My sadness has been set on fire. That’s it; that’s what I’ve been feeling for the past five weeks, watching the unrelenting attacks on civilians in Gaza. I’ve been struggling to describe it as I go about my daily life, dragging despair behind me like a sea turtle with an abandoned fishing net wrapped around its throat. Feeling the outraged tears and exhaling in horror as I see images of small bodies crushed, covered in dust, torn into pieces. But words have failed me. So, I lean on the piercing poetry of artist Basma Al Hajaj (@frombeewithlove____ on Instagram):
“I have never felt this before. They tell me it’s called anger. I think it’s sadness set on fire.”
And, my God, can sadness burn.
It’s clear that humanitarians around the world are not OK right now. As the bombardment of Gaza approaches its sixth week and most of the hostages taken from Israel are still missing, Palestinians and Israelis, other Arabs and other Muslim, Jewish and Christian people are struggling. Aid and development workers are also not doing well. They’re emotionally drained and their mental health is suffering; they’re crying at work and at home, finding it hard to sleep and to focus. They’re terrified for friends and colleagues working in Gaza and the West Bank, with at least 107 humanitarians now killed; distraught at the growing civilian toll; and feeling helpless and frustrated.

This baby was among the wounded Palestinians transferred to Al-Najjar Hospital in Rafah, southern Gaza Strip, on October 13 2023. Shutterstock: Anas Mohammed.
In late October, the United Nations (UN) warned that “hell is settling in” as the siege and bombing of Gaza continued and the humanitarian crisis worsened in the 41km-long strip of land. By the first week of November, the UN said Gaza was becoming a “graveyard for children” and a rare joint statement from the heads of 18 UN agencies and NGOs called again for an immediate humanitarian ceasefire, saying, “It’s been 30 days. Enough is enough. This must stop now.”

Palestinians receive the bodies of relatives who were killed in an Israeli air strike, at Al-Najjar Hospital, in the southern Gaza Strip, on October 21, 2023. Shutterstock: Anas Mohammed.
At least 101 aid workers with the UN Relief and Works Agency for Palestine Refugees (UNRWA) are also among the dead – the highest number of UN fatalities ever recorded in a single conflict.
More than 10,020 people have now reportedly been killed in Gaza, including 4,104 children. At least 101 aid workers with the UN Relief and Works Agency for Palestine Refugees (UNRWA) are also among the dead – the highest number of UN fatalities ever recorded in a single conflict. Eighteen members of the Palestinian Civil Defence, working on emergency services and rescue, have also been killed in Gaza; along with at least four aid workers with the Palestine Red Crescent Society and at least one Doctors Without Borders team member. Three medical staff of Magen David Adom, Israel’s emergency medical service, were killed in the attack on 7 October.
The aid delivered so far is “nowhere near enough” according to the World Food Programme. Humanitarians still working in Gaza have spoken of their exhaustion and anguish at seeing the suffering of civilians and worrying about the safety of their own families.

Palestinians collect some much-needed water in Rafah, southern Gaza Strip, on October 20, 2023. Shutterstock: Anas Mohammed.
Telling humanitarians that they can’t reach more civilians in Gaza because there’s a siege is like telling firefighters to stand and watch as a house burns down.
Because of their jobs, aid and development workers globally have a unique perspective on this disaster and a distinctly personal connection to the events.
First, telling humanitarians that they can’t reach more civilians in Gaza because there’s a siege is like telling firefighters to stand and watch as a house burns down. Their whole purpose is to respond at moments like this. Normally, when there’s a major crisis, aid workers will hear almost immediately about how their organisation is mobilising to support affected communities; some may already be en route to the disaster while the world is still digesting the breaking news. Teams are proud to know that colleagues are swinging into action, travelling to the heart of the impacted area – no matter how remote – figuring out what is needed, ordering supplies and delivering life-saving services.

