How US aid cuts will lead to more refugee deaths

On the morning of 26 January, Donald Trump settled into his chair in the Oval Office, and with the flick of his pen, set off a chain reaction that could upend the lives of millions.

The executive order titled “Re-evaluating and Realigning United States Foreign Aid” paused all foreign assistance funded by the State Department, plunging critical humanitarian projects worldwide into financial limbo.

In the pursuit of his America first agenda, President Trump handed the reins of government to South African billionaire Elon Musk, who’s so-called “department of government efficiency” has been tasked with choosing which projects to axe.

With aid frozen and humanitarian projects facing cuts, nowhere is the fallout more immediate — or more devastating — than in war-torn nations like Syria and the Democratic Republic of the Congo (DRC), where millions of people are now teetering on the edge of catastrophe.

Humanitarian workers working in these countries told The i Paper that the dismantling of the United States Agency for International Development (USAid), will remove life-saving humanitarian aid – leading to more deaths among people already fleeing war.

A growing catastrophe in the DRC

The DRC – a country that shares a collective memory of ethnic cleansing after millions were killed in the 1990s – is once again experiencing violence.

In mid-January, fighting between Congolese security forces and the M23 armed rebel group led to the deaths of thousands in a matter of weeks. Rwandan-backed M23 seized control of Goma, a vital economic hub in eastern Congo, sending waves of terrified civilians fleeing south.

For those caught in the crossfire, medical aid and humanitarian relief had been waiting for them just south of Goma.

But Trump’s freeze on USAid funding has forced Doctors of the World, one of the few organisations providing essential healthcare in the region, to scale back it’s support.

“Congo is home to some of the most vulnerable people on the planet,” Simon Tyler, executive director at Doctors of the World UK, said.

“Only a few weeks ago, we launched an appeal on DRC operations. It had already deteriorated to the point where clinics are overflowing and support is necessary – and then this happens.”

“It’s a double hit, at a time when we need to scale up and have higher capacity and greater resources, the rug gets pulled from under you.”

Documents seen by The i Paper reveal the extent of the damage. More than 20,000 people will lose access to essential medication, at least 7,000 children under five will no longer be screened for severe acute malnutrition, and over 90,000 people will be cut off from sanitation services, raising the spectre of deadly waterborne diseases.

Displaced families crammed into makeshift camps with no international aid to rely on, the crisis is metastasizing into something far graver.

“People’s health is already deteriorating with a lack of safe drinking water, and the cuts add more stress to services,” Tyler said.

“In certain locations, we can bear witness that can detract from armed groups people acting with impunity and doing whatever they wish.

“There is a protective element to our work, and with less presence it means we can no longer advocate for people we support.”

Syrian refugees: Already with nothing

The Syrian refugee crisis is one of the world’s largest displacements of people, with over 14 million people forced to flee their homes since the 2011 civil war. People were forced out of their homes, where they flung off to the four corners of the world, with many arriving on the shores of Europe, and the UK by small boat.

In late 2024, the fall of Bashar al-Assad gave way to cautious optimism that refugees could return home. But with humanitarian aid cut, there are no services for returning refugees, meaning many have nothing to return to.

“The impact is heartbreaking,” says Ahmad Hallak, a Doctors of the World official in Syria.

“People can’t secure livelihood, they can’t even afford to buy bread or water, and how can they afford medicine from the private sector?

“The impact is really bad, especially as most families have no income and they rely on US aid.”

With much of Syria reduced to rubble after years of fighting, and unexploded munitions around each corner, the UN-supported White Helmets are struggling to continue clearing unexploded ordnance following the cuts – leaving major hazards that have already claimed hundreds of civilian lives.

Meanwhile, 16.7 million people required assistance in 2024 – the highest number since the civil war began – with aid groups already struggling to meet demand.

Twelve out of seventeen health centres run by Doctors of the World in northern Syria — a region devastated by war and a massive earthquake in 2023 — have also been forced to close.

For every month the funding freeze continues, an estimated 9,000 patients are deprived of the care they need, according to Doctors of the World.

The scramble for exemptions

Hallak said he found out the funding was cut after the USAid statement from Trump went viral on social media.

“The next day our HR department in Istanbul had to tell our staff to stay at home due to this statement,” he said.

Following international condemnation of the aid cut, Trump’s administration issued a limited waiver for “life-saving assistance” — including medical services, food, and shelter.

But for organisations like Doctors of the World, navigating the bureaucratic nightmare of securing exemptions means delays and uncertainty.

“Who do you even contact to raise an exemption?” asks Tyler. “Our contacts are gone, email addresses have vanished.”

As NGOs are scrambling to apply for new sources of funding, they warn that the delays are not just an administrative headache but a death sentence for those in need.

“Politics shouldn’t be entering the field of humanitarianism, but it is creeping in, more and more. Politicising humanitarian aid is just wrong.

“Hundreds of thousands have been affected. The reality is this will lead to more excess mortality – it will have this level of impact.”