The scope of the disaster is outlined in a new report by the International Rescue Committee, a U.S. aid group active in the Mideast: 600,000 Syrians have fled to overburdened neighboring countries such as Lebanon and Jordan. They need international help to cope, especially given that the number could rise.
Meantime, two million civilians are displaced inside Syria, trying to survive with little food, medicine, or shelter during a frigid winter. Rapes of women and girls by armed men are common, and the government has systematically targeted hospitals and doctors.
Yet a U.N. appeal for $1.5 billion to aid uprooted Syrians has fallen far short.
One reason, of course, is the difficulty of delivering aid in wartime. A once-peaceful revolt against Assad descended into civil war after Syrian forces attacked nonviolent demonstrators. U.S. policy (which I question) still opposes any military aid to the rebels, who have battled Assad to a stalemate but can't take Damascus. So the war continues, with noncombatants trapped in the middle.
Yet there are many ways to help civilians in Syria, even as the fighting drags on.
For months, global aid to Syria was largely channeled through international agencies that dealt only with sovereign governments. That meant they worked with Damascus or the Syrian Red Crescent, which wouldn't deliver aid to areas freed from government control.
More recently, however, several international aid agencies, along with Syrian American volunteers, have found ways to transport tents, medical supplies, and other humanitarian goods across the border. USAID (the U.S. Agency for International Development), which has allotted $210 million in humanitarian aid to the Syrian crisis, is getting supplies into the country, too.
Within Syria, civilians are organizing local relief committees in liberated areas, as well as volunteer clinics, schools, and bakeries. They are desperately awaiting equipment, money for salaries, and flour.
Getting relief supplies into Syria can be very risky. This week, one activist told me, Syrian refugees were cheered by wonderful, clear weather in the north of the country, but it also gave government jets an opportunity "to come and bomb."
Still, courageous Syrian civilians are willing to risk all. But their success will depend heavily on whether the United States is willing to expand its role.
In November, U.S. officials helped organize a new Syrian Opposition Coalition, known as the SOC, with broader representation from inside Syria than previous such groups. President Obama recognized it as Syrians' "legitimate representative."
The immediate hope was that the SOC could serve as the focal point for coordinating aid to liberated areas of Syria and, with its contacts inside the country, identify needs. But to have credibility inside Syria, the SOC must be able to deliver benefits, which requires resources.
The Arab emirate of Qatar had promised to hand over hundreds of millions of dollars in Qatari banks from accounts belonging to Assad, opposition sources say. That hasn't happened. Nor have the Saudis delivered on their pledges.
Meantime, private Gulf donors continue to channel funds to Islamist groups in Syria, who distribute charity to desperate civilians and become heroes.
U.S. officials are trying to get donors to coordinate with the SOC, and they hope to deliver new U.S. humanitarian aid through the group. But this process is moving far too slowly, and U.S. officials need to expedite it.
Without resources, the SOC will quickly come to be dismissed as ineffective, like its predecessor, the Syrian National Council. It will not be able to establish itself in liberated areas of Syria or bolster nascent networks of civilian councils. A crucial chance to set up an effective channel to relieve Syrian suffering - and to facilitate a transitional government that might negotiate peace - will be lost.
That would be yet another tragedy heaped on Syrians already tormented by Assad's war crimes - in full view of the world.
Organizations helping Syrian refugees include the International Rescue Committee (rescue.org),
Save the Children (savethechildren.org),
Mercy Corps (mercycorps.org), Doctors Without Borders (doctorswithoutborders.org), and the Syrian American Medical Society (sams-usa.net). Trudy Rubin can be reached at firstname.lastname@example.org.