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THE SYRIAN HUMANITARIAN CRISIS: FOUR YEARS

LATER AND NO END IN SIGHT

JOINT HEARING

BEFORE THE

SUBCOMMITTEE ON 

THE MIDDLE EAST AND NORTH AFRICA

AND THE

SUBCOMMITTEE ON AFRICA, GLOBAL HEALTH, 

GLOBAL HUMAN RIGHTS, AND 

INTERNATIONAL ORGANIZATIONS

OF THE

COMMITTEE ON FOREIGN AFFAIRS 

HOUSE OF REPRESENTATIVES

ONE HUNDRED FOURTEENTH CONGRESS

FIRST SESSION

FEBRUARY 12, 2015

Serial No. 114–7

Printed for the use of the Committee on Foreign Affairs

(

Available via the World Wide Web: http://www.foreignaffairs.house.gov/ or

http://www.gpo.gov/fdsys/

(II)

COMMITTEE ON FOREIGN AFFAIRS 

EDWARD R. ROYCE, California, Chairman 

CHRISTOPHER H. SMITH, New Jersey 

ILEANA ROS-LEHTINEN, Florida 

DANA ROHRABACHER, California 

STEVE CHABOT, Ohio 

JOE WILSON, South Carolina 

MICHAEL T. MCCAUL, Texas 

TED POE, Texas 

MATT SALMON, Arizona 

DARRELL E. ISSA, California 

TOM MARINO, Pennsylvania 

JEFF DUNCAN, South Carolina 

MO BROOKS, Alabama 

PAUL COOK, California 

RANDY K. WEBER SR., Texas 

SCOTT PERRY, Pennsylvania 

RON DESANTIS, Florida 

MARK MEADOWS, North Carolina 

TED S. YOHO, Florida 

CURT CLAWSON, Florida 

SCOTT DESJARLAIS, Tennessee 

REID J. RIBBLE, Wisconsin 

DAVID A. TROTT, Michigan 

LEE M. ZELDIN, New York 

TOM EMMER, Minnesota 

ELIOT L. ENGEL, New York 

BRAD SHERMAN, California 

GREGORY W. MEEKS, New York 

ALBIO SIRES, New Jersey 

GERALD E. CONNOLLY, Virginia 

THEODORE E. DEUTCH, Florida 

BRIAN HIGGINS, New York 

KAREN BASS, California 

WILLIAM KEATING, Massachusetts 

DAVID CICILLINE, Rhode Island 

ALAN GRAYSON, Florida 

AMI BERA, California 

ALAN S. LOWENTHAL, California 

GRACE MENG, New York 

LOIS FRANKEL, Florida 

TULSI GABBARD, Hawaii 

JOAQUIN CASTRO, Texas 

ROBIN L. KELLY, Illinois 

BRENDAN F. BOYLE, Pennsylvania

AMY PORTER, Chief of Staff THOMAS SHEEHY, Staff Director

JASON STEINBAUM, Democratic Staff Director 

(III)

SUBCOMMITTEE ON THE MIDDLE EAST AND NORTH AFRICA

ILEANA ROS-LEHTINEN, Florida, Chairman 

STEVE CHABOT, Ohio 

JOE WILSON, South Carolina 

DARRELL E. ISSA, California 

RANDY K. WEBER SR., Texas 

RON DESANTIS, Florida 

MARK MEADOWS, North Carolina 

TED S. YOHO, Florida 

CURT CLAWSON, Florida 

DAVID A. TROTT, Michigan 

LEE M. ZELDIN, New York 

THEODORE E. DEUTCH, Florida 

GERALD E. CONNOLLY, Virginia 

BRIAN HIGGINS, New York 

DAVID CICILLINE, Rhode Island 

ALAN GRAYSON, Florida 

GRACE MENG, New York 

LOIS FRANKEL, Florida 

BRENDAN F. BOYLE, Pennsylvania

SUBCOMMITTEE ON AFRICA, GLOBAL HEALTH, GLOBAL HUMAN RIGHTS, AND

INTERNATIONAL ORGANIZATIONS

CHRISTOPHER H. SMITH, New Jersey, Chairman 

MARK MEADOWS, North Carolina 

CURT CLAWSON, Florida 

SCOTT DESJARLAIS, Tennessee 

TOM EMMER, Minnesota 

KAREN BASS, California 

DAVID CICILLINE, Rhode Island 

AMI BERA, California 

(V)

C O N T E N T S 

Page

WITNESSES 

Ms. Kelly Tallman Clements, Deputy Assistant Secretary, Bureau of Population, Refugees, and Migration, U.S. Department of State ............................. 9

Mr. Thomas Staal, Acting Assistant Administrator, Bureau for Democracy, 

Conflict and Humanitarian Assistance, U.S. Agency for International Development .................................................................................................................. 18

LETTERS, STATEMENTS, ETC., SUBMITTED FOR THE HEARING 

Ms. Kelly Tallman Clements: Prepared statement ............................................... 11

Mr. Thomas Staal: Prepared statement ................................................................. 20

APPENDIX 

Hearing notice .......................................................................................................... 46

Hearing minutes ...................................................................................................... 47

The Honorable Gerald E. Connolly, a Representative in Congress from the 

Commonwealth of Virginia: Prepared statement .............................................. 48

The Honorable Ileana Ros-Lehtinen, a Representative in Congress from the 

State of Florida, and chairman, Subcommittee on the Middle East and 

North Africa: Statement for the record by Ms. Sharon Waxman, Vice President for Public Policy and Advocacy, International Rescue Committee .......... 50

(1)

THE SYRIAN HUMANITARIAN CRISIS: FOUR 

YEARS LATER AND NO END IN SIGHT 

THURSDAY, FEBRUARY 12, 2015

HOUSE OF REPRESENTATIVES,

SUBCOMMITTEE ON THE MIDDLE EAST AND NORTH AFRICA AND

SUBCOMMITTEE ON AFRICA, GLOBAL HEALTH,

COMMITTEE ON FOREIGN AFFAIRS,

Washington, DC. 

The committees met, pursuant to notice, at 1:30 p.m., in room 

2172 Rayburn House Office Building, Hon. Ileana Ros-Lehtinen 

(chairman of the Subcommittee on Middle East and North Africa) 

presiding. 

Ms. ROS-LEHTINEN. With all due apologies to the members who 

are not here yet, I am going to start because pretty soon we will 

be going back into the session and be voting. So, thank you very 

much. I know that the members will be coming right quick. When 

they come here, I will recognize them for their opening statements. 

So, the joint subcommittees will come to order. 

After recognizing myself, Chairman Smith, Ranking Members 

Deutch and Bass, as soon as they come for 5 minutes each for our 

opening statements, I will, then, recognize any other members 

seeking recognition for 1 minute. We will, then, hear from our witnesses. 

Without objection, the witnesses’ prepared statements will be 

made a part of the record, and members may have 5 days in which 

to insert statements and questions for the record, subject to the 

length limitation in the rules. 

Before I begin my opening remarks, I want to take a moment to 

offer our most sincere condolences to the friends and family of 

Kayla Mueller. Our thoughts and prayers are with them in this 

most trying of times. Kayla was taken hostage while doing humanitarian work in Syria, which is the subject of our hearing, helping 

those who are in such dire need of her help. All of America mourns 

her loss and the family’s loss. 

The terrorists have proven time and again that they have no respect for human rights, and that is why we must redouble our efforts to defeat this scourge and its radical ideology. Kayla’s legacy 

will be the work that she had done to alleviate the suffering of a 

countless many in Syria and around the world. 

It is important that our Government will continue to respond to 

this humanitarian crisis, but also that we will make the respect for 

human rights across the globe a priority and not just an afterthought. 

2

With that, the Chair now recognizes herself for 5 minutes. 

Next month will mark the fourth anniversary since the start of 

the Syrian conflict, and there are no signs that the crisis will abate 

anytime soon. Assad has demonstrated no remorse, and, indeed, his 

intransigence has only hardened as he maintains his grasp on 

power and the enclaves of Syria, thanks to the support from Iran 

and the United States’ unwillingness to engage both ISIL and 

Assad in a comprehensive strategy. ISIL and other terror groups 

have managed to wrest control of other large areas of Syria, and 

they, too, have no intention of giving up the territory they have 

claimed. 

Since President Obama announced strikes against Syria last September, ISIL has actually gained more territory. That leaves little 

territory for those Syrians who wish to flee the fighting and flee 

the violence. What we are seeing unfold in Syria is one of the worst 

humanitarian crises in the region in recent memory, and it isn’t 

just limited to Syrian and Iraq. Jordan and other neighboring countries have been forced to bear the brunt of a massive influx of refugees fleeing the fighting. That has tested the limits of their already-strained capabilities. 

Last Congress Ranking Member Ted Deutch and I convened four 

hearings on the humanitarian situation in Syria. One we were 

pleased to join with Congressman Smith’s and Congresswoman 

Bass’ subcommittee in an effort to continue to shine a light on this 

aspect of the conflict that gets ignored. 

When we held our first subcommittee hearing on the situation 

Syria, 80,000 Syrians has been killed and 1.5 million people had 

been displaced. Less than 2 years later, those numbers have 

swelled. Over 200,000 have been killed, more than 3 million have 

fled, and now more than half of Syria’s population is in dire need 

of humanitarian assistance. 

The U.S. has been the largest provider of humanitarian assistance in response to the crisis, providing much-needed aid to Syria, 

to Iraq, to Jordan, and other countries that have been severely impacted by this crisis. We have spent over $3 billion since the start 

of the conflict, and the President’s budget request, released last 

week, is seeking an additional $1.6 billion to address the humanitarian needs in Syria and in Iraq. 

While some of this goes directly to the neighboring countries that 

host refugees and directly to the NGOs, the vast majority of our 

funding for Syria supports multilateral initiatives through the 

United States. I worry that some of the assistance we provide that 

goes to the U.N. and its implementing partners might get diverted 

to ISIL or other terrorist groups or the Assad regime by force or 

through bribes, in order to gain access to certain areas. 

While I understand there are some very real and dangerous obstacles in place to reaching the maximum amount of people, Americans are concerned over where this $5 billion is going, especially 

if most of it could be going through third and fourth parties, as evidence shows that it is. 

There have been reports that some of the humanitarian assistance is going through middlemen in Syrian when the implementing 

partners can’t get access to the locations that they are trying to 

reach. More recently, food rations have been handed out by the 

3

World Food Program, and they are tagged with the Islamic State 

symbol. 

