia's deputy U.N. ambassador Vladimir Safronkov said Russian planes have been carrying out humanitarian air drops in Syria "for a long time," and he welcomed the "very important" recognition that this may be the only way to supply aid to some areas.
In Brussels, European Union leaders were expected to call on Russia and Syrian President Bashar Assad's forces to halt attacks on moderate opposition groups and immediately end all airstrikes.
A draft statement for their summit starting Thursday, seen by The Associated Press, calls on "Russia and the Syrian regime to stop at once attacking moderate opposition groups" and for "an immediate cessation of aerial bombardments in civilian areas."
MSF said that since the war broke out in 2011, the Syrian government has not granted permission for it to provide medical aid in the country, despite its repeated requests. Because of that, its work has been limited to areas held by opposition forces.
After the latest strikes, MSF operations director Isabelle Defourny said she expects affiliated medical staffers in Syria will now ask that their locations be specified to government officials.
"We gave to the Russian ambassadors in Paris (and) in Geneva coordinates for three hospitals located in very intense conflict zones, but not for all of them, and it was a decision taken together with the medical staff of the health facilities that we support," she said.
"It was a huge discussion inside MSF and mainly with the medical directors of the health facilities that we support inside Syria," Defourny added. "The staff of the hospital (and) the director of the hospital didn't know if they would be better protected if they give the GPS or not."
She said the Maaret al-Numan hospital was widely known and had already been hit by strikes in the past. "Those are not underground or invisible hospitals," she said of the medical sites, alluding to the difficulty of the decision not to formally identify its location.
Even giving GPS coordinates is no guarantee of protection, she said, citing a deadly U.S. airstrike in October that destroyed a MSF hospital in Kunduz, Afghanistan. That hospital had been identified to both Afghan and U.S. forces fighting an insurgency there.
Also Thursday, MSF provided a report documenting war wounded and deaths that draws on information from 70 "makeshift hospitals" and clinics it works with in Syria. While only "a small fraction of the health facilities in Syria," those medical facilities recorded a total of 7,009 people dead and 154,647 people wounded last year.
The U.N. estimates that more than 250,000 people have been killed and at 11 million displaced from their homes during the war.
Associated Press writers Lorne Cook in Brussels, Cara Anna in New York and Edith M. Lederer at the United Nations contributed to this report.
This story has been corrected to show that the latest death toll is 25, not seven, in the second paragraph. It also corrects to show that 7,009 people died and 154,647 were wounded last year, not during the whole Syrian conflict, in the penultimate paragraph.