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Brian Lehrer: It's The Brian Lehrer Show on WNYC. Good morning again, everyone. Here's a clip of President Biden talking about one of the things that he accomplished on his Israel trip this week. It was getting both Israel and Egypt to agree to allow humanitarian aid supplies to be trucked into Gaza from across its southern border with Egypt.

President Biden: "Up to 20 trucks. This has been a very blunt negotiation I've had. And so, we want to get as many of the trucks out as possible. There's, I guess, 150 or something there. Not all of them will go the first tranche. If there's a second tranche — see how it goes."

Brian Lehrer: President Biden yesterday, we will carry his Oval Office address on the Middle East schedule for eight o'clock tonight. We'll have that on all our frequencies or live stream it at wnyc.org, eight o'clock tonight. It's a little weird to my eye that they named a specific number of trucks, 20, which seems small compared to what the need might be for food, water, medicine, and more, for 2 million people in a very active war zone. I guess 20 is a start, and the opening of the border to that at all is a start.

Also, the news always reports the number of people killed on each side, which matters, of course, but left out sometimes is the number of people injured, people who need medical attention. Estimates reported by ABC News on Tuesday were of 3,400 Israelis injured in the October 7th terrorist attack by Hamas, 9,900 Gazans injured since the beginning of the start or the beginning of the military response.

We'll talk now about the medical situation with Avril Benoît, the United States Executive Director of Doctors Without Borders. She was last on the show in February to talk about medical needs after the devastating earthquake in Syria and Turkey, and in April of last year to discuss medical needs in the war in Ukraine, and now for this. We'll also touch on their work, providing medical assistance to migrants in Latin America, making the treacherous trip North from their desperate circumstances there.

Avril, thank you for your commitment to this work, and welcome back to WNYC.

Avril Benoît: Thanks very much, Brian. Good to talk to you.

Brian Lehrer: I want to start with the hospital bombing in Gaza on Tuesday because most of the press coverage has been about determining who did it, and the estimates of hundreds of people killed. I've seen a few vague references to there also being many more people who survive that attack but are injured. I don't think it gets enough discussion. Do you have any sense of the extent of that or what's needed to assist those who were?

Avril Benoît: Yes. This strike on that hospital is horrifying. So much of what we've seen since October 7th is just devastating to see. At the same time, there's a lot of contradictory information flying around in the moment. We were not officially working at that hospital, although one of our longtime colleagues happened to be there, and gave his perspective and the number of people who were killed, the number of people injured, who did it, all these things. Really, in an ideal world, you'd have an independent investigation and some confidence in the information that's flying around. Personally, as I look at all of this go down, I really don't know.

What we can say though for certainty is that a lot of medical structures and even ambulances have been struck in Gaza. I mentioned what's happening on that side of things, because as a medical humanitarian organization, although we totally recognize the burden on the health facilities in Israel, and the grieving and suffering there, we have always worked in Gaza where the health system was nearing collapse even before this particular episode in the history of violence there. We typically work in under-resourced settings like that where they need the extra humanitarian support. Any attack on a medical facility or on an ambulance is unacceptable to us.

Although we can't say who was being treated there, if it's a functioning medical facility under international humanitarian law, we and other humanitarian organizations like the International Committee of the Red Cross or the United Nations, and many other non-governmental organizations like Doctors Without Borders, insist that they must be protected in conflict zones. This is a basic for international humanitarian law under the Geneva Conventions.

Brian Lehrer: If we accept the United States version of what they believe happened there, it was actually an accident. It was a rocket from Islamic Jihad that was not targeting the hospital. It was a misfire. That's that version of it turns out to be true, but that's not what we're talking about in this segment. Do you have any way of describing who's helping those people and how?

Avril Benoît: It's been so difficult. Doctors Without Borders has more than 300 people on the ground, and we often lose contact with them because their phones die, or they are caught in the fighting. They're trying to flee. They're trying to save their families. They are separated from their colleagues or even members of their families. Then, occasionally, they pop up again a few days later and tell us they're all right. We check in on them. They check in with us. We do have a good sense of what's happening in many of the hospitals though because some of our medical staff chose to stay at the bedside of patients.

They made that harrowing choice of either fleeing and going with the population to the South, where there were promises that it would be safer there. It turns out not because there are continued to be airstrikes in the Southern Gaza area, but they have stayed in the hospitals, and what they report is so awful under the siege. You've got a lack of electricity. Most of the electricity backup is from fuel generators, and no fuel, running out of fuel. You've got a dire lack of water. We have focused a lot on water because we see that people are drinking salty water, untreated water, brackish water, and it's making people sick.

