Amb. David Satterfield: Humanitarian Aid in Gaza

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This transcript is from a CSIS podcast published on February 20, 2024. Listen to the podcast here.
Dr. Alterman: Amb. David Satterfield is the U.S. special envoy for Middle East humanitarian issues. He comes to that role after nearly 40 years of experience in Middle East diplomacy on behalf of the United States. Amb. Satterfield, thanks very much for joining us on Babel.
Amb. Satterfield: Delighted to be here.
Dr. Alterman: Give me a sense both of what conditions are on the ground in Gaza now, and how people should think about getting authoritative information as it seems like there are a lot of different accounts going on about exactly what's happening and how bad things are.
Amb. Satterfield: Jon, from the standpoint of the humanitarian situation for Gaza's 2.2, 2.3 million population, they are exceedingly difficult. By dint of U.S. leadership, strong support from the international humanitarian community, and decisions taken over the course of the last three months by the government of Israel, there's enough feeding assistance coming in to meet a minimal goal of preventing famine and actual starvation, but I don't say that as if this was a mission accomplished. It's not. The president, Secretary Blinken, Jake Sullivan, have made very clear that we don't regard this avoidance of famine as a satisfactory outcome. Much more needs to be done.
The more that needs to be done has to address the other humanitarian factors beyond just feeding. The health situation is extraordinarily precarious. The concentration of population, particularly in Rafah, a place that had a pre-October 7th population of maybe 280,000 or 300,000, now has a population of at least 1.4, 1.5 million. The shelter situation is wholly inadequate to need. It's winter, with torrential storms, wind, and rain. The product of a compression of a population into a single small space without adequate shelter and with marginal availability of potable drinking water is the beginnings of a clinical outbreak of disease.
Right now, the situation is short of epidemic proportion, but one could predict if there is not some relief from this concentration of population, better ability to access healthcare, potable water, a fully nutritious diet—not just a diet that prevents starvation as they are two different things—then you will see disease spreading. So, we have not been wholly unsuccessful; we and our partners in the four months since the events of October 7th, but we are not successful enough from a humanitarian standpoint.
Jon, you asked me another harder question: how do you get accurate information? It's difficult. Much of the information that comes into the international press, comes from Palestinian Hamas sources. Hamas controls the Ministry of Health, as the de facto authority in Gaza. Some of what they report is accurate. Some of it is not.
Dr. Alterman: One of the stories that I had seen widely reported is that Gazans had access to three liters of water a day, below the minimal requirements for survival. What I've heard from Israelis is that there are 28 million liters of water a day flowing in from Israeli pipelines. On issues like that, is it the international community that is slow to revise? Are the Israelis painting too rosy a picture? If you have conflicting views like that, what should ordinary people do to try to figure out where the truth is?
Amb. Satterfield: Well, Jon, this is very hard. I can tell you in this case, a quantity of water does indeed flow in the two pipelines from Israel. Similar to that, does that get distributed to the population? No, it does not. Because of damage to the distribution networks, a far lower quantity of potable water coming from those two operative pipelines, center and south, are accessible to the population. So that's a fact that is both true but also not relevant to the ability of two million people to actually get the water they need.
I cannot give you a solution to how to find accurate information. We find it by consulting throughout the international humanitarian community, with the United Nations (UN) or International Committee of the Red Cross (ICRC), with the other entities who are active in Gaza to formulate a picture. I have to tell you, however, that at times we spend hours or days trying to discern the truth in a flat statement, which we can't verify immediately but can only do over time.
Dr. Alterman: And it's my understanding we don't have Americans in Gaza assessing this. You're trying to be the humanitarian coordinator from outside this situation where you're trying to affect the humanitarian environment. Is that correct?
Amb. Satterfield: The answer is yes, we are outside, but we have very close, continuous, throughout the day, every day contact with professional staff, humanitarian staff inside Gaza. Collectively, the picture that we draw from them is a pretty good one, but it can take time.