So, there are some very real and pressing problems that need to 

be corrected. Congress and the administration, we have a responsibility to the American public to be good stewards of their tax dollars. So, it is imperative that we find the right balance of efficiency 

and transparency. Our comprehensive strategy toward Syria must 

take into effect the humanitarian crisis that we are confronting 

today. 

That is why it is so important, it is imperative, that we hold 

these hearings not only to hear from the vital work that we are 

doing and the lives that we are saving, but also conduct our proper 

oversight role. It is also why I was joined this week by Ranking 

Member Deutch, Mr. DeSantis, and Mr. Connolly in sending a request to the Government Accountability Office, GAO, requesting a 

report to ensure that our aid is reaching its intended recipients and 

to get a better understanding regarding our visibility into the large 

sums of money that we send through the U.N. 

The Syrian humanitarian crisis is not a problem that is going 

away anytime soon, not until we defeat ISIL and Assad, and Assad 

is removed from power. But the U.S. cannot afford to continue to 

provide billions indefinitely. It is imperative that we have confidence that what we are providing is not subject to waste, fraud, 

abuse, or diversion to terror groups, so that we can continue playing a key role in responding to this crisis and maximize our effectiveness. 

With that, I am proud to yield to the ranking member of our subcommittee, Mr. Deutch. 

Mr. DEUTCH. Thank you, Madam Chairman. 

I, too, would like to associate myself with the chairman’s remarks about the tragic death of Kayla Mueller at the hands of the 

barbaric ISIS terrorists. Our thoughts and prayers go out to 

Kayla’s family and friends during this difficult time. Please know 

that we will continue to honor Kayla’s memory and her life’s work 

by giving this humanitarian crisis the attention that it deserves. 

I want to thank the chairman for starting this Congress with a 

hearing specifically focused on the humanitarian aspect of the Syrian conflict, a followup to four humanitarian-focused hearings that 

we held last Congress. 

The title of this hearing speaks volumes to the situation inside 

Syria and in neighboring countries. There is no end in sight. Members had the opportunity to discuss the political and security components of this conflict in the full Foreign Affairs Committee this 

morning, but this afternoon we are here to focus on the growing 

humanitarian crisis. 

There are now 2.2 million people in need of humanitarian assistance. As Mr. Staal’s testimony notes, that is the populations of 

New York City and Los Angeles, the two largest cities in the 

United States combined. There are 3.8 million refugees in neighboring countries. There are 241,000 people in besieged areas inside 

Syria. There are 9.8 million people who are food insecure. Madam 

Chairman, these numbers are truly staggering. 

The situation inside Syria has complicated the ability of humanitarian organizations to effectively deliver aid. Despite the first auVerDate 0ct 09 2002 11:10 Mar 31, 2015 Jkt 000000 PO 00000 Frm 00009 Fmt 6633 Sfmt 6633 F:\WORK\_MENA\021215\93286 SHIRL
4

thorization of cross-border aid deliveries in the United Nations Security Council Resolution 2165, it is becoming increasingly difficult 

to get aid safely into the country and to its intended recipients. 

Deputy Assistant Secretary Clements, I hope you will speak to 

the effectiveness of cross-border and cross-line aid. We continue to 

engage in a political process that is yet to even yield a sustainable 

truce inside Syria, an effort that would at least help deliver aid to 

those with the most critical needs. 

Syrian refugees have flooded into Jordan, Lebanon, and Turkey 

at a staggering rate. Jordan has 622,000 registered refugees, and 

in Lebanon the Syrian refugees now make up one-fourth of the population. These overwhelming numbers do not even include potentially hundreds of thousands of unregistered refugees that have 

been absorbed into urban areas. We have got to continue to support 

these host communities and help to mitigate the understandable 

strain that it places on their resources. 

The United States has now provided over $3.5 billion in humanitarian assistance. We are the largest individual donor. I offer my 

full support of continued humanitarian funding for this crisis, but 

I also want to make sure that our aid is effective and not falling 

into the wrong hands. 

I was troubled by reports last week that showed ISIS fighters 

handing out U.N. food packages. That is why, as Chairman RosLehtinen had mentioned, I joined with her and Congressmen 

Connolly and DeSantis in commissioning a GAO report, so we can 

be absolutely sure that the proper mechanisms are in place to 

spend our aid dollars most effectively. 

I have got to say I have been shocked and truly dismayed 

throughout this crisis at the lack of financial support coming from 

the international community. Last year only half of the U.N. budget was funded. These unfulfilled pledges of assistance led to the 

World Food Program literally having to stop its operations while an 

emergency fundraising campaign took place. That is unacceptable. 

I recognize that most of us were unprepared to deal with a protracted crisis. Now, after 4 years, we are at risk of losing an entire 

generation; 5.6 million children have been affected. 

We have seen the outbreak of formerly eradicated diseases like 

polio, simply because infants and children couldn’t get vaccinations. 

Refugee children have been absorbed into unfamiliar school systems, many of which didn’t have the staff or resources necessary 

to shoulder these additional students. Many have been forced to 

abandon school altogether and find work to help support their families. 

Women and children have borne the brunt of this humanitarian 

crisis. I hope that Mr. Staal can address some of the programs that 

we are funding aimed at protecting these vulnerable populations. 

Before I close, I want to remind everyone of one critical factor. 

Despite the horrific brutality of ISIS and its devastating attacks in 

Syria and Iraq and against American and other Western citizens, 

it is still the ruthless Assad regime that remains the biggest threat 

to the Syrian people. We may share a common enemy in ISIS, but 

we are not partners with this deadly regime that has the blood of 

hundreds of thousands of its own people on its hands. 

5

Finally, I want to commend the work of State and USAID. This 

is a tremendous challenge, and we recognize the work you do is not 

easy. The work of your partners on the ground who risk their lives 

to help those in need deserves to be recognized in this body and 

in capitals around the world every day. 

I thank our witnesses for being here. 

Ms. ROS-LEHTINEN. Very good. Thank you, Mr. Deutch. 

I am so pleased to yield to the subcommittee chairman, Chairman Smith, who has made it his life’s mission to fight human 

rights violations and to spearhead humanitarian missions. Thank 

you, Mr. Chairman. 

Mr. SMITH. Madam Chair, thank you so very much. It is an 

honor and a privilege to join you, for both of our subcommittees to 

be receiving this testimony and really broadcasting to all who will 

hear our solidarity with the victims, those men, women, and children who are being savagely beaten and killed and raped and tortured by Assad and by other players and other actors in Syria. So, 

thank you again for pulling us together for this hearing. 

As we all know, since the beginning of the Syrian conflict in 

2011, the U.N. estimates that more than 200,000 have been killed. 

It would be terrible enough if we could count the dead in Syria as 

collateral damage from a civil war gone completely out of control. 

Unfortunately, the truth is far more horrific than that. 

According to the U.N., the government of Bashar al-Assad initiated the conflict to crush the opposition to his brutal rule. In the 

process, he has used chemical weapons, barrel bombs, and other 

weapons of mass destruction to kill his own people. This regime 

has been involved in widespread killings, including children, torture, again, against children, as well as hospital patients, arbitrary 

arrests and imprisonment on a massive scale, deployment of tanks 

and helicopter gunships in densely-populated areas, heavy and indiscriminate shelling of civilian areas, enforced disappearances, 

systematic destruction of property and looting, systematic denial of 

food and water in some areas, and prevention of medical treatment, 

again, including children. So depraved has the Assad regime been, 

that it has been reported to have indiscriminately shelled bakeries 

with artillery rounds, even though the targets were civilian, and 

not military, targets. 

David Nott, a British volunteer surgeon in Syria, reported in 

2013 that ‘‘Victims of government snipers would display wounds in 

a particular area of the body on particular days,’’ indicating that 

they may have been targeted in a gruesome game. 

The Syrian Government came to view doctors and nurses as collaborators because they were willing to help rebels in need of medical care. Early on in the conflict, the Assad regime imprisoned 

hundreds of health workers and tortured many of them to death. 

Others have just disappeared. Government forces targeted health 

workers in medical facilities in attacks, erasing the universal principle of medical neutrality. 

However, the government isn’t the only perpetrator of human 

rights violations in Syria. The U.N. reports that armed opposition 

groups, including militia supporting the Assad regime, have been 

responsible for unlawful and indiscriminate killings, tortured 

abuse, including hostage-taking. One rebel commander told the AsVerDate 0ct 09 2002 11:10 Mar 31, 2015 Jkt 000000 PO 00000 Frm 00011 Fmt 6633 Sfmt 6633 F:\WORK\_MENA\021215\93286 SHIRL
6

sociated Press that his group had released prisoners in bombrigged cars, turning them into unwitting suicide bombers. Other 

groups have perpetrated crimes too egregious to present today in 

detail. 

In addition to armed groups such as the Free Syrian Army and 

the Syrian Revolutionaries Front, al-Qaeda and its offshoot, including al-Nusra Front, ISIS, operate within this conflict committing 

heinous crimes against those unable to leave Syria. 

We know—and this was in the testimony by the Deputy Assistant Secretary Clements—half of its prewar population in Syria has 

been displaced. Half of a country gone, displaced, and that is almost without precedent anywhere in the world. 

The Euro-Mediterranean Human Rights Network reported in 

late 2013 that at least 6,000 women have been reported being 

raped by one armed group or another, and that the genuine figure 

was likely much higher due to underreporting. In fact, the International Rescue Committee reported 2 years ago that the primary 

reason for Syrians to flee their country has been fear of rape. 

The various armed groups terrorizing people in Syria operate 

with impunity. Since Syria is not a party to the Rome Statute, the 

International Criminal Court has no jurisdiction over these human 

rights violators, although there could be a referral, if they were so 

inclined, from the Security Council. Even if the ICC could get involved, Russia has already indicated its opposition to that kind of 

referral. 

That is why again I introduced last year—and I will do it again 

soon—a resolution to create an independent tribunal to begin the 

process of investigating human rights crimes in Syria and bring to 

reality the promise of justice to those who now have no fear of any 

kind of accountability. It would be patterned on what we had in 

Yugoslavia, Rwanda, and, of course, the Independent Court in Sierra Leone. 

The tribunal would prosecute the perpetrators of mass atrocities, 

war crimes, and crimes against humanity, no matter who committed the crime. Hopefully, these individuals would be brought to 

justice. 

Again, I want to thank you, Madam Chair, for doing this hearing 

together with our subcommittees and for your extraordinary leadership. 

Ms. ROS-LEHTINEN. Thank you so much, a powerful statement. 

Because Ms. Bass, the ranking member of Mr. Smith’s committee, is not here, I would like to recognize Ms. Frankel and Mr. 

Boyle to share those 5 minutes, however way you would like to divide them. 

Ms. Frankel is recognized. 

