Gaza Dispatches: An UNRWA Worker on Providing Aid Under Siege

The voice on the other end of the line was steady, but there was an unmistakable note of exhaustion. “I arrived in Egypt on the 4th of May,” Hazem* began. As a father and an aid worker at the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), Hazem’s humanitarian work in Gaza has always been challenging. But the events of the past months have pushed him and everyone he knows to the brink. Our conversation, conducted by phone in a Cairo apartment, was a window into a life shaped by conflict, displacement, and resilience—and the immense sacrifices humanitarians are making amid the Gaza war.

War and Displacement

On October 7th, Hazem, who lives in the eastern part of Khan Younis, south of Gaza, was jolted awake by the sounds of bombing. “We woke up suddenly at 6 or 7am to the sounds of explosions,” he recalled. “We could tell that something major had happened. Then we saw it in the news.” Hamas had just carried out a massive attack on Israel, killing nearly 1,200 people. 

It became clear to Hazem and his family that this was no ordinary escalation, and the worst was yet to come.

Two days later, the Israeli Defense Forces (IDF) launched a Gaza-wide bombing campaign in retaliation. “They started bombing us more extensively—mortar bombing and air raids from all directions. It was frightening,” Hazem explained. 

With the situation deteriorating rapidly, Hazem and his family made the difficult decision to leave their home and seek refuge in the western part of Gaza at his uncle’s house. They would return home briefly during an unsteady ceasefire in December, but it was not long before the ceasefire failed, forcing them to flee once again. “We left again around the end of November. Afterwards, there were warnings all over Khan Younis that we should move to Rafah.”

By December 4, Hazem and his family had relocated to Rafah at Tal Al Sultan, where they sought shelter with his cousin. But even here, safety was elusive. As the conflict dragged on, the threat of an invasion loomed over Rafah, prompting yet another move. “In February, they [Israeli authorities] started talking about invading Rafah, so we decided to move again to west Khan Younis, near the seaside,” Hazem said. They lived in a tent there together until finally leaving Gaza altogether as Israeli forces mobilized for the Rafah offensive.

Witnessing the Collapse

With each new displacement, Hazem’s challenges multiplied. At each step, he and his UNRWA colleagues worked under impossible circumstances to continue UNRWA’s humanitarian services to affected Palestinians. However, for the most important services, like healthcare, they were witnesses to a near total collapse.

The healthcare system – already fragile due to widespread destruction, limited supplies, and surging demand – began to crumble under the strain. “At UNRWA, we primarily provide healthcare; we have no hospitals, just small clinics,” Hazem explained. But as the conflict intensified, even these clinics were not spared. “We had 22 clinics operating in Gaza. After the invasion in the north, we lost all those clinics,” he said. After just two months of war, pharmacies were completely depleted of medicine, and hospitals were overwhelmed with the wounded and lacked supplies.

The situation was dire. In Rafah, only three operational clinics remained, and they were overwhelmed with patients. “People would go to the clinics directly because the hospitals in Rafah are few and small,” Hazem said. 

The shortage of medical supplies, especially for chronic conditions, exacerbated the crisis. “We [UNRWA] were handling ten times the patient capacity we could manage,” he continued. The system was stretched to its limits, and despite the best efforts of the staff, many patients could not be saved.

One such case haunts Hazem. “A student of mine from college contacted me. His three-year-old daughter had lung problems due to the bombing and dust,” he recalled. Desperate to get her the help she needed, her father sought Hazem’s assistance in arranging an evacuation. “We tried for three days to coordinate with WHO, but on the fourth day, he told me it was no use; the child had already died,” Hazem recounted. The child’s death was not an isolated incident. It was one of countless examples, a heartbreaking reminder of the human cost of a healthcare system brought to its knees.

Under Fire: The Humanitarian Toll

As we talked, Hazem’s stories grew more harrowing. Even those tasked with saving lives were not safe from the violence. “The IDF targeted healthcare workers in Gaza,” Hazem said. By late May, the toll on UNRWA staff was staggering. “Around 192 UNRWA aid workers from all around Gaza were killed,” he reported. The number, he warned, could rise at any moment, as many bodies remained under the rubble, unreachable by their friends and family. And, indeed, that number did rise, reaching a staggering 220 UNRWA workers killed in Gaza by September 2024.

