Updated at 12:11 p.m. ET

The United States has long boasted of giving more money to help the Palestinian people in recent decades, in development and humanitarian aid, than any other country has.

But not this year.

The Trump administration is withholding millions of dollars in aid for the Palestinians, even money that seeks to address a deepening humanitarian crisis in the Gaza Strip.

Food vouchers for needy families. Doctors sent to Gaza to perform complex surgeries. Money has run out for these projects and more, say U.S.-funded aid groups working in Gaza.

"Nothing is more frustrating as a humanitarian aid worker to see a crisis unfolding in front of you that you can't do anything about," said Hilary DuBose of Catholic Relief Services, an American group that runs aid projects in Gaza.

The United States has frozen most of the $251 million earmarked for the Palestinians this year, after the Palestinian Authority said it would boycott the Trump administration — and its Israeli-Palestinian peace efforts — because President Trump recognized the contested city of Jerusalem as Israel's capital. The administration hasn't said when it began the freeze, but U.S.-funded aid groups believe it began in January.

The U.S. has also withheld $300 million to the United Nations agency that cares for Palestinian refugees.

...peace treaty with Israel. We have taken Jerusalem, the toughest part of the negotiation, off the table, but Israel, for that, would have had to pay more. But with the Palestinians no longer willing to talk peace, why should we make any of these massive future payments to them? — Donald J. Trump (@realDonaldTrump) January 2, 2018

"We pay the Palestinians HUNDRED OF MILLIONS OF DOLLARS a year and get no appreciation or respect," Trump tweeted in January. "With the Palestinians no longer willing to talk peace, why should we make any of these massive future payments to them?

Top Trump administration officials have talked up America's years of assistance to Palestinians — even as the administration has taken steps to curtail its own contributions.

"The United States has given billions of dollars in aid to the Palestinians. We've done nothing but help," a senior administration official told NPR. The official spoke on condition of anonymity because of the sensitivity of the topic. "Anybody who thinks that the United States has to engender more goodwill with them after all this country has done for them is not necessarily looking at the full picture."

Under both the Obama and Trump administrations, the White House and Congress frequently held up and limited aid to the Palestinians to protest Palestinian actions deemed as undermining Israel. A new law passed by Congress forbids aid directly benefitting the Palestinian Authority government until it stops the practice of paying stipends to Palestinians in Israeli prison convicted for violence.

What money the U.S. has given to the Palestinians is but a small sliver of what it gives to its neighbor Israel. Israel has received more U.S. aid than any other country since World War II.

The U.S. quietly released funding a few weeks ago to the Palestinian Authority security forces. The money supports them working with Israel to maintain security in the West Bank, the State Department said.

Now the administration is deciding which other Palestinian aid projects it might unfreeze, based on whether the projects meet national security interests and policy goals and provide "value to U.S. taxpayers," a State Department official said, without specifying.

The deadline is approaching soon: Action must be taken before the fiscal year finishes at the end of next month and funding disappears for good.

The U.S. has asked other countries to step up their contributions to the Palestinians. Some have, pledging money to U.N. Relief and Works Agency, which handles programs serving Palestinian refugees. The U.K. recently announced it would double its aid to the West Bank and Gaza.

But aid agencies say they struggle to raise money to help Palestinians, with international donors spread thin combatting other crises in the region. These groups say the U.S. funding freeze means they must wind down programs developed with — and funded entirely by — the U.S. Agency for International Development, USAID.

Here's a quick glance at how the U.S. funding freeze is affecting Gaza.

Eye surgeries

At St. John Eye Hospital in Gaza, surgeons remove cataracts using state-of-the-art eye surgery equipment branded with a sticker that says, in Arabic, "From The American People." U.S. money bought the equipment and subsidized the surgeries for Palestinians who could not otherwise afford them, hospital administrators say.

"After the surgery she can see fingers!" said Abdel Rahman al-Hams about his mother Shafika, from the recovery room at St. John after cataract surgery.

International Medical Corps, a U.S.-funded aid group, says because of the funding freeze, by late August it will no longer be able to bring doctors to Gaza to perform complex eye surgeries. It will also not be able to continue training a local surgeon to operate on eyelids — training that is unavailable in Gaza. And it will no longer subsidize the surgeries.

Food for the needy

In Gaza, about half of the population lives under the poverty line. Catholic Relief Services says the U.S. funding freeze means it can no longer provide food vouchers to Palestinians like Manal Fasih.

She lists the food she used to buy with U.S.-funded vouchers: white cheese, yellow cheese, halva, spices, tomatoes, pasta, noodles, sugar, rice. "Everything we needed for the home they gave us. May God bless them," 51-year-old Fasih said.

She opens an empty jar in her kitchen: She's run out of za'atar, a local spice as basic as salt and pepper. She's run out of rice and oil and cheese. She begins to cry silently over the sink.

Fasih's husband, an unemployed fisherman named Fathi, thinks the U.S. is cutting aid to pressure Palestinians to get on board with the Trump administration's peace efforts with the Israelis. "This is humanitarian aid, for people who need it. It shouldn't have anything to do with politics," he said.

Job cuts

Almost half of Gaza's workforce is without jobs. Now without U.S. funds, some Gazans who work for aid projects are themselves out of a job.

Bassam Nasser, who runs the Catholic Relief Services' programs in Gaza, said he has had to lay off about half his staff over the last three months. Several of his offices are dark.