At a time when they're already undernourished because they haven't had access to proper nutrition and food. This includes young people and the elderly and so on. It means in essence that people will die from things other than airstrikes and the violence. They will die from a lack of medical care. We also hear that a lot of people who are injured, who are sick, who need medical assistance don't even dare go to hospitals because they consider the trip too dangerous and also knowing that ambulances have been destroyed.

Brian Lehrer: Listeners, your questions are welcome for of Avril Benoît, Executive Director of Doctors Without Borders USA, on the medical situation in Israel and Gaza. We'll also touch on Ukraine and for the migrants below the US Southern border. You can call about those two, 212-433-WNYC, 212-433-9692. Call or text.

I saw on your website, Avril, as of yesterday, Doctors Without Borders was calling for the opening of the Rafah border crossing with Egypt for Palestinians to have safe access to essential supplies and the ability to send much-needed humanitarian aid, including medicine, medical equipment, food, fuel, and water across the border into Gaza. That's the language from the Doctors Without Borders website.

With the new agreement now that President Biden announced with Israel and Egypt and the clip that we played, how much do you now have the access that you were asking for?

Avril Benoît: We have almost no access right now. It is virtually impossible to offer coordinated humanitarian assistance because the siege continues. Brian, I'm a hopeful person. By nature, I'm optimistic, or I wouldn't be doing this kind of work. Actions are stronger than hope. Actions are louder than words. I would like to see these trucks start to come in, and hopefully demonstrate that it's okay, that we can bring in the necessities, the water, the fuel, the anesthesia, so surgeons can do operations and not be forced to stop saving lives. All the things that we need to keep people alive.

We hope that we start seeing that come through, and that also for those who wish to leave Gaza, who have international passports. Among my more than 300 colleagues, I've got international colleagues, as well as Palestinian ones, and we've got more than 17 different nationalities among the internationals. The UN has even more international. Of course, then there are all the people who are there for family reasons, who are international people with passports. We hope that they, and anyone else, who needs that exit, that way to leave and find safety can do so through whatever crossings open up. Of course, everyone's looking at the Rafah one to Egypt.

This is essential, and it should be for Palestinians who choose to leave without any prejudice of their right to return to their homes, because that's an important point for them. We are mainly concerned that the bombing, the attacks, the violence stops, that aid can get in, that the hospitals are replenished, protected and functioning.

Brian Lehrer: I said in the intro that I don't know how to understand the specified number of humanitarian aid trucks that will be allowed to cross 20 trucks. The President in the clip we played said, "I guess there's 150 or something there. Not all of them will go." How do you understand why there is a number and how it came to be 20, and what 20 trucks can carry compared to the need?

Avril Benoît: We are not one of the states that is working behind the scenes, trying to negotiate all of this. We do appreciate the efforts, the bilateral negotiations that are going on to try to find some humanity in all of this and bring a little bit of aid. Of course, we would say, given the scale of the suffering, 2.2 million people with more than a million having been told, okay, leave the north, go to the south where you will be safer, and then the south is not safe at all, and it lacks just about everything to stay alive.

We would say, well, that's not nearly enough. It's absurd to think that would do much to alleviate things. At the same time, we have teams who are still there and preparing. They're working on plans to be able to take whatever medical materials that we can bring in, the supplies, the medicines, equipment to be able to get back to responding to some of those medical needs. The efforts are completely thwarted by the siege, and we hope that that can end so that we can bring the lifesaving assistance that we're committed to bringing.

Brian Lehrer: These 20 trucks with 150 there, according to the President, and even the 20 was the result of what the President called in the clip a blunt negotiation. How long would it take for those 20 trucks to arrive? Then, would they presumably have to go back for another round of negotiations between, I guess, the US and Egypt and Israel? It's at least three-party talks there. Near where I live in New York, 20 trucks would cross the George Washington Bridge probably every five minutes when traffic is moving. Are we talking about a shipment that will be there almost right away, and then back to the diplomatic drawing board for another 20 trucks, and on from there?

Avril Benoît: Your guess is as good as mine. Obviously, there will be a lot of efforts to check what's in the trucks. There will be a lot of suspicion. There will be a lot of cross-checking the supplies. I really can't tell you that. We can only hope that it's the beginning of a corridor to be able to continue bringing in the assistance.

Really lives depend on this working, and I think everybody who's trying to negotiate behind the scenes from the US, from other countries understands that, because even on this question of water, illnesses like diarrhea, for a young child, that can cause death. The water issue is vital, and it requires getting those desalination and the chlorination all that going again which requires fuel. That you can go through a lot of that just to run a water treatment for relatively small population, let alone 2.2 million people.