The dangers extended beyond UNRWA. Colleagues from other organizations have been hit by Israeli airstrikes. “I know some colleagues from MSF [Médecins Sans Frontières] , three or four killed, some from WHO were killed, some from UNDSS [United Nations Department for Safety and Security], and some from other international organizations as well,” Hazem recounted. These losses were not just statistics; they were friends, coworkers, people who had dedicated their lives to helping others. “We all heard about the targeting of World Central Kitchen [WCK] staff as well,” he added. The killing of seven WCK staff was certainly not the first of such attacks, but the high-profile nature of the organization and the specific attack forced the White House to publicly acknowledge the horrifying toll of Israel’s attacks on aid workers in Gaza. 

The toll has been perhaps most costly for children. More than 16,000 children have been killed, and many more have been wounded or permanently maimed. One story in particular stood out to Hazem—a nine-year-old boy named Moaatasem. Displaced from Gaza to Khan Younis, he had lost his entire family in a bombing. “He survived alone. His uncles, grandmother, brothers, mother—all of them died,” Hazem said. The boy, now confined to a wheelchair and severely burned, had no one left except an uncle who was also in dire condition. This memory encapsulated the brutality of the conflict and the deep scars it has left behind on the most vulnerable.

Starvation and Deprivation

Food shortages became another devastating consequence of the war and continued violence, leaving hundreds of thousands without access to food for months. “There are many cases of extreme starvation throughout Gaza, especially in the north,” Hazem said. The situation was desperate. People risked their lives to obtain food, only to return home empty-handed. “Some people went 24 days without eating anything,” he continued.

Hazem told the story of a woman in Jabilya in northern Gaza who had lost her four sons, leaving behind a newborn grandchild. With no milk to feed the baby, the grandmother resorted to giving him water. “The child died four days later of starvation,” Hazem said, the weight of the tragedy hanging heavy in the air. 

The scarcity of food was not just a problem of supply; it was a problem of access. Even if people had the money, which many did not due to the collapse of banking services, food was nearly impossible to find. “During Ramadan, I lost around 13 kg due to the lack of food supplies,” he added. The irony was not lost on him when he described himself as “very privileged” compared to others in Gaza. His wife, breastfeeding at the time, struggled to find nutritious food, relying on vitamins brought in by colleagues he knew from outside of Gaza.

What’s Next?

For Hazem, each displacement, each death, each moment of scarcity is a chapter in a story that is still being written—a story of unimaginable suffering and unyielding resilience of Palestianians caught between Hamas and Israel’s war. A humanitarian aid worker and a father, Hazem represents one of the thousands of UNRWA staff who labor daily to provide aid to their fellow Palestinians—even as their own struggles grow heavier. 

In January 2024, The Biden administration froze U.S. funding for UNRWA due to security concerns over a few UNRWA staffers’ involvement in the October 7 attacks, which has since been investigated and addressed. While all other major donors globally have resumed critical and life saving funding for UNRWA, the United States has yet to follow suit—this despite a lack of evidence of any further security threats. This prolonged decision left thousands of Palestinian aid workers in Gaza into greater uncertainty both for their own safety, but also for the safety of the Palestinian communities they serve. 

Restoring U.S. funding to UNRWA is a critical next step to helping Hazem and his colleagues in their efforts to serve their community. New legislation being introduced in the U.S. Congress offers a potential path forward. Several Democratic representatives are introducing the UNRWA Emergency Restoration Act of 2024, which aims to restore U.S. funding by repealing previous prohibitions and urging the Secretary of State to lift the current pause on federal support. This bill sends a clear signal to the Biden administration that there is strong congressional support for UNRWA and a recognition of its critical role in Gaza. 

The future of UNRWA is far from guaranteed. What is clear is that UNRWA’s persistent lingering in fiscal purgatory comes with significant impacts—for people like Hazem and his family, for the humanitarian response inside Gaza, and for Palestinian refugees across the region.  

*Refugees International is using a pseudonym to protect the identity of our interviewee.

Featured Image: UNRWA employees and Palestinians inspect a damaged school after an attack by Israeli fighter jets that killed and injured many in the Nuseirat Refugee Camp of Deir al-Balah, Gaza on July 15, 2024. Photo by Ashraf Amra/Anadolu via Getty Images.