War in Gaza traps some foreign aid workers inside, others outside, hoping for reprieve

Emily Callahan, an American nurse with Doctors without Borders, was glued to her phone – trying to reach the Palestinian colleagues she’d worked with during nearly four harrowing weeks of war. 

Tareq. Ibrahim. Taher. They had become like family. Were they safe? 

She had been messaging constantly. But her texts began going unreturned. She kept her eyes on WhatsApp, waiting for the double-check mark that would show her message had been delivered. 

Callahan, like many citizens of other countries, was able to evacuate earlier this month. But for her colleagues who were Palestinian – and their families – there was no such way out.

Amid the fighting, some ended up trapped inside a guesthouse, scattered among camps or hiding out with relatives. Like many in Gaza, they faced shortages of food, water and medicine. 

From afar, Callahan was gripped with uncertainty over their safety.

“We are absolutely terrified,” Callahan said. “There's no way for us to find out if they’re OK.”

Her colleagues are among thousands of Palestinians who work with the scores of international humanitarian aid and development groups that have long played a key role in the Gaza Strip. Even before the war, more than half of its 2.2 million residents depended on international assistance for basic services.

Many of those aid workers have been as desperate as those they usually help, aid groups say. The Israel-Hamas war has left the region with a fraction of the aid it needs.

Between Oct. 21 and Nov. 20, about 1,320 trucks of humanitarian supplies have entered Gaza via Egypt, the U.N. said. Even before the conflict, about 500 trucks of food and goods came into Gaza each day. 

Aid workers inside Gaza “are shellshocked. Many have lost family members, friends, relatives, property,” said Juliette Touma, spokeswoman for the U.N. agency for Palestinian refugees, known as UNRWA, one of the largest.

More than 100 U.N. staff have been killed in Gaza, most while at home, making the war the deadliest conflict yet for U.N. aid workers. Unlike other conflicts, the longstanding Israeli blockade of Hamas-controlled Gaza, and Egypt’s tight control over its border, means there is little chance for civilians or aid workers to exit.

Larger aid groups are doing what they can, sheltering civilians in UN schools, trying to evacuate patients from hospitals, distributing aid and trying to provide clean water. So far, continued fighting and shelling has stymied much of their work, and too little aid is getting into Gaza, they say. 

Late Tuesday, Israel and Hamas announced an agreement to free 50 hostages in exchange for Palestinian prisoners. The deal included a cease-fire slated to last four days, which would also be a window for more humanitarian aid reach Gaza.

But aid groups on Wednesday said the short window of time would do little to alleviate the humanitarian crisis. They cited challenges including a dearth of fuel to distribute aid, access to only one Gaza entry point and lingering dangers without a full or permanent cease-fire.

"It’s not enough. It’s a band-aid," said Joël Weiler, director of Médecins du Monde.

Callahan, now back home in Connecticut, checks daily on the colleagues she credited with keeping her safe when the fighting began. But that depends on intermittent phone or internet connections. 

Over the course of a few recent days, with phones down again, all she could do was keep texting – and wait for the checkmarks. 

More:For American stuck in Gaza, escape from war had a painful cost: Leaving family behind

Nurse providing medical help in Gaza caught in war 

Callahan arrived in Gaza in August. She previously spent a year with Doctors Without Borders providing medical care in South Sudan. 

She and a team from the international nonprofit were assigned to the Indonesian Hospital, in Beit Lahiya, just 3 miles from Israel’s fortified southern border. Their mission was to help with limb reconstruction, including those from past clashes in the region. Her emergency room experience also led her to help the hospital’s 12-bed emergency room better handle a crush of 600 patients each day. 

About a 20-minute drive into Gaza City was her Doctors Without Borders guesthouse, close to the Mediterranean Sea. Her home shared a wall with the now-embattled Shifa hospital, though she didn’t have a view inside. After work, she went to the gym, out to dinner or played volleyball with other aid workers. 

