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Israeli restrictions have created a “deliberately impossible” environment for humanitarian aid organisations to address the Gaza Strip’s immense humanitarian needs, the head of a group operating in Gaza said on Thursday.
On her third visit to Gaza since war broke out in October, founder of the International Network for Aid, Relief, and Assistance (Inara) and former CNN international correspondent Arwa Damon said aid has become “even more limited than it already was".
Inara began its work in Gaza in November 2023, a month after Israel’s assault on Gaza began. The war, now in its 11th month, has killed more than 40,500 people, according to local health authorities — the vast majority of whom are women and children.
Gaza is now the deadliest place in the world to be a child, according to the UN.
Every time Ms Damon returns, the humanitarian reality in the strip is more brutal, Ms Damon said.
After 20 years of covering war and violence as a journalist and as a humanitarian, she had become adept at finding solutions to logistical problems.
Despite this experience, “working in Gaza is excruciating. Finding a solution is almost impossible 90 per cent of the time. Our wins are so minuscule it’s almost laughable", she said.
This is because humanitarian aid does not enter Gaza without Israeli approval. “And when it does get cleared by Israel, aid gets dumped as a box that we can't safely pick up."
Maximising aid in a war economy
The war economy has created severe shortages in food, medicine, and cleaning supplies, while inflating the prices of these basic needs.
Life-saving aid must be picked up through routes that the Israeli army designates, but Israel’s “economy of scarcity” has created a “deliberately orchestrated anarchy that has allowed for criminal gangs and looters to operate, targeting aid lorries", making aid deliveries a slow and dangerous process, Ms Damon said.
Inara works with about 13 small shelters in the middle and south of the strip “that are tucked into areas that tend to fall outside of the wider reach that larger organisations have".
Often that means co-ordinating with larger international agencies to deliver life-saving aid to these more neglected areas, which are under constant threat of eviction.
The organisation has maximised its limited resources. It has installed solar panels in the shelters in which it operates to ensure that critical medical devices can remain charged, providing a lifeline for people with conditions such as asthma or those who rely on hearing aids.
But even these small victories are hard-won and come with significant delays.
The vast majority of Gaza’s population – about 90 per cent, according to UN estimates – is displaced. Israeli displacement orders and the constant movement of families further complicate efforts, making it challenging to deliver aid quickly and efficiently.
The constant evictions often force displaced Palestinians and aid agencies to start from scratch with each move. It means displaced Palestinians living in shelters must pick up their tents, mattresses, and what little else they have left and scatter at a moment’s notice.
Since mid-August, five of the 13 shelters in which Inara worked were under eviction orders by the Israeli army – the largest number of orders in a single week since the start of the war.
Each time, Inara and other aid organisations have also had to relocate with displaced Gazans, severely hindering their ability to deliver essential support and services.
And each time, families scatter and Inara must go through the process of finding them to provide the help needed – shelter, food, medical supplies, and so on.
“For example, for us to get four tents for four families picked up and deliver to them at their various locations and set up for them, that took us about six hours,” Ms Damon said.
Wretched and unable to help
The breadth of Gaza’s collapse means no task has become too small for Inara, which provides services ranging from running play therapy for traumatised children, to enabling access to life-saving medical care, to tracking down bars of soap.
Ms Damon says that when Inara was recently able to get hold of 100 hygiene kits, it was an achievement. But in the larger context of Gaza – “where everyone needs everything and nothing really is available” – it felt like a drop in the ocean.
Soap is scarce, which means basic hygiene has become a major challenge for Gaza’s population. In the absence of soap and clean water, Ms Damon said, some people have had to mix sand with lemon and salt to bathe themselves.
This is the case for 16-year-old Dima Abu Ghali from Rafah, who has been displaced to a shelter in Khan Younes. “We bathe in salt water from the beach. We also wash our clothes with sea water,” she told The National.
“It makes our skin peel and gives us bacterial infections… and there’s no medicine to be found [to treat our skin].
”The price of basic goods has soared, Ms Abu Ghali said, so even on rare occasions when soap and cleaning supplies can be found they are not just of low quality, but unaffordable.
For example, “Shampoo that used to cost 5 shekels ($1.36 USD) is now 85 shekels ($23.19 USD). Soap that used to cost 3 shekels ($0.82 USD) is now 15 shekels ($4.09 USD),” Ms Abu Ghali said. “We can’t afford it. We’ve been displaced so many times, our money is depleted.”
Abdulah Mterr, who owns a cleaning supply shop, said soap and other cleaning supplies were difficult to come by.
“One of the things we suffer from amid this genocide is the limited amount of cleaning supplies,” he said. “They only come through international aid organisations, and even then it’s in small quantities. In the meantime there is our own domestic manufacturing. But it's lower quality than it was before the war, and it’s all more expensive.”
The lack of access to basic hygiene, nutrition and medical supplies has led to major outbreaks of preventable diseases such as polio, hepatitis A, meningitis and impetigo.
“Soap can decrease disease by 40 per cent and if we're able to decrease disease and illnesses by that much, then maybe we can lift some of the burden off the hospitals,” Ms Damon said.
“At this point people are dying [on their own] physically and psychologically without the help of Israel’s bombs. Meanwhile, humanitarian organisations have been reduced to advocating for a bar of soap.”
The Inara chief is often at a loss for words as she tries to describe the level of despair in Gaza.
“You feel wretched when you go to a camp when mothers show you malnourished babies covered in skin disease and you can’t provide anything or help them in that moment,” she said.
Ms Damon recounted coming across an 18-month-old girl at the intensive care unit of Al Aqsa Hospital – the only functioning hospital left in central Gaza – who needed a tracheotomy. The hospital lacked a child-sized tracheotomy tube.
Inara was able to facilitate some tracheotomy tubes for the hospital, saving the girl’s life.
“But if she wakes up — if she survives all of this — she's going to find out she's an orphan.”
