"We had emergency plans in place. But even our worst-case scenario was nothing like what is happening now.”
Hiba Tibi, CARE West Bank and Gaza Country Director.
Hiba is in Ramallah, West Bank, coordinating with colleagues like Saaeed Rafiq Al-Madhoun, CARE’s emergency humanitarian coordinator in Gaza, who is working with local groups to get clean water, medical supplies, and food to the people in need as best they can, despite the escalating violence since the attacks of Oct. 7.
“My biggest fear,” says Saaeed, “is that the bombing of Gaza will not be the only threat. Diseases and dehydration will be even more destructive.”
Navigating the blockade
“Our colleagues in the West Bank are operating almost as some sort of Uber central,” Hiba told Norway’s TV 2 Direkte. “They’re calling potential vendors inside Gaza and advising people on what roads they can take and where they can find something to buy.”
After Israel announced its “total blockade” on Oct. 9, the UN and other humanitarian organisations warned of the critical shortage of clean water, and of hospitals on the verge of collapse, which put thousands of already vulnerable lives at further risk.
Aid groups have had to improvise
“Creative thinking is essential in this crisis,” Hiba says. “Despite being displaced themselves, our colleagues are working so hard for us to fulfill our mandate under the worst circumstances, and that gives us the energy to keep going.”
On October 21, a 20-truck convoy with bottled water, food, and medicines, entered Gaza through the Rafah crossing point in Egypt. It was the first aid truck convoy allowed through since the attacks began.
According to the UN, the convoy represented “about four percent of the daily average of imports into Gaza prior to the hostilities, and a fraction of what is needed after 13 days of complete siege.”
On October 22, another 14 trucks crossed.
A ‘drop in the ocean’
According to UNICEF, the 44,000 water bottles with the first convoy fulfilled the needs of 22,000 people for one day. The UN and other humanitarian groups called it a “drop in the ocean” for the 2.1 million people in Gaza. The cost of water has continued to skyrocket.
“Now, a litre of clean water in Gaza is ten times more expensive than in Manhattan.”
The water and fuel crises have compounded the search for other basic needs as well.
A four-hour bread queue in southern Gaza, where large numbers of people have been displaced. Photo: CARE International
“This morning,” Saaeed said on Saturday, “I and colleagues spent more than four hours in a queue with dozens of other people to buy bread, which is the staple food here.
“Some bakers were forced to close due to fuel shortages and a lack of essential ingredients, while others were closed because they sustained damage. Wheat flour across Gaza is expected to be depleted in about five days."
UN and other humanitarian groups are now stressing the urgency for fuel to be allowed in – to transport goods as well as to power hospital generators, water pumps, and sewage treatment plants.
“The fuel is not available,” Saaeed says, “And even if it is, we have to pay $15 per litre, which is immeasurable.”
Last mile delivery during escalating violence
“We work on three scenarios,” Hiba explained to SkyNews. “First, we managed to find in Gaza water and hygiene kits for displaced people and even medicine for hospitals.
“But I can’t tell you how difficult it was to secure the supplies and then transport them, as the fuel is very scarce and extremely expensive. Then, we try to secure the supplies in the West Bank to prepare for potential passage through the Erez border crossing [between Israel and Gaza] for later on when it opens, and also through the other side, from Egypt, in collaboration with the [Egyptian] Red Crescent.
“But with every hour that passes, we are running out of supplies.”
A Palestinian man walks among the debris of his house after it was destroyed by an Israeli airstrike in the al-Rimal neighborhood of Gaza City. Photo: Grayscale Media/CARE.
Working despite the trauma
This essential aid work is going on while humanitarian workers’ own lives are disrupted and thrown into uncertainty by the conflict.
“This morning I spoke to my colleagues in Khan Younis, like I do every morning,” Hiba said. “It’s an increasingly painful conversation.
“They can’t sleep at night due to the incessant airstrikes. The daughter of one of my colleagues has stopped talking. Completely stopped. I am so worried about the children of Gaza, many of whom have now lost their families. I keep thinking: who will take care of them? How will they process all this trauma?”
The United Nations estimates that there are nearly 1.4 million internally displaced people (IDPs) in Gaza, with nearly 580,000 sheltering in 150 UNRWA-designated emergency shelters (DES).
Overcrowding is a growing concern, as the average number of IDPs per shelter has reached more than 2.5 times their designated capacity.
“My colleagues have had to flee their homes in northern Gaza ten days ago and struggle like everyone else around them with overcrowded shelters, very little water, hours-long queues for a loaf of bread, no electricity,” Hiba said.
‘Survival is now a wonderful surprise’
According to the United Nations Office of Humanitarian Affairs, nearly 1,400 Israelis and foreign nationals have been killed in Israel since the escalation of violence began on Oct. 7, and at least 212 people are currently held captive in Gaza. The subsequent bombardment of Gaza has killed over 5,000 people, with children and women accounting for 62% of casualties, and over 1,000 are missing or presumed dead, while 15,000 have been injured.
CARE’s decades of work in conflict zones has shown over and over that women, the elderly, and the disabled are inordinately impacted in times like these. But the trauma that children face is incalculable.
“My colleagues are hoping their children won’t need hospital care as hospital generators are just hours away from running out of the last drop of fuel,” Hiba said.
“But still my team spends every day doing their best to provide humanitarian aid to the most vulnerable, with increasingly limited resources.”
As of Tuesday, seven hospitals, all in Gaza city and northern Gaza, have been forced to shut down due to the damage they’ve sustained, and many currently lack of power and supplies.
“When I heard of Al Ahli hospital being hit,” Hiba told TV2, “my immediate reaction was to call the director, who is a very dear friend of mine and who lives, literally, in the hospital. And I was shocked when she picked up the phone – she made it.”
“My days are now made of these moments when I pick up the phone, check on people, and get practically shocked when they answer. Survival is now a wonderful surprise.”
A worsening crisis
Despite the relief convoys and the work from aid groups on the ground, the primary UN agency in charge of assisting Palestinian refugees has stated it would run out of fuel within days. Without access to fuel or clean water, experts warn the crisis will only get worse.
“We need many more trucks to enter Gaza with food, with medical supplies, with fuel,” Hiba said. “And we need the water and electricity taps back on.
“If we have electricity, if we have fuel, we can power the water pumps, so that people stop drinking salty and contaminated water and the waterborne diseases that we are already seeing stop spreading.”
“Hospitals can keep their incubators going for newborn babies whose lives are now at risk, as are those of patients on dialysis, the wounded, and many more people in need of critical care that can’t be provided without power and medicines.
“And with fuel, our trucks can bring urgently needed aid to all those whose lives depend on it.”
On Monday, the Rafah crossing remained open for the third consecutive day, but the delivery was only equivalent to about four percent of the daily average volume of commodities entering Gaza prior to the hostilities, and it still does not include fuel.
“We desperately need humanitarian aid to come into Gaza in large quantities, we need water, we need electricity, we need fuel,” Hiba said. “We need a ceasefire because aid cannot be distributed under the bombs. And we need all that now.”
Main image: People flee from their homes in Northern Gaza on Oct. 14, 2023 © Grayscale Media/CARE