As Israel began a campaign of airstrikes in the Gaza Strip last week — which have since left more than 200 people dead, according to local officials — international aid organizations sprang into action, creating makeshift emergency shelters and arranging shipments of medical supplies for overwhelmed hospitals.

But the humanitarian response has been complicated by the reality on the ground: Continual Israeli strikes have torn up roads and made it difficult for residents of the Palestinian territory to access medical care, and border closures mean relief workers and critical supplies aren’t able to get where they’re needed.

“We keep planning, we keep mobilizing funds,” said Mohammed Ammar, Oxfam International’s humanitarian coordinator in Gaza. “But unfortunately there is no cease-fire.”

Ely Sok, the head of mission for Doctors Without Borders in the occupied Palestinian territories, said the organization has trauma surgeons and other specialists waiting to deploy to hospitals in the Gaza Strip, where their skills are in short supply. But those doctors remain stuck in Jerusalem as they wait to find out if Israel will grant them permits to enter the Gaza Strip.

A Doctors Without Borders team that is already on the ground has been working 24-hour shifts to treat patients who have been wounded by airstrikes, but Sok said that damaged roads mean many residents are unable to access care or must walk to the nearest hospital. Meanwhile, the specter of the next round of attacks is omnipresent, and some staffers’ homes have been destroyed.

“Anytime you go outside, you are taking the risk to be killed,” Sok said. “What we need most is a cease-fire.”

A Doctors Without Borders clinic was damaged by airstrikes on Sunday, rendering a room that was used for sterilizing surgical tools and medical dressings inoperable. On Monday, additional airstrikes damaged the Gaza City offices of the Palestine Children’s Relief Fund, a U.S.-based charity that helps children with severe needs to get medical treatment in the United States and Europe. That same day, the Qatar Red Crescent Society, a branch of the international humanitarian organization, said its office had been hit.

The impact on health infrastructure could continue long after the strikes cease: One of the enclave’s few remaining neurologists was killed in a strike over the weekend, Al Jazeera reported, and local officials said the territory’s only coronavirus testing lab had sustained damage.

The United Nations Relief and Works Agency for Palestine Refugees in the Near East, which runs dozens of schools across Gaza, has converted those facilities into emergency shelters because Israel typically takes care to avoid hitting them with airstrikes. Roughly 48,000 people have sought refuge in 58 schools, Tamara Alrifai, the UNWRA’s director of strategic communications, told The Washington Post. Aid workers fear that overcrowding will drive a surge in coronavirus infections, and personal protective equipment is in short supply.

Before the latest conflict exploded, the UNWRA had been focused on administering coronavirus vaccines to Gaza residents, but that campaign has now come to a halt.

“It’s been extremely difficult to organize a humanitarian response to match the huge emergency in Gaza because of the lack of a cease-fire,” Alrifai said.

Multiple humanitarian groups said medicine and supplies like beds and stretchers are already badly needed in Gaza, and food shortages are imminent if the border closures continue. Fuel that can be used for power generators is scarce — and essential.

“We see a chronic fuel shortage developing, with only a few hours of electricity a day for different parts of Gaza already,” said Suhair Zakkout, a spokesperson for the International Committee of the Red Cross in Gaza. “If fuel does not enter, hospitals won’t have electricity to run.”

Israel allowed a convoy of trucks carrying supplies donated by international aid organizations, including fuel and animal feed, to begin entering the Gaza Strip on Tuesday. But officials closed the border again hours later, before all the trucks could get through, citing a security risk.

United Nations officials have called for a humanitarian pause that would allow relief groups to distribute aid and civilians to seek out medical attention. Meanwhile, Egypt, which also shares a border with the Gaza Strip, has sent a convoy of trucks carrying food and medical supplies into the territory, and also set aside ambulances to transport injured Gaza residents to hospitals in Egypt.

Even if a cease-fire is declared, the damage of the past nine days could take years to undo: Water and sanitation systems have been badly compromised, and thousands of families have been displaced from their homes.

Gaza already had a large share of residents who depended on international aid before the most recent conflict broke out, and that number seems likely to grow. People who previously owned farms, factories or stores have seen their livelihoods vanish overnight as those businesses are destroyed by airstrikes, said Ammar, of Oxfam International.

Rebuilding could cost billions of dollars, but humanitarian groups emphasize that it’s also necessary to stop the cycle of violence.

“We’re prepared, we’re on the ground, we have the years of experience, the connections, the local partners,” Noah Gottschalk, Oxfam America’s global policy lead, told The Post. “But we need the bombs to stop.”

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