Humanitarian workers detail challenges getting aid into Gaza despite ceasefire

Dozens of humanitarian organizations have begun rapidly scaling up operations in the hopes of delivering aid to Gaza again amid the Israel-Hamas ceasefire.

Items in Gaza -- including food, clean water, medicine and hygiene products -- are running low, the organizations say. Additionally, hundreds of thousands of families have been displaced, many living in tents in extremely crowded areas.

Humanitarian aid workers told ABC News that they will face several challenges in delivering aid to Gaza. Israeli authorities have limited the amount of aid that can enter the strip, and destroyed roads and neighborhoods make it difficult to reach areas of the enclave.

Additionally, winter is fast-approaching, and aid workers say they have a limited amount of time to deliver provisions to help Palestinians in Gaza get through the cold weather months.

"We're not asking for anything unreasonable. We're asking for the volume of aid that entered Gaza Strip before the escalation in October 2023," Tess Ingram, communications manager for UNICEF, told ABC News. "I think that's something to watch for in the coming days. Does the aid flow? Are the crossings open? Is the U.N. enabled to do its job, to serve the children of Gaza?. ... But the other part is, does the ceasefire hold? The stakes are really high right now, so that ceasefire has to hold."

Lifting restrictions on aid

The U.N. said that Sunday, Oct. 12, was the first day progress was seen in the scale-up of humanitarian aid deliveries into Gaza.

Hundreds of thousands of hot meals and bread bundles were distributed in the north and south, according to the U.N. Additionally, cooking gas entered the strip for the first time since March as well as tents, frozen meat, fresh fruit, flour and medicine, the U.N. said.

However, on Monday, no trucks entered Gaza because of the transfer of Israeli hostages, and border crossings were also closed on Tuesday due to the Jewish religious holiday of Shemini Atzeret and Simchat Torah.

Israeli officials announced on Tuesday it would not reopen the Rafah crossing on the border with Egypt and would limit aid entering Gaza after Hamas failed to return all the bodies of the deceased hostages, as called for under the ceasefire agreement.

"Starting tomorrow, only half of the agreed number of trucks -- 300 trucks -- will be allowed to enter, and all of them will belong to the U.N. and humanitarian NGOs, with no private sector involvement," COGAT, the Israeli defense body in charge of coordinating aid to Gaza, said in a statement. "No fuel or gas will be allowed into the Strip, except for specific needs related to humanitarian infrastructure."

Hamas said the rubble makes it logistically challenging to locate the bodies of the deceased hostages, but Israel said it believes Hamas knows where the hostages' bodies are and is purposefully delaying their return.

Jolien Veldwijk, CARE Palestine Country Director, said the number of trucks entering Gaza is just "a trickle" of what is needed to meet the needs of the population.

"The destruction is significantly worse than compared to seven, eight months ago," she told ABC News, compared to the first ceasefire when she was also in Gaza.

Multiple organizations, including CARE, said they have not been able to get aid into Gaza since March 2, when Israel imposed a total blockade -- in an effort to pressure Hamas to release the remaining hostages -- that lasted for 11 weeks.

The organization said their repeated requests to deliver aid have been denied by Israeli authorities. Veldwijk said supplies are currently stuck in warehouses in Egypt and in Jordan.

Similarly, James Hoobler, a humanitarian policy adviser with Oxfam America, told ABC News the group has had 4,000 food parcels and a large volume of essential water sanitation and hygiene equipment stuck in its warehouse in Amman, Jordan, since March.

Some organizations say they are also running into red tape while trying to access the strip.

"We're running out of supplies now," Veldwijk said of the CARE team on the ground in Gaza. "We still can't bring anything in. ... We're desperate to get our supplies in, but we're also sort of desperate for all the border crossings to open."

Ingram, from UNICEF, who is currently in Gaza, said limiting the volume of aid entering the strip is the opposite of what is needed but that UNICEF has seen some success in its operations on the ground since the ceasefire went into effect.

"We are able to move far more freely, get access to areas that we haven't been able to get to for a while," she told ABC News. "We don't have to coordinate our movements with the Israeli authorities anymore, which means that we're not facing delays or denials."

She went on, "So for example, the last three days, I was in and around Gaza City, and that was kind of the first time in a while that we were able to get into parts of Gaza City that were the focus of that intense bombardment in August and September, and really get a sense of how that has affected the area and how people are planning to resume living there, and what they need."