Ms. FRANKEL. Thank you, Madam Chair. I thank both you and 

the ranking member for this hearing, which I believe is very important. 

I want to share your sentiments on or sorrow for the loss of 

Kayla Mueller. 

We have heard from the administration, obviously, in the past 

several months why we should train and arm Syrian rebels. We 

now have a request for authorization for the use of military force. 

7

So, I am very pleased that you are here to talk about—it is a little 

change of pace; let’s put it that way. 

This is what I am particularly interested in, not only the type 

of humanitarian assistance and answering some of the questions 

about whether we are effectively getting it to those who are suffering, but I am also interested in your opinion as to the role that 

humanitarian assistance in the larger goal of defeating those forces 

like Assad, like ISIL, that are causing the pain. 

Then, what else I would be interested in, especially in light of 

what happened to Kayla Mueller, is how safe it is for our AID 

workers in delivering this humanitarian assistance. 

I thank you, and I will yield the rest of my time to Mr. Boyle. 

Ms. ROS-LEHTINEN. Mr. Boyle is recognized. 

Mr. BOYLE. Thank you very much. 

I have to say, being on the Foreign Affairs Committee and this 

subcommittee for the last 6 weeks, I keep waiting until we get to 

have hearings about good news. I suspect that we would be waiting 

a very long time. 

The scale of the human tragedy that has taken place in Syria is 

unbelievable, now over 12 million human beings, 12 million people, 

who have been dislocated. This has created enormous instability 

not just in Syria, but, obviously, in northern Iraq and in other 

nearby areas. 

I would just ask—and a lot of my comments were echoed earlier—so, rather than being repetitive, I would just ask that, when 

you are giving your statements, while this subject might be specifically about Syria, this is part of a regional fight, part of a fight that 

King Hussein of Jordan said has been going on for approximately 

1,400 years, I would like you to talk about, to the extent that you 

are knowledgeable about it, the stability of the regime in Jordan. 

Because with being bordered with Israel and what was going on 

last summer in Gaza and the disruptions to a lesser extent in the 

West Bank, and then, of course, what is going on, a de facto ShiaSunni civil war, and, also, at the same time a war between those 

who believe in a very radical militant, violent form of Islam and 

those who do not, with all that going in the region, we have one 

little island of stability smack dab in the middle there. I am deeply 

concerned, and you do not hear about this much, but I am deeply 

concerned that the Syrian conflict, if it were to spread to the West, 

would finally topple one of the few regimes that we can actually 

count on as an ally. So, I hope that when you give your comments, 

you will broaden it and talk about that a bit. 

I thank the Madam Chair. It is an honor to be on her subcommittee. I thank the ranking member. 

Also, to say this in person, I have watched the human rights 

work that Chairman Smith has done for many, many years, and 

am a big admirer of it. It is great to be a part of this. 

Ms. ROS-LEHTINEN. It is an honor to have you. Thank you very 

much. 

Mr. Chabot of Ohio. 

Mr. CHABOT. Thank you, Madam Chairman, for calling this important joint hearing. 

The violence in Syria over the past 4 years has spiraled out of 

control, as we know, yielding a serious and grave humanitarian criVerDate 0ct 09 2002 11:10 Mar 31, 2015 Jkt 000000 PO 00000 Frm 00013 Fmt 6633 Sfmt 6633 F:\WORK\_MENA\021215\93286 SHIRL
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sis. It was in August 2012 that the President famously declared the 

red line. However, today nearly 200,000 people have been senselessly killed, over 3 million are refugees in neighboring countries, 

with millions more internally displaced, and we are no closer to 

ending this humanitarian tragedy. 

As this work continues, I believe that this crisis will, unfortunately, only get worse. The refugee flows into Jordan, Lebanon, and 

Turkey have hardly diminished, and these countries are at their 

peak in terms of the numbers that they can support. At the same 

time, unprecedented numbers are streaming into Syria to join ISIL 

and other extremist groups, which are further complicating and exacerbating this situation. 

As the U.S. is the largest contributor of humanitarian assistance, 

we need to implement a strategy that most effectively deals with 

this growing crisis, while ensuring those in most need are receiving 

our support. Various reports have indicated that U.S. assistance is 

reaching the hands of ISIS and other terrorist groups, and that is 

very alarming. 

I hope that today’s witnesses will discuss what is being done to 

address this issue and all the other things my colleagues have 

mentioned. There is, indeed, a lot to talk about today. 

Thank you, Madam Chair, and I yield back the balance. 

Ms. ROS-LEHTINEN. Thank you, Mr. Chabot. 

Mr. Trott is recognized. Dr. Yoho is recognized. 

Mr. YOHO. Thank you, Madam Chair. I just want to say I look 

forward to hearing your information, so that we can come to some 

common-sense solutions to the Middle East over there and work 

with the AUMF and the President to get some resolution. 

With that, I yield back. 

Ms. ROS-LEHTINEN. Thank you very much. 

So now, we turn to our witnesses. Let me introduce our panelists. 

First, we are pleased to welcome Deputy Assistant Secretary 

Kelly Clements of the Bureau of Population, Refugees, and Migration at the Department of State. She was detailed to the Office of 

the U.N. High Commissioner of Refugees in Bangladesh and has 

served on the State Department’s Task Force on Kurdish Refugees 

and Displaced Persons. She has also been a Special Assistant to 

the Under Secretary of State for Global Affairs and a Senior Emergency Office for Europe during the Balkan crisis. 

Welcome. 

Then, we will also hear from Acting Assistant Administrator 

Thomas Staal of the Bureau of Democracy, Conflict, and Humanitarian Assistance at USAID. He has served in USAID since the 

late eighties and has managed project developments in eastern and 

southern Africa as well as in the West Bank and Gaza. More recently, he has served as the Director of the Iraq Reconstruction Office here in Washington, DC, and as Mission Director in Lebanon, 

Ethiopia, and Iraq. 

Excellent panelists. 

We will begin with you, Ms. Clements. 

The prepared statements will be made a part of the record. 

9

STATEMENT OF MS. KELLY TALLMAN CLEMENTS, DEPUTY ASSISTANT SECRETARY, BUREAU OF POPULATION, REFUGEES, 

AND MIGRATION, U.S. DEPARTMENT OF STATE 

Ms. CLEMENTS. Thank you so much, Chairman Ros-Lehtinen, 

Ranking Member Deutch, Chairman Smith, and members of the 

committee, for inviting us to this very important hearing on humanitarian assistance for those imperiled and uprooted by the 

worst human-made catastrophe of our time. 

I have submitted my full testimony for the record, and I am 

grateful for the opportunity to update you and to thank you for 

your leadership and to Congress for its unwavering support. 

The Syrian crisis has claimed nearly 200,000 lives, forcibly displaced half of Syria’s prewar population of 24 million people. Almost 4 million have fled to neighboring countries and many will remain in exile for years to come. 

The Assad regime and extremist groups target innocent civilians 

already suffering from food shortages, inadequate shelter, and preventable diseases. Right now, 12.2 million people inside Syria need 

urgent humanitarian aid, and half of them are children. 

The humanitarian response has been the most expensive in modern history, and the needs have outstripped available resources. Although U.N. humanitarian appeals have grown exponentially, the 

total amount pledged has plateaued. The 2014 appeals were just 

over half-funded, as you noted earlier. 

The United States remains the single largest donor and has con- tributed over $3 billion since the crisis began. In 2014, my Bureau 

at the State Department provided more than a third of all funding 

for the Syrian humanitarian response. That $725 million is the 

largest single-year contribution in our Bureau’s history. Roughly 

half of all U.S. humanitarian aid has gone to conflict victims inside 

Syria and half to refugees and communities hosting them. 

Over the last 6 months, U.N. Security Council Resolutions 2191, 

2139, 2165 enabled U.N. convoys to cross borders and battle lines 

and to reach millions of civilians in governorates, including Dar’a, 

Idlib, Quneitra, and Aleppo that have been encircled, blockaded, 

and under siege. 

In 2014, the U.N. Refugee Agency provided aid to more than one 

out of every three Syrians in need, including 1 million people in difficult-to-reach areas. USAID feeds nearly half of all Syrian refugees, roughly 2 million people, and provides relief items, everything 

from cooking pots to shoes and blankets to insulated tents to help 

refugee families survive the winter. Our programs aid survivors of 

gender-based violence, elderly and disabled people, unaccompanied 

children, and others who need services and protection. With U.S. 

support, in 2014, the U.N. and its strong NGO partners were able 

to triple the number of Syrian children enrolled in school. 

But vast needs remain. Half of Syrian children are still not in 

school. Last week Tom Staal and I saw thousands of them while 

visiting the Domiz Camp in the Iraqi Kurdistan region. It is bursting at the seams with an official tally of 35,000, but far more are 

seeking services not available in overwhelmed host communities. 

Heroic efforts are underway to educate, feed, shelter, and clothe 

the displaced, but everything is in short supply. More than eight 

in ten Syrian refugees live outside of camps, straining host commuVerDate 0ct 09 2002 11:10 Mar 31, 2015 Jkt 000000 PO 00000 Frm 00015 Fmt 6633 Sfmt 6633 F:\WORK\_MENA\021215\93286 SHIRL
10

nities across a region that was already economically fragile and politically volatile. Syrian refugees are crowded into communities in 

Turkey, Lebanon, Jordan, Iraq, and Egypt. In Lebanon, one in four 

residents is now a refugee. In Jordan, housing shortages have doubled rents; schools and hospitals are overcrowded; municipal services cannot keep up; tensions are rising, and beleaguered governments have responded by closing or tightly managing borders. 

To ease these pressures, the Department and USAID are coordinating humanitarian and development assistance and funding 

projects that provide important services, clean water, sanitization, 

education, and economic opportunities to both host communities 

and refugees. 

We have encouraged other donors to come forward, and many 

have been generous, including Saudi Arabia and Kuwait. The 

United States is also accelerating resettlement of Syrian refugees. 

We have received referrals from over 10,000 Syrian refugees and 

expect to admit between 1,000 and 2,000 this fiscal year and many 

more in 2016 and beyond. 

Thank you very much for your support, and I welcome your questions. 

[The prepared statement of Ms. Clements follows:]

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Ms. ROS-LEHTINEN. Thank you very much, Ms. Clements. 

Mr. Staal? 

STATEMENT OF MR. THOMAS STAAL, ACTING ASSISTANT ADMINISTRATOR, BUREAU FOR DEMOCRACY, CONFLICT AND 

HUMANITARIAN ASSISTANCE, U.S. AGENCY FOR INTERNATIONAL DEVELOPMENT 

Mr. STAAL. Chairman Ros-Lehtinen, Ranking Member Deutch, 

Chairman Smith, and members of the subcommittees, thank you 

for the opportunity to testify today and for highlighting the needs 

of the Syrian people and the needs of the people in their neighborhood. For me, it is especially important because I grew up in the 

area and I have lived and worked there for many years. 

