Trump’s foreign aid freeze has pummelled organizations, large and small, around the world — and each has a story to tell. My colleague Sara Jerving chronicles one group’s up-and-down-and-still-uncertain journey.

Nairobi-based Amref Health Africa initially had to put 692 of its staff members on unpaid leave for at least three months and halt 20 of its initiatives across multiple countries after the aid freeze went into effect.

However, it received waivers from the U.S. Centers for Disease Control and Prevention to continue some work covering five programs largely related to HIV. This will bring about 300 of the 692 Amref staffers placed on unpaid leave back to work.

However, 15 of its programs are still paused and the waivers are only temporary. Because of this, Amref Health Africa could lose about $30 million it receives from the U.S. this year, Dr. Githinji Gitahi, the group’s CEO, tells Sara.

The ripple effects are real. In Malawi, 108,443 babies and children will go without full immunizations if funding doesn’t resume. In Kenya, the organization needs funding to provide nutrition support for 175,995 children.

Across five countries under Amref’s programs, nearly half a million children won’t be treated for common childhood diseases such as pneumonia, diarrhea, malaria, and measles. The organization also trains over 6,000 health workers in the public sector across multiple countries in skills ranging from delivering babies to detecting and containing Ebola.

Gitahi told colleagues that while the organization anticipated a future where foreign assistance was reduced and domestic resources from African countries increased, “it’s just coming sooner than we expected and therefore we have to take urgent and significant measures for resilience.”

Still, Amref may be in a better position than most. Some 80% of its work across Africa — worth over $200 million — remains unhindered “due to diversified resources in light of shifting aid dynamics,” he says.

Read: US aid freeze could cost Amref $30M amid some work stoppages and furloughs