Humanitarian needs have escalated dramatically since a similar donor conference in the oil-rich Gulf nation last January. The United Nations warns that more than 9 million people need assistance as the conflict grinds on.
"A year ago ... We were talking about a catastrophic disaster that engulfed the entire country with regional implications," said Jens Laerke, a spokesman for the UN office in charge of coordinating humanitarian affairs. "Now a year after, I'm almost at a loss of words for how big this has become. It really is catastrophic."
But the needs keep growing. Millions have been uprooted from their homes, many scattered in refugee camps and informal settlements dotting neighboring Lebanon, Jordan, Turkey and Iraq.
One refugee community, the Zaatari camp in Jordan, has burgeoned into a city with an estimated 120,000 residents living under plastic tents and competing for limited water supplies and other resources.
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"The needs on the ground are much higher than the response from the international community," said Mohammad al-Hadid, who heads the Jordanian Red Crescent.
The war, now in its third year, has killed more than 130,000 people, according to the Syrian Observatory for Human Rights, which tracks the fighting.