Rafah is already in a humanitarian crisis. Now, an Israeli offensive looms. | Mint

Rafah is already in a humanitarian crisis. Now, an Israeli offensive looms.

Palestinians getting donated food this month in the city of Rafah in southern Gaza. (Photo: AFP/Getty Images)
Palestinians getting donated food this month in the city of Rafah in southern Gaza. (Photo: AFP/Getty Images)


War has driven more than a million men, women and children into a corner of Gaza, where aid bottlenecks keep them short of food, fuel and water.

JERUSALEM—Rafah, on Gaza’s southern edge, is now a city of tents, and the epicenter of one of the worst humanitarian disasters in years.

Yet a deadly mix of war, politics and logistics is choking off emergency aid, and the scale of suffering has raised international pressure on Israel ahead of an anticipated offensive.

More than 1.3 million civilians, which amounts to over half of the Gaza Strip’s population, have fled fighting in the Palestinian enclave and crowded into Rafah, normally home to about 300,000 residents. Families shelter from rain and cold beneath plastic sheets strung up along roadsides. Tents from international donors have been sold for $500 on the black market by families desperate to raise money for food. People make fires with plastic refuse to bake flatbread.

Four months into Israel’s invasion of Gaza, many residents say they haven’t received any aid.

“We have to buy every single thing. We pay so much money just for food each day. We don’t have cooking gas. When we find wood, we make a fire to cook lentils or pasta. Otherwise all we have is canned food," said Suha Arafat, 47 years old. She lives in a storage room in Rafah with her husband, five children and three other families.

Aid deliveries are hindered by the war’s intensity, the closure of Gaza’s borders by Israel and Egypt, and strict inspections and restrictions by Israel on what goods can enter Gaza and where they can go. The aid shortfall is made worse by the size of the displaced population and the unpreparedness of the United Nations for the scale of need. Assistance is further hampered by anarchy and pervasive looting within the Gaza Strip.

Israel, Egypt and the U.N. each say they are doing the best they can to facilitate emergency deliveries and have blamed each other for the crisis. Israel, which is seeking to destroy Hamas, said the Palestinian Islamist militant group is seizing some of the aid.

Fear is growing that the Israeli military will launch a ground offensive against Hamas in the Rafah area. The U.S. and European countries worry such a battle would cause mass fatalities, squeeze already scarce aid and leave displaced Palestinians with nowhere to go. The war has so far killed more than 28,000 people in Gaza, most of them women and children, according to Palestinian health authorities. The figures don’t distinguish between civilians and combatants.

The deepening humanitarian crisis and the death toll are fueling frustration in the Biden administration. President Biden has broadly supported Israel in the war, but he has become increasingly critical of how Israel is waging its campaign and is pressing for a cease-fire deal.

The war has divided Democratic voters whom Biden needs for his re-election bid. A battle for Rafah could further alienate left-leaning voters angry over the level of civilian suffering.

Rafah is the last bastion of Hamas, and its militants are sheltering among civilians there, according to Israel. Hamas, which the U.S., EU and others have designated a terrorist organization, triggered the war with the Oct. 7 attack on Israel, killing about 1,200 people and taking around 250 hostages.

The U.S. has urged Israel not to launch a major assault in Rafah without a credible plan to safeguard refugees. Israel wants the U.S. and Gulf Arab countries to fund tent cities in southwestern Gaza so people can shelter there before Israeli forces move into Rafah.

Most of the humanitarian aid to Gaza passes through Rafah, where the U.N. and nongovernmental organizations run their operations. With only a trickle of commercial goods entering Gaza, these organizations remain the only means for filling basic needs.

Finding clean water and food is a daily struggle. Most people often go a full day without eating, according to residents and the World Food Program. Flour costs as much as 10 times its prewar price, residents said. Many people are making bread with grains used to feed animals. Women limit how much water they drink to avoid hours in line at filthy public toilets.

“I’ve never seen anything as desperate, complex and challenging," said Sam Bloch, director of emergency response at World Central Kitchen, a Washington-based nonprofit that provides meals in crisis zones.

When Bloch arrived in Rafah in December, he said, the town had trees. Almost all of them have since been chopped down for firewood. “By the time I left, people were digging up the roots of those trees to cook with, to make a cup of tea," he said.

Hard border

After Hamas’s Oct. 7 attack, Israel blocked all goods and aid from entering the Gaza Strip. Following U.S. pressure, Israel allowed food, water, some medical and shelter supplies and limited amounts of fuel.

Around 170 relief trucks enter Gaza daily through Rafah and the nearby crossing of Kerem Shalom on the Israel side of the border. Before the war, an average of 500 commercial trucks and 100 aid trucks a day passed into the enclave. Aid deliveries are closely examined by Egyptian and Israeli authorities before they enter.

Getting aid into Gaza is just part of the problem. The U.N., which oversees the humanitarian effort, has limited capabilities within the strip. Moving the aid to other parts of Gaza is dangerous because of the war. At night, criminal gangs pounce on aid trucks.

On a recent day, a convoy of U.N. aid trucks left Rafah before dawn for the northern part of Gaza. The trucks waited hours at an Israeli army checkpoint. By midmorning, a crowd looted four of the six trucks. Looting is so common that the U.N. has coined the euphemism, spontaneous self-distribution.

Israel is under international pressure to do more to relieve the humanitarian crisis in Gaza, where most of its 2.3 million people are displaced and without adequate access to medical care.

At the same time, Israeli Prime Minister Benjamin Netanyahu is facing criticism from his far-right allies for allowing any aid. “The minimal aid we committed to is an important condition for the continuation of the war, because if there is a large humanitarian collapse, we can’t continue the war," he told reporters last week.

