In famine-stricken Sudan, soup kitchens that feed hundreds of thousands of civilians trapped in a war zone have shut down.
In Thailand, war refugees with life-threatening diseases have been turned away by hospitals and carted off on makeshift stretchers.
In Ukraine, residents on the frontline of the war with Russia may be going without firewood in the middle of winter.
Some of the world’s most vulnerable populations are already feeling President Trump’s sudden cutoff of billions of dollars in American aid that helps fend off starvation, treats diseases and provides shelter for the displaced.
In a matter of days, Mr. Trump’s order to freeze nearly all U.S. foreign aid has intensified humanitarian crises and raised profound questions about America’s reliability and global standing.
“Everyone is freaking out,” Atif Mukhtar of the Emergency Response Rooms, a local volunteer group in the besieged Sudanese capital, Khartoum, said of the aid freeze.
Soon after announcing the cut off, the Trump administration abruptly switched gears. Secretary of State Marco Rubio said this week that “life-saving humanitarian assistance” could continue, offering a respite for what he called “core” efforts to provide food, medicine, shelter and other emergency needs.
But he stressed that the reprieve was “temporary in nature,” with limited exceptions. Beyond that, hundreds of senior officials and workers who help distribute American aid had already been fired or put on leave, and many aid efforts remain paralyzed around the world.
Most of the soup kitchens in Khartoum, the battle-torn capital of Sudan, have shut down. Until last week, the United States was the largest source of money for the volunteer-run kitchens that fed 816,000 people there.
“For most people, it’s the only meal they get,” said Hajooj Kuka, a spokesman for the Emergency Response Rooms, describing Khartoum as a city “on the edge of starvation.”
After the American money was frozen last week, some of the aid groups that channel those funds to the food kitchens said they were unsure if they were allowed to continue. Others cut off the money completely. Now, 434 of the 634 volunteer kitchens in the capital have shut down, Mr. Kuka said.
“And more are going out of service every day,” he added.
Many of the aid workers, doctors and people in need who rely on American aid are now reckoning with their relationship with the United States and the message the Trump administration is sending: America is focusing on itself.
“It feels like one easy decision by the U.S. president is quietly killing so many lives,” said Saw Nah Pha, a tuberculosis patient who said he was told to leave a U.S.-funded hospital in the Mae La refugee camp, the largest refugee camp on the Thai-Myanmar border.
Mr. Nah Pha, who fled Myanmar in 2007 to escape the fighting there, said the staff gave him a week’s supply of medicine and told him that was all they could provide. “Once my medicine runs out, I have nowhere else to get it,” he added.
The public health implications of the aid freeze are broad, health workers say. In Cambodia, which had been on the cusp of eradicating malaria with the help of the United States, officials now worry that a halt in funding will set them back. In Nepal, a $72 million program to reduce malnutrition has been suspended. In South Africa and Haiti, officials and aid workers worry that hundreds of thousands of people could die if the Trump administration withdraws support for a signature American program to fight H.I.V. and AIDS.
Some programs that don’t fit the category of lifesaving aid remain frozen, while others are explicitly barred because they fall outside of the administration’s ideological bounds, including any help with abortions, gender or diversity issues.
The United Nations Population Fund, the U.N.’s sexual and reproductive health agency, said that because of the funding freeze, maternal and mental health services to millions of women in Afghanistan, Pakistan, Gaza, Ukraine, and other places had been disrupted or eliminated. In Afghanistan, where the Taliban has banned women from working, 1,700 Afghan women who worked for the agency would no longer be employed.
At stake is not just the good will that the United States has built internationally, but also its work to promote America’s security interests. In Ivory Coast, an American-sponsored program collecting sensitive intelligence on Al Qaeda-related incidents has been interrupted.
In the Democratic Republic of Congo, some of the funding to United Nations agencies supporting more than 4.5 million people displaced by a rapidly growing conflict in the country’s east has been frozen, according to a U.S. humanitarian official on the continent.
Even with Mr. Rubio’s announcements that lifesaving efforts could resume, much of the American aid system in Africa remained paralyzed by the confusion and disruptions, including in conflict-hit areas where every day counts.
