By Hassan Abo Qamar, Prism | –
On Jan. 1, Israel revoked the licenses of 37 international and local humanitarian organizations in Gaza, in an attempt to force them to end their operations in the region by March. While organizations are still operating for now, the move is affecting the groups’ access to supplies and is already impacting daily life in Gaza. Organizations that have provided the foundations of civilian survival—health care, food distribution, water and sanitation, shelter, education, and psychological support—are being treated by Israeli authorities as a threat, and aid is increasingly framed as a security issue. As a result, it can be blocked at moments of greatest vulnerability and need.
Israeli authorities framed the decision as an administrative measure, claiming that the organizations failed to meet new “security and transparency requirements” that demand detailed information about staff, funding, and operations. Aid organizations say it undermines their humanitarian neutrality and places local Palestinian staff at serious risk.
The ban on humanitarian organizations comes as President Donald Trump established a “Board of Peace” that is supposed to oversee reconstruction and governance in Gaza under phase two of the ceasefire agreement, though Israel has not met most of the conditions required under phase one. The board’s senior members do not include Palestinians, and a copy of its charter viewed by media outlets suggests that Trump is aiming to establish a U.S.-led alternative to the United Nations.
Under international humanitarian law, parties must allow and facilitate rapid, unimpeded access for impartial humanitarian organizations to people in need. This obligation is neither optional nor contingent on political approval. Israel, as the occupying power, is obligated to ensure the protection and survival of the civilian population under its control and to allow humanitarian organizations to operate freely and impartially, facilitating access to food, medical supplies, and relief services, where it “is unable to provide” these itself. But in practice, humanitarian law is often treated as little more than ink on paper, allowing powerful states to act with limited consequences.
“We see Israel’s recent restrictions on NGO registration as a clear attempt to undermine humanitarian work in Gaza,” said Yousef M. Aljamal, Gaza coordinator at the Palestine Activism Program for the American Friends Service Committee (AFSC). “These measures go beyond reasonable regulation and aim to criminalize humanitarian organizations, weaken aid infrastructure, and further harm Gaza’s civilian population. They violate international humanitarian law and core humanitarian principles, such as independence and impartiality.”
In response to the ban, AFSC decided not to comply with Israel’s registration requirements.
“Following these requirements would put our staff and partners at risk and compromise our ability to operate ethically and independently,” Aljamal said.
According to the latest U.N. data, Israel has killed 579 aid workers—including nearly 400 from UNRWA—since Oct. 7, 2023. It has also killed more than 1,700 health workers, more than 140 civil defense staff, and 256 journalists. What many legal and human rights experts describe as Israel’s genocidal war has killed more than 70,000 people in Gaza, according to official tallies that experts say are severe undercounts.
Aljamal added that Israel’s new registration requirements create grave security risks by demanding sensitive personal information about staff and their families, which would weaken AFSC’s ability to operate safely and independently.
“Humanitarian work relies on trust, neutrality, and access,” Aljamal said. “When these are compromised, aid operations suffer, and staff and community partners face real danger, especially given that many aid workers have already been killed.”
Aljamal rejected Israeli claims that AFSC failed to meet reasonable requirements, emphasizing that compliance would violate humanitarian principles.
“AFSC already goes through thorough vetting under U.S. and international sanctions, and we operate in many restrictive environments worldwide,” he said. “Nowhere else do [international nongovernmental organizations] face such extreme and dangerous conditions.”
The collapse of health care
Israeli restrictions seriously disrupt humanitarian operations. They delay or block the delivery of trucks carrying food, medical supplies, shelter materials, and other lifesaving aid, making it harder to respond to urgent needs.
“Civilians continue to die from hunger, exposure, and treatable diseases, while trucks filled with food, medical supplies, and shelter materials are kept from entering,” Aljamal said. “These restrictions do not just hinder humanitarian organizations—they result in civilian deaths and worsen an already-dire humanitarian crisis.”
Health care has become one of the most affected sectors. The practical impact of the ban is especially severe for patients. Suspended organizations can no longer directly import medicines and medical consumables. Clinics that once treated hundreds of patients daily are now forced to turn most people away. Approximately 94% of Gaza’s hospitals have been damaged or destroyed, leaving much of the hospital infrastructure inoperable. What remains depends heavily on field hospitals and emergency facilities run by international organizations.
