Gaza's widening humanitarian crisis

More than 10,000 Palestinians have been killed so far in the Israel-Hamas war.

Food and water are scarce. The health care system in Gaza has collapsed.

"Children are being orphaned inside the hospital," Maria Abi-Habib, investigative correspondent for the New York Times, says. "They’ll come with their families, their parents on the brink of death and then they’ll watch their parents die."

Amid reports that Pres. Joe Biden is pushing Israeli Prime Minister Benjamin Netanyahu for a "tactical pause," international pressure for a broader ceasefire is rising.

Today, On Point: Gaza's widening humanitarian crisis.

Maria Abi-Habib, investigative correspondent for the New York Times.

Hiba Tibi, country director for CARE International in the West Bank and Gaza.

Merissa Khurma, director of the Middle East Program at the Wilson Center.

Saaed Al-Madhoun, Gaza resident and humanitarian coordinator for CARE International.

Part I

Saaed Al-Madhoun lives in Gaza. After some effort, our producer Dan Ackerman was able to connect with him last night over an unstable WhatsApp connection.

(Beep beep)

SAAED AL-MADHOUN: Yes, hello.

DAN ACKERMAN: Yes. Hello. (Ineligible)

AL-MADHOUN: Unfortunately, I have a very poor internet connection due to the current situation and the current circumstances. But if you are hearing me well, I can describe you a little bit about the humanitarian situation currently in Gaza. Are you? Are you here? Are you hearing?

CHAKRABARTI: Hamas attacked Israel on October 7th. It’s been just over one month since Israel’s retaliatory bombardment of Gaza began. Saaed told us that his first, most urgent need was to try to keep his children safe and calm. His oldest child is 12. The youngest, one year old. So every time they were overwhelmed by the sounds of bombs exploding or ambulances rushing by, Saaed tried to make a game of it for his five young children.

AL-MADHOUN: I tried to inform them, let’s try to make some games together when we are hearing bombardment. It’s like the games in the sky. Don’t worry, things will be calmed down soon. Our home is very safe. We tried to minimize the issue for them in order to be more comfortable. But unfortunately, we didn’t succeed because things are out of our hands, honestly.

CHAKRABARTI: The damage across Gaza has been extensive. Anywhere from 18% to 25% of all structures in Gaza have been destroyed or damaged. That's up to 51,000 buildings, according to various estimates of satellite images. Among the hardest hit areas: Gaza City, in the north of the enclave, where Saaed’s family lived.

AL-MADHOUN: There was a warning that will destroy the building near to my house. So I moved directly from my house to my brother house in the same city in Gaza. After I just arrived my brother house, the building beside my original house was destroyed.

CHAKRABARTI: Saaed’s house was also seriously damaged. It was uninhabitable. Three days later, Israel ordered more than a million people to evacuate to southern Gaza. Saaed, his wife, and five children fled to his uncle’s home in Khan Yunis, near Gaza’s southern border with Egypt, where he is now.

AL-MADHOUN: In this flat we have more than 30, 30 people. Some people are sleeping on the floor. Some people said, "I don’t need to sleep. I will wake up so I can inform you if things happening, if there is any emergency situation around us." Because to be honest, to be honest, there is no safe place.

CHAKRABARTI: Saaed says the basic necessities of life, such as water, are getting harder to come by.

AL-MADHOUN: Again, please (INELIGABLE). We are suffering at, in bringing the drinking water, because the water resources is very limited. And most of the water treatment and water bombing are operating using the fuel. And the fuel is not allowed to enter Gaza. So we are in a very hard situation in bringing water.

CHAKRABARTI: He told us that he does have a water supply now – because he’s buying it from a private company that’s charging triple the regular price.

The same goes for bread. He says Gazans in Khan Younis are going to extraordinary lengths to find food in any bakery that’s open. Many are not, because some bakeries have been destroyed, others don’t have enough fuel or power to stay open.

AL-MADHOUN: And sometimes it takes us about five hours or more in line to bring the bread from the bakery to our houses. 

CHAKRABARTI: Five hours in line to buy bread. But they can’t eat it with hot meals cooked at home.

AL-MADHOUN: We are not able to make any cooking, because gas is not available. We are bringing some of the canned food, but it is currently most of the canned food is not available in the supermarket. I am personally trying to minimize my meals to one meal in order to save things for the kids.