As Deputy Assistant Secretary Clements has mentioned, and 

many of you know, the Syrian crisis is the largest and most complex humanitarian emergency of our time. More than 2.2 million 

Syrians are in need of humanitarian assistance. You mentioned 

New York and Los Angeles. It is also just about the entire population of the State of Pennsylvania, is another way to look at it. 

We continue to do everything possible to help those most in need, 

and our FY16 request that you mentioned, the USAID piece of it 

at $735 million for the Syrian humanitarian response demonstrates 

that continued commitment. 

Now 4 years into this conflict, Syrians see no end in sight to the 

violence. ISIL’s abuses, including the death of Kayla Mueller you 

mentioned, have been layered on top of the Assad regime’s indiscriminate killings and barrel bombings. 

Our partners are heroically working through all possible channels, often at considerable risk, to reach those in need, including 

in regime areas, in opposition- and ISIL-controlled areas of Syria. 

For over 3 years, we have provided emergency care to nearly 2 million patients at 300 U.S.-supported health facilities throughout the 

area. I saw some of those patients myself last week at a hospital 

in Jordan. 

Thanks to the aggressive vaccination campaign, by the number 

of polio cases in Syria is now down to zero. We have improved 

water and sanitation for 1.3 million Syrians, repairing water networks, installing latrines and bathrooms in camps. These efforts 

have helped to prevent the spread of disease. 

And then, for the third year we are working tirelessly to help the 

most vulnerable cope with winter, especially those who are living 

in makeshift homes and tents. So far, we have distributed blankets, warm clothing, plastic sheeting to almost 1⁄2 million people. 

We have also distributed air heaters and put up windows and doors 

to help insulate homes. 

We know that women and children are the most impacted in this 

crisis. And so, we also prioritize and integrate their protection into 

all of our humanitarian assistance efforts. 

As you mentioned, the United States is the largest donor, and including the largest food donor, to the crisis, providing more than 

$1.1 billion worth to date to feed more than 4.8 million people inside Syria and 1.7 million in the neighboring countries. The food 

vouchers we provide to Syrian refugees so that they can buy locally 

have also injected about $1 billion into the economies of Lebanon 

19

and Jordan, Turkey, Egypt, and Iraq. In fact, within Jordan, it 

equals to about .7 percent of their GDP. And we have a robust system for monitoring our humanitarian assistance to ensure that it 

does, indeed, get to the most in-need people for whom it is intended. 

We know that Syria’s neighbors are stretched beyond capacity. 

That is why we are also helping, working in host communities, in 

cooperation with our State Department colleagues, to build resilient systems that can withstand the increased demand on services 

from the flow of refugees into their countries. 

In Jordan, for instance, we are working to conserve water. With 

the Complex Crisis Fund resources, we have built cisterns to collect 

rainwater in 90 schools in Jordan and provided more than 2,200 

no-interest loans, so that families can install rainwater-harvesting 

systems. These efforts have saved 200,000 cubic meters of water, 

equal to 5.5 million showers. 

In Lebanon, we are working to decrease tensions between host 

communities and refugees. Following clashes recently between militants and Lebanese armed forces in Tripoli, our partners worked 

with the community to rehabilitate the old city and involved young 

people to reduce the appeal to extremism. 

So, we are doing everything we can, but important challenges remain. Constrained access, insecurity, including targeted attacks 

against humanitarian workers, are a prime challenge. As Kelly 

mentioned, we are working with donors to try to jointly meet the 

overwhelming needs for resources. 

Despite many challenges, we remain committed to saving lives 

and to helping host communities, recognizing this is a long-term 

crisis. 

Thank you for your support. Thank you for this hearing. And 

again, I look forward to your questions. 

[The prepared statement of Mr. Staal follows:]

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Ms. ROS-LEHTINEN. Thank you. Our members thank you for your 

service, your dedication, your hard work in responding to this serious humanitarian crisis unfolding before us. 

As you both have said, the United States plays a critical role in 

the international response as the largest donor country, having 

contributed more than $3 billion. But, as I mentioned earlier, we 

also have a responsibility to ensure that we are being good stewards of U.S. taxpayer money and that these funds are being used 

to maximize efficacy and transparency. 

How much of that $3 billion has gone directly to neighboring 

countries or directly to NGOs and implementing partners on the 

ground, and how much has gone through multilateral initiatives 

through U.N. appeals? I will ask you to respond. 

It seems that the majority of our assistance, from what I have 

read, actually goes to the U.N. and third-party implementing partners. Also, while it was positive that the U.N. Security Council 

passed Resolutions 1239 and 2165 calling upon all parties to allow 

delivery of humanitarian assistance and authorizing the U.N. to 

carry out relief delivery across these conflict lines, that is really a 

fanciful notion to think that the Assad regime, ISIL, al-Nusra, 

other belligerent actors are actually going to adhere to these resolutions. Yet, since those resolutions passed, the U.S. has been going 

into the war zones and the most difficult-to-reach areas of Syria. 

How are these resolutions of full access being enforced? We have 

seen reports that ISIL and others have gotten some of this assistance or that implementing partners are forced to go through middlemen to get to some of these most dangerous areas. Do we have 

an idea of how much of our assistance is being co-oped by these belligerent actors or going through middlemen? What kind of visibility 

do we have? How can we ensure that the billions of dollars that 

we are providing are reaching the intended recipients and not falling into the wrong hands? And also, do we have any oversight over 

these U.N. agencies operate? Is there a transparency or reporting 

requirements for the agencies or implementing partners or is it 

more of a case of, well, our responsibility ends once we hand the 

money over to the U.N.? Finally, what are the reporting requirements for the NGOs directly funded by the U.S. Government? Do 

we have enough oversight mechanisms? Are they sufficient? 

Thank you. 

Mr. STAAL. Thank you, Chairman Ros-Lehtinen. 

That is a critical question. I am really glad you brought it up because I think we actually have a good news story there. 

It is always important that our aid gets to the right people. We 

realize the challenges in this crisis. So, we have actually upped the 

ante and increased our systems for overseeing that. So, in addition 

to the regular quarterly and annual reports, we actually require 

now weekly reports from our partners, where they identify particular issues. 

Remember, in Syria we are working with partners that are experienced. They have worked in these kinds of areas before and know 

how to work in these areas. They are careful about taking risk, but 

they also understand the importance of oversight. 

27

So, they have instituted multiple systems to ensure that oversight. They work through local partners, but ones that they know. 

They get their regular reports. 

But, in addition to that, because it is a relatively-sophisticated 

society—Syria was a middle-income country really and people have 

cell phones, and so on—so, we actually have a system where, when 

food is delivered, they can send a picture taken from the cell phone 

with the barcode so we know exactly where it went and when it 

arrived. 

Ms. ROS-LEHTINEN. Well, thank you. Let me interrupt you here 

a second. 

Mr. STAAL. We have got multiple systems like that going on. 

Ms. ROS-LEHTINEN. Let me ask about a majority of assistance. 

Does it go through to the U.N. and third-party implementing partners or directly to the partner? 

Ms. CLEMENTS. Thank you for that question, Chairman. 

About 72 percent of that $3 billion goes through U.N. mechanisms. About $750 million goes to NGOs through a joint effort really in terms of collaboration. You know our No. 1 humanitarian objective in this crisis is to get as much aid through as many channels as we possibly can. Whoever is best placed in certain circumstances are the ones that we ask to deliver, obviously, to the 

extent that they are comfortable delivering, given all the challenges 

that are actually there. 

You asked, in particular, about the crossing lines and cross-border, Ranking Member Deutch. Since the resolutions have passed in 

the Security Council, we have had about 54 of those AID shipments 

reach about 600,000 people in terms of the cross-border efforts. 

That doesn’t mean that we are keeping up with need, though. So, 

I don’t want you to be left with a good news story. The needs are 

vastly outstripping the humanitarian aid that we are able to provide. 

Tom mentioned the enhanced monitoring. We, too, on the U.N., 

at least the U.N. Refugee Agency and others that we support, have 

asked for enhanced monitoring plans. 

Ms. ROS-LEHTINEN. Thank you. 

Ms. CLEMENTS. In terms of diversion——

Ms. ROS-LEHTINEN. My time is up. 

Ms. CLEMENTS. Okay. 

Ms. ROS-LEHTINEN. And we have votes on the floor. 

But would you like for me to recognize you or we will break? Mr. 

Deutch? 

Mr. DEUTCH. Just for one observation. We have to go the floor 

for votes. 

But before we leave, I just wanted to say that listening to the 

two of you give your testimony and respond to the chair’s questions 

I think reminds us that, it is a good reminder of why we are proud 

to be Americans. 

Ms. ROS-LEHTINEN. Amen. 

Thank you very much. Excellent work. 

And we will be back, and Mr. Smith will chair the remainder of 

the hearing. 

With that, our subcommittees are in recess. Thank you. 

[Recess.] 

28

Mr. SMITH [presiding]. The hearing will resume its sitting, and 

we will be joined by Mr. Deutch, who is under a time constraint. 

I will yield to him when he comes back for any questions he might 

have. 

But let me, first of all, thank you again for the tremendous work 

you are doing in saving lives. I think sometimes people are very 

critical of foreign aid. They should know the robust efforts you, the 

administration, the Congress in a supportive role, are undertaking 

to save lives of the most precious and the most vulnerable people, 

particularly women and children. So, again, let me echo what we 

all said, I think, in our openings, just how grateful we all are for 

the work that you are doing for people who have been displaced, 

the refugees, the IDPs, women and children who are being savagely 

attacked and women who have been raped. 

I will never forget years ago during the Balkan wars I had hearings with women who had been raped. One, she was so traumatized and she thought she could handle speaking what other 

women were experiencing during the Balkan wars. Bianca Jagger 

was actually here as well speaking to that. And she froze; she 

couldn’t speak. She had been so utterly traumatized. 

And I know you are helping women who have been so horrifically 

violated. So, thank you for that as well. 

I do have a question. Secretary Clements, Deputy Assistant Secretary, you mentioned with regards to the vaccination 2.9 million 

children require lifesaving vaccinations. I wonder if you could 

break that out a little bit. They have not gotten it or some of those 

have already received it? What vaccinations are we talking about? 

I have always believed that vaccinations like antibiotics as well 

as anesthesia are among the wonders of the world in terms of how 

they mitigate disease and pain. So, the question would be, 2.9 million, what are they lacking and what is being done to try to get 

those vaccinations to them? 

