After the Trump administration moved to freeze nearly $60 billion in foreign aid in January, officials like Secretary of State Marco Rubio repeatedly assured Americans that lifesaving operations would continue. “We don’t want to see anybody die,” he told reporters in early February.

Aid organizations the world over scrambled to prove their work saved lives, seeking permission from the State Department and the U.S. Agency for International Development to continue operating.

The administration conceded that many programs prevent immediate death and should remain online: field hospitals in Gaza, an HIV drug supplier for the Democratic Republic of Congo, Syrian refugee food programs, health clinics that combat Ebola in Uganda and most of the landmark President’s Emergency Plan for AIDS Relief, known as PEPFAR.

In late January, Rubio and one of his top aides, Peter Marocco, said those programs and dozens of others could continue, granting them temporary waivers while the officials conducted what they have called a “targeted, case-by-case review” of all foreign aid programs managed by the State Department and USAID. That review, they said, would take three months.

Four weeks later, on Wednesday, Rubio and Marocco completely ended nearly 10,000 aid programs in one fell swoop — including those they had granted waivers just days earlier — saying the programs did not align with Trump’s agenda. The move consigns untold numbers of the world’s poorest children, refugees and other vulnerable people to death, according to several senior federal officials. Local authorities have already begun estimating a death toll in the hundreds of thousands.

Now, as the administration faces multiple lawsuits challenging its actions, the court fights largely hinge on whether government officials deliberated responsibly before cutting off funding. The U.S. has also refused to pay almost $2 billion that the government owes aid organizations for work they’ve already completed.

Rubio and Marocco appear to have taken their dramatic steps without the careful review they’ve described to the courts, according to internal documents and interviews with more than a dozen officials from the State Department and USAID, which raises fresh questions about the legality of President Donald Trump’s evisceration of the American foreign aid system.

Current and former officials say that Marocco and Rubio cut critical programs without consulting contract officers, who have oversight of individual programs and are aid groups’ primary contacts. “None of us believe that they’re conducting a careful, individualized review,” one official said.

In an episode that highlights how cursory and haphazard their efforts appear to have been, Marocco and Rubio ordered the cancellation of contracts, including for cellphone service, at an office they do not control. The move stranded people in war zones without phones, according to multiple officials and internal correspondence obtained by ProPublica. On Wednesday, AT&T received a termination notice for a $430,000 contract with USAID’s Office of Inspector General. That office is meant to be independent from USAID so that it can effectively audit the agency.

For more than 24 hours, OIG staff, including people in Ukraine and Haiti, did not have access to their government phones. No one at the OIG, including contract officers, knew it was coming, according to the officials. “This is an urgent issue for us, as we have OIG staff in warzones with no ability to receive security alerts,” a senior official in the agency wrote in an email to the company.

Eventually USAID reversed the termination.

Current and former officials throughout USAID and the State Department said the breakneck pace, lack of input from key officials, mistaken cancellations and boilerplate language in Wednesday’s termination notices undermine Marocco’s claims of a deliberative process.

“It’s a pretext,” one USAID official told ProPublica. “The review was supposed to take 90 days. An actual review based on substance requires laying out a process with guidelines, identifying info on each project, and selecting working groups to review. Any review they did was fake.”

If that turns out to be the case, legal experts and government officials say, the administration will have defied a federal judge’s order in a brazen gambit to continue dismantling USAID.

The morning after the mass termination notices went out, a senior USAID official sent an email saying Marocco and Rubio had canceled awards for essential services that the agency now wanted reinstated, telling staff, “We need your immediate input on any awards that may have been terminated that contain essential services related to the safety, security, and operations of USAID staff,” according to a court filing.

Since the initial decision to suspend foreign aid, humanitarian organizations and labor groups have taken the government to court, arguing that only Congress can dismantle USAID and that Trump’s blanket actions are unconstitutional. The government has told the courts that it has the right to cancel contracts, dismiss staff and reorganize USAID to align with Trump’s agenda.

