What's going wrong with aid in Gaza?
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Dr. Ahmed Abuswade is matter-of-fact and precise when he describes what he saw Tuesday in a voice memo to NPR. Another mass casualty event, the third I've seen in the last three days at Al-Nasr Hospital, the last partially functioning hospital. He's an emergency physician visiting Gaza from Australia, and here we'll note that his brief account includes graphic details.

In his voice memo, he lists the number of fatalities and injured, the types of patients. I myself saw many children today, three of whom were dead on arrival. He describes the injuries. And what I've seen today is bullet wounds to the head, the neck, and the chest. And we know this because we pulled the bullets out. There's one point that he pauses on. He wants it to sink in, he says. I want to emphasize that point. These were children looking to get food.

The International Committee of the Red Cross says at least 27 people were killed near a food distribution site in southern Gaza after Israeli troops opened fire. David Menser, a spokesman in the Israeli prime minister's office, said that several individuals were, quote, deviating from the approved access route. Now, our troops diligently issued warning shots.

And as some of the suspects continued, despite these warning shots, advancing towards the troops in a threatening manner, further fire was directed near these specific individuals. He said the Israeli military was aware of reports of casualties and is reviewing the incident.

There have been three such shootings in three days. NPR spoke to two eyewitnesses who said they were in a crowd heading toward a food distribution site on Sunday when Israeli troops fired at them. Menser, the spokesman, called the allegations false and baseless. The IDF's initial investigation confirms that serious accusations made on Sunday in so much of the media...

They were based on Hamas propaganda. This food aid site is operated by private American contractors. It's part of an Israel and U.S.-backed food distribution system launched last month after Israel had blockaded all supplies from coming into Gaza for nearly three months. Only four sites are operational. None are in northern Gaza. And there are over two million people in Gaza.

Consider this. Getting food to desperate people is always a challenge. In Gaza, a new system is not meeting the need. From NPR, I'm Ari Shapiro.

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It's Consider This from NPR. The violence outside the new aid sites in Gaza may have something to do with the way Israel is managing food distribution there. It's not how aid is typically given out in war zones. I spoke with Avril Benoit about this. She's CEO of Doctors Without Borders within the U.S. and has helped distribute aid in conflict zones around the world.

So these food distribution sites in southern Gaza are not run by the UN or other well-established international aid organizations. A private group backed by the U.S. is overseeing the effort. How unusual is that?

Very unusual. So this food distribution scheme is coordinated by something called Gaza Humanitarian Foundation, created by the U.S. and Israel, not just backed. But it's been disastrous. In the first afternoon of the distribution in Rafah, people were shot, injured. You can imagine after so many weeks and months of siege just to fight to get scraps of food to survive. It's...

the kind of thing that's predictable when you run things this way without the usual humanitarian principles, which involve a certain expertise, but also notions of impartiality, making sure that the aid isn't politicized, that you're not militarizing aid, which is very much the whole concept here. You say this is predictable when you run things this way. Can you be more specific? What do you see this organization doing that a group like the UN would not do?

This is a cynical ploy, if you will, to feign compliance with international humanitarian law, to say, look, we have this humanitarian foundation. It's delivering food. But for all my years working in humanitarian crisis zones, I've never seen a three-month siege. For about three months, Israel did not deliver food to the Gaza Strip is what you're referring to.

Yes. I mean, even the number of trucks that are getting in are paltry compared to what's needed. We have, as Doctors Without Borders, over 106 trucks waiting authorization to cross. And they contain medical items, you know, painkillers, antibiotics, saline, compressed gauzes.

things like that. But in a food distribution, normally you would do it in an impartial way. You don't ask people to risk their lives to get it. You try to reach people where the aid is most needed. As opposed to asking people to reach you. Yeah. Exactly. In any war zone where people are at risk of starvation, there is going to be

security concerns. There is going to be the risk of panic and chaos. How is that typically mitigated in aid distribution sites and conflict zones? Well, the first step is not to withdraw it, not to withhold it, not to block it so that people are so desperate. I mean, that's the first step. Now, understandably, in many conflict zones, that's not the case. Think of Sudan, where you have

very high levels of malnutrition, even famine. And it's so insecure that the World Food Program and other delivery systems have just been unable to reach people. But in a situation like this is very much under the control of Israeli military operations with intensified airstrikes, widespread evacuation orders one after the other. So it's

For me, it's quite obviously a situation of violence and panic that is entirely human-made. It's not surprising that people who are suffering so much will take risks also to be able to feed themselves and their children.

Israel controls all aid into Gaza. Do you see a diplomatic path for the U.N. and other experienced aid organizations like yours to resume the work that you've done in other parts of the world in Gaza in the past? Well, it just has to. It has to.

I mean, there's just no way around it. Think of... Well, I mean, I don't know that Netanyahu will respond to someone saying it has to. Is there a way to persuade the Israeli government of what you're saying? Well, look, what we have under the circumstances now...

what many would say is exactly what Israel was warned not to do, which is to manage this conflict in a way that creates violations of international law, such as the mass starving of people and withholding humanitarian aid from them. Obviously, it's a very complex issue.

situation politically. I'm not an expert in that. Our organization doesn't weigh into this. If we're political at all, it's just to speak for people's right to survive. What we need is for this violence to stop, for people to be able to receive aid and

We're currently working under unbearable conditions. Even our own staff are barely eating one meal a day. And it's, you know, for us, it's just an unbearable situation of violence. Avril Benoit is CEO of Doctors Without Borders in the U.S. Thank you for speaking with us. Thank you. Thank you.

And you heard reporting at the top of this episode from NPR's Anas Baba in Gaza. This episode was produced by Michelle Aslam and Connor Donovan. It was edited by Patrick Jaron-Watanana. Our executive producer is Sammy Yenigan. It's Consider This from NPR. I'm Ari Shapiro. Shortwave thinks of science as an invisible force showing up in your everyday life.

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