Brian Lehrer: Let's take a phone call. Yigal in Fort Lee. You're on WNYC, with Avril Benoît, Executive Director of Doctors Without Borders USA. Thanks for calling, Yigal. Hi.

Yigal: Thank you very much. I'd like to make two points, one for the previous segment, and I actually have a solution for the problem. Nobody said it, so I'll say it. The point is that first of all, the ambulances that are traveling are often used or sometimes used by Hamas to move munitions and missiles, and these raiders are bombing those ambulances based on intelligence, not indiscriminately. That's the first point.

The second point is, read what's on the side of the trucks. It says in Arabic, with pictures of the dome of the rock, we are here to help you take over Jerusalem. Take those signs off. They are poking the eye to the Israelis. It will help the trucks go in. I have a solution for the problem. The problem is there's actually a third door of evacuation. The third door of evacuation is through the sea. Israel can create a safe corridor through the sea, put refugees on boats, and send them to any country that will take them.

That's part of the problem, no Arab country is willing to take them. Start working on that solution. Turkey already said they will take them, but no other countries is ready to take them. You can create a safe evacuation corridor from that place, you solve a lot of problems through the sea, not through the Rafah crossing, and definitely not through the Israel crossing. Thank you for your time, Brian

Brian Lehrer: Yigal, thank you for your call. I don't know if you get involved in questions of where refugees might go at Doctors Without Borders. It's not about medical relief per se. Do you have anything to say on that or say that's really for a different guest?

Avril Benoît: Yes. It's the United Nations High Commission for Refugees, typically that is in negotiations, but of course, you need all parties to agree. I can appreciate that everybody is looking at this with a certain amount of caution because, like you, like me, I see things in the news, on the internet, and I'm looking at it saying, is this misinformation? Is this disinformation? Is this an old photo? Is this deep fake? All the risks nowadays.

That's one of the reasons that we are trying very hard to just report on what we see. Of course, sometimes we see things, we think we see it, and you can get things wrong in the heat of the moment, that's the challenge of doing things so quickly and commenting, but we really try to focus on what we witness ourselves.

I have not seen those trucks. We are not loading trucks. That is something that's happening with others first, but we're very eager. We're ready. We have a whole logistical capacity in Egypt that is organizing with really experienced people in working in conflict zones and being able to respond quickly to set up mobile clinics and all the things we're used to doing very quickly. I do not believe that they will be the first trucks. There will be other trucks that'll be prioritized, and we can only hope that more comes through in order to alleviate the suffering.

Brian Lehrer: On the first point that the caller made about how Hamas uses ambulances, sometimes President Biden expressed concern about that, too, that humanitarian aid coming into Gaza might be intercepted by Hamas, and they might prevent it from getting to the people who need it. At Doctors Without Borders, do you have ways of trying to see that it does get through? Or is that more a security function and not what your group can do?

Avril Benoît: Yes. In terms of the actual trucks on standby, I'm not sure. One of the things that we experience a lot in conflict zones, and whether it's Yemen or Somali or anywhere else, Democratic Republic of Congo, is we always insist that there should be no weapons. We have that on our ambulances, a big huge sticker, we check in Haiti. I've seen how we have our guards ask for everybody to leave their weapons at the door, all the guns and so forth. It is important for hospitals to be a weapons-free space. Of course, when there's a derogation of that, it endangers the medical personnel, it endangers the patients, and so it is very important that hospitals be respected as a place for healing, for treating the injured.

Brian Lehrer: Another listener says they are outraged at activists bringing aid to Gaza, which the listener describes as a self-imposed crisis. The question they ask is, why at the same time? Are they not demanding the release of the hostages talking about activist groups and aid groups? I realize that your role at Doctors Without Borders is not to get political in that respect, but of course, anybody being held hostage is also under an extremely precarious medical situation, almost by definition. I wonder if there's anything that your group does to try to aid the hostages who, of course, you're not going to be given access to in any easy way, but is that on your plate at all?

Avril Benoît: We would say that everybody who is in Gaza, people who live there, who are from there, internationals, hostages, all civilians in this conflict are the ones who are suffering and being killed for the most part. That's the vast majority of the victims of this conflict are civilians, including elderly people, women, children. That includes the hostages, of course.

What we would say always is the reason that we are not working in Israel is that they have a highly functioning health system that's well-funded, well-staffed, and we've offered our support to Israeli hospitals that are treating a high number of casualties, and for the time being, they thanked us and said, it's okay.

Nobody is bringing in aid to Gaza right now. There's a siege. Nothing is coming in. That's why all this discussion about bringing in the humanitarian supplies that the President and others have been trying to negotiate.