“The health situation we are living through in Gaza is extremely bad—devastating, honestly,” said Hassan Al-Shafei, a nurse working at Al-Aqsa Martyrs Hospital and with Doctors Without Borders.
Al-Shafei described a system overwhelmed not only by war injuries, but also by disease fueled by displacement, poor water quality, malnutrition, and weakened immunity.
“We are seeing many infections spreading because people’s immunity is low and the water is contaminated,” he said, adding that there is also a sharp outbreak of severe influenza-like illnesses, including COVID-19. “We have cases with temperatures of 39 and 40 degrees Celsius [102 to 104 degrees Fahrenheit]. Some have entered intensive care. Controlling the spread is extremely difficult under these conditions.”
Al-Shafei said that only one or two hospitals in Gaza are still partially functional, forcing medical workers to rely on field hospitals established by international organizations. He said if Israel heavily enforces its ban, the impact will be severe, particularly for vulnerable groups.
“If the ban is fully enforced, the impact on health care will be massive—especially for children, pregnant women, the wounded, and newborns. Maternity hospitals, surgical services, emergency care—all of this will be severely affected.”
Al-Shafei gave concrete examples of daily operational impact: Certain medical services have been scaled back, and health care workers have been dismissed to reduce staff.
“Before, we were receiving hundreds of cases. Now, because of shortages, we can only receive dozens,” Al-Shafei said. “Since Israel began withdrawing licenses from humanitarian organizations, we are working under constant pressure. At any moment, an organization could be forced to stop operating, and we could lose our jobs.”
Even basic logistics have been disrupted. Al-Shafei said some organizations have stopped transporting staff to hospitals due to fuel shortages and operational restrictions, leaving them to reach work at their own expense.
The crisis is also personal for Al-Shafei. His own child required a medical brace, known as an AFO, following tendon-lengthening surgery. Because of restrictions on medical imports, the device never arrived.
“We were forced to improvise. We made a substitute using regular plaster casts,” he said. “We survive by adapting with whatever is available. That is how Palestinians live under siege. But this is not proper health care—this is survival with almost nothing.”
International condemnation, limited consequences
Despite widespread international condemnation, no meaningful accountability has followed. Israel has continued to enforce restrictions while the international community looks on. The Palestinian Ministry of Foreign Affairs and Expatriates released a statement in which it “strongly” condemned Israel’s decision to introduce the registration requirements for relief organizations, warning that the measures could halt lifesaving aid for hundreds of thousands of people in Gaza.
“Israel has no sovereignty over the occupied Palestinian territory, including Jerusalem,” the ministry said, noting that Palestinians welcome the work carried out by humanitarian groups.
At the same time, AFSC and other humanitarian organizations have sought to challenge the restrictions through collective international pressure, but they say there has been little concrete action from world governments.
“AFSC is collaborating with United Nations agencies, humanitarian partners, and civil society organizations to demand the full removal of these restrictions,” Aljamal said. “We are pushing the international community to take real political and diplomatic action to ensure that humanitarian access to Gaza is unhindered.”
Doctors without Borders / MSF HQ in Geneva. Public Domain. Via Picryl.com.
For two years, Israel has taken steps to further control and weaken the Gaza Strip, even during what critics describe as a nominal ceasefire. Aid remains conditional, and the threat of losing food and essential supplies for tens of thousands of civilians—and a return to famine—grows daily. At the same time, hundreds of aid workers who have devoted their lives to helping their communities face the risk of losing their jobs.
If Israel continues what rights groups describe as systematic, punitive violations of the ceasefire and international law in Gaza—converting legal obligations into discretionary privileges, jeopardizing lives, undermining humanitarian neutrality, and weakening the institutions that sustain Gaza’s population—the consequences will become apparent as soon as the crossings reopen. Advocates warn that current policies are pushing many of Gaza’s residents toward forced or pressured migration.
Editorial Team:
Sahar Fatima, Lead Editor
Carolyn Copeland, Top Editor
Rashmee Kumar, Copy Editor
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