What Aid Groups Say Gaza Needs

On Wednesday evening, Gaza is expected to run out of fuel. Cars and ambulances will no longer be able to reach hospitals; generators and water pumping stations will cease working; humanitarian efforts on the ground will collapse, aid workers tell TIME.

For the first time since Israel began launching airstrikes in Gaza, in retaliation to Hamas’ surprise attack on Oct. 7 that killed 1,400 people in Israel, 20 trucks carrying essential aid were allowed to pass through the Rafah crossing from Egypt into Gaza on Saturday. A further 34 trucks of aid have since entered Gaza and are solely being administered by the U.N., whose biggest agency on the ground is the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA).

But experts say the deliveries—first brokered by the U.S. and containing food, medicine, and other medical supplies—are a drop in the bucket of what Gazans need.

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“It’s a glimmer of light but it’s not enough,” Juliette Touma, director of communications for UNRWA, tells TIME from Amman, Jordan, where she has recently moved to from East Jerusalem. “If we don't have fuel, Gaza will collapse. The people of Gaza will collapse, and the largest humanitarian operation which is run by UNRWA will come to a halt,” Touma says. She adds that fuel is needed to keep the bakeries that are feeding people and the hospitals open, both of which are struggling.

At least 5,087 Palestinians have been killed since Israel began launching airstrikes in the enclave, which is one of the most densely populated places on Earth. But Gaza has long faced a humanitarian crisis; the Strip has been under a 16-year blockade before the latest escalation. As a result, 1.2 million Gazans were already relying on food assistance from UNRWA.

Amid global calls for a ceasefire, and the fight to establish a permanent humanitarian aid corridor, here’s what to know about aid efforts into Gaza.

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How much aid went to Gaza before the war?

Before the Israel-Hamas war broke out, Gaza’s 2.2 million citizens required an average of 500 trucks of aid and fuel per day from a number of organizations. Such deliveries took place at Israel’s Kerem Shalom crossing point, while the Erez crossing point was used by aid workers, a small number of Palestinians working in Israel, and Gazans with a permit to seek health services in Israel. Aid typically included food and water assistance, as well as health and education services.

“UNICEF has been providing health material medicine and that includes, for example, the support to frontline clinics, support to rehabilitation of primary health care units. That also includes the creation of a neonatal unit in one of Gaza's Hospitals,” Jonathan Cricks, a spokesperson for UNICEF, tells TIME. He adds that the organization also supported Gazans with mental health and psychosocial needs, citing UNICEF figures that 816,000 children have needed these services since 2008.

One of the most vital lifelines UNICEF and other organizations provide is safe drinking water. “There is a desalination plant that was developed and when it's fully functioning it is supposed to provide potable, safe water for 250,000 people,” Cricks says. The lack of electricity and fuel has left Gazans to ration three liters (0.79 gallons) of water per day for cleaning, cooking, and drinking, well below then the international standard of 15 liters (3.3 gallons) needed in an emergency situation, according to the World Health Organization.

Cricks adds that UNICEF has water and hygiene kits waiting at the Egyptian border ready to enter when more trucks are approved.

Meanwhile, UNRWA—which operates across Gaza, the West Bank and East Jerusalem, Syria, Lebanon, and Jordan—also runs 700 schools across the region. “We give an education to more than half a million boys and girls,” Touma says. Some of these schools in Gaza are now acting as a refuge for people who have lost their homes during airstrikes.

The major organizations who administer aid and humanitarian services in Gaza are the World Health Organization, the World Food Programme, the Red Cross, the Red Crescent, and Doctors Without Borders. UNRWA remains the largest humanitarian operation on the ground.

How is aid administered in Gaza?

Aid previously entered the Gaza Strip via Israel’s Kerem Shalom crossing point. But aid organizations have had to quickly establish new routes via Egypt’s Rafah crossing following the Israel-Hamas war. “It’s a very complex logistics operation,” Touma says. “The U.N. overall, and other humanitarian organizations, have to set up this operation almost from scratch.”

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When trucks enter Gaza, the U.N. is responsible for the distribution of supplies, Touma says. “It's a lot of physical work. It's actually quite dangerous for our own staff to do this because they're doing this sometimes late at night, sometimes during the bombardments and the airstrikes,” Touma says.

Some 35 of UNRWA colleagues stationed in Gaza have been confirmed as killed by airstrikes.

So far, food, bottled water, and some medicine have been received and administered. Israel has warned that aid deliveries will once again be halted if supplies are seized by Hamas, which controls the Gaza Strip. But Touma says UNRWA—who has been on the ground for seven decades and built local trust—operates on a “strict scrutiny system” for aid distribution. Deliveries are monitored and audited so they reach the vulnerable, she adds.

What are humanitarian organizations calling for?

Touma warns that UNRWA has been in a “deep financial crisis” for the best part of a decade. This has left the agency with little to no reserves for an unprecedented crisis like the one unfolding now in Gaza.

Donations from around the world are rising as the death toll in Gaza surges. But aid officials tell TIME they are only helpful if they can continuously reach those in need.

As such, most humanitarian groups are calling for a sustained route into Gaza to deliver vital aid. UNICEF’s resources have quickly depleted, says Cricks. “That’s why we are asking for a humanitarian corridor that is safe and sustained,” he adds.

Touma says that there are efforts taking place “at the highest level” of the U.N. to advocate for a regular and sustained supply of aid and fuel into Gaza. “There are also efforts to reach a humanitarian ceasefire,” she says.

Write to Armani Syed at armani.syed@time.com.