Rebuilding water systems

Humanitarian workers told ABC News that rebuilding water networks will be critical in the rebuilding effort in Gaza, but it comes with many logistical challenges.

Aid workers said water that comes from the ground in Gaza is very salty from years of degradation. Drinking water needs to be desalinated, which is accomplished by desalination plants across Gaza, aid workers say.

"There needs to be quite a bit of work to make sure that they're all functioning properly." Ingram said. "There's some that are out of service. So, there's work that needs to go into making sure that drinking water production increases."

The network of pipes that brought water into homes has mostly been destroyed so most people in Gaza receive their water from water trucks, which collect drinking water from desalination plants and distribute it throughout the strip.

Ingram said the trucks have gone through wear and tear, which may limit their ability to distribute water as water networks and wells are rehabilitated.

"The water trucks themselves are a limited fleet that have done two years in a war zone over rubble," she said. "They need maintenance and repairs."

Aid workers say there are many groundwater wells, which pump domestic water that people use for cooking, cleaning and showering, many of which need repairs.

Veldwijk said CARE has rehabilitated water networks in the past to bring drinking water and domestic water to people's homes to complement the water supplied by trucks, but some of have been destroyed and need to be rebuilt.

She said the group is also working to rehabilitate wells as well as desalination units.

Aid workers added that rebuilding sanitation networks is also necessary but will be a challenge until the supplies entering Gaza necessary increase.

"I went to a big wastewater dam in Gaza City, which is surrounded by residential area, and it's at risk of flooding because the pumps aren't working," Ingram said. "Sanitation presents a massive disease risk if we don't get on top of it. So, we need to really improve the systems that remove solid waste, that deal with sewage and wastewater."

Clearing rubble and rebuilding roads

Destruction across Gaza also presents a logistical challenge in delivering aid to the civilian population. Many roads have been destroyed, and rubble may be hiding unexploded ordinances.

Zaheer Kham, global director of fundraising for the humanitarian charity Human Appeal, told ABC News that he received a message from teams on the ground in Gaza on Tuesday that rubble in the roads is starting to be removed.

"Is it enough? Of course not, we need heavy machinery to remove the rubble in the roads that has accumulated over two years," he told ABC News.

Veldwijk said the roads being destroyed make it difficult to travel from southern Gaza to central Gaza to northern Gaza and if all the border crossings are opened, supplies can more easily be funneled throughout Gaza.

Aid workers say entire sections in Gaza have been destroyed, making it difficult to find people who may be in need of aid.

"It's like being inside the skeleton of a city," Ingram said of visiting neighborhoods in Gaza City and Jabalia, just north of Gaza City. "Everything is gray. Things that would normally tell you where you are, are gone, and it's very disorienting."

On Tuesday, the U.N. Development Programme announced that the cost of rebuilding Gaza is estimated at around $70 billion, with $20 billion needed in the next three years alone.

Fast-approaching winter season

With the cold weather months approaching, humanitarian organizations say there is an urgent need to get warm clothes and blankets into Gaza.

Winters in Gaza are usually not very severe with low temperatures typically in the 40s F, but heavy rains and its seaside location can make it feel colder.

"It really is a race against time," Hoobler, with Oxfam America, said. "Winterization is a major issue, especially with the amount of destruction to housing that we've seen. So, we know people are in very overcrowded conditions there. They don't have adequate shelter. Many of the makeshift shelters that people were in were destroyed in bombings."

Nine out of 10 homes have been damaged or destroyed in Gaza, meaning some people are sleeping in homes with missing walls or roofs while others are sleeping in tents, according to Ingram, increasing the need for mattresses, blankets and other provisions.

Ingram said that last winter, some children -- including babies -- died of hypothermia, which she said is preventable with the proper supplies.

She added that she is concerned that many children in Gaza have only one or two sets of clothes, many of which are not warm enough for winter months.

"Our aim is to provide every child in the Gaza Strip under the age of 10 with a new set of winter clothes during the ceasefire and a new pair of shoes," Ingram said. "That goal is heavily dependent on the volume of aid that gets into the Gaza Strip, so we remain hopeful, but we do call on both parties to the conflict to adhere to the terms of the ceasefire."