Israel-Lebanon Border Escalation, Ukraine Peace Summit, Military Healthcare Deserts

That's A. Martinez, and this is Up First from NPR News.

Most of the 90 countries at a Swiss summit trying to broker peace in Ukraine supported

the final declaration calling on Russia to withdraw from Ukrainian territories.

what's known as health care deserts.

That means one in three troops and their families live in areas where a private medical facility

is hard to find.

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rule.

If they gain more power, it could mean fewer rights for you.

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Israel's military announced Sunday it will pause fighting during daytime hours along

a route in southern Gaza.

crossings into Gaza, which has been the scene of an intense Israeli military campaign since

Hamas fighters based there attacked Israel last October.

The people trapped in Gaza are desperate for food, medical supplies, water, and fuel in

a worsening humanitarian crisis as the war enters its ninth month.

So, Kat, this was announced yesterday, this daytime pause.

Can you tell us more about it?

So, this is a pause in fighting applying to just around seven miles of road in the Rafah

area in the south from the hours of 8 a.m. to 7 p.m.

It's not an overall ceasefire, which is what many in the international community, including

the U.S., have been calling for.

The point is to allow for safe travel for aid trucks from the Krem Shalom crossing in

southern Israel.

That's the main entry point for aid now further into Gaza.

But for the past month or so, aid groups have been telling us that even if aid can get in

there, it has been extremely difficult for them to reach it, to be able to distribute

it, because there's been just so much fighting happening around that main road into Rafah.

So, the Israeli military says this daily pause is meant to help with that.

Any sense of how it's gone so far?

A spokesperson for the U.N. Agency for Palestinian Affairs told NPR this morning that, quote,

law and order and conditions on the ground didn't allow them to take advantage of the

pause yesterday.

He said the environment on that stretch of road is still extremely complex.

You know, aid groups have told us that trucks have been being looted there.

Our colleague, Daniel Estrin, is down at the Krem Shalom crossing on the Israeli side on

a press tour with the Israeli military right now.

He says that the Israeli military told reporters that more than a thousand trucks worth of

aid are waiting at the border, but blamed the U.N. and other aid groups for not doing

their part.

You know, Daniel asked how the Israeli military would protect aid trucks into Gaza, and the

spokesperson didn't really elaborate.

For Palestinians in Gaza, everything, as far as we can tell, is still just as difficult

as it has been.

Yesterday was the first day of the Muslim holiday Eid al-Adha.

It's a holiday of feasting, traditionally marked by the sacrifice of a sheep or a goat.

But our producer in Gaza, Anas Baba, told us that it's nearly impossible to find meat

there.

Instead, he managed to find some canned fava beans to mark the holiday.

between Israel and the Iranian-backed militia Hezbollah.

What have you been hearing about that?

Last week, we saw the highest exchange of fire between the two sides since they started

this kind of low-grade war last October.

Hezbollah pounded northern Israel with more than 200 rockets in just one day last week.

Israel's military spokesperson warned late yesterday night of a greater escalation.

He said it could, quote, have devastating consequences for Lebanon and the entire region.

And Israeli officials have been very clear that they are prepped and ready for another

offensive and that they will not tolerate these attacks by Hezbollah much longer.

So it seems more and more of a real possibility that another war could start.

Netanyahu.

How's that been playing out?

This weekend here in Tel Aviv was one of the largest since the war in Gaza started in October.

People are calling for the government here to get the remaining 120 hostages home from

Gaza and more broadly calling for new elections here in the fall.

Many feel that as long as Netanyahu is in charge, the war in Gaza will continue.

And Israel is suffering losses in Gaza.

More than 300 soldiers have been killed since late October and eight Israeli soldiers died

in Gaza on just Saturday alone.

It's the highest number in many months.

So the cost of this war is weighing heavily on many Israelis, especially with another

possible war looming.

Kat, thank you very much.

for future peace negotiations.

Ukraine's borders must be respected in any deal to end the war.

Joining us now to discuss this is NPR's Ukraine correspondent, Joanna Kakissis, who is in

Kyiv.

