CAIRO -- Koert Debeuf, a Belgian who works in Cairo as a representative of centrist parties in the European Parliament, says he was smuggled from Turkey into Syria by rebel commanders in January to study conditions in the rebel-held territories. But when he asked the commanders to show him the Azaz refugee camp in northern Aleppo Province, he said he had the impression that they felt ashamed.
"They were too proud to ask us to help them with aid or weapons, and it was as if showing us the misery they thought would have been like admitting their own failures as the F.S.A.," Mr. Debeuf said, referring to the Free Syrian Army, a loose coalition of armed rebels.
When he persisted and was finally allowed to enter the camp, he said, it was he who left feeling embarrassed because of the squalor and the fact that so little help from Europe was reaching the people there.
"I felt so ashamed to be European. It was very emotional. I was very angry," he said during an interview last month in Cairo. "The whole thing is just so unjust, so inhumane."
In what has been called one of the worst humanitarian situations produced by the civil war, international humanitarian aid has largely failed to reach camps in rebel strongholds, leaving internally displaced Syrians living in squalor just meters from the Turkish border.
"The humanitarian aid is coming through the regime" of president Bashar al-Assad, said the rebel Gen. Salim Idris, chief of staff of the F.S.A., on Tuesday by telephone from Brussels. "It is coming through the Syrian Red Crescent, and only a little of this is coming to the liberated areas."
During his visit, the first by a rebel commander to the European capital, General Idris accused the Syrian regime of blocking international aid from reaching rebel-held areas, and he called on Europe to provide direct humanitarian aid through the rebel command organization.
"We have the structures needed to receive this aid to get it to the liberated areas, to the people who need it," General Idris said.
The next day, addressing a meeting of Mr. Debeuf's group, the Alliance of Liberals and Democrats for Europe, or A.L.D.E., at the European Parliament, General Idris said the rebel army controlled as much as 70 percent of certain regions of Syria. He also said that if the F.S.A. were given sufficient support, radical units like the jihadist Al-Nusra Front, a Sunni insurgent force that U.S. officials have blacklisted as a terrorist organization, would become irrelevant.
General Idris said there were five million civilian refugees in Syria, and he condemned the lack of humanitarian aid from the West. "We look to people in the west as our brothers in humanity, but people in Syria say that the international community just looks at the TV screens, says Assad should go -- but does not act," he said.
In January, with two Syrian activists based in Cairo and a guide, Mr. Debeuf traveled with commanders of the F.S.A into Aleppo Province at his own initiative, he said, to see first-hand what was happening.
The Azaz camp, he said, "was the worst thing I've seen in my life."
Built for only a few hundred refugees, numbers at the camp in northern Aleppo had grown to more than 11,000, including more than 8,000 children. With no heat, no electricity and no running water, families were crammed into tents and children were infested with lice.
The room designed to store milk was empty, he said, and babies as young as three months had only sugar water to drink. Food was scarce and meals were rationed to one per day. In two days, food was set to run out.
Inside one tent, he saw a disabled girl lying motionless on the ground. She suffered from epilepsy and needed medicine. In another tent, he met a father holding his year-old son. While fleeing their home, the child's leg had been ripped open by shrapnel and it was clear, Mr. Debeuf said, that if the child did not receive treatment soon, he would die. That day alone, Mr. Debeuf was told, four children had died from cold.
Mr. Debeuf said people in the camp were angry: "Every single one of them was convinced that we were supporting Assad, and if you are there, what can you say? There was $519 million in aid promised and they've got nothing."
That was a reference to developments in January, when donors pledged $1.5 billion in assistance to U.N. humanitarian agencies, with $519 million being requested for humanitarian aid to those inside the country. The United Nations, which works with various partners, including international and national non-government organizations, has repeatedly stressed the need for humanitarian operations to remain neutral and to avoid politicization.
But according to U.N. rules, N.G.O.'s and their partners in Syria must be authorized to work by the Syrian government. That has brought accusations from the rebels that aid is being unequally distributed.
"Some in the opposition have criticized this, saying the U.N. is funding the regime," said Omar Hossino, a Syrian-American researcher based in Washington, who recently visited the rebel-held northern regions.
"That is an exaggeration," he said: "but there is a legitimacy to those critiques. If you are going to be an N.G.O., national or international, authorized by the Syrian government, you are going to be under strict restrictions."
At the center of criticism has been the Syrian Red Crescent, one of the main U.N. partners in distributing aid. General Idris and others in opposition strongholds have accused it of unequal distribution, favoring supporters of the regime.
But with the situation on the ground already perilous, others say the accusations are unfair and risk putting aid workers at an even greater risk of becoming targets. Aid workers of the Syrian Red Crescent have been killed by both government and opposition forces, and some have reportedly been imprisoned by the regime.
Syrian Red Crescent workers "have shown a lot of dedication and determination and they are really doing a tremendous job," Dibeh Fakhr, a Red Cross spokeswoman said last month by telephone from Geneva. "We should not forget also that they are being killed. Seven volunteers have lost their life while on duty."