Palestinians look for survivors after an Israeli airstrike in Rafah refugee camp, southern Gaza Strip, on October 12 2023. Shuttershock: Anas Mohammed.
“[We feel] so powerless watching from our comfort abroad, watching our colleagues on the ground continuing to work in impossible conditions…”
But this time, humanitarians have watched for weeks as more than two million people cower under bombardment and plead for food, water, fuel, medicine and other humanitarian necessities. More supplies are ready to be moved in, but can’t be safely transported at the scale needed without a humanitarian ceasefire. Aid workers feel helpless and guilty for not being able to do more.
One humanitarian working for the UN said she hadn’t been able to sleep since the bombardment of Gaza began. “Image-after-image of traumatized or dead children, rampant misinformation spreading hate and vitriol – it’s too much, especially for those working in the humanitarian sector,” she said. “One feels so powerless watching from our comfort abroad, watching our colleagues on the ground continuing to work in impossible conditions and watching ceasefires be delayed. Another said she “can’t function” and is “haunted by this 24-hours-a-day.”

Palestinians take shelter in an UNRWA school in Gaza. Photo: @UNRWA
Aid workers are also haunted by their inability to support their own colleagues in Gaza. Typically, the burden of an emergency response is shared across many shoulders. Organisations mobilise teams from around the world to boost capacity or give fatigued peers a break, particularly when they’re traumatised by what they’ve seen, or their own families are at risk. Yet, in the case of Gaza, humanitarians on the outside can only watch as colleagues on the inside continue to do their jobs with staggering courage, while openly wondering if each day will be their last. We’re supposed to be a family, to be there for each other when things seem unbearable. But we can only send messages, hold our communal breath when communication is cut off, support as much as possible from a distance and remain in position at key supply hubs, ready to send in more team members and aid as soon as possible.
“The constant barrage of distressing images and heart-wrenching stories, along with the personal connections I have to friends and their families in Gaza, leaves me utterly exhausted.”
One friend, Salimah Mahadevia, who works in refugee resettlement and integration in Washington D.C., said that, as a humanitarian aid worker, recent weeks had been “incredibly disheartening and emotionally taxing”. “The constant barrage of distressing images and heart-wrenching stories, along with the personal connections I have to friends and their families in Gaza, leaves me utterly exhausted,” she said. “Each day begins and ends with the weight of Gaza, leaving me in disbelief that such a humanitarian crisis persists.”

Women queuing for food in Gaza. Photo: @WFP
“As humanitarians, we know war, we know tragedy, we know trauma and violence and death. We know the worst things in the world.”
In addition to feeling frustrated at the blocking of aid and the inability to reach shattered colleagues, many aid workers know better than most what war is really like. They have horrifying images from other crises seared into their minds, offering a devastatingly vivid understanding of what is happening in Gaza right now. They’ve seen up-close what a hungry child looks like. They know what decaying bodies in a war zone smell like. What exploding bombs sound like. “This is what I keep telling people…who sit here in New York and say, ‘Why are you advocating for a ceasefire?’,” explained Arab-American global women’s rights expert, academic and aid worker, Lina AbiRafeh. “It is because we know war, we know tragedy, we know trauma and violence and death. We know the worst things in the world.”

Palestinians killed in an Israeli air strike in southern Gaza Strip, on October 24, 2023. Shutterstock: Anas Mohammed.
It also means this latest catastrophe can trigger past traumas. Aid workers are at significant risk of experiencing PTSD, depression, anxiety and other stress-related psychological health issues, because of what they witness and the threats they can experience to their own safety. In a survey of aid workers by the Guardian in 2015, around 80% of respondents had experienced a mental health issue and 90% of those said it was work-related. Non-profit and UN staff working on the Gaza conflict could face fresh mental health challenges in the future due to the distress, trauma and tremendous personal risk they endure. The horrific reports are also triggering pre-existing trauma in humanitarians not working directly on the conflict. (See other Hit the Iron Bell posts on this topic, here and here.)

