The dominoes fell really fast. On Monday, Jan. 20, shortly after his inauguration, President Donald Trump signed an Executive Order that called for a 90-day pause on new foreign-aid programs for efficiency and "consistency with U.S. foreign policy." The order got less attention than some of the others he signed that day but may have much more far-reaching effects.

By the evening of Friday, Jan. 24, Secretary of State Marco Rubio had issued a directive that went even further, effectively freezing operations at the United States Agency for International Development (USAID), the U.S. government's lead provider of nonmilitary foreign aid. No new projects were to be started, no contracts were to be extended, and work was to be stopped on most existing programs. By Monday, Jan. 27, at least 56 of USAID's top brass were sent home on paid administrative leave for 90 days, reportedly cut off from their email, and, in case the message was not clear, the photos from the walls of their office were removed.

Chaos and confusion began to spread through the ranks of USAID, both in Washington, D.C, where there are about 15,000 employees and abroad, where there are thousands more. It also spread among the many nongovernmental organizations and religious groups that receive funds from it, and the small businesses the agency contracts to provide services. Some of them had to guess whether their programs had to be paused under the terms of their agreement with the State Department and others received suspension notices and memos from a variety of different channels.

TIME spoke to several current and former senior officials at USAID and others who head up organizations it supports about the impact of the move on their activity. Almost all requested that TIME not use their names because they didn't want to jeopardize their future funding or employment.

On Tuesday morning one of those aid organizations, which runs dozens of child nutrition clinics in several extremely impoverished countries, had an emergency meeting to try to decide whether to close them. "Those kids have to be fed every three to four hours with therapeutic feeding products in order to reverse the effects of malnutrition, prevent long-term harm, and basically keep them alive," says an official at the NGO. "We had to make a decision: Do we close those centers? Or do we keep them open at the risk of being in violation of our suspension notice or stop-work order?"

Later that day, after the NGO opted to keep the clinic open by repurposing some non-USAID funding, Secretary Rubio released a clarification that "life-saving humanitarian assistance" could proceed. The organization believes, but is not sure, the clinics fall under that heading.

Charitable groups around the world told TIME they were making similar agonizing choices. One had to decide whether to abide by a stop-work order or deliver lunches to schoolchildren in impoverished communities, as it has for years. It decided to obey the order, wasting hundreds of thousands of dollars' worth of perishable food. Another is figuring out whether to close health clinics for pregnant mothers in Haiti, leaving them with scant alternatives for a place to give birth. Yet another was forced to pause a program that helped migrants fleeing Venezuela stay in South American countries (rather than continuing north to the U.S. border), through work training, housing, and support of the host community.

The U.S. plays an outsize role in responding to international crises, providing 40% of the world's humanitarian assistance. Most people in the humanitarian sector acknowledge that Washington has the right to review how the more than $40 billion it spends doing so every year is used. "The government has the prerogative to conduct a review of spending and programs against their priorities," says an executive of a major aid organization. "But the ways in which they're going about it, in my mind, would undermine the likelihood of them actually having an aid sector to work with as they go forward."