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

0:01Israel pauses daytime fighting in Rafah as attacks intensify on the Lebanese border. Can a wider war with the Iranian-backed Hezbollah militia be avoided? I'm Michelle Martin. That's A. Martinez. And this is Up First from NPR News.

0:18Most 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. We don't have time for prolonged war. Why did some nations hold out and can anything be achieved without Russian input? And an NPR investigation finds 50 % of American military bases in the U.S. are located in 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. Stay with us. We've got all the news you need to start your day.

0:56This message comes from NPR sponsor Walmart. Did you know that Walmart is one of Fortune's 100 best companies to work for in 2025? It's no surprise. Walmart is investing$1 billion in training and development to help associates build lasting careers with or without a degree. In fact, 75 % of Walmart management started in hourly roles. With benefits like health care, paid parental leave, and tuition support, Walmart isn't just a place to work. It's a place to grow. Learn more at walmart.com slash spark. Israel's military announced Sunday will pause fighting during daytime hours along a route in southern Gaza.

1:39That's in order to help deliver a backlog of aid that's piled up at one of the few border 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. For more, we bring in NPR's Kat Lonsdorff in Tel Aviv. So Kat, this was announced yesterday, this daytime pause. Can you tell us more about it? Yeah, 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.

2:15to 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 Refa. So the Israeli military says this daily pause is meant to help with that.

2:45Okay, any sense of how it's gone so far? Well, it's still a bit too early to know. A spokesperson for the UN 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 Shulam 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 blame the UN and other aid groups for not doing their part.

3:22Daniel 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. You've also been keeping an eye on another possible war on Israel's border with Lebanon between Israel and the Iranian-backed militia Hezbollah.

3:55What have you been hearing about that? Well, it's been getting increasingly tense up there. 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.

4:26So it seems more and more of a real possibility that another war could start. And meanwhile, there's been a lot of Israelis who are not happy with Prime Minister Benjamin Netanyahu. How's that been playing out? Well, there have been huge protests across the country. 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 we're 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.

4:57More 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. That is NPR's Kat Lonsdorff in Tel Aviv. Kat, thank you very much. Thank you.

5:26Switzerland hosted a summit this weekend organized by Ukraine and intended to set the foundation for future peace negotiations. Envoys and leaders of more than 90 nations participated, and most signed a statement saying Ukraine's borders must be respected in any deal to end the war. But Russia wasn't invited, and one of its backers, China, declined to attend. 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? So, A, this summit was not supposed to be about negotiating peace because, as you said, Russia was not invited.

6:05But 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.

6:44Okay, so who did not sign this statement and why? Well, India, Mexico, South Africa and Saudi Arabia were among the nations that did not sign. These are countries that have maintained official neutrality during this war. Here's Saudi Foreign Minister Faisal bin Farhan al-Saud. Any credible process will need Russia's participation. We hope the outcomes of this summit reflect those aims. Ukraine's President Volodymyr Zelensky said Russia wasn't invited because it started this war and because its demands to end it are unreasonable. So what are those demands? Well, Russian President Vladimir Putin said Ukraine must give up not only the land that Russia currently occupies, but also land under Ukrainian control and that Ukraine must drop its NATO bid.

7:33U.S. National Security Advisor Jake Sullivan responded to Putin's demands at the summit. No responsible nation can say that is a reasonable basis for peace. It defies the U.N. charter. It defies basic morality. It defies basic common sense. Many Western leaders say you can't have peace until Putin is forced to see that the costs 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 on. Yeah, the war is well into its third year. Do Ukrainians have any hope the summit will end it soon? Well, you know, from what we've heard from reporting all over Ukraine, Ukrainians are tired and pessimistic.

8:14optimistic. We spoke to a soldier. His name is Serhi. 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.

8:27He 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. And we don't have time for prolonged work. Moving to peace means acting fast. Preparations will take months, not years. He says preparation for a second summit has already begun and that he's pushing to end a war that is threatening his country's very existence.

9:04That is NPR's Joanna Kakissis in Kyiv. Joanna, thank you. You're welcome.

9:17The United States military has its own health care system for troops and their families. But an NPR investigation found that 50 percent of U.S. military bases are located within what's called a federally designated health professional shortage area, basically a health care desert. NPR's Quill Lawrence joins us now to explain. So, Quill, how did you come to that conclusion and that stat, 50 percent? Well, so each year, the government identifies these areas nationwide where health care is 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.

9:54And 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. But these bases, I mean, they have military hospitals and clinics of their own, don't they? Yeah, some do. 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.

10:35Yeah, it's a chore. Yeah. 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. So what does the Pentagon say? The Defense Health Agency, DHA, sent us a statement. 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.

11:14And 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 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.

11:54Wow. What does this mean for the U.S. military, Quill? Yeah, well, the military needs a healthy force to fight wars and defend the country. 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, you know, 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.

12:28That's what we're going to try and report on next. All right, that's NPR's Quill Lawrence. Quill, thanks. Thank you, Egg.

12:37And that's up first for Monday, June 17th. I'm Amy Martinez. And I'm Michelle Martin. For your next Listen Try, Consider This from NPR. In 1999, the film Boys Don't Cry was a landmark in the representation of transgender people. At the time, trans people were rarely depicted on screen, and if they were, it usually wasn't positive. 25 years later, the film's writer and director reflects on the challenges of getting the film made and whether she would do things differently if she made it now. Listen to Consider This. Today's episode of Up First was edited by Hannah Block, Nick Spicer, Andrew Sussman, Mohamed Elbardisi, and Alice Wolfley.

13:11It was produced by Zia Butch, Christopher Thomas, and Taylor Haney. We get engineering support from Carly Strange, and our technical director is Zach Coleman. Join us again tomorrow.