Paris/Geneva: The United States has softened its stance on Syria including the future of President Bashar Al Assad to accommodate Russia, opposition coordinator Riad Hijab said, warning the opposition would face a hard choice on whether to attend peace talks this month.
Hijab, who was chosen in December as coordinator of the opposition negotiating body to lead future Syria talks, said the opposition still had disagreements with the Syrian government and the United Nations over the talks' agenda.
"Sadly, there is very clear backtracking, especially from the United States, with regard to the agenda of the negotiations," Hijab said on Tuesday.
"They want the creation of a government whereby the regime would leave us - the opposition - a few ministries."
He said this US backtracking had enabled the December UN resolution, which had a great deal of "holes and ambiguities".
The UN Security Council resolution adopted on December 18 set out a two-year road map for peace talks, but failed to address the issue of Assad's future.
"The Russians and Americans did not cite Assad (during the negotiations) and did not talk about his departure and that is clear backtracking," he said. "When (President Barack) Obama said he (Assad) had no legitimacy, Kerry was making concessions."
It also called for an end to the bombing of civilians and on the parties to allow aid workers unhindered access throughout Syria, particularly in besieged and hard-to-reach areas.
He took specific aim at the US administration and President Obama over his policies, including proposals to create a no-fly zone to protect Syrians and his handling of Assad's chemical arsenal.
"Obama didn't want (a no-fly zone).. (and) with the red lines on chemical weapons, he took out the weapons, but not those who used them. I don't think history will forgive Obama."
The peace talks are scheduled to be held under UN auspices in Geneva on January 25.
However, with the continued bombing of civilians, Syrian towns being besieged with some citizens starving to death, and differences on the agenda, the prospects of holding the talks to end the five-year-old war appear complicated.
"The choice is extremely difficult," Hijab said when asked if the opposition would attend the talks. "If we don't go to the negotiations they will say we don't respect the UN resolutions, but our people are being bombed and starved.
"If the negotiations are not well prepared they will fail," he said, warning that failure would mean more refugees heading to Europe and more moderates turning to extremism.
"If we go and they fail, it would be catastrophe for Syrian society and it would be the world that pays the price."
He said there were still disagreements with the United Nations and the Syrian government over the agenda of the talks, primarily the transitional governing body.
A senior Western diplomat also said the differences among regional and international actors as well as rivalries among opposition groups was playing into Syrian government hands.
"In December 2013 (former negotiator) Lakhdar Brahimi said he was obliged to show something was being done when all sides were not ready for talks. I fear that two years later we will reach the same conclusion. I regret it, but for me I have already seen this happen," the diplomat said. Meanwhile, the World Health Organization has asked the Syrian government for permission to send mobile clinics and medical teams to the besieged town of Madaya to assess the extent of malnutrition and evacuate the worst cases, its representative said on Tuesday.
An aid convoy on Monday brought the first food and medical supplies for months to the town, where thousands are trapped and local doctors say some have starved to death.
Elizabeth Hoff, WHO representative in Damascus who went into Madaya on Monday in the convoy, said the agency needed to do a "door-to-door assessment" in the town of 42,000 people, where a Syrian doctor told her 300-400 needed "special medical care".
"I am really alarmed," Hoff told Reuters, speaking by telephone from the Syrian capital where the Norwegian expert has been based since July 2012.
"People gathered in the market place. You could see many were malnourished, starving. They were skinny, tired, severely distressed. There was no smile on anybody's face. It is not what you see when you arrive with a convoy. The children I talked to said they had no strength to play."
On Monday, the WHO brought in 7.8 tonnes of medicines including trauma kits for wounds, medicines for treating both chronic and communicable diseases, and antibiotics and nutritional therapeutic supplies for children, Hoff said.
It intends to return on Thursday as part of a UN convoy with more medical and food supplies, she said.
The Syrian Observatory for Human Rights, a group that monitors the war, said at least 300 people left the town and were taken by government forces to the Damascus region. The UN said its vehicles were not used to take anyone out of Madaya.
Hoff said another Syrian doctor had told her that "mothers had absolutely no milk for breast-feeding, the milk had dried up and the babies are not satisfied".
"The female doctor also reported having done 27-30 C-sections (caesarean sections) in the past seven months. She does not have the requisite training, but she saw it as a life-saving intervention," Hoff said.
Many malnourished people were too weak to leave their homes.
"We need to go in with the Syrian Arab Red Crescent for a door-to-door assessment, if there are these cases we need to verify and make sure they get urgent treatment," Hoff said.
"I sent an immediate request to authorities for more supplies to be brought in. We are asking for mobile clinics and medical teams to be dispatched."
She added: "We need unhindered, sustained access, the only thing that will help in the long term is lifting the siege."
WHO simultaneously delivered 3.9 tonnes each to Foua and Kafraya, two villages in Idlib province encircled by rebels fighting the Syrian government.
Hoff visited two medical sites in Madaya, one a private practice based in a home run by two doctors, and the other a makeshift field hospital in a basement. Neither had supplies.
"The doctors at the private practice said they had run out of medicines they received in October and patients preferred to spend what little money they had on food and not health care," Hoff said. "They reported widespread malnutrition and serious problems with severe acute malnutrition, I cannot confirm what they reported."
The two doctors lacked equipment for measuring wasting in a child, or even a scale to weigh patients, she said.
The makeshift field hospital, down a dark flight of stairs, lacked hygienic conditions, Hoff said. "The room is often so crowded that they had to give a drip to a patient outdoors because there was no room in the clinic."
The two doctors at the private clinic told her that they see patients with "acute respiratory infections, urinary tract infections and anaemia", she said. Others had low blood sugar.
"An elderly lady had not eaten for 20 days, she was picked up unconscious on the street and brought in. She had bruises from the fall. She was severely undernourished."
The first Syrian doctor there told her he had names of 300-400 people requiring immediate medical care. "The doctor in the clinic reported that he hadn't eaten for three days."
"I spoke with a man who said he was 45 and severely malnourished, he could hardly talk. He said he had four children at home who are in a bad situation. He was totally dehydrated and had a yellow colour and was distressed."
"A pregnant woman was there who came in regularly unconscious... she was lying in front of me, with very low blood sugar and lacking food. The nurse had nothing to give."