"It takes five minutes for a staff member to start crying," Nasser said. "The majority of the staff members will have serious financial problems as they get their termination letters."

Trump administration blames Hamas

After a recent wave of violence on the Gaza border, White House officials said it's impossible to make a lasting investment in Gaza because the militant group Hamas rules there.

"For far too long, Gaza has lurched from crisis to crisis, sustained by emergency appeals and one-time caravans of aid, without dealing with the root cause: Hamas leadership is holding the Palestinians of Gaza captive. This problem must be recognized and resolved or we will witness yet another disastrous cycle," White House senior adviser Jared Kushner and other top administration officials wrote last month in The Washington Post.

This week, 70 Democratic Congress members wrote to Secretary of State Mike Pompeo and National Security Adviser John Bolton requesting the administration immediately restore U.S. funding for humanitarian aid in Gaza, noting recent Israeli military officials' statements expressing concern about the effects of Gaza's humanitarian crisis on Israel's security.

"We all recognize the serious security and political challenges in Gaza. However, U.S. support for the basic human rights of Palestinians living in Gaza must not be conditioned on progress on those fronts," their letter said.

Dave Harden, the former director of USAID's West Bank and Gaza mission under the Obama administration, warns that shutting down U.S. aid projects could empower Hamas.

"I can tell you who will fill the vacuum: Hamas and Hezbollah and Iran and Islamic Jihad. And we will have ceded this space," said Harden, who is now the managing director of the Georgetown Strategy Group, a private consulting firm in Washington. "We will be continuing to devolve power from the business community and civil society and professional class to the most extreme elements."



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RACHEL MARTIN, HOST:

The U.S. government is a major aid donor to the Palestinians, but this year, the Trump administration has withheld millions of dollars even for projects to address a humanitarian crisis in Gaza. NPR's Daniel Estrin went to see what effect that's having on people there.

DANIEL ESTRIN, BYLINE: Here's one thing U.S. taxpayers have paid for in Gaza - eye surgeries. This state-of-the-art surgical equipment comes with a sticker that says in Arabic, from the American people. U.S. money subsidizes cataract surgeries so even poor Palestinians can get them. Abdel Rahman al Hams watches over his mom, Shafika, in the recovery room at St. John Eye Hospital in Gaza.

ABDEL RAHMAN AL HAMS: She says that she's feeling better now because she can see around. After the surgery, she count fingers.

ESTRIN: And she couldn't do that before the surgery?

HAMS: No.

ESTRIN: But money's nearly run out to send doctors to do eye surgeries and train local surgeons. That's because the Trump administration has frozen most of the $251 million earmarked for Palestinian aid projects this year. Aid agencies are cutting back. Hilary DuBose says her group, Catholic Relief Services, can't give any more food vouchers. Half of Gazans live under the poverty line.

HILARY DUBOSE: And nothing is more frustrating as a humanitarian aid worker to see a humanitarian crisis unfolding in front of you that you can't do anything about.

MANAL FASIH: (Speaking Arabic).

ESTRIN: Manal Fasih lists the food she used to get with U.S. funding.

FASIH: (Through interpreter) White cheese, yellow cheese, halva for the kids, spices, tomatoes, pasta, noodles, sugar, rice - everything we needed for the home, they gave us. May God bless them.

(CROSSTALK)

ESTRIN: She opens an empty jar in her kitchen. She's run out of za'atar, a local spice as basic as salt and pepper. She's run out of rice and oil and cheese. She begins to cry silently over the sink. She says she's sorry to bother me with her troubles. Her husband Fathi he thinks the U.S. is cutting aid to pressure Palestinians to get on board with the Trump administration's peace efforts with the Israelis.

FATHI: (Through interpreter) This is humanitarian aid for people who need it. It shouldn't have anything to do with politics.

ESTRIN: The U.S. says it's freezing aid to review if it's advancing U.S. policy goals. This came after the Palestinian Authority stopped dealing with the Trump administration because President Trump recognized Jerusalem as Israel's capital. U.S. ambassador to the United Nations, Nikki Haley, says the U.S. does want to help the Palestinians.

(SOUNDBITE OF ARCHIVED RECORDING)

NIKKI HALEY: But we're not fools. If we extend a hand in friendship and generosity, we do not expect our hand to be bitten.

ESTRIN: Gaza is in crisis. Almost half of the workforce is without jobs. Now, without U.S. funds, some Gazans who work for U.S. aid projects are themselves out of a job. Bassam Nasser is a Palestinian who runs the Catholic Relief Services' Programs in Gaza. He walks me through dark offices. He's given the pink slip to half his staff.

BASSAM NASSER: It takes five minutes for a staff member to start crying. The majority of the staff members will have serious financial problems as they receive the termination letters. We are very sad. We don't want this. We want to continue.

ESTRIN: After a recent wave of violence, Trump administration officials said it's impossible to make a lasting investment in Gaza because the militant group Hamas rules there. Dave Harden, who used to oversee U.S. aid to the Palestinians during the Obama administration, says shutting down U.S. aid projects could actually empower Hamas.

DAVE HARDEN: I can tell you who will fill the vacuum - Hamas and Hezbollah and Iran and Islamic Jihad. And we will have ceded this space.

ESTRIN: There is some money the U.S. recently released for Palestinians - money for Palestinian security forces to help Israel combat militants in the West Bank. Daniel Estrin, NPR News, Gaza.

(SOUNDBITE OF AES DANA'S "ANTHRAZIT") Transcript provided by NPR, Copyright NPR.