Joanna, since Russia was not there, I mean, how does this summit get any closer to a peaceful

resolution of this war?

Russia was not invited.

But what this gathering tried to do instead is try to build solidarity among participating

nations to support Ukraine's vision of peace.

Ukraine needs as many nations as possible to support its conditions for any future peace

talks as leverage against Russia.

These conditions include issues of global concern, such as food security and nuclear

safety, as well as the return of thousands of deported Ukrainian children and prisoners

of war.

Ukraine also insists that Russian troops must withdraw from all Ukrainian land.

Eighty of the 92 nations participating in the summit signed a communique supporting

this.

sign.

These are countries that have maintained official neutrality during this war.

Here's Saudi Foreign Minister Faisal bin Farhan al-Saud.

We hope the outcomes of this summit reflect those aims.

war and because its demands to end it are unreasonable.

Russia currently occupies, but also land under Ukrainian control and that Ukraine must drop

its NATO bid.

U.S. National Security Advisor Jake Sullivan responded to Putin's demands at the summit.

It defies basic common sense.

of Russia's war on Ukraine outweigh its benefits.

And right now, the war has many benefits for the Kremlin, especially the longer it drags

Yeah, the war is well into its third year.

Do Ukrainians have any hope the summit will end it soon?

tired and pessimistic.

We spoke to a soldier.

His name is Serhii.

He declined to give his last name for security reasons.

But he said he didn't see how the summit would help end the war quickly.

He told us that the longer the war goes on, the more hopeless soldiers and the rest of

society feel.

He says his fellow soldiers are exhausted by long deployments and are losing the energy

to fight a war with no end in sight.

And during his closing remarks at the summit, President Zelensky made it clear that he knows

the clock is ticking.

what's called a federally designated health professional shortage area, basically a health

care desert.

So Quill, how did you come to that conclusion and that stat, 50 percent?

really hard to find.

And along with NPR's Brent Jones, we mapped these so-called health care deserts for primary

care, mental health care and maternity care.

And we put that map on top of a map of all the U.S. military bases.

And we found that half of the Army, Navy, Air Force and Marine camps, forts, bases listed

on that are in at least one of those health care deserts.

Some are in all three.

And you can look at that map at NPR.org.

They're very expensive.

In the past decade, the Pentagon has really tried to cut those costs and downsize its

medical care.

And part of that, what they did was outsource it to private civilian care.

But I don't know if you've tried to get a new doctor lately.

Yeah.

It's not easy because there's no slack in the civilian health care system.

And that's what the Pentagon has discovered.

So in half of these bases and population-wise, that came out to one in three troops and their

families outside their base, there is a health care desert.

Wow.

They said that when care is not available, they try other methods like telehealth or

they'll bring traveling providers or they'll pay for patients to travel either to other

military or civilian care.

But an internal memo that NPR obtained has shown that the Pentagon knows that the downsizing

has gone too far and it didn't actually save them money.

And they think they need to reverse course, hire more clinicians.

That's going to take a lot of time.

And one of the big issues is TRICARE, which is the insurance that military families and

retirees use when they pay for civilian care.

It pays at the same as Medicare rates.

So a lot of doctors and hospitals are reluctant to take them.

And I've heard this from dozens of military families and retirees nationwide.

One crazy example, I talked with a military wife up at Fort Drum in upstate New York or

along the Canadian border.

And I thought I was going to go have to interview her up there, but I didn't because she drove

seven hours down here to New York City, which was the only place she could find a specialist

to get her daughter treated.

What does this mean for the U.S. military?

And they also need to be keeping enough doctors and nurses and medics trained up in case of

a war.

But right now they're in a recruitment slump.

So if you plan on having a family, this might really discourage you from joining or staying

in the military if you're going to be ordered to go live in one of those health care deserts.

The VA has been combining with some military facilities.

There's some civilian military partnerships as a possible solution.

That's what we're going to try and report on next.

All right.

Quill, thanks.

Emmy Martinez.

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