Updated

Russian warplanes and the aircraft of dictator Bashar al-Assad are still bombing civilians and civilian infrastructure in opposition areas, attacking U.S.-backed opposition forces to advantage radical jihadists, and consolidating Assad’s grip on major parts of the battered country, even as a United Nations-sponsored effort to produce peace in Syria staggers toward a Geneva meeting on Feb. 23.

But those forces, especially Assad’s rag-tag military and militia, though bolstered by thousands of Iranian and Iranian-trained foreign irregulars and members of radical Hezbollah, are still not enough to win outright victory.

Net result: behind a façade of preparations for peace talks, “the scale of attacks is going back up again” after a decline following the fall of  the rebel stronghold of east Aleppo City last December, warns Dr. Ahmed Tarakji, president of the Syrian American Medical Society.

SAMS is  a non-profit organization that maintains more than 100 medical facilities in Syria, mostly in non-government areas, and has been deeply involved in training doctors and other medical personnel to cope with the havoc of the civil war..

Tarakji’s organization is receiving “hourly” reports of the destruction, he said, but  declined to put numbers to the resulting civilian casualties, saying instead that “the pattern of injuries is scaling up” as a result.

“The regime has not ceased fire anywhere,” says Valerie Szybala, executive director of The Syria Institute, an independent non-profit research institute based in Washington that is focused on the battered country. “There is constant bloodletting. We are just waiting for the next large-scale atrocity.”

One definite casualty, if not fatality, is the peace process itself -- even a portion being orchestrated by Russia, Iran and Turkey, with the U.S. and Europe on the sidelines, has been wounded.

A two-day meeting of Syrian government and opposition representatives, slated to start on Feb. 15  in the Kazakh city of Astana, was postponed for at least a day, “for technical reasons,” a spokesman for Kazakhstan’s foreign ministry reportedly told journalists.

The purpose of the session is ostensibly to consolidate a ceasefire in advance of the broader U.N. meeting. Some opposition groups  have said they did not receive invitations to the session and others are apparently still holding back on participation, reportedly due to the  lack of a ceasefire or other “confidence-building steps.”

No matter how the peace negotiations go—or don’t go--the likely outcome is grim for Syrians, according to experts who closely follow the Russian and Syrian military campaigns.

They foresee  a continuing spiral of violence, including the possibility of new major Assad offensives in coming months;  significant fresh flows of refugees escaping the country; an even greater humanitarian crisis straining international resources--and greater opportunities for the spread of Al Qaeda and its fanatical Syrian counterparts.

Other humanitarian sources with experience in Syria also see a winnowing down by the Assad government of independent local aid organizations in reconquered territory, putting more of the relief effort in the hands of the United Nations—which depends on government permissions to make its deliveries successfully.

The independent organizations “are a fulcrum of how the system works right now,” says Christy Delafield, senior global communications officer for Mercy Corps, one of the world’s largest independent aid organizations, which was especially active in areas around the fallen stronghold of east Aleppo City.

“Mercy Corps and the entire international aid community have been able to reach millions in need in large part thanks to the bravery of anonymous Syrian aid workers across the country,” she said.  “These people need legal protections and international support.”

Delafield notes that of 32 local organizations Mercy Corps was tracking, where government “reconciliation” efforts are taking place in former opposition territory, only five remain.

(The toll of devastation in east Aleppo itself, after months of  encirclement and  years of blasting of civilian centers, schools, markets, and medical facilities, is still being analyzed, most recently in an exhaustive  study sponsored by the Atlantic Council, Breaking Aleppo. It provides no definitive figures, even of the population inside the city in its last days, noting that a U.N. humanitarian center in Assad’s capital of Damascus used numbers ranging from 70,000 to 137,500.)

Moreover, life will likely become even worse, if possible, for as many as 1 million Syrians  by some estimates, are still trapped in besieged areas, where U.N. food and medical aid deliveries are virtually non-existent, attacks have included continuing alleged use of illegal chlorine barrel bombs, and where in some areas the regime’s meat-grinder tactics have recently made slow headway.

(For its part, the U.N. has officially reduced the number of officially besieged areas, to 13—others say there are 30—and the number of people in them to fewer than 650,000.)

“The scorched-earth policy is making life impossible for people,” sayd Dr.  Basel Termanini, vice president of SAMS. “There is definitely less attention from the media but people are still suffering.”

That analysis  of   Syria’s six-year civil war contrasts sharply with recent hosannas of hope from top U.N. officials about the likely peace prospects for  Syria—predictions  that  have become more muted as planned U.N. peace talks in Geneva between the regime and opposition forces have been delayed, first from Feb. 8 to Feb. 20, and then for an additional four days.