Earlier this month, a federal judge issued a temporary restraining order prohibiting USAID and the State Department from following Trump’s executive orders to stop all foreign aid and to force the agency to pay its bills. When it didn’t comply, the judge issued another order, giving the government until midnight Wednesday to pay what it owes to aid groups.

On Wednesday, the Supreme Court temporarily paused the last order over unpaid bills to conduct further legal review. That same day, aid organizations around the world began receiving termination notices.

More than 90% of USAID’s global aid operations and half of those managed by the State Department received termination notices. The move is already putting children and refugees in gravely dangerous situations. The administration canceled almost 50 United Nations Population Fund projects worth more than $370 million, including programs to address maternal deaths and gender-based violence in Egypt, Nigeria and several other member nations around the world.

In early February, the nonprofit Alight received waivers for its programs supporting refugees in war-torn Sudan, Somalia and South Sudan. On Wednesday, they were all terminated.

Alight runs six centers for extremely malnourished children in Sudan, where the organization treats babies and infants so sick that they will die within hours without ongoing care. The centers cost about $120,000 a month to operate. Alight is trying to fundraise to keep them open, knowing that the day they close their doors, children will die, CEO Jocelyn Wyatt told ProPublica.

In the meantime, they have been forced to close other lifesaving programs. In Somalia, around 700 malnourished children visited Alight clinics every day for weight check-ins and to pick up special food. Thirteen health clinics and a mobile unit served around 1,200 patients a day. On Thursday, all of those clinics closed, Wyatt said.

Alight also shuttered 33 primary health clinics in Sudan and stopped providing water to three refugee camps that house people displaced by decades of war. Alight had kept all those programs running these past five weeks, even though the organization hasn’t received any payments since Trump took office.

“We believed when Rubio said that there was no intention of cutting emergency lifesaving services that would basically cause immediate death,” said Wyatt. “We trusted that those would be protected.”

One of the State Department’s highest-ranking humanitarian aid officials, Jennifer Davis, stepped down this week, according to her resignation letter, which was obtained by ProPublica. During a meeting earlier this week, Davis, the principal deputy assistant secretary of the agency’s refugees bureau, told staff she believed she was bound by the judge’s order to restore programs and their funding, according to an attendee. “She was in tears about it,” the attendee said. (Davis did not respond to a request for comment.)

The State Department, USAID and the White House did not respond to a detailed list of questions for this story. The State Department did not make Rubio available for an interview. Marocco also did not respond to questions.

By Thursday, hundreds of workers had returned to USAID’s former headquarters, where the name has been removed from the building facade, to collect their personal items. They left with boxes and suitcases. Some were crying. Dozens of people cheered and rang bells each time someone exited the building; many of them had recently lost humanitarian aid jobs as well.

“This is more than lost jobs. We’re losing the sector,” a former USAID employee said through tears as she waited for her allotted 15-minute time window to pick up her belongings. “The U.S. government is losing its influence. We’re now more unsafe as a country.”

In the early hours of Feb. 13 at a refugee camp in northern Syria, two armed men wearing masks and police uniforms broke into offices and a warehouse for the aid group Blumont, stealing more than $12,000 worth of laptops and other supplies the U.S. government had already paid for. Because the organization hadn’t received any funds since Trump took office, it no longer had personnel at the camp full time and had paused all its U.S.-funded work except a daily bread delivery.

The armed theft was the result of the U.S. not paying its bills, the group told USAID officials, according to an internal agency email obtained by ProPublica.

Shortly after the incident, the government started paying Blumont’s invoices and the aid group brought back staff and food services that had received a waiver. It is one of the few programs still online and receiving money.

Prior to Jan. 20, the U.S. spent about $60 billion on nonmilitary humanitarian and developmental aid each year — far more than any other country in total dollars, but less than 1% of the federal budget. The vast majority of that money is managed by USAID and the State Department. A network of aid organizations carry out the work, which is funded by Congress.

