Why is it so hard to get aid into Gaza?

When the war began in October, Israel closed all entry and exit points from the already besieged Gaza Strip.

“This complete blockade was in effect up until October 21, when trucks with humanitarian aid were allowed through the Rafah crossing between northern Sinai in Egypt and southern Gaza. This was the only entry point allowed by the Israeli authorities,” deputy spokesman for the UN Office for the Co-ordination of Humanitarian Affairs, Jens Laerke, told The National.

The Rafah crossing – which has been controlled by Egypt since 2007, but requires Israel to approve imports to Gaza – is designed for the movement of people, not aid or commercial goods.

Two weeks after the war began, Israel allowed the crossing to open and aid began trickling in, though it remains a fraction of what is needed.

NGOs say the process is slowed by exhaustive inspections by Israeli authorities, who say they must ensure no items deemed a security risk enter Gaza.

“This physical constraint, in combination with complicated logistics, has made entry problematic. In addition, Israeli authorities require inspection of trucks in Nitzana, some 100km from the Rafah crossing, prior to entry into Gaza,” Mr Laerke said.

Amid growing international pressure, Israel opened the Kerem Shalom border crossing on December 17.

“The facility is equipped to process hundreds of trucks, and we hope that it will accelerate the entrance of aid,” Mr Laerke said.

Israel’s Co-ordinator of Government Activities in the Territories (Cogat), which must approve the entry of all aid along with the Egyptian General Intelligence Service, said the capacity for lorry inspections “will double” with the opening of Kerem Shalom.

Stephen Ryan, rapid deployment co-ordinator for the International Committee of the Red Cross, said the move was still not enough to meet growing needs of Gazans.

“The disparity between urgently needed aid and what is currently entering Gaza is a chasm,” he said.

“There still aren't enough relief items that are coming into Gaza despite the recent developments of a further border opening.”

Before the war, about 500 lorries were allowed to cross through Kerem Shalom into Gaza each day. Of these, 100 contained aid and the rest carried commercial goods for sale in supermarkets.

Tamara Alrifai, director of external relations and communications at the UN agency for Palestine refugees, told The National there was a “huge gap” between the amount of aid needed in Gaza and how much was being allowed in.

“They need much more to meet people’s needs now that they lost everything, and many were displaced with just the clothes they had on them,” she said.

Mr Ryan said some food remained on the market in Gaza, but prices have surged.

“This means that those who have limited resources already, people who have fled their homes with little or nothing, who are now perhaps living under tents or plastic sheeting, are having to face very high prices for the limited food that's available on the market," he said.

While some organisations distribute aid directly, the ICRC is working with groups in Gaza and is focused on supporting the health system, he said.

Aid groups have also faced increasing difficulties with distributing aid inside Gaza due to frequent road closures, Israeli military operations and cuts to communications.

“Verification of trucks is long and cumbersome indeed, which delays the passage of trucks,” Ms Alrifai said.

Fuel, medical aid and equipment to ensure Gazans have access to clean water is also critical.

Mr Laerke said health infrastructure at the enclave had been “decimated”, with just six of the enclave’s 36 hospitals currently functioning. Gaza’s chronic water crisis, which began before the war, has been exacerbated, forcing many Gazans to drink unclean water – if they can find anything to drink at all.

“According to humanitarian standards, the minimum amount of water needed in an emergency is 15 litres [per person per day], which includes water for drinking, washing and cooking. For survival alone, the estimated minimum is three litres per day,” Mr Laerke said.

On December 18, Human Rights Watch accused Israel of deliberately blocking the delivery of water, food and fuel into Gaza to use starvation as a method of conflict, which is a war crime.

“One father told us he gets one can of beans or one box of cheese every three days for his family of five kids,” Ms Alrifai said.

“We have to get supplies to the scale of the needs. This is not the case yet,” she said.

The World Health Organisation said “worrying signals of epidemic diseases” have begun to emerge, with the threat “expected to worsen with the deteriorating situation and approaching winter conditions”.