CHAKRABARTI: Again, because of that unstable WhatsApp connect Saaed said he's personally trying to minimize his meals to one meal a day in order to save things for his children.

Trucks and cars have long since run out of fuel in Gaza. People move around by foot or bike. Some use donkeys to carry home whatever rations they can find. The electricity grid is down. Though Saaed says he’s lucky, because his uncle has solar panels. And that’s how he was able to charge his phone, turn on lights and speak with us.

A month into the fighting between Israel and Hamas, Israeli ground forces have encircled and entered Gaza City. And Israeli leaders are promising to complete their stated mission to eradicate Hamas.

Saaed Al-Madhoun has a unique perspective on the crisis in Gaza right now. Not only because he’s one of more than a million Gazans who’ve been internally displaced by the war. He’s also Gaza humanitarian coordinator for CARE International. And he says that even he is wondering how long will he have to make a game out of the sound of exploding bombs in order to comfort his children.

AL-MADHOUN: Honestly, I am worried, because we didn’t know when this war would be end. I feel worried because I am worried about my children, because they are not feeling safe at any time. And they have some psychosocial problem due to the current situation. But I think there is a window for hope. I feel we still have some hope in the future that this critical crisis will be ended soon.

CHAKRABARTI: That was Saaed Al-Madhoun. He spoke to us last night from southern Gaza.

More than 10,000 people in Gaza have died since the start of the Israel-Hamas war. Scores more injured. And more than 1.4 million, like Saaed, displaced from their homes. The World Health Organization is warning of rampant outbreaks of respiratory infections, diarrhea, chickenpox and scabies.

At a meeting in Paris this week there’s discussion of opening a maritime corridor to bring goods into Gaza and injured people out by boat. And separate talks are ongoing between Israel and Hamas about a possible 3-day pause in the fighting, to allow for more aid to enter Gaza and for some hostages to be freed.

How significantly, if at all, will this change the humanitarian crisis on the ground?

Maria Abi-Habib joins us. She’s an investigative correspondent for the New York Times. She’s been covering the situation in Gaza. Maria, welcome to On Point.

MARIA ABI-HABIB: Thank you for having me.

CHAKRABARTI: So first of all, tell us a little bit more about what you know or have seen about the humanitarian situation in Gaza now.

ABI-HABIB: The humanitarian situation is as dire as anyone can imagine. Having covered large scale offenses during the Arab Spring, for instance, Aleppo, we have seen the destruction of an entire population center, not in months, not in years. As in most major wars, like Chechnya or Aleppo or any of the ones that really come to mind over the last decade or two or three, this is the destruction of entire territory or large chunks of this territory. Major population centers, in a matter of weeks, really.

It is as bad as you think. There are at least 10,000 dead, and people say, aid organizations say, ones that we trust in every other war, have said, but it's much more than 10,000 people, probably, because there are hundreds of people buried under rubble. We're talking about entire city blocks just coming down with Israeli strikes, for instance.

And the Israelis will say Hamas hides among the civilian population. But others will say that's not really true. That's just an excuse to justify the airstrikes.

CHAKRABARTI: Yeah. Maria may I just jump in here for a second?

ABI-HABIB: We are in a terrible situation.

CHAKRABARTI: Sorry to, I'm very sorry to interrupt there, but you've also reported extensively and quite recently on the health care infrastructure in Gaza. That Gazan hospitals are essentially in a state of collapse.

Can you tell me more about that?

ABI-HABIB: Sure. So you have everything from brain surgeries to actual amputation of limbs happening for children, the elderly and everything in between, without anesthetic. You have people using vinegar because they have run out of other disinfectants. You have people being operated on in some cases on tile floors because they've run out of hospital beds.

And then you also have doctors having to make this very difficult choice, which they get very sensitive about, because they took the Hippocratic oath, just like every other doctor in every other country in this world, to do their utmost to save people. But they are faced with this terrible choice.

We only have so many hands and we only have so many supplies, who gets what, who dies, who lives. At some point, somebody will come in with needing CPR and they'll assess how far gone they are in cardiac arrest and say, "We don't have the ability to resuscitate you." So oftentimes they're not even able to resuscitate heart patients, people who are suffering from a heart attack.

So it's really a mixture of horrible choices. And then the strain on Gaza's hospitals are not enough. Considering that there's also a lot of people who have been, who've lost their homes and are now living inside the hospitals. There are also now these temporary orphanages.

