The U.N. Tried to Save Hospitals in Syria. It Didn’t Work.

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A United Nations system to prevent attacks on hospitals and other humanitarian sites in insurgent-held areas of Syria has been ignored by Russian and Syrian forces and marred by internal errors, a New York Times investigation has found.

The repeated bombing and shelling of these sites has led relief group leaders to openly criticize the United Nations over the system, which is meant to provide warring parties with the precise locations of humanitarian sites that under international law are exempt from attack. Some of these groups have described the system of identifying and sharing sites, known as the “humanitarian deconfliction mechanism,” as effectively useless.

A new offensive by Syrian and Russian forces that began in late December has devastated what remains of several towns in northwestern Syria and caused tens of thousands of civilians to flee.

United Nations officials only recently created a unit to verify locations provided by relief groups that managed the exempt sites, some of which had been submitted incorrectly, The Times found. Such instances of misinformation give credibility to Russian criticisms that the system cannot be trusted and is vulnerable to misuse.

“The level and scale of attacks has not really decreased,” said Dr. Mufaddal Hamadeh, the president of the Syrian American Medical Society, which supports more than 40 hospitals and other sites in insurgent-held areas of northwestern Syria. “We can say categorically that in terms of accountability, in terms of deterrence, that doesn’t work.”

The Times compiled a list of 182 no-strike sites by using data provided by five relief groups and compiling public statements from others. Of those facilities, 27 were damaged by Russian or Syrian attacks since April. All were hospitals or clinics. Such a list is likely to represent only a small portion of the exempt sites struck during the Syrian war, now almost nine years old.

Under international law, intentionally or recklessly bombing hospitals is a war crime.

The deconfliction system works by sharing the location of humanitarian sites with Russian, Turkish and United States-led coalition forces operating in Syria, on the understanding that they will not target those sites. The system is voluntary, but relief groups said they felt intense pressure from donors and United Nations officials to participate. The groups give locations of their own choosing to the United Nations Office for the Coordination of Humanitarian Affairs, the agency that runs the system.

A document prepared by the agency warned that participation in the system “does not guarantee” the safety of the sites or their personnel. The document also stated that the United Nations would not verify information provided by participating groups. The system also does not require the Russians, Turks or Americans to acknowledge receipt of no-strike locations.

Whether such an arrangement could ever be successful in the brutal Syria conflict, where laws of war are disregarded on a daily basis, is an open question.

The forces of President Bashar al-Assad of Syria, alongside their Russian allies, have acted as if the deconfliction system did not exist. Local journalists and relief groups have recorded at least 69 attacks on no-strike sites since the Russian military intervention to help Mr. Assad began in October 2015, all but a few of them most likely committed by Russian or Syrian forces.

Jan Egeland, a Norwegian diplomat who was an adviser to the United Nations on Syria from 2015 to 2018, said the United Nations had failed to impose sufficient repercussions on those responsible.

“In general, deconfliction can work if there is a very loud, very noisy, very reliable investigation follow-up, accountability-oriented mechanism around it,” Mr. Egeland said, “so that the men who sit with their finger on the trigger understand there will be consequences if they don’t check the list or if they even deliberately target deconflicted places.”

Growing frustration over the failure of the deconfliction system led to a June meeting between an association of relief groups and Trond Jensen, a top United Nations humanitarian official in Turkey who has since moved to a new position in Gaza.

A summary of the meeting sent to participants afterward by Mr. Jensen and obtained by The Times acknowledged “a huge trust deficit in the process and with those who manage it.”

Relief groups felt they were putting the lives of their colleagues and other civilians at risk by participating, Mr. Jensen’s summary said.

Fadi al-Dairi, chairman of the association that met with Mr. Jensen, said that the United Nations and humanitarian groups had acted in “good faith” when they began using the system but that “we’ve not achieved anything.”

“There is a sense of frustration, lack of trust in everyone,” said Mr. al-Dairi, who is a co-founder of Hand in Hand for Aid and Development, which supports 53 deconflicted sites in Syria.

Though the deconfliction system has existed for years, Mr. al-Dairi and others involved in relief efforts said that the United Nations humanitarian agency had only recently hired dedicated deconfliction staff in southern Turkey and Amman, Jordan, to verify locations of deconflicted sites so that false information was not sent to the warring parties.

Previously, United Nations officials had told the groups that they did not have the capacity to hire more people, Mr. al-Dairi said.

“Some NGOs might lack the skills when it comes to reporting the coordinates,” Mr. al-Dairi said of the groups, “but it’s up to the U.N. to confirm it.”

“It is a matter of life and death,” he added, “so that’s why they should have been more proactive, like they are now.”

United Nations humanitarian officials privately told The Times that some relief groups had previously submitted incorrect locations and that, although rare, in a few cases misinformation had been shared with Russia, Turkey and the American-led coalition.

The United Nations humanitarian agency has taken steps to improve the system in recent months, including the creation of a “centralized entity” to run it, according to Zoe Paxton, a spokeswoman for the agency. It also is now giving participant organizations a second opportunity to confirm submitted locations. United Nations officials emphasize that under international law, the warring parties are responsible for verifying targets and minimizing harm.

Vassily Nebenzia, Russia’s ambassador to the United Nations, told a news conference in September that Russian military reconnaissance had discovered “lots of instances of deliberate disinformation” in the system.

One site listed as a hospital was actually being used to store firearms, Mr. Nebenzia claimed, while other sites had been submitted with coordinates sometimes up to 10 kilometers from their real locations.

“To get you a sense of an ‘iceberg’ size here, I will just say that only in July alone we were provided with 12 false coordinates,” he said. “And that is only about what we had capacity and time to check.”

While some of Mr. Nebenzia’s claims were shown to be false, at least three relief groups did submit incorrect coordinates to the United Nations on various occasions, The Times found.

While investigating an airstrike in November, The Times discovered that a relief group had provided coordinates for its health center that were around 240 meters away. When another hospital was bombed in May, The Times found that the coordinates submitted by its supporting organization pointed to an unrelated structure around 765 meters north.

After questions from The Times prompted the organization to review its deconfliction list, a staff member discovered that it had provided the United Nations with incorrect locations for 14 of its 19 deconflicted sites. The original locations had been logged by a pharmacist. The list had been with the United Nations humanitarian agency for eight months, and no one had contacted the organization to correct the locations, a member of the organization’s staff said.

Mr. al-Dairi and others involved in relief work said they assumed Russian and Syrian forces could find and target hospitals and other humanitarian sites without using the information shared by the United Nations. But they said they felt pressured to join the deconfliction system and had to convince skeptical Syrian doctors and aid workers to let them share their locations, knowing the information would go to the Russians and almost assuredly their Syrian government allies.

Dr. Munzer al-Khalil, the head of the Idlib Health Directorate, which oversees health care in Syria’s last opposition-held province, said many international donors would not support medical facilities unless they joined the U.N.’s deconfliction system.

“Therefore, we did not have much of an option,” Dr. al-Khalil said. “We paid a price by sharing the coordinates of the medical facilities with the United Nations. And what we got lately, frankly, was more bombing of medical facilities, and more precise bombing, and more destructive than before.”

Relief group leaders said that their only remaining hope was that adding their sites to the deconfliction list had left Russia and the Syrian government with no deniability — important for theoretical war crimes trials decades in the future.

“We truly believe the world has abandoned us,” Dr. al-Khalil said.

Christiaan Triebert, Malachy Browne, Carlotta Gall, Haley Willis and Logan Mitchell contributed reporting.

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