Dr. Alterman: Much of the aid getting into Gaza is coming not through a water pipeline, but through crossings, and goods going through the crossings have to be inspected before they're allowed in. Are these sites operating at their limits, or do we need to revise the procedures to get more throughput?
Amb. Satterfield: The two inspection sites maintained by Israel, the Nitzana crossing between Egypt and Israel and the Kerem Shalom crossing between Israel and Gaza, together have a capacity, a demonstrated capacity of between 300 to 320 inspected trucks a day. That capacity could be increased if the hours of the crossings were expanded. They're open each about eight to eight and a half hours a day. If trucks arrived promptly from Egypt, which is where the deliveries come in from except for a small proportion from Jordan, you could get more done through the day. But even if those two crossings operated as perfectly as they could, more needs to be done.
Now, the more that needs to be done is not necessarily moving more trucks of humanitarian assistance. It's moving commercial goods from Egypt that supplement what we could call the ready to eat, fully prepared meals that go in right now as humanitarian assistance—the high-energy biscuits, that sort of material, to supplement a true normal diet, which Gazans haven't had since shortly after October 7th. Additional crossings need to be opened to make this possible. The secretary of state called both privately and publicly for the opening of Erez crossing in northern Gaza for the movement of humanitarian assistance. We're working with other partners in the region and beyond on the possibility of establishing a maritime humanitarian supply route into Gaza. All of that, not to replace what is being done at Kerem Shalom or Nitzana, but to supplement the movement in.
But there is another problem, which is the ability to safely and efficiently distribute goods inside Gaza once they have entered. You can deposit hundreds of truckloads of goods inside Gaza, but if the environment is not secure and safe for the UN or other humanitarian implementers to take aid to the distribution points or the shelters that need them, then you haven't met the goals. Just counting truckloads into Gaza is a false metric of how much actually gets to Gazans in need.
I must tell you, over the course of the past 10 days, there have been very significant obstacles to getting assistance first into Gaza. Kerem Shalom and Nitzana were closed for much of the last week because of demonstrations on the Israeli side. They have reopened, but now there are problems from criminal gangs inside Gaza looting commercial goods and the humanitarian shipments coming in not just via the UN, but from Jordan, the UAE, and goods directed to the Palestinian Red Crescent Society. This is a big problem. It is one we are trying to address to see what can be done to resolve it.
Dr. Alterman: What's the solution set? When I was talking to some folks at the Israeli Embassy a few weeks ago, they talked about Hamas providing security for food shipments and the Israelis being okay with that to prevent rioting because people were seeking food. Is the answer working with Hamas? Is the answer working with former security officials of Fatah? Is there some other solution set that we need to be looking at?
Amb. Satterfield: Those moving goods for distribution in Gaza have indeed relied, certainly over the last month, month and a half, on what we would call the de facto security forces there. Is that Hamas? Yes, as a practical matter, it is. Are there concerns about Hamas? You bet there are. But the overarching concern as we would see it is the ability to meet the minimal survival needs of two million Gazans in the center and in the south. And if actions are taken that render convoys, whether by the UN or anyone else, incapable of moving securely without assaults on drivers, attacks on the trucks, looting, and not looting by desperate civilians but criminal gangs for resale for profit in the black market, if that can't be addressed or if addressal requires those de facto elements to do it, there's got to be a triaging here of where the strategic priorities lie.
For us, the strategic priority in the immediate sense is the ability to meet the basic survival needs of the population of Gaza. We absolutely support the goal of eliminating the ability of Hamas to either govern in Gaza or to pose a security threat again to Israelis and to the State of Israel, no question about that at all. But in order to see those goals achieved, there must be a strong humanitarian component that purchases and secures time and space for this very difficult military campaign.
Dr. Alterman: Is there any sign that Hamas is interested in either deepening or worsening the humanitarian crisis because it helps them in terms of reaching out to the rest of the world and building support for the Palestinian cause overseas?