Because there are quite a few children who are showing up, watching their kids, their parents and their siblings die in the hospital, or they show up the only surviving family member and then the hospital all of a sudden is taking care of an orphaned child waiting for extended family members to come and claim them, it's the worst, it's one of the worst situations I've ever seen as a conflict correspondent.

Part II

CHAKRABARTI: Today, we're talking about the humanitarian crisis on the ground in Gaza. Maria Abi-Habib joins us. She's a correspondent for the New York Times who's reported extensively from Gaza. And as Maria's reporting has shown us, the hospital and health care infrastructure in Gaza is basically in a state of collapse. Including the fact that, as Maria has reported, because telecommunications infrastructure has been cut off by Israeli bombing.

Oftentimes Gazan ambulance drivers say they can't communicate with each other and have to chase the sound of explosions in order to know how and where to get to the injured now. In addition to that, of course, there are basic necessities that every hospital needs to operate or to function normally, including power, fuel and clean water.

Now, on the point of the water, Gaza typically gets just 10% of its drinking water from Israel via pipeline. The other 90% is produced in Gaza itself. And that becomes a major issue, of course, when the electric grid goes down or is destroyed and fuel supplies are low. Dr. Elai Rettig researches energy geopolitics at Bar-Ilan University in Israel, and during a press briefing last week, he described the cascading impacts of power outages in Gaza.

ELAI RETTIG: Your main problem is now water. Because water needs continuous electricity, either from the grid or from desalination plants that have their own small-scale diesels, diesel generators. So this is where things get complicated. The connection between electricity, diesel and water.

CHAKRABARTI: Now, Dr. Rettig also said that when it comes to that original importance of fuel and diesel, to power everything from lights to water in Gaza, he talked about Hamas's potential stockpile of diesel fuel, and that likely includes fuel it took, that Hamas took from Gaza's only power plant.

RETTIG: The power plant should have a minimum of 500,000 liters at any given time. If on the first day that Israel cut it off, Hamas already said that it's out of diesel for the power plant.

It means that they depleted the diesel themselves, which means they have something like 500,000 just from the power plant. Other than that, we've had reports about diesel being stolen from other facilities.

CHAKRABARTI: Now, Dr. Rettig also noted that a half a million liters of diesel is enough to run that power plant for three to four days.

Same amount of fuel could run Gaza's biggest drinking water desalination plant for about a week.

Maria, you have reported on the existence and size of this Hamas stockpile. What can, what more can you tell us about it?

ABI-HABIB: By most people's estimates, including the Israelis, it seems that there is a stock, that Hamas has stockpiled between 800,000 to a million liters of fuel.

But we should note that the World Health Organization has said that 94, about 100,000 liters are needed to just run 12 of Gaza's biggest hospitals. That does not include needs for bakeries. That does not include needs, fuel needs for desalination plants so that people can drink fresh water, for instance.

So even with the stockpile, that Hamas sits on, which is real and significant. It still wouldn't be enough to meet Gaza's needs for more than a week at best. There is still the need, even if Hamas were to give out all of its fuel stocks, as the Israelis have been asking them to do or challenging them to do, Gaza would still need significant fuel from Egypt, for instance, and the Israelis are holding that up.

So while it is true to say that Hamas is sitting on a stockpile, it is nowhere enough, it would nowhere near meet the needs of Gaza and its everyday, for more than a week.

CHAKRABARTI: Point well taken. Simultaneously though, has Hamas made any indication of releasing even a part of the stockpile it has?

ABI-HABIB: No, they have not. As you can maybe imagine, it's not the easiest to get a hold of people from Hamas right now. But no, they have not. So they have been pushing on the humanitarian aid aspect and allowing the wounded, the severely wounded to leave Gaza for medical attention in Egypt.

CHAKRABARTI: Maria Abi-Habib, reporter for the New York Times, correspondent for the New York Times, who's reported extensively on conflicts around the world, including what's going on right now on the ground in Gaza. Maria, thank you for joining us.

ABI-HABIB: Thank you.

CHAKRABARTI: At least 89 United Nations workers have been killed in Gaza so far.

And that's according to a speech given on Monday by UN Secretary General António Guterres. He also said, not nearly enough aid is getting into Gaza.

GUTERRES: Just over 400 trucks have crossed into Gaza over the past two weeks, compared with 500 a day before the conflict, and crucially, this does not include fuel.

