As doctors at the International Committee of the Red Cross-run field hospital in Rafah, Gaza, begin to ration resources, the organization finds itself in the crosshairs of American politics.
The Red Cross is lobbying Congress to maintain its funding levels in the next government spending bill. Roughly 25% of ICRC’s annual budget comes from the United States. But it’s facing an administration and Republican Party increasingly antagonistic toward foreign aid — and navigating a highly-charged geopolitical landscape in Gaza while maintaining neutrality.
Many Republican lawmakers told NOTUS they were in support of the Red Cross continuing to get funding through Congress, but included a caveat. They need to see outcomes: “What the American taxpayer gets out of it,” as Sen. Rick Scott said.
“I have a very good working relationship with the Red Cross. I think the Red Cross does a fabulous job,” Scott said. “I do believe that for every international organization, NGOs that work with the United States should show the return we get.”
ICRC points to the hospital — the closest field hospital to the now renewed fighting in the south — as one of those returns on investment. But its future is uncertain; the Red Cross estimates the hospital only has two months of medical supplies left amid Israel’s aid blockades and bombings.
“The hospital itself is a real tangible delivery on the ground,” said Marc Rivers, the ICRC’s Chief Financial Officer, who has been doing outreach to lawmakers. “The challenge, however, now is resupplying it. Being able to have access, that’s very much a problem right now.”
The vast majority of aid the organization receives — 93%, per the organization — goes directly to the ground, and the Red Cross has been involved in aiding the release of Americans being held hostage by Hamas. It’s been pitching its efforts to Republicans as a show of its neutrality in global conflicts.
“We have direct contact with so many, with all actors in a conflict,” Rivers said. “For us to be able to do what only we can do, this principle of neutrality is very important. That allows us to have access to all the actors.”
Rep. Brian Mast, the chair of the House Foreign Affairs Committee, confirmed that he met with ICRC last week and said there wasn’t “anything contentious” about the meeting, but he wasn’t completely sold on funding the organization either. He specifically wanted to know how the organization was serving Israelis and Americans being held hostage by Hamas.
“I think one of the things that I brought up specifically was about what visits had they had with American or Israelis held by Hamas,” Mast said. “It’s all got to be performance-based.”
This week, ICRC facilitated the return of Edan Alexander, the last known living American hostage held by Hamas. The U.S. negotiated directly with Hamas, with special envoy Steve Witkoff connecting with the group to negotiate Alexander’s release without the knowledge of the Israeli government.
ICRC headed south to receive Alexander from Hamas and bring him to facilities further north, reuniting him with his family. Transporting Alexander was the first time the ICRC was allowed access to see him and review his condition, something the organization requested for all the hostages at the start of the war to “ensure their well-being, facilitate communication with their families, and assess their conditions in accordance with international humanitarian law,” according to the organization’s website.
Mast said that facilitating the release of Alexander was an example of the types of “positive impact” he wanted to see out of organizations receiving U.S. funds. If their humanitarian work meant that they were “able to meet and not get a gun put in their face,” that was the type of thing he wanted to see and hear more about.
This added scrutiny on foreign aid in Congress is an extension of an administration that attempted to freeze foreign aid funds — a move that was ultimately struck down by the courts. How Congress navigates that going forward remains an open question.
Rep. Michael McCaul, the former chair of the House Foreign Affairs Committee, was adamant that while the State Department “can reorganize things,” it “can’t eliminate something that was created into law by Congress.”
Though McCaul acknowledged there has been some pullback on funding, he said it shouldn’t be for “meritorious programs” like ICRC.
“If it’s already authorized in the law, you know, Article 2 can’t eliminate that,” McCaul said. “That’s a responsibility under Article 1.”
Still, Trump has made foreign aid a hyper-political issue. And funding international aid organizations remains a point of division in the Republican Party. Funding, even for organizations like the Red Cross, is no longer a given.
“With $36 trillion in debt, I think our country is the country we should focus on,” Rep. Marjorie Taylor Greene said, reflecting a viewpoint that many of Trump’s staunchest allies in Congress have adopted. “I think we need to solve our problems here at home before we’re throwing money all over the world.”
“We will have the discussion,” Rep. Aaron Bean, one of the co-chairs of the DOGE Caucus, said. “Yes, we need to look at everything and listen. There’s going to be worthy things that rise that we should continue to fund. But, your priorities change.”He described the process more like reviewing the household checkbook and canceling things like “spending money at Blockbuster,” which would be outdated in today’s landscape.
“That’s what DOGE is going to do,” he said on foreign aid spending in general. “And some things we’ll say, ‘Yes, we want to continue doing that.’ Others we’ll say, ‘Ah, I think we need to do something different.’”
As of last Thursday, the ICRC’s field hospital in Rafah has been operational for one year. The hospital is a cooperation supported by the ICRC, 14 different national humanitarian societies, and the Gaza Ministry of Health. It was also established in coordination with and approved by Israel.
Now, resupply has become a serious issue with access to the facility being limited and restrictions on supplies coming in and out of the region.
“It was an interesting day, because we don’t want to celebrate,” Felicity Gapes, the deputy health coordinator for the ICRC in Gaza, told NOTUS. Over 80,000 people have come through the hospital facility in the past year, including 3,400 amputee patients, Gapes said. Forty-six percent of patients are women. Workers there have delivered over 400 babies.
ICRC anticipated the need for more emergency response resources ahead of time, so they stored a “buffer stock” that they’re now digging into.
“That’s what’s going to limit its ability to be effective, is its supply,” Rivers said. “If you have no medicines, then obviously there’s only so much you can do, beyond what just a volunteer can do.”
But if funding isn’t maintained in the next spending bill, problems for the Red Cross will only compound.
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John T. Seward is a NOTUS reporter and an Allbritton Journalism Institute fellow.