Ms. CLEMENTS. Thank you very much, Chairman Smith, and 

thanks for your kind words. 

I have to say, to follow up on a point that the ranking member 

made before he left, it is a moment to be proud as an American 

in terms of what the U.S. taxpayer is doing to help us provide this 

kind of humanitarian aid to so many people in need. We deeply appreciate that. 

In terms of the vaccination question—and we can take that and 

get some more granularity for you certainly——

Mr. SMITH. Great. 

Ms. CLEMENTS [continuing]. But between USAID and the State 

Department’s humanitarian programs, both inside Syria as well as 

in the neighboring countries, a very strong network of health providers. And obviously, through UNICEF and through the World 

Health Organization, with a large number of implementers, there 

has been a great effort underway to try to vaccinate as many kids 

as possible. I can speak more to the refugee side of things in terms 

of in the neighboring countries, but it is a core part of the health 

services that we are providing every day. 

Mr. STAAL. Yes, thanks for that question. It is important. 

I mentioned the polio vaccination, and that an indication that 

they are actually able to get out to a lot of places that you might 

29

not think they could. It is still not perfect, and we continue to try 

to get as far as we can. 

Last week when I was in Jordan, I visited one of our implementing partners. They have been able to establish and are continuing to expand their network of field hospitals and clinics in opposition-held areas from across the border. That is another way we 

can start to push out the reach of healthcare, including vaccination. 

But that is a critical issue, yes. 

Mr. SMITH. Let me ask you a question. I mean, we all know from 

history that the Spanish flu epidemic, of course, had nothing to do 

with Spain, but it was a terrible pandemic. Following World War 

I, it infected some 500 million people. The estimates are upwards 

of 50 million, some say more, some say less, actually died, 5 percent of the world’s population. 

Health services have been disrupted with more than 73 percent 

of hospitals, 27 percent of primary healthcare facilities, and 65 to 

70 percent of the pharmaceutical companies out of service. A couple 

of weeks ago, I met with Dr. Peter Hotez, who has been here before 

to testify. He is the leader on neglected tropical diseases. As a matter of fact, I have a pending bill that we wrote with his very, very 

insightful suggestions on what it should look like. 

But I know he has said that he has concerns that a pandemic 

could arise out of Syria or the region, war conditions, lack of sanitation, cholera, all the other attendant problems. The longer this 

conflict goes on—and again, the Spanish flu occurred near the end 

or at the end of all of the blood-letting in World War I. I am just 

wondering what your thoughts might be on that. I know we are far 

more advanced than they were back in 1918. But when we and people like you don’t have access to contested areas or healthcare 

workers are being killed simply because they are trying to assist, 

it makes it harder and these things could happen. What are your 

thoughts on that? 

Ms. CLEMENTS. I wonder sometimes whether or not you have 

read so much into my bio that you know that my husband works 

on pandemic preparedness at USAID, actually. 

In terms of this, obviously, it is a huge concern. You know, with 

the war that has raged on now for over 4 years, the concern in 

terms of the health system inside Syria, losing 30 years in that 

time at least. As you well know, the medical facilities and the personnel delivering those services have been under attack. Until very 

recently, actually, even in some of the cross-border/cross-line operations, some of the partners we are trying to get aid out to could 

not put any kind of medical health into their kits, into the aid that 

they were delivering in communities. So, it is a real concern. 

I think we do the best we can in terms of the areas we can access. I think our support systems are much stronger in the neighboring countries; in Jordan, in particular, in Lebanon, and the 

Iraqi Kurdistan region, and so on, in terms of what we are trying 

to do. Obviously, Turkey has done a tremendous amount on the 

health side. But that is something that we need to continue to 

work on, to try to prevent what you have just outlined. 

Mr. STAAL. And I might add, it is all the more reason why it is 

important that this U.N. resolution last year, 2165, being able to 

30

work across borders, so organizations like WHO, then, can move 

across those lines of conflict. We need to continue to support that. 

The other maybe helpful mitigating factor is that Syrians are 

used to getting vaccination and they demand it. Okay? Some refugees we work with or people in underdeveloped countries are not 

used to it. They are used to it. And so, they are looking for vaccination, and that does help mitigate some of the problems. 

Mr. SMITH. Ranking Member Deutch? 

Mr. DEUTCH. Thank you, Mr. Chairman. 

Thanks again to both of you and thanks for being so patient and 

for allowing us to do the other part of our job. 

Ms. Clements, I would like to ask you about another issue that 

I have raised several times in this committee. What are we doing 

to increase our support from the international community? It is 

really frustrating, as I said in my opening statement and as you 

referred to as well, it is frustrating to learn that last year’s U.N. 

appeal was only 50 percent funded. It is clear that, even if there 

is a political agreement, if there were a political agreement tomorrow in Syria, the humanitarian crisis is going for years to come. 

So, how do we get our partners around the world to not only to continue to care about the humanitarian crisis and talk about the humanitarian crisis, but to actually do their part to help alleviate the 

suffering? 

Ms. CLEMENTS. Thank you very much, Congressman. 

This is the key issue. We have in terms of the Syria crisis right now appeal levels of $8.4 billion. I mean, that is more than $2 billion more than last year. We are approaching a year where we are 

dealing with—and we have talked about this a little bit—the global 

humanitarian crises. We have Sudan. We have C.A.R. We have 

Iraq. I mean, all of that adds to the attention that is being diverted 

somewhat from this crisis. So, I think it is very important, for example, for this hearing to take place and to continue to bring attention to it. 

We have worked very hard with other governments, with traditional and non-traditional donors, to try to increase support. Obviously, we continue that effort. Tom and I were actually in Kuwait 

City about 10 days ago at a top donors’ group meeting that was 

hosted by Kuwait to try to bring attention to the Syrian response, 

what we are going to do this year, and perhaps even more importantly, what comes next year and the year after. Given that this 

is going to be protracted, we need to continue that support, for example, to Jordan and to the other neighbors that are shouldering 

the burden. 

So, it is a very high priority. There is a lot of engagement at very 

senior levels of our Government, and that will continue. 

Mr. DEUTCH. And what is that? What is the response? I appreciate that there is engagement. 

Ms. CLEMENTS. I think, as I outlined in terms of the number of 

crises, the places that we are asking people to put their money, unfortunately, it is increasing rather than decreasing. We have seen, 

for example, Saudi Arabia, when WFP, as you mentioned in your 

opening statement, had their fundraising campaign in December, it 

was Saudi Arabia that stepped forward with I think $72 million to 

help to close that gap. That was unexpected. 

31

We just saw the EU last week announce a $1 billion package for 

both development and humanitarian support. The UK, the visit of 

Prince Charles and the Secretary of State, just announced another 

100 million pounds. 

So, we are seeing donors step forward. The problem is we are not 

able to get to the levels, the astronomical levels, now in terms of 

trying to meet the need. 

Mr. DEUTCH. Okay. I would just make the observation that we 

are about to begin a debate about AUMF to combat ISIS. We are 

devoting an enormous amount of resources on security in the region already, in addition to the security arrangements that we have 

within the region that benefit, in particular, those countries that 

we have asked to step up in providing humanitarian assistance. I 

trust that in terms of engagement that those points are made loudly and clearly to our allies when we have those discussions. 

Mr. Staal, I want to return to a topic that I focused on in each 

of the hearings that we have had on humanitarian needs. I would 

just love an update. That is the issue of branding. 

Chairman Ros-Lehtinen and I visited the Zaatari Camp in Jordan this past summer, and we saw temporary housing stamped 

with a green flag, the Saudi Arabian flag, many other donor countries. We didn’t see a lot of U.S. flags. And I understand the difficulties of branding inside Syria, and we would never want to put 

AID workers at risk. But in refugee camps and in communities, 

have we increased U.S. branding, so that the Syrian people know 

that they have the full support of the United States? 

Mr. STAAL. Yes, thank you very much for that question, Ranking 

Member Deutch. 

It is an issue that we continue to discuss with our partners. As 

you mentioned, inside Syria it is very dangerous. And so, we don’t 

require that. 

Within the surrounding countries, we are asking them to step up 

their branding. It may not be on every bag because some of that 

goes into Syria and some doesn’t. So, it is difficult to differentiate. 

But at least to put up more signs around and portray that. 

Also, just in discussions with the officials who are working in 

those camps to make sure they understand where the assistance is 

coming from, and, in fact, we are able to do that even inside Syria, 

in a quiet way to let people know the local organizations that we 

are working with, where it comes from, to get the word out. 

Mr. DEUTCH. All right. Great. 

Ms. Clements? 

Ms. CLEMENTS. A quick add, because we are very familiar with 

the Zaatari example. We have had a number of discussions, actually, with UNHCR, Andrew Harper, in particular, about the visibility issues related to Zaatari. 

The challenge has been, as soon as a U.S. flag goes up, it comes 

down. And so, we have a requirement, actually, in our contributions that U.S. flags should be on items that we have actually supported, particularly, for example, in Jordan and northern Iraq, 

places where it is quite safe and we want to get the word out. But 

it is a challenge keeping it visible for extended periods of time. 

Mr. DEUTCH. Okay. I appreciate it. 

32

Thank you to the witnesses. Again, I would just ask if you would 

please pass on our sincere thanks and appreciation to all of those 

on whose behalf you appear here today. Thank you. 

Mr. SMITH. Thank you very much. 

Mr. Meadows? 

Mr. MEADOWS. Yes, thank you, Mr. Chairman. 

And thank each of you for being here. This particular issue is not 

as telling from a standpoint of getting the American people to act 

as perhaps other things that we see on TV on a regular basis. But, 

yet, when it comes to asking for people to give, either personally 

or allow their government to give on their behalf, it is the one 

thing that typically can unite people on both sides of the aisle. 

The American people are very generous and caring and giving 

people. It is hard for them, Ms. Clements, when you make statements like, well, the American flag goes up and it gets ripped 

down. It also makes it very difficult for a lot of people to continue 

to say, why give money for humanitarian purposes when they don’t 

care? 

So, getting back to the branding issue that the ranking member 

was talking about, I think it is important for us to tell the stories 

of the impact on the lives that we really are affecting. Because not 

only in Syria and Jordan and some of the other places where the 

refugee and the migration from this conflict is huge, we are making 

real-life differences to moms and dads and kids. We have got to do 

a better job of sharing that, if we can. 

And so, I guess my question to both of you is, how, as a Member 

of Congress, can we do that? As either NGOs or the like, how can 

we do a better job of thanking the American taxpayer back home 

and telling the stories? I mean, we see ads all the time of starving 

children, and people willing give because they believe that they are 

making a difference. How can we do a better job of that? 