Without fuel, newborn babies in incubators and patients on life support will die. Water cannot be pumped or purified. Raw sewage could soon start gushing onto the streets, further spreading disease. Trucks loaded with critical relief will be stranded. The way forward is clear. A humanitarian ceasefire now.

CHAKRABARTI: That's the UN Secretary General António Guterres on Monday. Joining us now from Ramallah on the West Bank is Hiba Tibi. She's country director for CARE International in the West Bank and in Gaza. Hiba, welcome to On Point.

HIBA TIBI: Thank you so much, Meghna. It's really an honor to be with you today.

CHAKRABARTI: Can you tell us more about what your colleagues and other Gazans that you've been able to be in contact with are telling us about the current situation that they're living through right now?

TIBI: This question becomes every time asked harder and harder to answer. I think everyone here mentioned and it is not different from what others are telling us. Unfortunately, the colleagues were telling us that they are afraid that they are very close to come to the last drop of water, last drop of fuel.

Last loaf of bread. And this is the situation now in Gaza. It was already hard over the last week, but it's almost impossible now to find bread in certain areas. And I'm talking about the south. All of my team evacuated to the south. My partners are also working in the south, but the situation is even harder in the north.

There are many people who did not leave. 100,000 people are still in the north where they are under constant shelling, unable to find food, water. Of course, fuel is missing everywhere. And of course, access to medical services is really becoming very hard.

CHAKRABARTI: Now you make the distinction between southern Gaza and northern Gaza, I presume for a couple of reasons.

One is that the Israeli military told Gazans to move south, right? And so therefore the implication being that the humanitarian crisis would be less intense there versus the fact that Gaza City in the north is being currently encircled by IDF forces. But you're saying that it's bad in the south, too.

How does this compare to other wartime or escalations that CARE International has had to deal with in past conflicts in Gaza?

TIBI: So only in September, just before the war, we have carried out a regular exercise that we normally do on annual basis. It's called emergency preparedness plan.

And Meghna, you take the worst-case scenario, and you design your intervention around it. Our worst-case scenario was 2014 escalation, but it is nothing close to what we are seeing now. The situation is something that we have never foreseen or got prepared for. It's not only care, but this is the situation with all other organizations, peer organizations.

We attend what we call working clusters that are run by the UN agencies. And everyone is really trying to find out how we are going to do that. We ask how we are going to intervene. We ask also, for instance, care colleagues who came up with most innovative solutions under similar circumstances, like for instance, in Yemen.

Within the wartime, or in Turkey with such a huge scale, but what we face here in Gaza is very unique. Where you don't have, where the blockade on humanitarian assistance makes it extremely difficult. The lack of resources for basic humanitarian need is also massive, for instance, as you were mentioning, the electricity, fuel, water, even before war, water was 97% of the water in Gaza was not drinkable.

That huge number of people being internally displaced from the north to the south is not only shocking for the resources in the south, but also is making life very difficult for the people themselves where they are overcrowded inside the shelters, outdoor, in the apartments.

As you have seen that it was among the very lucky people to be in an apartment with 30 people, one of my colleagues staying with 120 people and they are unable to, she told me, we have queues for everything. Queue to use the restroom, queue to go to sleep, queue to go out of the house, all of these changes and the sudden lack of basic needs make everything very difficult for them to survive.

Plus, the feel of being unsecure and unsafe.

CHAKRABARTI: Yeah. But Hiba, may I just ask something for clarification, that you said that it was just in September that was CARE International doing some sort of preparedness exercises in Gaza? Did I hear that correctly?

TIBI: Yes, these are annual regular exercises that we do in potential emergency situations and all contexts, like the one in Gaza.

CHAKRABARTI: I see. And of course, this was before October 7th. So what was revealed to you even in that September exercise?

TIBI: One of the major issues was related to the health system.

CHAKRABARTI: Uh huh.

TIBI: Because one of our biggest programming in Gaza is around health services. Our focus was around what we call sexual reproductive health sector.

So we work with a woman, young woman on their sexual being, health, we take care of women before and after pre and postnatal medical services, raising awareness, et cetera, et cetera. What was very apparent is that, or very clear, is that the services that are provided is not the most secured, up to date practices.

Already, the health system was doing its maximum. By that time, the teams were not relaxed in what they are providing. The dependency on importing everything, on the markets from abroad, on either from West Bank side or from Egypt side, made it very clear that any moment, if any tension occurs on the borders, a cut can happen, but there are not lots of stocks.

