GENEVA (Reuters) - Desperate civilians in a swathe of Syria from Aleppo in the north to the southern border are largely out of reach of aid workers, the International Committee of the Red Cross (ICRC) said on Thursday.
Throughout the country, the wounded are often denied medical treatment by either government officials or rebels, while hospitals and ambulances remain targets of unlawful attacks, ICRC President Peter Maurer said.
The ICRC is seeking 105.3 million Swiss francs (71.3 million pounds) in 2014 for Syria, its largest operation worldwide.
Syria accounts for one-tenth of its 1.29 billion Swiss franc emergency appeal for 80 countries, the largest in the 150-year history of the independent humanitarian agency.
"Syria will remain a top priority for 2014. Winter is coming with no improvement in sight. More death, injuries and displacement are causing immense suffering and tearing apart families in besieged areas. Many civilians have not had proper access to food, water, medical care or electricity for more than a year," Maurer told a news conference.
"Despite all our calls to the parties to the conflict to respect people's rights to medical care without any discrimination, we are not seeing any light at the end of the tunnel," he said.
In the last four months, the ICRC has been able to increase the number of Syrians it reaches with food and water to about 500,000 from 200,000 previously, according to Maurer.
"Where we haven't been particularly successful is in increasing our medical activities in Syria, which remain below our expectations," he said.
"Because on both sides we are struggling with the argument that whatever medical aid is brought to one part or the other is interpreted as an indirect military support to the other side."
Areas of heavy fighting in the western part of Syria, from Aleppo in the north down through Homs, Hama and Damascus to the southern border, as well as the eastern province of Deir al-Zor bordering Iraq, remain virtually off limits, Maurer said.
"In geographic terms it is the combat zones from Aleppo to the south and Deir al-Zor which are those which suffer from the biggest restrictions to access. We haven't been able in those critical areas to expand considerably our operations although from time to time we have been able to negotiate a convoy here or a convoy there," he said.
In 2013, the ICRC conducted 120 operations across front lines to deliver aid to opposition-held areas, according to Regis Savioz, deputy director of operations.
"It's a continuous struggle to negotiate access on a daily basis," Savioz said.
Referring to besieged areas, he said: "There remain these pockets, Mouadamiya, eastern Ghouta, the Old City of Homs, where we definitely never got access despite all the negotiations we had and all the efforts we have put into that. But we will continue."
Reporting by Stephanie Nebehay; editing by Andrew Roche