Amb. Satterfield: Jon, I have seen little indication that Hamas cares one way or the other regarding the suffering of the civilians of Gaza. It is Hamas that over the years since 2006 has built an embedded terrorist network infrastructure under, within, beside humanitarian infrastructure in Gaza, which has in a calculated fashion over those many years relied upon the presence of population of civilians, of human shields, if you want to use that term, to offer some imagined protection to itself. No, I don't think they give a damn one way or the other what happens to the civilian population. It's not a pressure on them, and it is not something they hope can yield perhaps lessened pressure upon them.
Dr. Alterman: Is it your sense that the Israelis want to ensure that Gaza is miserable to try to push either Gazans to turn away from Hamas or to turn Hamas toward negotiations? Is there a sense that the humanitarian situation is being used as a lever by the Israelis?
Amb. Satterfield: Jon, I have never seen that demonstrated. What Israel does believe is that sustained kinetic pressure on Hamas is necessary to secure the goal of release of all of the Israeli hostages living and those dead, that without that kinetic pressure, Hamas would have little incentive to move. And frankly, that's a point I can't take issue with. I have not seen any theory of the case in which depriving the civilian population of food and water somehow is a pressure point on Hamas. As I said, Hamas doesn't care. The Israelis would acknowledge that same argument. It doesn't mean anything to Hamas what happens to the civilian population. So no, I don't see that.
What I do believe needs to continue to be reinforced, and we do, is the concept that without a strong humanitarian component, the ability to sustain that kinetic campaign over time becomes challenged.
Dr. Alterman: I've been struck when I look at the Israeli press in Hebrew using the translation function on a browser that the humanitarian issues are simply not present in the Israeli press. They talk about Israeli heroes, they talk about Israeli martyrs, they talk about the kinetic operations, but the humanitarian issue seems consistently absent at a time when the international press is quite focused on the humanitarian issue. As you spend time talking to Israelis, do you sense that the attitude toward the humanitarian component is moving in the direction that you've described? Or does it remain something that Israelis say, "I'm sorry, that's just not our problem"?
Amb. Satterfield: I'm going to give you two responses to that, Jon. The first is that Israeli journalists, particularly those posting on Israeli and international social media, very actively cover the humanitarian situation and the positions or responses of Israeli officials in the government to that humanitarian challenge. That reporting is very much out there.
If you're speaking about the mainstream print media in Israel, yes, your comments are not off the mark.
Social media does a far better job of this than print media does. You asked me, "What do Israelis think about this?" Not what the media reflects, what do Israeli thinks? Israel is traumatized, and Secretary Blinken has spoken to this publicly on many occasions. Without coming and being there, it's very difficult in a cold analytical sense to comprehend. The events of October 7 were shattering in a way that October '73 was not. They challenged, if not overturned, the basic premise, the basic social contract of Israel that their sons and daughters would serve in Israel's security forces and perhaps have to sacrifice in that process. But in return, Israeli citizens would have the ability to lead what Bill Clinton once said, referring to the Israel-Palestinian peace process, as the "quiet miracle of a normal life."
That assumption, that contract was broken on October 7. And the trauma that it invoked, reinforced every day by the continued presence of the hostages in Gaza, by the fact that 200,000 Israeli civilians are displaced from their homes in Gaza corridor, the perimeter around Gaza and Israel, but also from Northern Israel. That is profoundly compressing in a social, in a political, in a psychological sense to the government, to the choices the government makes. If you asked, what is the view of most Israelis on the street to humanitarian assistance, they would put humanitarian assistance well below the return of their hostages and to the ending of the threat posed by Hamas to Israel, not now, but in the future.
Dr. Alterman: I don't want to create a false equivalence, but you've worked on Arab-Israeli issues for a very long time. When you first met me, you were a veteran on Arab-Israeli issues already, and that was 25 years ago. It seems to me that the trauma you've described is a trauma that many Palestinians have felt they have been experiencing for decades. Is it different in some way? And is there a way we should think about the trauma that's a key to unlocking what has been a very difficult problem for many, many years?