CHAKRABARTI: I see.

TIBI: So this was the situation before, but now everything is collapsing in terms of communication, as you mentioned. So for instance, the doctors themselves, or the medical centers, the maternal, those that are providing pre and postnatal services, they themselves flew, evacuated from the north towards the south and now everything is disconnected.

Completely disconnected.

CHAKRABARTI: Hiba, you also had said that the humanitarian disaster in Gaza right now is completely different from other major humanitarian crises that CARE International has worked with or worked in before.

You mentioned Yemen, which, of course, that country has been bombarded for years and its populace been starved, essentially. The UN called it before October, the largest humanitarian crisis in the world. But Gaza is different because you cannot get additional supplies into Gaza.

TIBI: So this is one thing.

You have the people, all of the people in Gaza are now in need of aid. All of them, they are affected. Normally, you would find teams that would be able to provide support. You will find certain areas that would be unaffected by the escalations. But now it's all the Gaza Strip, all over Gaza Strip.

So these are two things. The third one is that normally, for instance, let's take the worst-case scenario, which is the earthquake. In the earthquake, what you were able, Turkey was able at a certain moment to fly human resources, to fly humanitarian assistance to, let's say, Adana or the areas that were affected by the earthquake.

Now this is not happening. The destruction of areas' passage that links between West Bank and Gaza, which was one area that we used to send our supplies in previous escalations, is no longer opening. The same is happening with the crossing through Rafah with Egyptian border. The nation number of the trucks to enter Gaza makes it very difficult.

Where it's like people, you refer to it as a drop of the ocean, crumbs of the bread, which is so true, because, as you could hear, now the number came next to more than 500 trucks since October 21st. But it's the estimation of the daily need for immediate and not even sustained, immediate response to the survival requirement of the people.

CHAKRABARTI: Yeah. Just to clarify what you're referencing, we did play that tape, right. from the UN secretary general who said that before the conflict, 500 trucks a day were coming into Gaza and in the past two weeks, only 400 trucks have crossed into Gaza total versus the 500 a day that you were talking about.

We have about one minute until our next break, Hiba. It seems as if, is Gaza at the point where it's seeing or will see more death due to the lack of clean water, the lack of food, the hygiene and contamination issues, more death from that than possibly even the bombing that's been happening?

TIBI: It's true. These estimations have been announced by World Health Program, World Health Organization, WHO, that already shared a lot about the outbreaking of diseases that are first of all coming due to the consumption of contaminated water. New types of diseases are occurring because of lack of hygiene practices related to skin, but also those related to breathing the dust and the traces of bombing. And also, what is happening due to decaying bodies, and these are going to be, on long run, really huge diseases issues.

Part III

CHAKRABARTI: Now, as global calls for a ceasefire grow louder with every passing day, Secretary of State Antony Blinken says the United States is advocating for something different, what it calls humanitarian pauses. Here's what Blinken told reporters on Friday.

ANTONY BLINKEN: We need to substantially and immediately increase the sustained flow of humanitarian assistance into Gaza and getting American citizens and other foreign nationals out of Gaza.

We believe that each of these efforts would be facilitated by humanitarian pauses, by arrangements on the ground that increase security for civilians and permit the more effective and sustained delivery of humanitarian assistance.

CHAKRABARTI: That's the Secretary of State, Antony Blinken, late last week. More recently, according to a report from Axios, President Joe Biden on Monday urged Israeli Prime Minister Benjamin Netanyahu to agree to a three day pause in the fighting.

That pause could allow for the release of some hostages by Hamas and allow more aid to enter Gaza. Netanyahu has so far resisted calls for a ceasefire, and here's what he told ABC World News on Tuesday.

BENJAMIN NETANYAHU: There'll be no ceasefire, general ceasefire in Gaza without the release of our hostages. As far as tactical little pauses, an hour here, an hour there, we've had them before.

I suppose we'll check the circumstances in order to enable goods, humanitarian goods to come in, or our hostages, individual hostages to leave. But I don't think there's going to be a general ceasefire. It's not that I don't think, I think it will hamper the war effort. It'll hamper our effort to get our hostages out. Because the only thing that works on these criminals in Hamas is the military pressure that we're exerting.