Palestinians look for survivors after an Israeli airstrike in Rafah refugee camp, southern Gaza Strip, on October 12 2023. Shutterstock: Anas Mohammed.
Further, when more relief teams finally enter Gaza, they could include humanitarians who have come virtually directly from other crises. With so many overlapping, complex and long-running emergencies – from Sudan, Ethiopia and the Democratic Republic of the Congo to Yemen and Syria, and of course other countries like Ukraine – it can be a challenge for agencies to find enough good staff who are available to respond. And, despite some growing recognition of the need to better support aid workers’ psychological well-being, they still often simply get on with the job, ignoring their own exhaustion or deteriorating mental health. As one aid worker friend described it, you’re told on airplanes that you should put your own mask on first, in an emergency. But humanitarians can be so focused on everyone else’s oxygen, they don’t realise their own has run out.
“[Humanitarians] are…a target as much as the populations we’re trying to serve.”
Next, there are few careers where you know you could be killed doing your job; aid work is one of them. At the very least, there are rules of war and laws and customs in place designed to offer some protection. According to International Humanitarian Law, humanitarian relief personnel must be “respected and protected”. Specific protection for United Nations personnel is also laid out in its own convention. Yet, at least 112 humanitarians have now been killed in Gaza. As one woman working in Gaza for Oxfam said, “[humanitarians] are…a target as much as the populations we’re trying to serve.”

A wreath in memory of UNRWA colleagues killed in the bombardment of Gaza. Photo: @UNRWA
Journalists who are not party to a conflict are also protected under international humanitarian law. In a heartbreaking live television cross, a journalist in Gaza, Salman al Bashir, broke down after his colleague, Mohammed Abu Hatab, was killed in an air strike on his home, along with ten family members. Al Bashir began removing his safety vest, marked ‘PRESS’, and his helmet, while the anchor in the studio cried. “We have no immunity at all – not for these [press] shields or these helmets,” he said, grief-stricken. “We are victims directly on live television. We wait our turn, one after the other.”
It’s agonising to see aid workers – and journalists – putting their lives on the line to do their jobs and to watch so many of them die. It’s also deeply unsettling to think that anything could erode the principle of protecting aid workers or normalise attacks on humanitarians.
As a humanitarian, you are already a “keeper of the world’s tragedies”. You can experience “activist fatigue…[and]…humanitarian depletion [as you] sit and watch the mess being made, over-and-over again.”
Finally, this crisis has exposed faultlines in the community that are deeper and closer to home than many of us thought and that feels ‘terrifying’, explains Lina AbiRafeh. As a humanitarian, you are already a “keeper of the world’s tragedies”, she says. You can experience “activist fatigue…[and]…humanitarian depletion [as you] sit and watch the mess being made, over-and-over again”. But the war in Gaza feels particularly bleak, she says, because it has been so polarising. “When did peace become controversial?” Lina asks. “When did any of those things become scandalous or dangerous or wrong or the subject of online bullying? I really don’t understand, I find the hostility around this terrifying.”

Distressed women and children during a bombardment of Gaza. Shutterstock: A-One Rawan.
“Inhale. This is too much to hold. Exhale. So, we hold it together.”
And so, my sadness has been set on fire and it burns my heart. I’ll let it; it’s not a fire I want to extinguish. Instead, I turn again to someone who is doing much better at finding the words needed right now: author Cole Arthur Riley, who runs the ‘Black Liturgies’ project, a ‘space that integrates spiritual practice with Black emotion’. In a recent Instagram post, she quoted the author James Baldwin, speaking about anger and despair. “I’ve been enraged by the world, but never despair,” he said. “I cannot afford despair…you can’t tell the children there is no hope.” Then Riley added the simple meditation, “Inhale. This is too much to hold. Exhale. So, we hold it together.”
Every day. Inhale. Exhale. Burn.

Smoke rises after Israeli air strikes in Rafah in the southern Gaza Strip, October 09, 2023. Shutterstock: Anas Mohammed.