“The entire population of the Gaza Strip now needs some form of humanitarian support: food, water, health care, protection, shelter, psycho-social support to mitigate war-trauma, and so on. Winter weather is only going to make those needs even more dire,” Mr Laerke said.

Only 10 per cent of the food available in Gaza entered the enclave in the past 70 days, Ocha said on December 19.

There is so little food available that Gazans have been filmed jumping on to aid lorries in an attempt to secure supplies for their families.

Any aid is difficult to store, with NGO staff and warehouses under threat from Israeli strikes.

The UN said more of its workers had been killed in Gaza than any other single conflict since the organisation was founded in 1945.

"What is happening in Gaza should make all of us outraged. It should push all of us to rethink our values, our humanity," said Juliette Touma, director of communications for the UNRWA.

“UNRWA has had 170 facilities in Gaza hit, and 136 colleagues killed since the war began.

“The level of despair is unimaginable.”

On the day it opened, 79 aid lorries passed through the Kerem Shalom crossing, the UN said.

"This is well below the daily average of 500 truckloads that entered every working day prior to October 7," the UN said in a statement.

But moving aid into Gaza is a long and tedious process that involves stops at several checkpoints, inspections and, in some cases, rejection by Israeli authorities.

NGOs trying to distribute aid in Gaza have to make decisions “hour by hour” to avoid the threats posed by Israeli shelling or ground operations and accommodate the massive displacement of people, Mr Bayram said.

Sometimes, last minute but vital logistical decisions are made “as the trucks come in”, he said.

NGOs have had to change their plans when fighting cuts supplies off from those in need.

“Some NGOs don’t have warehouses, but the aid has to be stored somewhere. So, they end up using UNRWA warehouses and storage, which requires a lot of co-ordination as well,” Mr Bayram said.

“You need to know where you need to bring your aid to and whether that area is safe, while your truck is on the way.”

During a seven-day truce in November, the Norwegian Refugee Council identified an area in central Gaza as a safe place to store aid.

“But when the truce was over, that area was not reachable any more. So effectively our teams in Rafah were cut off from the aid. That’s an example of the hourly decisions you make because of the fluidity of the situation,” Mr Bayram said.

More often than not, aid workers only know a few details of the distribution plan a day before the aid arrives, he said.

IN Gaza,mid communication cuts and security concerns, NGOs have to co-ordinate between themselves to determine who has received supplies and who is still in need.

“People are constantly on the move and so you need to co-ordinate with other NGOs so that you’re not giving one family two bottles of water and other families no bottles of water. To move around Gaza with a truck full of items is also not safe and you need to specify where you’re going,” Mr Bayram said.

Bodies still lie in the streets in many parts of Gaza.

Israel has also instructed Gazans to relocate to Al Mawasi, an underdeveloped Bedouin settlement in the south-west of the enclave.

Many have not travelled to the so-called humanitarian zone due to injury, old age or fear of being unable to return home. The roads to the south have also been heavily bombed.

“People here are desperate, when they've already lost so much, when they're living in such difficult conditions,” Mr Ryan said.

“You can see that many people are worried about where they're going to find food for their children, how they're going to look after their loved ones and elderly family members.”

He said most organisations, including the ICRC, had been calling for greater sustained delivery of humanitarian aid to meet the ever-growing need in Gaza.

“In recent weeks, many more people have left the north and travelled towards the south seeking somewhere safe to be. Those people have arrived with only the most basic items, things like blankets, mattresses if they have them and maybe a small meagre supply of food, this is not enough to sustain a family," Mr Ryan said.

“And as the fighting continues, the need continues to grow."

Steve Sosebee, who leads the Palestine Children’s Relief Fund, told The National that aid organisations also needed to prepare for what happens after the war.

“To provide immediate, life-saving support to Gaza is critical, but we also have to think about the long-term planning required for Gaza to rehabilitate the lives of tens of thousands of children who have been significantly damaged and impaired as a result of this terrible crisis over the past months,” he said.

“We need fresh thinking and strategies and interventions that’ll take on the healing of Gaza’s younger generations.”