CHAKRABARTI: Israeli Prime Minister Benjamin Netanyahu on Tuesday. Joining us now is Merissa Khurma. She's director of the Middle East program at the Wilson Center and is with us from Washington.

Merissa, welcome to on point.

MERISSA KHURMA: Thank you, Meghna, for having me. So first of all, right now in France, there's a major meeting of what, over 50 countries. Officials from Western and Arab nations trying to discuss how to provide more aid to Gazan civilians. There's proposals, I'm seeing, for the humanitarian maritime quarter that we mentioned at the top of the show, floating field hospitals.

What do you hope, or think could come out of this meeting of officials?

KHURMA: The hope is that Western countries, the United States together in coordination, of course, with the regional neighbors, primarily Jordan and Egypt, will agree on a modus operandi moving forward to increase different points of access for humanitarian aid.

Given that Rafah has the only lifeline currently for humanitarian aid, and we've heard from your other guests about the scarcity of aid going in. And the deterioration of the humanitarian crisis in Gaza. We have to be creative and that is absolutely the time to come up with more solutions.

So the hope is that there will be agreement moving forward on various points of access beyond RAFA, in order to have more presence for medics and ensure that necessary humanitarian aid is going in.

CHAKRABARTI: Hiba Tibi, let me hear from you on this. As country director for CARE International, you're in the West Bank. Do you have any hope for what might emerge from this meeting in France right now?

Could significant amounts of aid start coming into Gaza, you think?

TIBI: That will be something that we all hope for and pray for. As this is, if we don't have that assistance going to Gaza immediately, this will be, everyone was calling it already a catastrophe. This would be something that we cannot even describe in human words.

Creative ideas like what happened with the field hospital in Jordan, the Jordanian field hospital. There were supplies for that specific hospital. And I don't know if there are other creative ideas that can help. Any help is needed to save lives. This is a survival moment for people on different levels, medical, water, fuel that is required for them.

CHAKRABARTI: In fact, right now I am seeing a report from the White House that Israel is agreeing to four-hour daily humanitarian pauses in the fighting in northern Gaza to allow civilians to flee. That's according to the White House. Four hour daily humanitarian pauses. It doesn't say anything about allowing humanitarian aid into Gaza, but at least we have that.

Merissa is there, I know you may just be hearing about this now, but is there any significance to that?

KHURMA: It seems that the American administration's diplomatic maneuvering with Israel is starting to take some shape. Of course, you've mentioned earlier that President Biden has called on Bibi Netanyahu for a few days' pause, which is much needed, beyond just the humanitarian aid that needs to go in.

And of course, the safe passage for the hostages and that is all interconnected. All these different efforts are interconnected. There is also psychological impact of daily bombardment. And very little time for innocent civilians to flee from one point to another. And so any of these pauses are crucial.

We've seen similar pauses in the conflict in Yemen. And those are extremely crucial, particularly when we see the humanitarian situation deteriorate on a regular basis, as we've also heard from Hiba about what could be much worse, given that there are bodies that are still trapped under the rubble that have to be pulled in.

You have bodies that are decaying. And those who have had to go to emergency rooms and discharged within 10 to 15 minutes, because there's such a huge number that needs to be processed on an hourly basis. So those pauses, a few hours of a pause a day could definitely help.

But of course, it's nowhere near what is needed.

CHAKRABARTI: So I'd like to have you help us understand more about the actual crossings in and out of Gaza. There are not that many of them. And obviously, the Israelis are not going to allow a lot, or if anything, in and out of Gaza right now on the Israeli security border with Gaza.

That leaves primarily, as you've both mentioned, that Rafah crossing between Gaza and Egypt. Can you tell us a little bit more about Egypt's role here? Why hasn't Egypt allowed or facilitated more humanitarian assistance coming in and out of Gaza?

KHURMA: The Rafah border is, as you said, is controlled by Egypt.

The other two border crossings, the Erez crossing is controlled by Israel. And of course, with the Hamas unprecedented attack on October 7, there is significant damage done. And for security reasons, the Israelis will not open that border and make it an access point for humanitarian aid. And so that is the only pressure point, also for Egypt, because there are security concerns.

They cannot keep the border open. They fear like a huge influx of Palestinian refugees. And with that, there are of course memories of the past. Forced displacement is a recurring theme in the Palestinian-Israeli conflict, in the history of the Palestinians. And starting with 1948, with the expulsion and forced displacement of over 700,000 Palestinians into neighboring countries, primarily Jordan and Egypt.

