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On today's episode of The Excerpt podcast: Hamas and Israel appear open to a truce extension. USA TODAY National Correspondent Chris Kenning talks about the struggles of aid workers in Gaza. Authorities are looking into a possible hate crime after threecollege students of Palestinian descent were shot in Vermont. Fights over the IRS and border security are stalling wartime aid to Israel and Ukraine. USA TODAY Health Reporter Karen Weintraub discusses the future of bespoke medical therapies.

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Hit play on the player above to hear the podcast and follow along with the transcript below. This transcript was automatically generated, and then edited for clarity in its current form. There may be some differences between the audio and the text.

Taylor Wilson:

Good morning. I'm Taylor Wilson, and today is Monday, November 27th, 2023. This is the Excerpt.

Today, leaders say they're open to extending the ceasefire in the Israel-Hamas war. Plus, the FBI is investigating weekend shootings of young Palestinian men in Vermont as a possible hate crime. We look at the future of bespoke therapies in medicine.

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We have several stories this Monday morning related to the Israel-Hamas war, where a ceasefire continues today. 17 more hostages, including an American child, were freed by Hamas yesterday. That now brings the total to 62 of the 240 hostages captured by Hamas last month who have been freed during the pause. The hostages being released are women and children. Israel's prison service said it had begun releasing 39 Palestinians facing or convicted of terror-related charges. They are also all women and children.

Hamas leaders yesterday announced an effort to extend the ceasefire that's still set to expire after today. They said that would include the release of more Palestinians held in Israel and more hostages held by militants. The Israeli Army's chief spokesman said Israel was open to extending the truce if more hostages were released.

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Amid the truce deal, there have been increased shipments of fuel and supplies into Gaza. The UN said 61 trucks delivered aid into Northern Gaza on Saturday, according to a CNN report. But aid groups say it's not nearly enough for the needs of the 2.3 million Palestinians in a territory where the UN says 45% of housing is now too destroyed to be lived in. Still, aid workers, both Gazans and those from abroad are doing their best to help a traumatized population. I spoke with USA Today national correspondent Chris Kenning about their work and well-being. Chris, thanks for hopping on The Excerpt today.

Chris Kenning:

Thanks for having me.

Taylor Wilson:

Chris, let's just start here. How much aid has actually gotten into Gaza during the war's first few weeks, and just how badly has it been needed?

Chris Kenning:

Gaza is a place that has for years been dependent on humanitarian aid even before the war. More than half of its 2.2 million residents depended on international assistance for basic services. Before the conflict started, about 500 trucks of food and goods were coming into Gaza every day. The war obviously disrupted that. For example, between October 21st and November 20th, you were seeing about an average of about 40 trucks a day. Some aid was getting in, but very little. Way too little, according to aid groups. They were also struggling to get it distributed because of the lack of fuel and the fighting.

According to the UN, more than 1.5 million Gazans are displaced. 18 hospitals shut down. Across Gaza, but particularly in the north, food and water supplies are running very, very low. The lack of fuel also means communications and essential services like water desalination plants are failing. The larger aid groups are doing what they can. They're sheltering civilians in UN schools. They're trying to evacuate patients from hospitals and distributing what they can get in, trying to keep clean water flowing where they can. But the fighting and the shelling has really stymied much of their work.

Taylor Wilson:

Yeah. Chris, you spoke with one American aid worker who was stationed in Gaza, Emily Callahan. What was her experience like, especially in the first few weeks of this war?

Chris Kenning:

Emily is a Connecticut emergency room nurse who works with Doctors Without Borders. She and a team from this group were signed to the Indonesian Hospital, as it's known, just about three miles from the border with Southern Israel. They had a mission to help with limb reconstruction surgeries and improve their ER there, which was overcrowded. On October 7th, when the war began, she was right next to another hospital where she was staying. She heard the rockets flying and very quickly the retaliation came from Israel. They had to move several different times to avoid the fighting. She wound up at a UN facility that was housing tens of thousands of displaced Palestinians. She described the scenes that she saw around her: grief, anger, desperation. She said a woman tried to give her a child to take out of Gaza, which, of course, she couldn't do. She worked with local colleagues with Doctors without Borders, who had lost relatives/who had lost homes. It was pretty tough. She eventually was able to evacuate through the Rafah gate. But unfortunately, her Palestinian colleagues weren't able to do that.

Taylor Wilson:

What is Emily hearing now about the aid workers still in Gaza? What's it like there for them?

Chris Kenning:

There's more than 15,000 Palestinians who work for some of these international groups. They're facing some of the same dangers that the rest of the population is. In fact, more than a hundred UN aid workers have been killed since the beginning of the conflict, which is, they said, the deadliest conflict yet for their staff. A lot of them are finding themselves in the position of needing the help that they would normally provide to others. People with different aid groups told me that they're shellshocked. Many have lost family members, friends, relatives, property. They're struggling to get medical care and water and all those things. Emily's colleagues with Doctors Without Borders, which she grew really close to during her time working there... They were logistics managers or drivers had other roles. They're scattered. They're struggling as well. Some ended up trapped inside a guest house, recently trapped by combat nearby.

Taylor Wilson:

Chris, a temporary ceasefire has begun in this conflict. What do aid organizations say about this and what it might or might not allow when it comes to aid in the coming days?

Chris Kenning:

Generally, what they said was it's not going to be enough. It's going to be a drop in the ocean, as one man described it. This agreement to release hostages and have a temporary pause in the fighting. It's unclear exactly how long it's going to last. One of the issues is that some of these aid groups said there's challenges to getting aid through a single entry point. There's only one entry point that they can get it through. There's also a lack of fuel to distribute the aid once it's into Gaza to get it to the various locations that they need. I think, from their perspective, any humanitarian aid is helpful. But they don't see it as being nearly enough.

