Boxes of Gaza-bound aid turned back by Israel on Sunday languished atop a truck and flatbed trailer parked metres from its border with Egypt, as exasperated drivers and UN officials criticised delays in sending food and medicine to the enclave.

Seven aid officials and three truckers interviewed by Reuters listed a host of obstacles, ranging from rejections of shipments for minor packing and paperwork issues to heavy scrutiny over possible dual military use for a range of goods, as well as short working hours at the Israeli border crossing.

The supplies seen by Reuters on Monday on the stalled truck and trailer outside Egypt’s Rafah border crossing carried blue logos of the World Health Organisation and labels describing contents like topical medications and suction devices to clean wounds.

A WHO employee working at the border said the cargo was blocked for carrying “illegal medicines”. Reuters could not independently verify why the trucks were not allowed to enter Gaza and the Israeli military authority in charge of coordinating aid did not respond to a question about why they were not let into the enclave.

Reuters visited Egypt’s border with Gaza on Monday on a trip organised by the Elders, a group of former world leaders set up by late South African President Nelson Mandela that backs a two-state solution to the Israeli-Palestinian conflict.

Some Elders members have been highly critical of Israel’s conduct in Gaza, including former Irish President Mary Robinson and former New Zealand Prime Minister Helen Clark, who joined the border trip.

Responding to international outrage sparked by images of starving Gazans, Israel on July 27 announced measures to let more aid into Gaza. But aid agencies say only a fraction of what they send is getting in. Israel strongly denies limiting aid supplies.

Speaking to reporters at the Rafah crossing, Clark expressed shock at the amount of aid turned back at the border.

“To see this crossing, which should be a place where people interact with each other, where people can come and go, where people aren’t under blockade, where people who are ill can leave to come out – to see it just silent for the people, it’s absolutely shocking for us,” Clark said.

‘BUREAUCRATIC HURDLES, DELAYS’

Approvals and clearance procedures that got a shipment through the Rafah border crossing “within a few days” of arrival in Egypt during a ceasefire earlier in the war now took “minimum one month,” according to the WHO employee at the border.

On Monday, the Hamas-run Gaza government media office said at least 1,334 trucks had entered Gaza through all land crossings, including from Egypt, since the Israeli measures announced on July 27, but this was far short of the 9,000 that would have gone in if 600 trucks had entered per day. The United States has said a minimum of 600 trucks per day are needed to feed Gaza’s population.

Reuters could not independently confirm the reasons for the delays described in this article or the specific figures supplied by those interviewed.

Asked for its response to allegations of curbs on aid flows, the Israeli military agency that coordinates aid, COGAT, said Israel invests “considerable efforts” in aid distribution. It said about 300 trucks had been transferred daily in “recent weeks,” mostly carrying food, via all land crossings.

“Despite the claims made, the State of Israel allows and facilitates the provision of humanitarian assistance to the Gaza Strip without any quantitative limit on the number of aid trucks entering the Gaza Strip,” COGAT said. The agency did not address specific questions about aid shipment volumes.

In mid-July, Israel introduced a requirement that shipments of humanitarian aid arriving from Egypt undergo customs clearance. According to the UN Office for the Coordination of Humanitarian Affairs, Israel’s move led to “additional bureaucratic hurdles, delays, and costs for humanitarian organisations.”

UN agencies were exempted from customs clearance from Egypt from July 27 to Aug. 3, OCHA said in a report on August 6. While not officially extended, the exemption still appeared to be in place, it said. Other international NGOs could be exempted only on a case-by-case basis and only for health items.

More than 200 Gazans have died of malnutrition or starvation in the war, according to Palestinian health authorities, adding to the over 61,000 dead they say have been killed by military action. The UN human rights office and several expert studies have said the number is probably an undercount.

Israel has disputed the Gaza health ministry figures, which do not distinguish between fighters and civilians, and says at least a third of the fatalities are militants. On Monday, COGAT said a review by its medical experts found the number of deaths reported by the Gaza health ministry due to malnutrition was inflated and most of those “allegedly dying from malnutrition” had pre-existing conditions.

A WAREHOUSE OF REJECTED GOODS

Drivers coming from Egypt cannot go directly to the Gaza side of the Rafah crossing, which had been operated by the Hamas-run border authority but is now closed. Instead, they route to the Israeli crossing of Kerem Shalom, about three km (two miles) to the south, where shipments undergo checks.

Kamel Atteiya Mohamed, an Egyptian truck driver, estimated that of the 200 or 300 trucks trying to get through this route every day, only 30 to 50 make it.

“They tell you, for example, that the pallet doesn’t have a sticker, the pallet is tilted, or the pallet is open from the top. This is no reason for us to return it,” he told Reuters.

He said that while the Egyptian crossing was open day and night, drivers often arrived at Kerem Shalom only to find it closed, as it does not normally operate beyond weekday business hours.

“Every day it’s like this,” he said. “Honestly, we’re fed up.”

While COGAT did not address specific questions about the driver’s remarks and allegations of inflexible working hours, it said that “hundreds of truckloads of aid still await collection by the UN and international organizations” on the Palestinian side of the border crossings.

A logistics site set up by the Egyptian Red Crescent near El Arish town, 40 km (25 miles) from the border, where shipments coming from Egypt to Gaza are loaded, has a tarp tent warehouse devoted to goods turned back from the border.

A Reuters reporter saw rows of white oxygen tanks, as well as wheelchairs, car tires and cartons labelled as containing generators and first-aid kits and with logos of aid groups from countries such as Luxembourg and Kuwait, among others.

Reuters was not able to verify when the items at the Red Crescent site were turned back or on what grounds. Aid workers describe such rejections as routine.

Speaking at the meeting with the Elders that Reuters attended, one World Food Programme worker said that only 73 of the 400 trucks the agency had sent since July 27 had made it in.

UN Palestinian refugee agency UNRWA has not been allowed to send aid into Gaza since March. The OCHA August 6 report said no shelter materials had been allowed to enter Gaza since March 2 and those available on the local market were “prohibitively expensive and limited in quantity.”

The WHO employee who works on the border said the truck and trailer seen by Reuters were among three trucks that had been turned back on Sunday. A manifest given for their cargo, seen by Reuters, included urine drainage bags, iodine, plasters and sutures.