Israel in December reopened its Kerem Shalom crossing into Gaza to allow the U.N. and NGOs to increase aid. More recently, Israel allowed flour shipments for Gaza to be unloaded in its port of Ashdod. Protesters have repeatedly blocked humanitarian convoys at both locations.

“We are feeding our enemy," said Rachel Touito, one of the protest organizers.


Before Oct. 7, the U.N. had an emergency plan for a war in Gaza. It mapped out shelters and matched various tasks to international agencies and aid groups.

U.N. staff planned to manage the humanitarian response from Gaza City in the north, where a bunker stored food and communications equipment. The plan’s worst-case scenario estimated around 500,000 displaced people.

The plan collapsed on Oct. 11, when senior U.N. officials received a late-night call from the Israeli military instructing U.N. staff to evacuate northern Gaza ahead of an aerial bombing campaign.

The only U.N. agency with a Gaza-wide network was the U.N. Relief and Works Agency. Unrwa, the largest U.N. operation in Gaza, runs schools, healthcare facilities and other services but doesn’t normally handle emergency aid. It quickly pivoted to aid delivery.

“We had to rethink completely, restart from scratch our operations in the south," said Andrea De Domenico, who heads the U.N. Office for the Coordination of Humanitarian Affairs in Gaza and the West Bank. “The only thing we could do was to piggyback on Unrwa’s presence."

Israel recently alleged that 10% of Unrwa staff in Gaza were affiliated with Hamas and that a dozen Unrwa employees took part in the Oct. 7 attacks. Unrwa fired employees allegedly involved. The U.S. and other Western donors have suspended funding, raising fears about the consequences.

“If Unrwa stops, the response stops," said Scott Anderson, who is overseeing Unrwa’s aid distribution in Gaza. “If we are not paying staff, I don’t know how anybody will be delivering aid."

Israel wants Unrwa reformed or abolished, but not yet. The Israeli military, fearing troops will end up dealing with mass starvation, has been lobbying the U.S. to restore Unrwa’s funding until the end of the war. “Without Unrwa there is no humanitarian aid in Gaza," an Israeli military official said.

Before the war, most humanitarian aid and commercial goods for Gaza entered via Israel. Aid now has to go through Egypt, which was ill-equipped for the job.

The U.N. and other aid groups are dependent on the Egyptian Red Crescent, or ERC, a local affiliate of the International Committee of the Red Cross, which oversees the movement of the bulk of humanitarian goods from Egypt to the Gaza border.

The ERC struggled with the size of the task, but the Egyptian government wants it to stay in the lead, Israeli and U.N. officials said. The ERC acknowledges it is short of warehouses and trained staff but has expanded the number of volunteers.

The U.N. has limited say on which goods should be given priority, which makes it harder for the U.N. to meet its target of sending 100 trucks of food a day into Gaza. Israeli and U.N. officials say donations from Arab countries, distributed in Gaza by the Palestinian Red Crescent Society, often take precedence.

“We do not reject anything," said Khaled Zayed, a senior ERC official. He said many donor countries are sending goods to Egypt without a plan for their storage or distribution.

Delays at the Egyptian checkpoints and at the crossings with Gaza means it often takes two weeks for humanitarian goods to reach the strip. Security and political requirements on both sides of the Gaza border, first by Egyptian and then by Israeli authorities, mean that goods have to be unloaded and reloaded in new trucks at least four times.

Israel says it doesn’t limit the amount of aid within permitted categories and blames the U.N. and other aid groups for lacking the capacity to deliver more. The U.N. says it could expand operations if Israel allowed more trucks, communications equipment, generators and other equipment. Israel officials say the gear might end up in the hands of Hamas.

The U.N. is pressing Israel to allow it to build a protective wall from Kerem Shalom to Rafah to protect aid convoys from criminal gangs. This week, men armed with knives and sticks assaulted truck drivers for the first time on the route.

‘Still bombing’

To avoid getting hit in the crossfire between Israel’s military and Hamas, the U.N. and aid groups share their movements with both sides. Missions to northern Gaza require Israeli military approval. More than half of requests since the beginning of this year have been denied, the U.N. said, sharply limiting aid in the north. Israeli authorities didn’t respond to requests for comment.

Extensive blackouts of mobile-phone and internet connections across Gaza have left aid groups dependent on a limited number of satellite phones. Teams delivering aid often can’t communicate.

World Central Kitchen’s main facility in Gaza provides around 30,000 hot meals and meal kits in Rafah every day. Getting food beyond Rafah is a struggle. Moving even a few miles can take hours because of crowds, combat and checkpoints.

Bloch, of World Central Kitchen, took part in some of the few U.N.-led convoys to the north. “You are driving into an active war zone, there is still bombing," he said. Many roads are little more than rubble and mud.

“Every bit of food we got to the north was more well-received than in any place we delivered food in the world," Bloch said. “In my 19 years of doing this, I never saw desperation like I have seen in northern Gaza."

In Rafah, Noha Saadawi is desperate for diapers for her 1-year-old baby, the youngest of her three children. The only ones she can find cost the equivalent of $55 a package. She can’t find baby formula, but on the black market she can buy a kilo of powdered milk. It is labeled as a humanitarian donation but sells for the equivalent of $10.

Israeli airstrikes, part of a special-forces operation that freed two hostages, killed dozens of civilians in Rafah on Monday, according to Palestinian health authorities. Some humanitarian organizations, including World Central Kitchen, are pulling staff from Gaza in response.

Saadawi fears what might come next. “We don’t know where we would go," she said.

Carrie Keller-Lynn and Menna Farouk contributed to this article.

Write to Margherita Stancati at margherita.stancati@wsj.com

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