As recently as the  end of January,  Stephen O’Brien, the U.N.’s Under Secretary General for Humanitarian Affairs and Emergency Relief Coordinator, declared that he saw  “some emerging reasons to hope” at the start of 2017.

Among other things, he said that since the end of 2016, “a nationwide ceasefire continues to hold, despite some breaches,” which he called “a rare moment of respite for many.”

The amount of the respite may be debatable, but it is even more rare now.

All of the  dire prospects, including  the faltering peace efforts, are the deliberate results of Russia’s and the regime’s  scorched-earth and starvation strategies, which reached an apogee of success in east Aleppo, and which never faced strenuous resistance over the years from the Obama Administration. Nor, so far, have they faced anything different from the Trump Administration.

“Russia is only willing to conclude a political settlement on its own terms,” observes Jonathan Mautner, who analyzes the pattern of Russian air strikes in Syria for the Washington-based Institute for the Study of War (ISW), an independent think tank specializing in Middle East military operations.

The terms are  brutally straightforward:  to force greater international acceptance of the Assad government by changing the military facts on the ground, tilt the opposition military balance away from more moderate forces that can get international backing to extremists that both Russia and the West agree must be fought, and guarantee the permanence of still expanding Russian naval and air bases in Syria.

One paradoxical result, Mautner notes, is that “the Russian air campaign has worked by design to accelerate the radicalization of the opposition. They are trying to make it a true narrative that Assad is fighting nothing but terrorists.”

But the air campaigns are not, in his opinion, “a substitute for competent ground forces that the regime does not have. We don’t assess that Russian air strikes alone will enable them to secure all of Syria.” But they do enable regular and Iranian-enhanced Syrian forces to “degrade and depopulate” areas in their wake.

But while it does, Russia in some ways is  also helping the extremists grow stronger.

Clashes between jihadist and other opposition forces have been increasing under the Russian and Iranian-supported military pressure—and so have mergers between some of the non-jihadists with more extreme forces, along with the ability of jihadists to mount more attacks on their own.

“It’s a misconception that Syria is going to quiet down,” says Genevieve Casagrande, another ISW analyst who focuses on the Syrian opposition. “The violence is going to continue to escalate.”

Both Russia and the Iranian backed forces,” she said,  “are preparing to launch operations in  Syria’s Idlib governate. But I don’t think they are going to be capable of cleaning it out.”

The devastating air campaign,  however, “will continue to drive population away from Syria.”

Casagrande adds that “it’s a real question whether the refugees will ever return home to areas held by Al Qaeda”—which include the stronghold in Idlib.

Moreover, while most of the recent military action in the civil war has occurred in the north, where Aleppo was situated, or in areas around Damascus, new opposition offensives have recently begun in the south.

That in turn, spells greater and even longer term pressure on humanitarian resources both inside the country, where as many as 7 million Syrians have been displaced,  and in neighboring nations, where the bulk of some 4.9 million Syrian refugees are located.

The resources are already far from adequate. Of some $3.2 billion requested by the U.N.’s 2016 Syrian Humanitarian Response Plan, only $1.57 billion, or about 49 per cent, has so far been funded, according to U.N. websites. For a $$.5 billion “regional refugee and resilience plan,” only $2.75 billion, or 61 per cent, has been handed over by the international community.

(The U.S. government contribution to the  Syria plan is some $295.3 million; to the regional plan, $667.8 million, according to the U.N.)

The U.N. peace process is supposed to be followed by another U.N. conference on Syria in April, which, according to Stephen O’Brien, “will be an opportunity for the international community to reiterate and pledge their commitment to support the Syrian people.”  Translation:  promise more money.

But he also noted that U.N. humanitarian efforts in non-government-controlled areas of Syria, which had never been large, had tapered off dramatically—as it happens, in tandem with the final ferocious offensive against Aleppo.

According to O’Brien the U.N. had asked permission from the Damascus regime to deliver assistance to more than besieged 930,000 people under what he called the “December inter-agency convoy plan.” The Assad regime allowed through aid for 6,000 people—and removed more than 23,000 medical items from the convoy.

Results since then, he said, are “not much better,” even as he hailed efforts in the rest of the country as greater successes.

The difficulties are also growing for medical organizations like SAMS, which relies heavily on private donations for support, and estimates it will need some $60 million this year to meet “basic medical needs,” according to president Tarakji—without additional destruction.

SAMS work has an additional importance amid the devastation, he notes. It is “bringing the values of U.S. civil society” to the crisis—something as rare, elusive and endangered as peace itself in Syria’s  scorched-earth reality.

George Russell is Editor-at-Large of Fox News. He is reachable on Twitter at @GeorgeRussell and on Facebook at Facebook.com/George.Russell