And so with that, Palestinians refer to this as the Nakba or which means the catastrophe. And we've seen other expulsions, of course, and forced displacement in 1967. And so far, all of the Palestinian refugees remain in either refugee camps that have morphed into cities and towns, particularly in Jordan, Syria, Lebanon.

And so there's no certainty that any of the refugees will go back. So any makeshift camp that will be set up on the Egyptian side, first of all, it's a security concern for Egypt. Second of all, there's certainly lessons learned from history. So far there's an unclear path towards how this war will end and how long it'll take for reconstruction.

And so there's no such thing as temporary when we're talking about refugee populations.

CHAKRABARTI: Yes. Understood. But I guess what I'm wondering, in addition to that, is that it's not just the flow of people that we're talking about, I'm still having difficulty understanding what the constraints are in the minds of the Egyptian government in facilitating the inflow of more actual aid to Gaza, through that Rafah border.

KHURMA: The Egyptians constantly referred to security circumstances and from their point of view, there has to be screening of everything that goes in. That is also a concern for Israelis and the United States and others.

For the humanitarian sector that is entirely focused on just getting basic aid in, there is also a security lens through which many others are looking at this. And this is why it is hampering a lot of this opening and closing. Only yesterday it was, the crossing was closed again.

And so there are temporary openings and closings, and a lot of it has to do, from the Egyptian side based on what they're saying on security considerations. And it's a convoluted situation where it's not just a matter of opening the border and bringing in all the needed aid trucks.

And this is war. There are other considerations with regards to where Hamas militants are, and how and where they could be. And how all of that impacts the delivery of aid is aid being diverted. For example, those are all concerns that many have raised. But of course, you're looking at, primarily security concerns in this regard.

CHAKRABARTI: Hiba Tibi, I'm going to come back to you in just a moment. But Merissa, now that we're seeing at least more, much more public discussion of somehow achieving enough of a humanitarian pause. That could potentially allow for more aid to come in. I'm not even going to talk about a ceasefire just yet. That seems premature.

But how do you think what would realistically need to happen for that aid to actually get to Gazans?

KHURMA: There has to be a lot of coordination with various actors. Hiba mentioned the Jordanian field hospital as a leading example of how that could happen. If there are other ideas with the maritime border, for example, it requires coordination with those who will be providing, whether it's a field hospital or it's a humanitarian aid brought in.

So it's a coordination game at this point, with various international organizations, as well as various state actors, primarily from the region and from those Western governments in the United States, who will also be part of bringing aid in or perhaps even providing some of the military field's hospital, military hospitals on ships.

And it's a lot of coordination. And the hope is that this will be enacted very quickly and implemented very quickly on the ground. But we will see what will come out of the Paris meeting today, but those things rarely happen overnight. But of course, the dire need of this aid should make it more urgent.

CHAKRABARTI: Hiba Tibi in Ramallah, what do you think of all the political considerations, as Merissa accurately described them, that are going into the creation of any kind of agreement on how to get more humanitarian aid into Gaza?

TIBI: So unfortunately, for instance, for me as a representative of a humanitarian organization, I understand, the only thing that I understand is saving lives.

All the politics, the war tactics, all this language. I honestly don't, I don't have the capacity to understand or to comment on. But what we urge as an organization is to have, of course, this is the ultimate request, is to have enough quantities of humanitarian assistance, not only to enter Gaza, but to a safe environment where we can practice the humanitarian distribution and actual aid that cannot happen under bombing.

That has been said, political discussions, war tactics or discussions might take long time. We are way behind. The way behind the moment where we can still negotiate or discuss, there are many people who are dying.

And as you articulated in an amazing way, bombing is not going to be the top cause of death, in Gaza, unfortunately. But hunger, thirst, outspread off diseases, it's about to go and the winter is on the door. The winter is on the door, and this will just make everything harsher and more difficult.

CHAKRABARTI: Merissa Khurma, we only have about 30 seconds left. Do you think the United States, the Biden administration is doing enough, whether overtly or through back channels to push for some kind of more significant pause to get aid into Gaza?

KHURMA: I think the Biden administration is cognizant of how dire the situation is in Gaza, beyond what we all see through footage and images.

I think they also have access to information about how much worse it could be. They are doing what they can and perhaps a lot more privately. So we only hope that this will end in a way that focuses on saving human lives.