Difficulties getting Israeli permission for foreign staff to work in Israel and the Palestinian territories are hampering efforts to get aid into war-shattered Gaza where civilians are facing imminent famine, according to U.N. data and aid workers.

Six aid workers from the U.N. and other groups interviewed by Reuters cited delays to visas as an example of red tape they say is thwarting aid to Gaza, nearly six months into Israel’s offensive against Hamas militants.

U.N. data shared with Reuters showed that 45 visa requests are pending, more than half of which have been on hold for over two months, and several stalled since at least November.

Israel’s Ministry of Foreign Affairs did not immediately respond to a request for comment. An Israeli official who asked for anonymity as the official was not authorised to speak publicly cited high demand as a challenge, and also raised question marks about some groups’ objectives, saying some aid workers “have designs that are not humanitarian”.