Taylor Wilson:

Chris Kenning is a national correspondent for USA Today. Powerful story, Chris. Thanks so much for coming on and talking about it.

Chris Kenning:

Thank you.

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Taylor Wilson:

Stateside, the FBI is investigating the shootings of three young men of Palestinian descent who were injured near the University of Vermont while visiting for a Thanksgiving holiday gathering on Saturday. Authorities said they're searching for the suspect and that the incident might've been a hate crime. The police chief of Burlington, Vermont, Jon Murad, said in a news release yesterday, "In this charged moment, no one can look at this incident and not suspect that it may have been a hate-motivated crime."

Two of the victims are in stable condition, while another sustained more serious injuries, according to police. The three 20-year-old college students were visiting one of the victim's relatives when they were approached by a white man with a handgun. Police say that at the time of the assault, two of the victims were wearing keffiyehs, traditional Palestinian scarves.

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Congress is aiming to pass a foreign aid package by the end of the year to bring what some lawmakers say is critical assistance for allies, including Israel and Ukraine. But how members craft a bipartisan deal with three weeks left on the legislative calendar is an open question. A bipartisan Israel-only aid bill is at a standstill, in part because House Republicans included an offset provision that would pay for the assistance through cuts to the IRS, something Democrats balked at. Democrats have had their own clashes over aid to Israel as progressive lawmakers call for Israel to reduce civilian deaths in its bombarding campaign of Gaza.

On aid to Ukraine, support is dwindling among a segment of Republicans. But three GOP senators earlier this month released a proposal tying demands related to immigration and the border in exchange for their support of a new Ukraine funding request from President Joe Biden. Senate Democrats have rejected that border proposal, but there is bipartisan appetite for a deal that would tie border measures to Ukraine aid. You can read more with the link in today's show notes.

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A lifesaving treatment was designed for one specific patient, and so-called bespoke therapies might just be the future of medical care. I spoke with USA Today health reporter Karen Weintraub to learn more. Karen, thanks for making the time.

Karen Weintraub:

No problem. Thanks for having me.

Taylor Wilson:

Can you just start by telling us a bit about Susannah Rosen's story?

Karen Weintraub:

Yeah. Susanna was diagnosed with a genetic mutation that causes neurodegeneration. Her nerves are dying essentially, and so will she without some viable treatment. Basically, she seemed normal and healthy at birth and was progressively getting worse at age six/seven, was losing her ability to walk, to see, to communicate with the world. Then, she got offered this experimental therapy that she has been on for the last year. She's now age nine.

Taylor Wilson:

Yeah. What has this therapy done for her, Karen?

Karen Weintraub:

The therapy, which was designed specifically for her, nobody else in the world, has stopped the progression of her disease seemingly and also has helped seemingly reverse some of the symptoms. She's been walking again with a little bit of help, but she's been able to get up from the floor by herself. She's got more energy. She doesn't seem to be having seizures at night anymore. She can sleep much better. She's got more energy to make it through a school day. Her therapy and her schooling is helping her more than it was before. The transition/the change has been really tremendous and noticeable for the family.

Taylor Wilson:

Karen, what other bespoke therapies have we seen pop-up in recent years thanks to medical advances?

Karen Weintraub:

We've all heard about these mRNA vaccines that most of us got during COVID. The same technology is being used for cancer treatment, and because everybody's tumor is different, everybody's cancer vaccine has to be different. They're now designing individualized, personalized cancer vaccines. There are also some possibility for gene therapies to be individualized. They're now developed for rare diseases, even ultra-rare diseases. But in a few cases, they're being developed even for single individuals.

Taylor Wilson:

Broadly speaking, what are some of the major challenges to bespoke therapies on the whole?

Karen Weintraub:

Well, cost is a huge issue. These therapies can be extremely expensive to make and to produce, to find/to come up with a system to make them more systematically, which would help reduce the cost. Delivering them is a challenge: getting them to the right place, to the right nerves, or the right muscles, or wherever they need to go. Also, a lot of these diseases we can say, "Oh, rare disease. Let's just cure them or treat them." They're all very, very different. Even the mutation that Susanna has is different in other people with a mutation in the same gene. The variations just make it incredibly difficult to come up with therapies that will be targeted enough to make a difference.

Then, safety is always an issue. In some people, these treatments, like Susanna, seem to be working really well. In others, there have been problems. Right now is a scary trial and error period where they're trying to work out for whom these therapies work and are safe and for whom they're not.

Taylor Wilson:

The man who helped Susanna, Stanley Crook, has started a non-profit aimed at other bespoke therapies. What's the latest from this organization? Can non-profits like this offer a solution going forward for these types of therapies?

Karen Weintraub:

His organization is called n-Lorem Foundation, and he is a leader in this field because he helped develop the technology. He really helped create this field. Right now, he's helped six people with very rare diseases. He's hoping to work up. There are 230 applications pending. He's hoping to work up eventually to thousands. But there are probably millions of people with these conditions. The scale-up is really a major challenge here. It's going to take years, if not decades, to get to the point where people could be routinely treated. There are a lot of people working on this, but it can't happen fast enough for the patients and their families.

Taylor Wilson:

Karen Weintraub covers health for USA Today. Thank you, Karen.

Karen Weintraub:

Thank you.

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Taylor Wilson:

Former first lady Rosalynn Carter will be honored in memorials beginning today. You can follow along with usatoday.com.

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Thanks for listening to The Excerpt. You can get the podcast wherever you get your audio. If you use a smart speaker, just ask for The Excerpt. I'm back tomorrow with more of The Excerpt from USA TODAY.