This article was first published in Issue 2, Volume 2 of The Journal of Humanitarian Affairs. 

How can a medical humanitarian organisation deliver emergency assistance in Syria when there is nowhere in the country where civilians, the wounded and their families, medical personnel and aid workers are not targeted? Not in the areas controlled by the government, nor in those held by the Kurdish Democratic Union Party (PYD), Islamic State of Iraq and the Levant (ISIL) or the different rebel groups. So what action could be taken, and how? Remotely or on site? At the very least, we had to decipher the diverging political and military agendas, and then adapt, persist or sometimes just give up. In this article, I will present the full range of methods used to acquire knowledge and obtain information as well as the various networks used to carry out this venture. I will also show how Médecins Sans Frontières’ operations became a balancing act, punctuated by episodes of adapting to the various difficulties encountered.