“When they issue these broad orders, they don’t seem to understand what exactly they are turning off,” said Jeremy Konyndyk, a former senior U.S.A.I.D. official under the Biden administration who is now the president of Refugees International. “They’re pulling levers without knowing what’s on the other end.”
Some of the roughly $70 billion in annual foreign aid approved by Congress has been directed at supporting civil society in countries with authoritarian regimes, especially in places where the United States sees democratic gains as furthering American security or diplomatic interests.
In Iran, where the work of documenting detentions, executions and women’s rights abuses is done by outside entities funded by the United States, activists say the U.S. pullback now means that there will be few entities holding the Iranian government accountable.
A Persian-language media outlet funded by the U.S. government said their employees were working on a voluntary basis to keep the website going for now, but they had fired all their freelancers. Without money, they said they could not keep going.
“While Trump campaigned on a promise of maximum pressure on the Iranian government, his decision to cut funding for dozens of U.S.-supported pro-democracy and human rights initiatives does the opposite — it applies maximum pressure on the regime’s opponents,” said Omid Memarian, an expert on Iran’s human rights issues at DAWN, a Washington-based group focused on American foreign policy.
In Cambodia, Pa Tongchen, 25, was relying on American funding for journalism in a country where nearly all independent media has been crushed. He was scheduled to start work on Feb. 3 as a staff reporter at a media outlet run by a nonprofit that was set up with U.S. support.
Mr. Pa said he had hoped to shine a light on corruption through his work. “I want to help people who are vulnerable in our society,” he said. “They are ignored if no journalists report about them.”
In Egypt, where the United States funds scholarships for more than 1,000 undergraduate students at private and public universities, students were left in limbo.
“I was in real shock, and I didn’t know what to do, especially since they told us to leave the dorm immediately,” said Ahmed Mahmoud, 18, a student who was about to start classes next semester at the American University but instead had to throw all his belongings into five boxes.
The fallout from the aid freeze is likely to reverberate geopolitically, giving American rivals, like China, a window of opportunity to present itself as a reliable partner.
“That will set China apart from the U.S. to win the hearts and minds of many of the global south countries,” said Jingdong Yuan, director of the Stockholm International Peace Research Institute’s China and Asia Security program.
In Africa, America’s well-run aid machinery was one of the factors that differentiated the United States from China and Russia. While Moscow deploys mercenaries and Beijing mines for rare minerals, Washington has reached across the continent with aid programs worth billions of dollars that not only save lives, but also provide a powerful form of diplomatic soft power.
Now much of that is in doubt. In Africa’s war zones, some are already regretful of their dependence on American aid.
“It was our fault to rely so heavily on one donor,” said Mr. Atif, of the Emergency Response Rooms in Sudan. “But this has really shocked us. You can’t take food off people who are starving. That’s just insane.”
On the border of Thailand and Myanmar, the implications of Mr. Trump’s decision were stark. There, a four-year civil war and decades of fighting between Myanmar’s military junta and ethnic armies have pushed thousands of refugees into Thailand.
Saw Tha Ker, the camp leader for the Mae La camp, said he was told on Friday by the International Rescue Committee, a group that receives U.S. funding, that it would stop supporting medical care, water and waste management for all of the seven refugee hospitals managed by his camp.
“The first thought that came to my mind was that whoever made this decision has no compassion at all,” said Mr. Tha Ker.
Mr. Tha Ker said he and his staff had to tell 60 patients in one hospital that they had to go home. Videos posted on social media showed men carrying patients on makeshift stretchers through unpaved streets.
“We explained to them that the hospital itself is like a person struggling to breathe through someone else’s nose,” he added. “Now that the support has stopped, it feels like we are just waiting for the end.”
Reporting was contributed by Mujib Mashal in New Delhi, Pamodi Waravita in Colombo, Bhadra Sharma from Kathmandu, Elian Peltier in Dakar, Vivian Yee and Rania Khaled in Cairo, Daniel Politi in Buenos Aires, David C. Adams in Florida, Leily Nikounazar in Brussels and Sun Narin in Phnom Penh.