Ms. CLEMENTS. Thank you very much, Congressman. 

I actually could not have said it better than the way you just did 

in terms of telling individual stories. Because I think with the way 

that this war has raged on and the number of people it has affected, that, unfortunately, the public has become numb to the 

numbers. And so, to try to pull out those stories of people who are 

actually assisting and what important work the partners that we 

are supporting are providing every day under difficult circumstances, to try to disentangle saving lives from the broader morass of extremist takeover of certain communities and Assad’s aggressions, and that sort of think, if we can keep it focused very 

much on the lifesaving, we might have a better chance. 

Unfortunately, we have those pictures to go along——

Mr. MEADOWS. Sure. 

Ms. CLEMENTS [continuing]. With the devastation. But the individual stories I think tell the best story. 

Mr. MEADOWS. Okay. 

Mr. STAAL. If I might add, Congressman Meadows, thank you 

very much for that question. It is sometimes tough. I know I have 

got relatives back home and they ask, okay, what is happening 

with all this assistance? You know, there is a big story and, then, 

there are the individuals. As you say, that is so important. 

33

In the big story, even though you have got 12 million people displace, yet there has been really no major malnutrition problems. 

We had a small outbreak of polio, but that was quickly stopped. 

And so, from a lifesaving thing, nobody froze to death because of 

the winter. We were able to get winterization. So, on a big scale, 

actually, it is pretty good. 

Then, even in our protection programs, for instance, we have 

been training women in peacekeeping. It has actually made a difference. Okay? There is a place like in what they call Rif 

Dimashq—it is sort of the rural areas around Damascus—with 

women peace circles, they were able to negotiate 20-day ceasefires. 

In the eastern Kurdish region, the women negotiated an end to 

price-fixing that some of the merchants were doing. So, they were 

able to step in and make a real difference to people on the ground 

that way. 

Then, when I visited the hospital in northern Jordan where they 

are getting refugees coming out who have been injured, it is not 

only medical support, but we are actually providing psychosocial 

support. I visited with a small child that had been injured. Obviously, they had not only the physical injuries, but the psychological 

injuries. Part of our work was supporting and training women who, 

then, provide psychosocial support to that child, so that their issues 

can be dealt with. 

Mr. MEADOWS. Well, let me close with a sincere thank you for 

your work, but also a request. On those individual stories like the 

story you just shared, if you can get that to committee, most of the 

Members of Congress can tweet out, Facebook out, and reach hundreds of thousands of people. 

Mr. STAAL. Sure. 

Mr. MEADOWS. And if we can help tell that story, because if we 

don’t, the American people will grow weary of giving. If they don’t 

see that they are making a difference, it will become very difficult 

to continue to fund worthwhile projects. 

So, thank you both. 

And I yield back. I thank you for your leadership, Mr. Chairman. 

Mr. SMITH. Thank you very much, Mr. Meadows. 

Mr. Higgins? Oh, he left. I am sorry. 

Ms. Frankel? 

Ms. FRANKEL. Thank you, Mr. Chair. 

I thank you for your service and for your testimony today. 

I know that humanitarian aid, by its nature, the purpose is to 

save lives and alleviate suffering, maintain human dignity. I was 

interested in your discussion with Mr. Deutch because I have heard 

people say that, if you give them food and medicine, that helps 

shape people’s minds also. 

So, my question is the overriding goal of trying to defeat ISIS 

and Assad, and so forth, I want to understand how the humanitarian aid plays into that. Do the folks who are receiving the aid, 

do they know that it is coming from—do they have any idea where 

it is coming from? And this humanitarian aid helps shape their 

thoughts or ideas, in your opinion? 

Mr. STAAL. Yes, thank you. That is an important question, not 

always easy to quantify. Certainly, through our aid programs, even 

within Syria, our partners are working through local organizations. 

34

They make sure that the local organizations know, even though it 

is not branded, that they know that it is coming from the U.S. and 

that it is U.S. taxpayers that are providing the funding for that. 

So, the word is getting out, not as much as we would like, and it 

is an ongoing challenge, but I think that it is important. 

I think part of it is, yes, you have to provide the immediate humanitarian assistance, but you also need to do it as much as possible in a way that protects their dignity. Okay? And so, we are trying as much as possible to move to a system of distribution of our 

assistance that just doesn’t make them totally dependent on handouts. 

So, that is part of the reason we have gone to these ration cards. 

I actually have one in my pocket here. That way, instead of getting 

a bag of rice and a can of vegetable oil, they get a card. They can 

go to a supermarket and buy the goods that they think they need. 

That gives them a little feeling of dignity, and, of course, it helps 

the local economy. 

Ms. FRANKEL. May I just change—oh, wait, you can answer that. 

Why don’t you answer the other question that I have also, which 

is this: In terms of our AID workers, first of all, do we have AID 

workers in Syria? Given what we just saw happen with Kayla 

Mueller, I think we all have a concern whether our AID workers 

in the region are safe. Could you also speak to that? 

Ms. CLEMENTS. Maybe if I could just respond to the last and let 

Tom——

Ms. FRANKEL. Yes, please do that. 

Ms. CLEMENTS [continuing]. Respond on the other? 

I think it was Congressman Boyle that mentioned this being a 

regional issue. Often, when Tom and I are talking about Syria, we 

will talk about Iraq, too, because we do actually view this as very 

much a regional issue. 

We, in terms of the anti-ISIL fight, humanitarian support is one 

of those lines of efforts, but it is not to battle ISIL. It is to aid those 

victims and those people in need. So, we try very much to keep it 

as a needs focus as opposed to part of the fight. So, it is a distinction that is very important to protect the safety of humanitarian 

workers, allow us to continue to save lives. I just wanted to make 

that clear. 

Ms. FRANKEL. Good. Okay. Thank you for that. 

Can you answer the question on the safety? 

Mr. STAAL. Yes, thank you, Congresswoman Frankel. 

Certainly, it is a dangerous place. I think I mentioned in my 

written testimony 150 humanitarian workers have been killed over 

the last 3 years. It is something that we continually have on our 

minds. 

The partners that we are working with and through, both U.N. 

and international NGOs, are all ones that are well-experienced in 

working these kinds of regions and these conflict areas. So, they 

are even more careful than we are. 

They work primarily through local partners, the NGOs. Some of 

the U.N. folks are there in Damascus, especially in the government-held areas. But in the opposition areas it is primarily the 

NGOs. They, in turn, work through local organizations. So, there 

35

are very few of our international staff going in. It is more focused 

with the local organizations who know the scene. 

Ms. FRANKEL. And this is in Syria? 

Mr. STAAL. In Syria, yes. 

Ms. FRANKEL. Thank you, Mr. Chair. 

Mr. SMITH. Thank you, Ms. Frankel. 

The Chair recognizes Mr. Yoho. 

Mr. YOHO. Thank you, Mr. Chairman. 

I appreciate your testimony today. 

You were stating that America is largest single donor in that region, and then, Mr. Staal, you were saying that you have, in virtually all the places you have looked, you have not found people 

starving. Did I understand that correctly. But are you talking 

about the refugees that are outside of Syria or the ones within 

Syria that you work with? Because reading my notes here, it says 

there are a lot of nutritionally-deprived people there. What is the 

dichotomy of the difference there visibly? I mean, is it distinctive? 

Mr. STAAL. Yes, thank you very much, Congressman Yoho. 

It is an important distinction. Certainly, within Syria they are 

worse off than outside of Syria, and they are nutritionally-deprived, 

but they aren’t to the point of starvation. 

Mr. YOHO. Okay, and that leads into my other question. 

Mr. STAAL. Yes. 

Mr. YOHO. When you are going in and trying to get access into 

Syria, are you running—I mean, you have got to worry about the 

Assad government forces and, then, you have got to worry about 

Freedom Fighters and ISIS and all those other ones. 

It just seems like one of the things I have seen on these other 

meetings that we have had, in particular, I think it was Afghan 

last year when we were talking to Dr. Shah. He said that Afghan 

was allocated or appropriated $1 billion in foreign aid through 

USAID, but they couldn’t account for $300 million. 

As you are going from taking our aid—and I would feel a lot better if it was branded. That is the American taxpayers’ money, and 

I agree with these other people that, if we are sending our money 

over there, well, I think they need to know where it is coming from. 

I know that is an issue in itself because it causes resentment. But, 

as you go into those areas, what are the biggest obstacles you are 

running into to make sure that we have accountability of those 

products, or whatever it is you are taking in there, and that it is 

not falling into hands where they are using it to raise revenues? 

Mr. STAAL. Yes, thank you. That is an important issue that we 

track very carefully. 

The branding issue, it is less about the resentment; it is more 

about the protection of our partners. Because if they are seen as 

working for the Americans, then that could put them in danger. So, 

that is the real issue, rather than the resentment issue. 

Mr. YOHO. How do other countries handle that? This is another 

question. We have given $3 billion since the beginning of this. The 

collection of other countries, have they come close to that as far as 

monetary input? Ms. Clements? 

Ms. CLEMENTS. Sure. Actually, we are about 30 percent of the 

overall giving last year, was from the United States. 

Mr. YOHO. Okay. 

36

Ms. CLEMENTS. And collectively, we are, obviously, the largest 

single donor. But, no, it is burden-sharing. 

Mr. YOHO. Okay. So, you are seeing other countries step up and 

help out? 

Ms. CLEMENTS. Yes. 

Mr. YOHO. This is only going to get worse until we have a resolution to the problem within Syria. I think it is going to wind up 

being a regime change, which at this point I think the rest of the 

world would be safer off and the people of Syria, obviously. 

When you are going in and you are putting in, say, water, are 

you building infrastructures or are you just taking supplies in, like 

bottled water? I saw you had Jerrycans and all that stuff. Are you 

putting in wells, septic tanks, or sewer systems? 

Mr. STAAL. Yes, that is a critical question. Thank you very much. 

We are, indeed, putting in some small-scale infrastructure as 

much as possible, where we can, in opposition-held areas and even 

in some of the government areas. But it is at a small scale, but, 

certainly, we are doing it, both water and other types of local infrastructure, repairing health clinics, schools, things like that. 

Mr. YOHO. Okay, and when you go in there, like in a host country that is housing the refugees, is the government working with 

you or are you finding them an impediment of making the situation 

better? 

Mr. STAAL. No, I was just referring now to within Syria. 

Mr. YOHO. Okay. 

Mr. STAAL. But, certainly, in the surrounding countries, in Jordan, in Lebanon, and other, the neighboring countries, we have 

really stepped up our programs. In Jordan, for instance, we have 

even put in a second Deputy Director for USAID and increased our 

assistance to the Jordanians to build up their systems to handle 

this big, huge influx. 