Last week, the U.N. undersecretary general for humanitarian affairs, Valerie Amos, acknowledged that the rebel-held north remained largely out of reach.
A "human tragedy is unfolding before our eyes," she said last month, according to Reuters. "We are crossing conflict lines, negotiating with armed groups on the ground, to reach more people in need. But we are not reaching enough of those who require our help."
"Limited access in the north is a major problem that we can only solve using alternative methods of aid delivery."
Ms. Amos said the Syrian government had recently authorized three additional international N.G.O.'s to work in Syria, raising the number authorized to 11.
The lack of aid reaching rebel-held areas has led to some calls for cross-border relief operations -- but that also is problematic: The United Nations requires government permission from all parties involved, and the Syrian government has refused to allow U.N. convoys to cross from Turkey into northern Syria -- where nearly all the border crossings are now under the control of the F.S.A.
Turkey has continued to maintain the official position that it will not violate Syrian sovereignty with cross-border operations. Nongovernmental agencies working in the region say that Turkey has nonetheless been the most permissive of Syria's neighbors in allowing aid to cross the border, despite its public stance. But Ankara's attitude has fluctuated after bombings at border crossings. Efforts by the Kurdistan Workers' Party, known by its Turkish acronym P.K.K., to take control of some areas along the northern border have also complicated the situation.
Despite the limitations on aid operations channeled through the U.N.'s humanitarian networks, some nongovernmental organizations, including Médecins sans Frontières have been working privately in rebel-held territory, and many have attested to the harsh conditions in those areas.
"This is exactly what we found. Liberated areas are getting virtually no aid from the U.N. or anyone else," said Kenan Rahmani, a board member of the Syrian American Council, the largest grassroots advocacy group for Syrians in the United States.
Earlier this year Mr. Rahmani went into rebel-held regions, where, he said the group had been compiling a list of organizations trying to bring in aid.
"We definitely advocated very strongly for the U.S. to use the Syrian opposition's coalition's Assistance Coordination Unit to distribute aid directly to liberated areas," said Mr. Rahmani, referring to a unit set up by the coalition at the request of the United Nations.
"The U.S. has started doing that. Hopefully European governments will follow in that trend," he added.
Mr. Hossino, the Syrian-American analyst, said private organizations were increasingly able to enter the country with aid supplies; the problem for official aid flows were not primarily practical, he said: "This is about legal barriers."
After seeing the Azaz camp, Mr. Debeuf said he felt obliged to do something, even if it was outside the U.N. framework, to provide aid.
The main problem, he said, had been an absence of coordination between the European Union, the Syrian opposition coalition, the F.S.A., and the N.G.O.'s trying to distribute aid on the ground. So, he said, he had tried to bring those players together and push them toward greater cooperation.
"It isn't really my job, but there is no-one else to do it," he said.
Last month he organized a meeting in Turkey between a high-level delegation of European officials and two commanders of the F.S.A.
He was also instrumental in setting up this week's visit by General Idris to the European Parliament at the invitation of Guy Verhofstadt, the president of the A.L.D.E. group.
While many have criticized the Syrian opposition as being fractured and disorganized, General Idris said, they have recently set up new structures needed for aid distribution. The general said all the documentation required is being gathered and can be provided by the F.S.A., including maps of where humanitarian and medical aid has been distributed and details of the recipients.
When the F.S.A. fails to receive aid, he said, it causes them to lose support. "The aid is coming through the regime, and it isn't reaching us," he said. "People begin blaming us and we lose support."
Abu Eesa, a military commander in Manbij in northeast Aleppo, was one of two F.S.A. generals to meet the delegation of high level European officials in Turkey in February. Mr. Eesa, who said he represented the more secular wings of the F.S.A., reinforced General Idris's warning.
"When I make promises on aid, I can't follow through," he said. "When Jabhat al-Nusra makes promises, they can follow through," he added, referring to the al-Nusra Front.
If Western governments continued to withhold aid supplies from the F.S.A. command structures, he said, "All of Syria will turn to Jabhat al-Nusra, because they are providing this aid at the moment, and this is what people need."
Mr. Hossino, the political analyst said, "Everyone is trying to buy legitimacy in Aleppo and Idlib through aid. Aid is a weapon for all kinds of unsavory actors, Jabhat al-Nusra, even the P.K.K. If the aid could get in, it could decrease this vacuum."
While legal obstacles to channeling aid through the U.N. system remain, and the concerns about aid falling into the wrong hands have not gone away, the pressure is growing for aid channels to be opened outside the framework of the United Nations. And with Secretary of State John Kerry of the United States recently pledging $60 million in additional nonlethal aid and training to the Syrian opposition, the pressure for Europe in particular to follow suit has been mounting.
"We need to take a leap of faith," Mr. Debeuf said. "Of course things will go wrong, but what we are doing now, is going very, very wrong, and we are only making two people stronger: Assad and Jabhat al-Nusra."
This article originally appeared in The New York Times.