Since Trump took office, Marocco and Rubio have not only halted foreign aid, laid off thousands of workers and put many more on administrative leave, they have also stopped paying bills for work that has already been done. In one of several lawsuits related to the administration’s dismantling of USAID, aid groups are suing the federal government over the mass program closures and unpaid bills. It was that case that led federal district court Judge Amir Ali to order the administration to settle those bills, which by Feb. 13 totaled nearly $2 billion, according to figures Marocco gave the court. Almost none of it has been paid, the court filings show.

U.S. taxpayers will also be on the hook for interest and damages from the unpaid bills and broken contracts, legal experts told ProPublica.

Organizations have struggled to get through the opaque waiver process, and programs that succeeded were often so strapped for cash because the government hadn’t reimbursed them that they remained inoperative. Medicines that were already purchased by U.S. taxpayers are languishing in warehouses instead of being delivered to the people who need them, several contractors told ProPublica.

On Wednesday, as Chief Justice John Roberts temporarily paused the district court’s order to the federal government to pay its bills, the administration told the court it had terminated 5,800 of the 6,300 foreign aid programs that USAID administered. The government also shuttered 4,100 programs managed by the State Department, about 60% of the total.

In Marocco’s own testimony to the court on Feb. 18 about the process, he said that senior staff and political appointees choose “specific awards” to be evaluated for termination or suspension. He said he personally examines the program and any potential consequences of terminating it before making final recommendations to Rubio.

But USAID staff say that subject-area experts and key personnel who are responsible for the programs were not involved in many terminations, while most others had already lost their jobs.

In the case of the phone contract for the OIG office, for example, the contract officers had no idea the termination notices were coming, officials said. Those officers are specially trained in contract law and regulations to manage these agreements and make sure the government is in compliance. But they were cut out of the process and only learned about it from AT&T, according to the officials and internal emails obtained by ProPublica. (AT&T did not respond to a request for comment.)

The one-page notice to the telecom giant said that Rubio and Marocco had “determined your award is not aligned with Agency priorities and made a determination that continuing this program is not in the national interest.” The notice added: “Immediately cease all activities.”

The notice came as an emailed PDF and not through the normal file management and correspondence system, which led multiple OIG officials to question whether anyone even looked at the contract’s basic information, like its statement of work, much less conducted a careful review.

David Black, an attorney specializing in government contracts, said that the law requires contract officers to approve termination notices and that the episode with the OIG raises questions about Marocco’s claims in court about careful reviews. “It suggests the process was done very hastily,” he said.

On the ground, in the places where the aid kept starvation at bay and deadly viruses in check, program directors say there will now be little to stop those threats.

“What really bothers me is that we’re just looking at numbers, we’re not thinking about real people who are actually going to suffer the consequences of these terminations,” said Dr. Anja Giphart, the acting president of the Elizabeth Glaser Pediatric AIDS Foundation, which had HIV programs terminated in Eswatini, Lesotho and Tanzania.

Pulling treatment away from pregnant women means children will be infected with HIV in the weeks ahead, Giphart said. And doing it so suddenly means other governments and donors don’t have the opportunity to step in. Half of children who are undiagnosed and untreated for HIV die before their first birthday. “We don’t have the luxury of waiting months and months to get this back on track again,” she said.

In Uganda, Baylor College of Medicine Children’s Foundation, which is funded by USAID, treats tens of thousands of patients for HIV and tuberculosis. In addition, it has for years been one of the only organizations in the country that helps contain Ebola outbreaks — including the current one, which has so far killed two people and infected at least eight others. Earlier this month, the U.S. government issued the foundation a waiver and said it could continue its lifesaving work.

So those who run the foundation were shocked to receive a termination notice hours later. The foundation’s executive director, Dr. Dithan Kiragga, told ProPublica his staff had just begun contact tracing patients with Ebola. He said they will likely now have to halt all U.S.-funded operations and hope that the Uganda health ministry can step in.

“The patients will be told that we are closing,” Kiragga said. “They’ve relied on our systems and support for quite a few years. We saved lives.”