Brian Lehrer: Yes, yesterday. We have a few minutes left. I want to ask you briefly about both Ukraine and Latin America. Ukraine has largely fallen out of the news because of Israel and Gaza. Are we missing anything? You're in a position to describe, is Russia taking advantage of a distraction to attack more civilians, increasing the medical needs there, or anything else?

Avril Benoît: Well, Brian, I could talk about a lot of places. Ukraine, yes, it continues. The needs will continue to be enormous there. There are other places that have not received the attention they deserve. Sudan comes to mind, where you've got more than 5 million people displaced by conflict. A lot of them crossing borders into Chad, but most of them trapped inside and suffering untold consequences, including hospital bombings in Khartoum. We can talk about Yemen, you can talk about Congo, South Sudan.

There are many, many places that we're always focused on. We continue to focus on, and it's sometimes hard to balance because, of course, what's happening in Gaza right now is incredibly dramatic and it's sudden, right? It really catches our focus. It's urgent. There are also a lot of other urgent humanitarian crisis zones where Doctors Without Borders and other humanitarians are trying to save lives

Brian Lehrer: Well, closer to home, where the asylum seekers are moving from south to north in this hemisphere. I see on the Doctors Without Borders website that it says you work at many points along this busy and dangerous migration route to help ensure people receive emergency medical and mental health care, including special assistance to people who have experienced extreme violence or torture on their journeys. How do you do that?

Avril Benoît: Well, the clinics that we offer and the mental health support, for example, is with psychologists, and remember that people who are along that route are people, they're humans. They suffer the consequences of exploitation, of sometimes kidnapping, a lot of violence, a lot of sexual violence, a lot of torture. By torture, I mean when they're kidnapped, their families are receiving calls, and in order to extract more ransom money, horrible crimes are committed and violence is committed, and this is just the reality they experience. We have a commitment to saving lives, alleviating suffering, and doing so without discrimination for race, religion, nationality, how you voted, what you think.

The goal for us is if somebody is in need in a vulnerable situation, having crossed the Darién Gap, and been through untold difficulties, if they need medical assistance, we will provide it. That's the focus for us in that whole situation.

Brian Lehrer: Related to where people go voluntarily or as refugees, I want to acknowledge some text messages that are coming in. As so often, when we talk about the Middle East, these are very polarized. One person writes, "As a Jewish American with strong ties to Israel, it's a travesty that the citizens in Gaza are living in squalor because Hamas uses the billions of dollars in aid that should be used for proper infrastructure. This is not on Israel," writes one listener.

Several people are also responding to the earlier caller who suggest that Palestinians not only be allowed to go into Egypt, to flee from the current Israeli military operation aimed at Hamas there, but be able to go by sea to other countries, listen to rights create Palestinian refugees. What chance would they have to return? Isn't that what some Israelis want in the West Bank?

Another one along those lines, you call them refugees. They are the indigenous people of Palestine. There's obviously a lot of objection to the idea of having people have to be displaced from their country when that has happened so much to Palestinians in the past.

I want to tie that for a final question to the situation at the US southern border, because in the context of your medical relief work, I wonder if you take a position on who should be allowed in where. I've been thinking about the paradox, or maybe I should call it hypocrisy of some of the same people in the United States demanding that Egypt open its borders to a million refugees at the snap of their fingers, but cry that the United States is overwhelmed and can't take in any more people fleeing those desperate situations closer to here. Is it outside your portfolio to advocate for who should be allowed in where, for medical reasons when they want to go?

Avril Benoît: Yes. Well, I'll put it this way. We expect states, like the United States and others, to adhere to international norms when it comes to people claiming asylum. They should have a due process. Their cases should be heard. They should be considered for the claims that they make, and then adjudicated properly and managed. This idea of planned migration or refugee, there are conventions on this. There are international human rights laws, refugee conventions and things like that. You'll often hear us just calling for those to be respected.

Then further to that, if there is a policy of the US government, for example, or any other government that is causing harm, that is adding to the health issues, the challenges, the health burden of people pushing them into danger or keeping them in a dangerous place in violation of those international norms, we would point that out as being wrong. We don't get into who should take which people and what numbers and quotas and all that. We're really focused on the medical needs, and sometimes immigration, asylum, refugee, migration policies cause actual harm that we then see through our medical programs, and we bear witness to what we see in our medical programs

Brian Lehrer: Avril Benoît is Executive Director of Doctors Without Borders USA. Thank you so much for joining us. Good luck with your work. May everybody in your group be safe, as well as obviously so many people in dire situations who you help. Thank you for joining us.

Avril Benoît: Thank you. Take care.

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