Mr. YOHO. Okay. 

Mr. STAAL. So, you know, additional schools, additional water 

systems, and so on. 

Mr. YOHO. Well, I appreciate the work you are doing—and I will 

get right back to you—that you are doing. If you could over the 

course of the work you do over the next, let’s say, 2 or 3 months, 

let us know what we can do better here to help you do better there, 

especially on the accountability, so that we are not wasting our 

money. 

Ms. Clements, you had something to say? 

Ms. CLEMENTS. Thank you. We really do appreciate the support. 

It is hugely needed. 

Just on the water issue, both inside Syria—Tom had mentioned 

part of it, but I will give you an example. The International Committee of the Red Cross, for example, has worked very closely to 

try to put stop-gap measures in place to actually make clean water 

available for about 10 million people. This is not building big waste 

treatment plants, that sort of thing. It is just trying to get the system that currently exists to function. So, that is just an example 

of support that has been tremendously important, yes. 

Mr. SMITH. Mr. Yoho, thank you. 

In follow up to your question, could you provide the committee 

a breakdown of what each country has pledged and how much they 

37

have actually lived up to their commitment? And secondly, for this 

new round, what countries are pledging, so we can get it? I mean, 

30 percent is certainly very, very generous on the part of the American public, the administration, and Congress, but it would be nice 

to know where the laggards are and where those—as you mentioned, Saudi Arabia stepped up on the food issue. So that we have 

contacts, all of us, all the time with people from these countries. 

It would be good to say, ‘‘Hey, do more’’ or ‘‘Well done.’’ So, if you 

could provide that, that would be very helpful. 

Mr. STAAL. If I can just respond to that, Chairman Smith, at the 

end of March, the Kuwaitis have already invited the donors to 

come to Kuwait for a major pledging conference for Syria and the 

neighboring countries. We are already encouraging our friends out 

there to be ready to step up with some major contributions. 

Mr. SMITH. Would a letter from Members of Congress, a bipartisan letter, be of any help in terms of backing what you are trying 

to accomplish? 

Mr. STAAL. Yes. 

Mr. SMITH. If you could give us some insights on how you think 

that might boost the aggregate——

Mr. STAAL. Right. 

Mr. SMITH [continuing]. It would be——

Mr. STAAL. Especially to the parliaments of some of the countries 

that we work with, yes. 

Mr. SMITH. Okay. Very good point. 

Ms. Frankel? 

Ms. FRANKEL. Thank you again. 

I have a different point of view here. So, yes, thank you again 

for your testimony. 

I wanted to just follow up on a line of questioning that I had 

when I was sitting at the other end of the table. This is one way 

to move up in rankings, right? Send everybody else away. 

I think I understand your testimony of separating the humanitarian effort from the fight against certain forces. So, my question 

is in Syria, for example, ISIL or Assad, are their forces, do they try 

to keep the humanitarian aid from getting to the Syrians? That is 

one question. 

Mr. STAAL. Yes, that is a very important question, and it is something we watch carefully and our partners, again. 

As I mentioned earlier, we actually have some pretty robust systems that are really tracking our aid very carefully, literally truckload-by-truckload that goes in there. And so, we have a very good 

idea of where it is going. 

There has been very little pressure really to divert or try to control it. When it does happen, the partners we are working with, 

they are experienced. They have worked in Afghanistan, in Iraq, in 

South Sudan, in Somalia, and places like this. So, they push back 

very hard. 

If it gets to the point where they feel they have to pay a bribe 

or allow some of it to go to a local official, they will just stop, and 

we don’t go into that town. That has happened. There are times 

when we just say, okay, we can’t work there. But, then, the surrounding towns continue to get it, and then, we find they come 

back and say, okay, well, we will let it in after all. 

38

Ms. FRANKEL. Did you want to respond to that? Yes. 

Ms. CLEMENTS. I would. I would. Thank you very much. 

Yes, they are inhibiting humanitarian aid workers from delivering aid. Just to give you an example, we talked earlier in the 

hearing about those in besieged areas, about 212,000 that are in 

besieged. About 145,000 of them are besieged by the regime. So, 

they are not allowing aid workers or aid organizations to get in. 

We probably come closest to your example of starvation in a 

place like Yarmouk, the Palestinian refugee camp, where it has 

been extremely difficult, for example, for the Palestinian U.N. 

Agency to get in and actually provide health and food, and so on. 

So, it is administrative obstacles, bureaucratic obstacles, you 

know, bombs, barrel bombing in terms of just not being able to get 

into key areas. But it has been a huge issue. 

Thank you. 

Ms. FRANKEL. And in the surrounding regions, which countries 

are actually helping you or assisting, both with resources, but actually are friendly toward the efforts? 

Ms. CLEMENTS. We are so fortunate to have the neighbors that 

we do surrounding Syria. I mean, we could go through them oneby-one, but Jordan, first and foremost, 650,000 registered refugees, 

probably many more that are in communities. Most are being supported outside of those two camps that are in Jordan. Billions of 

dollars spent in terms of GDP or lost economic revenue, and so on. 

There has been a tremendous outpouring of generosity and support from these neighbors to welcome refugees in, but the welcome 

mat is starting to wear thin because of how many refugees there 

are and the needs and the burdens, and so on, in terms of the economic system and the infrastructure and water and health, education, you name it. But I think in every circumstance of those five 

we have support from the government in terms of being able to 

help us help them in terms of responding to these massive needs. 

Ms. FRANKEL. So, I think what I hear you saying, also, is that—

and you may have said this before—is that this humanitarian aid 

not only is to reduce suffering and dignity, and so forth, but giving 

relief to some of these neighboring countries that will prevent their 

destabilization. Okay. 

Ms. CLEMENTS. It is a really important point, Congresswoman, 

because we try very hard not just to target aid toward the refugees 

or the displaced, but also the host communities. And aid in state 

programs in the partners we are serving, it is very much a dual 

approach because we do not want to increase tensions, and we see 

tensions rising. As you said, it is absolutely essential for regional 

stability. 

Ms. FRANKEL. Thank you very much, Mr. Chair. I yield the rest 

of my time. 

Mr. SMITH. Just a few final questions, and then, if my colleagues 

have any further, if you would answer those? 

As I think you may know, I am the prime author of the Trafficking Victims Protection Act of 2000. It is a very aggressive law 

that seeks to prevent/prosecute traffickers and protect women and 

children especially who are overwhelmingly the victims. 

Syria is a Tier 3 country. In the recommendations page of the 

TIP Report, it talks about child soldiers. I am wondering if you 

39

could shed any light on how many child soldiers we are talking 

about from either side or any side. 

In your testimony, Mr. Staal, you very strongly pointed to the 

barbarity of selling girls as young as 12 into sex slavery. I am wondering if any of those girls are being rescued. How many are we 

talking about, just like how many child soldiers are we talking 

about? Is there any guesstimate as to how much of this abuse is 

going on? 

And what happens when there is a rescue? You know, some 

young 12-year-old who has been so brutally abused finds their way 

particularly in the area of psychological treatment. You mentioned 

that generally before, those who are suffering trauma of war. 

And I am wondering, too, an additional question: Is our response 

integrating a faith-based response, Muslim or Christian, with best 

practices for psychological help? You know, one of the things I have 

learned being in trafficking shelters all over the world is that the 

healing process, the sense of personal reconciliation with the trauma and coming to a point where you reconcile with that you are 

a victim, you are not in any way responsible for this, happens more 

effectively in a faith-based setting where there is also the best psychological practices by psychologists or psychiatrists being employed. I am wondering what we are doing along those lines. And 

again, if you could, speak to the trafficking part. Mr. Staal? 

Mr. STAAL. Yes, thank you. Critical issues that you raise, Chairman Smith. 

As I mentioned, in all of our humanitarian assistance programs 

we include protection issues. In addition to that, we have put in 

$26 million specifically in protection programs, gender-based violence issues, child protection, and so on. 

Included as a piece of that has been tracking abuses that could 

someday be a way of keeping records that could someday be used 

later, as you mentioned, with the ICC, or whatever. And then, also, 

the State Department DRL program is continuing to try to track 

those kinds of abuses for future issues. 

We will have to get back to you on the child soldiers. I don’t 

know that we have a number on that. 

Mr. SMITH. Are you coordinating with the TIP office on this with 

regards to Syria? 

Mr. STAAL. Yes. 

Ms. CLEMENTS. Yes. Perhaps I can respond in terms of the trafficking piece because, obviously, this is something that is of high 

priority to us, as it obviously is to you as well. 

All of our programs actually have a GBV or prevention element. 

When I say that, you know, protection is important. There are a 

couple of things that we have tried to do very explicitly. 

Civil registration and identity documents, because often we find 

that those instances of trafficking are because they don’t have 

something to be able to provide for themselves in terms of livelihoods, or what have you. So, we have made a special effort through 

partners to be sure that that is certainly in place. 

We have found that the best defense is robust assistance. So, 

making sure kids are in school, for example, that information is 

flowing in terms of the dangers of early marriage, these sorts of 

40

things all combined have a comprehensive approach to try to at 

least decrease the scourge. 

But, yes, in fact, I was just talking with the trafficking office yesterday about this very issue. 

Mr. SMITH. That would be great. Any further for the record that 

you could provide on that, simply as it relates to sex trafficking 

and child soldiers, that would be greatly appreciated. 

You have pointed out that 85 percent of those killed are men. I 

am wondering with regard to the women, and especially pregnant 

women, are they getting to safe venues to have their children? Do 

they have access to safe blood, for example, if there is an obstructed delivery, to a Caesarean section, or has maternal mortality gone up because of the lack of that in Syria, the way that 

we have seen in other war-torn areas? 

Mr. STAAL. Yes, a critical question. I think we have a partial answer, but not a great answer. I mean, I think there are still a lot 

of women who aren’t able to get to a proper facility. As you have 

mentioned, health facilities have been targeted, especially by the 

regime. That has really reduced our ability to help. 

On the other hand, that is a major focus of some of our programs. I mentioned earlier that the hospital I visited in Jordan last 

week, they have an outreach program and are setting up field hospitals in opposition-held areas in southern Syria. And so, those 

kinds of things we are trying to address that issue. 

But, you know, certainly, in ISIL-held areas, we are not able to 

get there and provide that kind of assistance. It is an ongoing problem; no question. 

Mr. SMITH. Just a few final questions, if I could. You mentioned, 

Mr. Staal, that history has been made in the number of DARTS. 