Initially, she was uncertain how she’d be viewed as an American, given her home country’s ties to Israel amid a long-simmering conflict. Nurses quickly put her at ease. “People are not their governments,” they said.

She grew close to nurses and doctors, as well as local Doctors Without Borders colleagues – logistics managers, drivers who served as informal cultural advisers, fixers who could procure anything, friends. Some had big families and they seemed to know everyone in Gaza.

On Oct. 7, Callahan woke up at 6:30 a.m. to rocket fire echoing off the buildings in the densely packed neighborhood. She helped open windows to prevent them from shattering. 

At an emergency meeting later that morning, the extent of Hamas’ surprise attack on Israel emerged. Militants had killed civilians in their homes, revelers at a music festival and taken soldiers, women and children as hostages.

“We were just as shocked and surprised and horrified as the rest of the world,” she said. “And we knew that the retaliation was going to happen in a very big way.”

By Monday, she said, airstrikes were hitting nearby, forcing them into a safe room with metal shutters. Unable to safely reach the Indonesian Hospital, she and her team turned to cellphones to coordinate fast-dwindling supplies and help assess injuries. 

“The rockets were launching from nearby, which means that the retaliation also landed very nearby,” she said, with explosions rocking her home throughout the night.

The next day, she left her belongings behind, taking only a small backpack as the team moved to a building about a mile away. They huddled in a bunker with about 300 local residents. Not long after they learned the building would be targeted – and had to relocate again.

Some argued over whether it was too dangerous to ask local staff to leave their homes and bring cars to get them. Once they arrived, the local staff helped calm crowds outside. People nearby had swarmed the cars. They thought the group was headed out of Gaza and wanted to accompany them. 

“They’re just going south like everyone else,” they told residents.

Callahan and her team headed south to Khan Younis to a vocational training center where crowds soon swelled into the tens of thousands. Most camped outdoors, in cars and under tarps. There were long lines for four toilets and one shower, little food or water. At one point, Callahan said, they stayed hydrated with a bag of cucumbers. 

“We did not go a single day or night without a rocket or a bomb. Very, very close by to us,” she said. “People were scared.” 

All around them was grief and desperation.  A woman tried to give Callahan her baby to take out of Gaza. One colleague named Tare walked up to them one day in tears, she said, explaining that he’d lost 25 relatives.

Displaced and ailing residents approached them to treat devastating injuries, but Callahan had no soap, clean water or bandages to help. She told one mother how to remove dead tissue from her child’s burn wound. 

“I'm really sorry,” she recalled telling one woman, “but you’re going to have to hold your daughter down as she screams to do this.” 

She worried being American might make her a target of desperate or angry residents. And there were tense moments.

“There was a child at one point who walked past us and pointed at me and said ‘American!’ and then was pointing at all of us and saying ‘Israeli’ and accusing us of being Israeli spies, essentially,” she said.

Tareq asked the child to come over. He introduced them and explained what the aid workers were doing. The child “wound up being our buddy and hanging out with us,” Callahan said.

He repeated a familiar phrase, she said. People are not their government.

They moved again to a gated U.N. parking lot. 

Palestinian staffers networked to find out where they might find scarce food or water. One would go between them and 35 members of his family sleeping on a nearby sidewalk. Another showed up with hygiene products one day, bruised after being beaten up over a tarp while he slept the night before.

Callahan’s family had begged her to leave as soon as she could. Callahan and others wanted to stay. But the group had decided to issue a mandatory evacuation for those who could get out.

And while she and others struggled with leaving anyone behind, Callahan said, she worried her Palestinian colleagues were taking risks for her. 

On Nov. 1, Callahan and other foreign nationals reluctantly passed through the Rafah border crossing into Egypt. 

But leaving Gaza behind would be more difficult than crossing the border. 

More:A gulf of perspectives is growing among US millennials amid war in Israel

Aid workers see struggles 

Across Gaza, other humanitarian and development groups have continued to hear about dire challenges from their workers.