Amb. Satterfield: I'll echo Secretary Blinken again when he said, "Every death, every Palestinian child killed in this conflict is," he used the phrase, "a kick in the gut," something he thinks about constantly. The equivalency here, which is not a false one, is every human life is precious, and there must be no dehumanization in or as a consequence of the horrible events of October 7. Hamas dehumanized Israelis that day. Hamas dehumanizes in an active sense the hostages still being held in those tunnels underneath Gaza. But Israel must not dehumanize Palestinians or Gazans in specific. That would be a horrific legacy, however this conflict resolves itself, because that legacy will poison the ability to move in the future to what we profoundly believe is the only lasting means of assuring security, peace for both Palestinians and Israel, and that is a pathway to a two-state resolution.
Dr. Alterman: As you engage with the Israeli government, the Egyptian government, the Jordanian government, all sorts of governments through the region, what are the most important tools that you have to ensure humanitarian assistance, and what are the tools you wish you had?
Amb. Satterfield: The most important tool that I have is that all the governments you have just referenced, and I was just in the UAE yesterday morning, all those governments understand fully in a very immediate sense that without humanitarian assistance, it will be impossible for Israel to achieve the goals, which they do not disagree with, of making sure Hamas, that terrorist group, cannot dictate life and governance to the two million people of Gaza and cannot threaten, not just Israel, but to threaten them as well, with their political ambitions and their ideology. In other words, I'm not pushing on a closed door. The door's already open. They want to do what can be done that makes sense, is practical to improve the humanitarian situation.
That's certainly true for Egypt from the very beginning of this process, but it's true for the other critical states in the Middle East who are providing other material support or financial support for humanitarian aid. The greatest tool that I wish I had in greater abundance was a ceasefire that is the product of releases of hostages. Because a ceasefire that stands on its own and not as part of a hostage release only benefits Hamas and is not something that we find acceptable or advisable. A ceasefire would allow, particularly if it was of an enduring character, the ability to move more humanitarian assistance, not just into Gaza, but more freely throughout Gaza, including to the north, which has been a very difficult challenge for us and for the humanitarian implementers during these months.
Dr. Alterman: The last thing I want to get your judgment on is whether we are at a humanitarian inflection point. And if we do hit an inflection point, what do you think the first signs are that things are either decisively shifting in a better way or in a much worse way?
Amb. Satterfield: Well, Jon, there's a potential inflection point out there, which could be quite negative, and that is an Israeli kinetic campaign, ground campaign in Rafah. In Rafah, you have 1.4, 1.5 million people. All but a handful are already displaced to Rafah under IDF instructions from either north Gaza or, progressively, from the center of Gaza into this small area right up against the Egyptian border in the south. We have been very clear at the highest levels of government, the president, the secretary of state, the National Security Council, with the highest levels of government of Israel, the prime minister on down, that any kinetic campaign in Rafah must be preceded by a planned, coherent, and adequate movement of civilian population out of Rafah to appropriate shelter with full humanitarian support.
That takes time. It takes preparation. It takes the engagement of the international community. It takes Israel being willing to provide the permissions necessary. We call that deconfliction and coordination for humanitarian assistance to work. And Jon, this is a heck of a challenge, a million people plus being moved under the conditions that now exist in southern Gaza, as well as in the north, were any of them allowed to go to the north, very hard to do. But we've been clear, however hard, this needs to be the condition, precedent, or antecedent to any Israeli kinetic campaign in Rafah. So, there you have perhaps the biggest single inflection point out there right now.
The next inflection point is, of course, what I referenced a few minutes ago. If there is a hostage release deal, and I cannot and won't speculate on odds or chances, but if the deal comes and with it comes a prolonged ceasefire, more than the week we saw in November, that also should be a positive inflection point for that ability to get greater aid in, both humanitarian and commercial, and to see it distributed efficiently to all of Gaza, including the north.
Dr. Alterman: Amb. David Satterfield, the U.S. Special Envoy for Middle East Humanitarian Issues, thank you very much for joining us on Babel.
Amb. Satterfield: Thank you, Jon.
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