The urgent need for humanitarian aid in Gaza 

I just spent two days in Gaza, from Dec. 19-21, bearing witness to the terrible realities that Palestinians there are enduring. My visit was confined to the southern Rafah Governorate and Deir Al Balah in the Middle Area. However, even in these areas, the catastrophic conditions and the rapid escalation of the acute crisis was painfully evident. 

As I went through old refugee camps and new informal settlements of internally displaced people, the areas to which the majority of Gazans have evacuated exude an overwhelming sense of despair. Palestinians across Gaza describe feeling like "walking dead," relentlessly pursued by death. Their pleas for a ceasefire and the chance to return home, even in the knowledge that their homes no longer stand, reflect the desperation people are feeling. 

During my visit, I witnessed firsthand the profound grief of one of my colleagues who learned that his mother, brother and their family had perished in a bomb attack in Gaza City. The heart-wrenching reality of being unable to save loved ones and the subsequent struggle to get information amid communication barriers highlighted the anguish experienced by countless families in Gaza. 

Nowhere is safe 

Throughout the Gaza Strip, the ceaseless sounds of warplanes, drones and bombs create an unnerving atmosphere that has become tragically normalized for Palestinians. My hosts showed a disconcerting poise as they continued conversations without pause amid falling bombs. However, this stoicism does not diminish the fear that permeates their lives. "We fear the nights," confessed one of my hosts. I had a small taste of that reality as bombs fell through the nights that I was there, shaking the building I was staying in. 

The overcrowding in Rafah is unbearable 

With nearly 85 percent of Gaza's population now internally displaced, a mass migration toward Rafah has ensued. Most displaced people are either in Rafah or on their way, trying to survive as threats escalate in the north, the middle areas and Khan Younis. This convergence of nearly the entire population into the southwest corner of Rafah, an area about the size of LAX airport in Los Angeles, exacerbates an already confined space. 

During my visit, I spent most of my time in this crowded corner, navigating the city of Rafah and the two largest settlements. One, located at the "Qatari Hospital," consists of an unfinished concrete shell and a tent city, now “home” to over 70,000 Palestinians. The other sprawls across streets and open spaces around Al Quds Open University, lacking essential resources and facing an influx of more displaced persons. 

Desperate living conditions and coping mechanisms 

The overcrowding in these settlements, coupled with a severe shortage of food, water, shelter and healthcare, has rendered living conditions untenable. Even in the short span of my two-day visit, the situation appeared to grow increasingly desperate and tense. The normally strong bonds of community and mutual support in Palestinian society have been pushed to the breaking point as people tussle in the streets for a piece of the limited food parcels being distributed. 

While resilience and resourcefulness define the Palestinians of Gaza, their coping mechanisms, born out of necessity, are not sustainable in the long term. The environment is witnessing trees being cut down for firewood, and individuals foregoing water to avoid long lines at scarce toilets, leading to widespread health concerns. 

Aid shortcomings and urgent needs 

Amid the dire living conditions, the Integrated Food Security Phase Classification Famine Review Committee warns of an imminent risk of famine for the entire population. Over 55 percent of Gazans are classified at emergency or catastrophe levels, with more than 90 percent having less than one meal a day and going to bed hungry. Children have access to only 1.5 to 2 liters of water each day — about 10 percent of the humanitarian standard for emergencies and well below even the minimum standard for survival. Without a significant increase in aid, over half a million people are on the brink of facing catastrophic conditions in the coming weeks. 

Increases in aid desperately needed 

Aid is trickling into Gaza, but the speed and scale fall far short of the urgent requirements. On the day of my arrival, 177 aid trucks entered, marking a drop from the previous day's 204. These numbers, tracked by the Logistics Cluster based on data from the Egyptian Red Crescent and UNRWA, remain insufficient, with only one day since Oct. 7 reaching even half the typical pre-war number of trucks. Five crucial issues need immediate attention to enhance humanitarian relief flows: an increase in aid quantity and efficient delivery, cessation of political interference, streamlining delivery, accelerated efforts by aid agencies, and, most importantly, an end to the bombings. 

The day I arrived in Gaza, a United Nations convoy attempting to deliver aid to northern Gaza turned back due to targeted bombings. The next day, a successful U.N. delivery demonstrated the challenges faced in providing aid amid ongoing hostilities. The imperative for a ceasefire becomes even more apparent when considering the safety and effectiveness of aid delivery. 

What next? 

As people’s needs escalate, there is a looming fear that the world's attention will move away from the humanitarian crisis in Gaza and Palestine. This cannot happen. Alongside increased aid, a ceasefire and an end to hostilities are paramount. Only then can the focus shift toward recovery. The desire of Palestinians, now enduring overcrowded, unsanitary shelters, is simple — they want to return home. This fundamental aspiration must be integral to any post-war agreement, signaling the beginning of recovery and the rebuilding of shattered lives. 

Sean C. Carroll is president and CEO of humanitarian nonprofit Anera.