President Trump’s decision to clean house at the U.S. Agency for International Development (USAID) and initially freeze all foreign assistance is fueling chaos and uncertainty in Washington and across the world.

The entire scope of Trump’s freeze on foreign aid and “stop work” orders to nongovernmental organizations (NGOs), issued in an executive order on Jan. 20, is hard to fully comprehend, and it left aid groups, grantee recipients and lawmakers with more questions than answers.

“We’re checking to see what the directive is, and what the response has been, and what’s included in that. We’re trying to get it clarified,” Sen. Mike Rounds (R-S.D.) told The Hill, saying he was concerned about a halt in funding for PEPFAR.

The George W. Bush-era initiative to treat HIV/AIDS across Africa is credited with keeping 20 million people alive who are living with HIV. Advocates who work with clinics on the ground said the program’s funding is indefinitely on hold, leaving its future uncertain.

Amid the confusion and outrage, Secretary of State Marco Rubio issued a waiver Tuesday night that exempted critical humanitarian assistance and life-saving medical work for U.S. aid recipients.

The situation is causing whiplash for NGOs across Africa, the Middle East, in Ukraine and southeast Asia, which began shutting doors, sending staff home and turning away their dependents.

Brian Honermann, deputy director of the Andelson Public Policy Office at amfAR, the Foundation for AIDS Research, told The Hill he was aware of clinics closing because of the stop work order.

“Some of those …. patients at those facilities have been able to get medications, but otherwise they are being sent to other places to hopefully be able to get access to services, but it is not clear that they will be able to,” he said.

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