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New report describes how Israel prevents humanitarian aid from getting into Gaza

Refugees International says Israel has attacked aid convoys, enforced capricious bans against medicines and water filters, and turned back desperately needed assistance

Nail clippers, insulin pens and water filters are among the items Israel has prevented from entering Gaza, according to a new report that says the country’s “routine and arbitrary” denial of humanitarian assistance has produced an “apocalyptic” situation on the ground.

Thursday’s 23-page report from Refugees International, a Washington-based humanitarian organization founded in 1979, depicts an Israeli aid approval process that does not make clear what items are allowed in, attacks aid convoys it has approved for safe passage, and strikes humanitarian facilities such as offices, residences and bakeries. It echoes remarks made by senior U.S. officials and international human rights watchdogs that Israel has not allowed enough aid to get to Gaza’s civilians.

The report, which relied on interviews with dozens of government officials, aid workers, and people inside of Gaza, also hints at the growing unrest among a civilian population in Gaza staring down months of famine.

The report came as the number of Palestistinians killed in Israel’s war against Hamas surpassed 30,000, with thousands more in need of emergency medical evacuation, four in five Gazans lacking clean water and 90% of its children under five suffering from at least one infectious disease.

While those conditions result from the war — the report calls for a ceasefire and the release of Israeli hostages — Israel has, contrary to its own assertions, failed to mitigate them by facilitating safe delivery of aid, according to the report. About 50 to 100 aid trucks enter Gaza daily, down from an average of 500 before the war.

And the report says Israel’s facilitation of aid has only gotten worse since the International Court of Justice issued legally binding provisional measures Jan. 26 ordering Israel to facilitate the flow of aid and lessen humanitarian suffering in Gaza. Since then, the average number of trucks delivered per day has fallen 50%.

Denying aid in Gaza

Following Hamas’ Oct. 7 attacks, Israel announced it would lay total siege to Gaza, with Defense Minister Yoav Gallant saying it would deny entry of electricity, food and fuel. Today, all but two border crossings — Kerem Shalom and Rafah — remain closed to humanitarian aid.

Even at those two crossings, however, aid has had trouble getting in, according to the report. It describes week-long delays for aid trucks once they get to the border, and frequent rejections of their contents. Those delays at the crossing have created a bottleneck disrupting the rest of the supply chain, the report says. On any given day, several hundred trucks are waiting in week-long queues at the border to deliver their cargo.

“Aid that cannot be distributed quickly fills up the warehouse space that has not yet been destroyed,” the report asserts. “When warehouse space is full, more aid cannot be imported. When aid cannot be imported, enormous lines of trucks wait for days at the border crossings. When trucks are tied up waiting at border crossings, their capacity is taken off line for other movements.” 

The report blames unnecessary hurdles, complicated logistical processes and an unpredictable vetting system. According to UN personnel cited by the report, if even a single item on a truck is rejected, the entire cargo faces rejection.

Per Refugees International’s interviews with aid officials, rejected items include water purification tabs, nail clippers, insulin pens, tent poles, green-colored sleeping bags, water filters and ventilators. Additionally, there is no cold chain or cold warehouses in Gaza because aid workers cannot deliver any form of cold storage. Medical organizations cannot even get in solar panel fridges and refrigerators, the report says, because Israel considers them “dual use” items — in other words, they could be put toward the war effort.

Attacking aid convoys and humanitarian workers

A major issue underscored by the report is the lack of protection for aid workers. It is against international law to attack aid workers. But according to the report, Israel has repeatedly attacked humanitarian infrastructure, including the residences and offices of aid workers and in some instances aid convoys.

Israel has touted its system of announcing upcoming military actions to allow individuals in targeted areas to evacuate. But humanitarian operators and Palestinians told Refugees International that the approach frequently fails, putting aid workers and beneficiaries at risk. UN and NGO staff also reported several cases where humanitarian infrastructure was hit without prior warning, including a Feb. 21 attack on a MSF (France’s Doctors Without Borders) building in Gaza in which tank fire killed two and injured six from the organization.

Humanitarian agencies have provided Israel a list of their facilities with the understanding they would thereby be protected. But they have been attacked with enough frequency, the report says, that workers believe Israel may deliberately be targeting them, with one NGO staffer saying, “It’s basically a strike list.”

That security risks have made it nearly impossible for aid workers to do their job in Gaza has also been highlighted by top U.S. officials. The report cites a “senior U.S. official” who said Israeli authorities often provided them with no clear military justification for strikes on humanitarian infrastructure or for blocking UN movements to areas of critical need.

A breakdown in civil order

One of the well-documented issues at the Kerem Shalom crossing has been Israeli protesters blocking aid trucks. But once inside Gaza, delivery trucks can be attacked by criminal gangs, according to the report, which it says have been looting truck shipments entering Gaza. 

The problems are especially bad in the north, where since Jan. 1, Israeli authorities have facilitated less than 20% of humanitarian missions aimed at delivering aid, the report says, and outright rejected more than half of all requests.

According to the report, UN convoys facing protracted delays at the Wadi Gaza checkpoint — the main route for aid delivery in the north — have also been raided by local communities urgently in need of food. Partly due to the heightened risk, the World Food Program paused food deliveries to the north Feb. 20. 

Israel has defended itself against accusations that it has shut down humanitarian assistance by arguing that it has improved the entrance and distribution of aid by opening up the Kerem Shalom crossing, easing congestion at the Rafah crossing.

“This argument is contradicted by facts on the ground,” the report says. “They have created a complex system with multiple potential choke points rather than a good-faith system optimized to maximize aid volumes.”

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