JERUSALEM — The U.N. ambulance had just dropped off a patient in critical condition at a West Bank hospital and was headed back to a nearby refugee camp when it came under fire. One bullet narrowly missed the oxygen tank. A second came within inches of a nurse's head. A third entered the back of 43-year-old assistant Kamal Hamdan, piercing his aorta and killing him almost immediately.
"It was clearly gunfire from an Israeli position," Richard Cook, director of operations for the U.N. Relief Works Agency in the West Bank, said of the March 7 incident. "We had our flag lit with a floodlight; it was marked with a red cross and the U.N. emblem; we'd made several runs that day; and they knew we were in the area."
Arrests, deportations, visa and travel restrictions, checkpoint harassment, threats, injuries and deaths are among the impediments that humanitarian groups say they're facing at the hands of Israeli immigration and military authorities as they struggle to deliver food, medicine and humanitarian assistance to hundreds of thousands of Palestinians living in the West Bank and Gaza Strip.
"We in no way condone what is done from the other side with the suicide bombers and understand the Israeli need for security," Cook said. "If there's some sort of problem, show us the proof. But stop targeting our ambulances and stop killing our staff."
While international relief agencies voice some of the greatest frustration, Israeli groups aren't exempt. Add up the pieces, humanitarian groups say, and you have at best a loosely disciplined army with control problems, at worst a concerted campaign against anyone trying to assist Palestinians.
Israeli government and military officials strongly deny any discipline problems or any policy to hamper aid efforts, adding that any delays, gunfire or inconveniences are solely the result of real or perceived threats linked to their fight against Palestinian militias and suicide bombers.
"Every incident has a reason--either information of a roadside bomber, intelligence that a terrorist is going to come through or sometimes traffic, just like New York City," said Capt. Joseph Levy, military aid coordinator for the Gaza Strip. "We're doing everything to help humanitarian groups.... [But] it's a war zone. If you're going into an area with shooting, you take your chances."
Suzie Mordechay, a member of the Jerusalem-based Israeli Committee Against House Demolition, insists there is another reason for the difficulty aid groups face.
"The Israeli military doesn't want humanitarian workers in these areas because the army's doing a lot of things that violate international law and don't want it reported," she said. "They always give reasons, like the area's booby-trapped, blah, blah, blah, so they can't let ambulances in to help wounded people. But that's just an excuse to close things off to world scrutiny."
In addition to the aide killed in March, the U.N. agency says that a doctor, nurse and two ambulance drivers have been wounded while trying to deliver food and medicine--all but one wearing U.N. vests.
Save the Children USA coordinator Sarah Saleh said an Israeli soldier fired warning shots over her head--followed quickly by an offer to improve his aim.
"Soldiers seem to have a lot more impunity now to do what they wish," Saleh said.
According to Israel's Haaretz daily newspaper, about 200 people identifying themselves as humanitarian aid workers have been denied entry to Israel in the last few months, with about 50 others expelled.
Longtime foreign aid workers in the region also say they're coming under far greater scrutiny as once-routine visas are delayed, downgraded or denied.
Arguably more damaging to day-to-day operations, agencies say, are new restrictions placed on their Palestinian staff members. As checkpoints, tightened travel requirements and searches are stepped up against all Palestinians, staff members are unable to leave their homes or visit their Jerusalem headquarters, attend conferences or deliver humanitarian aid.
Most local employees have passed security checks for years to obtain their credentials, aid executives say. Many have worked at organizations for a decade or more and are well-known to the Israeli authorities.
The restrictions on movement are so onerous that many agencies say privately they're forced to turn a blind eye as their workers take risks, slipping across back roads themselves to save their jobs. "At what point do you fire someone who can't get into the office, adding injury to insult?" one senior aid official asked. "At other times, we've all had to resort to smuggling our staff in."
A few agencies have brought in foreign drivers and diplomatic vehicles to move across the barriers at enormous additional expense.
Aid agencies argue that their special status under the Geneva Convention and their rights outlined under numerous U.N. resolutions are routinely ignored under an overly broad definition of security.