As you have said, four Disaster Assistance Response Teams and 

three Response Management Teams have been deployed. Could you 

elaborate on that? Because many people, particularly those watching, the C–SPAN audience, for example, you know, what is a 

DART? 

I have actually been in areas where they have been in operation, 

and it is amazing how effectively they coordinate. If you could 

elaborate on that? 

Mr. STAAL. Yes, thank you, Chairman Smith. That is one of the 

things that I think we, as Americans, can be most proud of. That 

is a unique aspect of our humanitarian assistance that other countries can’t do. 

That is to actually put people on the ground within hours and 

days of a crisis, whether it is a tsunami and an earthquake, or in 

this situation a conflict-related crisis. So, DART is a Disaster Assistance Response Team, and we send them out to the affected area 

literally within hours or days, sometimes even, if we know there 

is a big typhoon coming, we will send them out a day or two ahead 

of time. 

And they include whatever is needed in terms of technical specialties. They coordinate the assistance. Ebola, for instance, we 

have a huge DART there. We coordinate the assistance provided by 

CDC, the World Health Organization, other donors. The DART provides that platform, and it works great. 

41

The RMT, the Response Management Team, is the operation center back here at headquarters that provides all the support that responds to your questions about what is going on and to our leaders 

in the administration. So, it provides that sort of op center for that. 

And so, we have a DART for Iraq, a DART for Syria that has 

people both in Jordan and in Turkey. We have a DART for South 

Sudan, and then, we have the huge DART for Ebola. 

Mr. SMITH. Thank you for that explanation and for that work. 

You point out in your testimony, Mr. Staal, that we have improved water and sanitation for 1.3 million Syrians in all 14 

governorates. You are absolutely right; in times of crisis, clean 

water and sanitation are critical to survival. 

How integrated or how expansive is our ORT, the Oral Rehydration Therapy, salts, those packets being disseminated for children 

especially, since diarrheal disease is one of the leading killers of 

children? 

Mr. STAAL. Yes, thank you. 

I don’t have the exact details. If you like, I can try to track those 

down. 

Mr. SMITH. We would like that, yes. 

Mr. STAAL. But it is certainly a part of whatever we do in our 

health, in our WASH programs where we are working. There are 

still areas we can’t reach. But, as I said, I think it is important 

that our humanitarian assistance also address some of those sort 

of resilience issues, so that people are not as dependent on humanitarian assistance. 

If they have got clean water, then they are less likely to get sick. 

If we have got a program providing flour to bakeries across-line, so 

that people can get bread, that also helps the economy. So, we try 

to do our humanitarian assistance in a way that builds resilience, 

reduces cost, and then, reaches out to the people. 

Mr. SMITH. You have testified that 9.8 million Syrians are foodinsecure. Is that number declining or worsening? 

Mr. STAAL. Yes, I think I will have to look at the exact details, 

but I am afraid to say it is probably worsening. Their situation is 

declining because of the scale of the crisis. 

Mr. SMITH. And one final question. You have pointed out that, since 2011, PRM has expended $1.4 billion. Has that impacted 

funding from other programs? Have you had to deplete some accounts or draw down from other accounts? And have those accounts 

been replenished, whether it be in Africa or anywhere else, so that 

there is no diminution of assistance to those other crisis areas? 

Ms. CLEMENTS. Thank you very much, Chairman, for the question. 

It is thanks to you and Congress that I can that we have not 

taken funding from Africa or other important programs to meet 

some of those other mega humanitarian emergencies, because you 

appropriated a generous amount to us in 2013, 2014, and again in 

2015. So, we appreciate that hugely. And you will see in terms of 

numbers on our congressional presentation document a significant 

upturn, not just in the Middle East, but in other regions as well. 

Mr. SMITH. Thank you. 

Ms. Frankel? 

Ms. FRANKEL. Thank you, Mr. Chair. 

42

I want to go back to my questioning on sort of, I guess, the domino effects of humanitarian aid or not having it. I do believe in humanitarian aid, but I want to sort of just play the devil’s advocate 

because of what we may hear constituents saying. I think some of 

my colleagues mentioned it. 

There is so much suffering in this world all over the world, including the United States of America. And so, I would like to hear 

your thoughts again in terms of, what if we did not provide this 

aid? What are some of the dominos? What would we see happening? What would be worse? What is the spinoff, and how does 

it affect, you know, somebody who lives in Florida? 

Ms. CLEMENTS. It is a terrific question, Congresswoman. 

In terms of not being able to provide aid, we touched on it a little 

bit earlier in terms of regional stability. I think in terms of humanitarian aid the best way to be able to support those that need to 

flee Syria is being able to provide that aid to the host communities 

and the neighboring countries to keep that protection space open, 

to make it possible for people, because it is much easier for us to 

assist those in Jordan and in Lebanon, frankly, than it is inside 

Syria. 

You would see an implosion. You would see massive malnutrition 

rates, for example, in terms of global acute malnutrition, mortality 

rates through the roof. Most of the deaths now, unfortunately, are 

because of the war. We would probably see in terms of social indicators a much larger humanitarian catastrophe without aid. 

Mr. STAAL. Yes, and I might add, obviously, if possible, we want 

to try to get our assistance to people in their homes, so they don’t 

have to flee. They need to be able to flee if they feel they have to, 

but it is better to get it there. And then, that reduces the strain 

on the surrounding countries. 

As you mentioned, Jordan is a critical partner for us. The same 

with Lebanon; we are very concerned about their stability—in 

those countries that is critical—and frankly, terrorism. 

You know, a young man growing up, he can’t feed his family. He 

hasn’t got a job. He is going to be much more open to the lure, if 

you will, of people asking him to do bad things. 

Ms. FRANKEL. Thank you very much. I think I got my question 

answered. 

Mr. SMITH. Thank you, Ms. Frankel. 

Mr. Yoho? 

Mr. YOHO. Yes, going back to the aid that you are giving, when 

you go into the different countries, there is Turkey, Syria, Lebanon, 

Jordan, Iraq where the refugees are going. When you are going into 

the different countries, like say Turkey, you know, the human 

rights that we stand by, that we believe in this country, are going 

to be different in those other countries. Is that correct? You know, 

freedom of religion, freedom of expression, those kinds of things. 

And so, when Chairman Smith brought up the different areas of 

abuses, like gender abuse, women’s rights, and things like that, 

how do you go about enforcing that? And is it different between 

country to country? How do we hold that government accountable? 

Mr. STAAL. That is an interesting and important question, Congressman. 

43

I can’t remember whether it was you or Chairman Smith who 

asked about working with faith-based organizations. We do work 

with that. In fact, Ms. Clements and I visited with the Archbishop 

in Kurdistan when we were there to talk about the work they are 

doing. I know the King in Jordan has been very open and meeting 

with different religious leaders, both from sort of an Islamic perspective to reduce the lure of the ISIL, but, also, how do we work 

with the various religious groups? 

And Syria was one of the most tolerant countries in the entire 

Middle East before all this took place. So, it is important, but there 

are many groups there that we work with. And that is a way to 

try to reduce the tension that is going on. 

Mr. YOHO. But is there a way to hold those areas that you have 

the refugees in—you know, they are going to school and they are 

being abused with whatever type of abuse it is. You know, the 

human trafficking thing is just unconscionable. But gender abuse, 

we will say that, how do you go about making—you said you are 

helping those countries deal with that and you are trying to make 

sure that they are protected, but how do you go about holding that 

country or that government of that country accountable? If we are 

in there giving aid, helping out a bad situation, and they are not 

living up to that standard, what do we do as far as holding those 

people accountable? Or do we not get into that? 

Mr. STAAL. Well, we do in the sense that there are international 

standards that these countries have signed onto through U.N. Conventions, and so on. And so, that is one advantage, if you will, with 

working through the U.N. system, is we can hold them accountable 

for those standards. 

Mr. YOHO. Do you feel it is working or is it something that we 

talk about and, then, we turn a blind eye to it, saying, ‘‘Well, we 

dealt with it. They are supposed to be doing it,’’ but we know it is 

not getting done? I mean, I have seen that in other parts of the 

world. I mean, is that what you are seeing over there? 

Ms. CLEMENTS. Maybe to give an example of trafficking cases or 

smuggling cases, or what have you, normally, the aid partners we 

would work with, if those cases are brought forward, they would 

work with the local authorities in terms of ensuring followup. 

Or, for example, refugees are detained, seeking access, for example, to prisons, to find out whether or not that was a rightful detention or what the due process is for that case to be able to be made. 

That is part of the protection part of what the organizations do 

that we support. 

I think the broader issue, as Tom has laid out, as part of our dialog, I think, goes well beyond the humanitarian sphere, but obviously connected. 

Mr. YOHO. Okay. Then, Mr. Staal, you had brought up that there 

has been approximately 150 aid workers killed. Does that take into 

account missing ones? Is there a number of missing people that 

more than likely could end up as hostages and we will see them 

on TV one day? And we will regret seeing that. Do you have a 

sense for how many that are unaccounted for that were aid workers? 

Mr. STAAL. Yes. As far as we know right now, there are certainly 

no Americans held that are unaccounted for that we know of. 

44

Mr. YOHO. Okay. 

Mr. STAAL. Most of those 150, frankly, are local Syrians who are 

working with different organizations that we support. 

Mr. YOHO. Okay. 

Mr. STAAL. And so, it is that way, yes. 

Mr. YOHO. I appreciate your time. 

Mr. Chairman, thank you for the extra time, and thank you. 

Mr. SMITH. Thank you very much, Mr. Yoho. 

Thank you again, Mr. Staal, Ms. Clements, for your tremendous 

leadership, for providing the two subcommittees with your very 

fine insights and incisive testimony. It does help us. Of course, by 

extension, we then brief other Members of Congress. So, thank you. 

You are saving lives every single day, and I do think the American public—I have traveled with some DART teams. I remember 

after the tsunami I was in Sri Lanka. We went from Banda Aceh 

to Sri Lanka. I was in the van with the DART teams, and I have 

never been more proud of people who were just absolutely can-do, 

trying to make the situation better for those who had lost life as 

well as property during that terrible tsunami. 

So, thank you for your leadership. 

The hearing is adjourned. 

[Whereupon, at 3:38 p.m., the meeting was adjourned.] 

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MATERIAL SUBMITTED FOR THE RECORD

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MATERIAL SUBMITTED FOR THE RECORD BY THE HONORABLE ILEANA ROS-LEHTINEN, 

A REPRESENTATIVE IN CONGRESS FROM THE STATE OF FLORIDA, AND CHAIRMAN, 

SUBCOMMITTEE ON THE MIDDLE EAST AND NORTH AFRICA


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Æ


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