“‘My house just got bombed last night.’ I literally get these messages. And I don't know what to say to people,” said Touma, of UNRWA.

Arwa Mhanna, a Mercy Corps official in Jordan, said her group has gotten wrenching messages from some of the nearly 70 staff members in Gaza. 

They include new parents struggling to find food for their sick baby. A family reverting to donkey carts for travel and open fires for cooking. Workers waiting six hours in line for bread, as others struggle with no power and limited clean water.

Mhanna said Mercy Corps has been working to get food kits to staff and residents, but limits on aid trucks and shortages in Gaza make it difficult. 

“It really breaks their heart that they know that they are supposed to be the ones helping people, and they need help now,” she said.  "But I'm sure once conditions allow, they will be the first people to be in the front line to deliver aid.”

Wassem Mushtaha, a manager with the humanitarian group Oxfam, left a message with the group on Nov. 15, reporting shortages of food, blankets, gas, electricity or water. 

“We feel trapped in a dark tunnel,” he said, according to a recording of the message provided by the group.

In Gaza, various U.N. agencies alone employ more than 15,000 people. Other international organizations employ about 1,500, said Faris Arouri, director of the Association of International Development Agencies, which helps coordinate about 50 international nongovernmental and nonprofit organizations working in the area. 

Amal Khayal, a Palestinian who helps operate an Italian-based humanitarian and development nonprofit that provides child psychological aid as well as water and sanitation, said her group’s 11 staffers are scattered. One in North Gaza is living on dates and using a bucket on the roof to capture rainwater to drink.

Now in Italy, Khayal says she is gripped by constant worries about staff who have to turn down help for residents in dire need.

“They have to tell people, we are even unable to help ourselves and our families,” she said. “It’s just heartbreaking.”

Reconnection and a daunting task ahead 

Speaking from her home in Connecticut, Callahan can’t help but feel guilty being safe at home with her family, or eating a hot meal.

Then, last week, her messages stopped going through. This time, it was because of a lack of fuel that powered the communications network.  

Over the weekend, a fuel shipment arrived to help restore internet and phone services. Callahan was able to reach some colleagues, including Tareq. 

But the news wasn’t always good. 

On Monday, a group chat she’s on with other aid workers pinged with news that a colleague had been injured. Also, the U.N. said a Doctors Without Borders clinic was hit by shelling.

“I heard that from a couple of our national staff. One of our bosses was injured yesterday. His text isn't going through but I do know he's alive. At least as of yesterday,” she said. 

She was also trying in vain to check on Palestinian staff at Indonesian Hospital, which has no electric power and faces medicine and water shortages. The U.N. said Monday that it had been hit for the fifth time, resulting in deaths and injuries. 

Earlier this week, the U.N. said two fuel trucks entered Gaza as part of an Israeli decision to allow the daily entry of small amounts of fuel for essential humanitarian operations, including food distribution, hospital generators, water and sanitation facilities and shelters. They arrived along with 151 trucks of humanitarian aid in recent days.

News reports were more encouraging on Tuesday evening. The agreement to release at least 50 hostages appeared to mean a pause in war operations for several days. 

Though a short surge of aid would be a "drop in the ocean," aid groups said, any additional medicine or supplies will help. Many fear conditions will worsen for displaced residents as winter approaches. Still, even a short pause could also give some aid workers a chance to reach relatively safer areas.

“Everyone will at least take a breath,” Khayal said. “Let’s hope for the best.”

Israeli Prime Minister Benjamin Netanyahu made it clear later Tuesday any pause would be temporary. “We are at war, and we will continue the war,” he said.

Callahan said she’d like to return to Gaza, knowing that humanitarian groups of all stripes will –  eventually – be needed in a massive recovery and construction effort. 

Callahan continues sharing information with former colleagues who are abroad and checking on those still in Gaza through messages. 

Press Send. Hold her breath. And hope for a double checkmark.