Due to Israel’s relentless airstrikes, blockades, and attacks in Gaza, there has been a persistent concern for famine in the region. Now, after many months of these warnings, there are reports of children succumbing to starvation.

Severe hunger is predominantly affecting the northern region of Gaza, where isolation imposed by the Israeli military has resulted in lengthy interruptions of food distribution. Official reports from the Health Ministry state that at least 20 individuals, primarily children and one elderly man, have succumbed to malnourishment and dehydration at Kamal Adwan and Shifa hospitals.

Children who are especially susceptible are also starting to give in, particularly in the southern region where receiving assistance is more consistent.

One of the lead doctors at the Rafah branch of the Emirati Hospital reported to The Associated Press that over the last five weeks, 16 premature infants have passed away due to causes attributed to malnutrition.

“The feared deaths of children have now become a reality,” expressed Adele Khodr, the Middle East head of UNICEF, in a statement earlier this week.

Malnutrition generally takes time to cause death and often affects young children and older individuals first. Other factors may also contribute. Mothers who do not receive enough nutrition may struggle to breastfeed their children. In areas like Gaza where there is a lack of clean water and sanitation, diarrheal diseases are common and make it difficult for individuals to absorb the calories they consume. According to Anuradha Narayan, a child nutrition expert from UNICEF, malnutrition can also weaken immune systems, making individuals more susceptible to other illnesses that can lead to death.

After Hamas’ attack on southern Israel on October 7th, Israel initiated its assault on Gaza and severely restricted the entry of essential resources such as food, water, and medicine. Only a small number of aid trucks were permitted through two crossings in the southern region.

The growing hunger crisis in Gaza is being attributed by Israel to inadequate distribution of supplies at Gaza’s border crossings by U.N. agencies. According to the largest U.N. agency in Gaza, UNRWA, Israel’s restrictions and time-consuming inspections are hindering the process. Additionally, distribution within Gaza is severely limited as Israeli forces frequently block U.N. convoys, refuse safe passage during conflict, and leave aid vulnerable to being taken by desperate civilians.

Israel heeded to pressure from the United States and the international community and announced that it would open crossings to allow aid to be delivered directly to northern Gaza. They have also agreed to allow sea shipments.

The situation in the northern region, which has been mostly under Israeli control for several months, has become dire. The Israeli forces have left entire neighborhoods in Gaza City and its outskirts completely destroyed. Despite this, there are still hundreds of thousands of Palestinians remaining.

Multiple residents, who were interviewed by the AP, have reported extreme difficulty in finding common household items such as meat, milk, vegetables, and fruit. The limited goods available in stores are sporadic and marked up significantly, consisting mostly of nuts, snacks, and spices. Some individuals have resorted to taking entire barrels of chocolate from bakeries to sell small portions at a high cost.

Many individuals consume a type of plant called “khubaiza,” which grows in vacant spaces. Fatima Shaheen, a 70-year-old residing with her two sons and grandchildren in north Gaza, shared that her primary source of sustenance is boiled khubaiza, and they even grind food usually meant for rabbits and use it as flour.

Shaheen stated that they were desperately in need of a piece of bread.

Qamar Ahmed has shared that his 18-month-old daughter, Mira, mainly consumes boiled weeds as there is no suitable food for her age. Ahmed, who works as a researcher for Euro-Med Human Rights Monitor and as an economic journalist, explains that his 70-year-old father shares his own meals with Ahmed’s young son, Oleyan. Despite their efforts, Ahmed’s father struggles to get Oleyan to eat as he often refuses.

At the Jabaliya refugee camp, Mahmoud Shalaby recalled observing a man at the market giving his two sons a bag of potato chips and instructing them to make it last for both breakfast and lunch. “People always comment on my weight loss,” shared Shalaby, who works as the senior program manager for Medical Aid for Palestinians in northern Gaza.

According to Dr. Husam Abu Safiya, the temporary director of Kamal Adwan Hospital, his team is currently attending to 300 to 400 children daily, with 75% of them presenting symptoms of malnutrition.

Recent airdrops of aid by the U.S. and other countries provide far lower amounts of aid than truck deliveries, which have become rare and sometimes dangerous. UNRWA says Israeli authorities haven’t allowed it to deliver supplies to the north since Jan. 23. The World Food Organization, which had paused deliveries because of safety concerns, said the military forced its first convoy to the north in two weeks to turn back Tuesday.

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Last week, the Israeli armed forces arranged for a shipment of food to be sent to Gaza City. However, soldiers guarding the convoy opened fire in response to what they believed was a threat, as thousands of hungry Palestinians rushed towards the trucks. Due to the ensuing chaos, around 120 people were killed, some by gunfire and others by being crushed in the stampede.

Yazan al-Kafarna, 10, died Monday after almost a week of unsuccessful treatment in Gaza’s southernmost city of Rafah. Photos of the boy showed him extremely emaciated, with twig-like limbs and deep-sunk eyes in a face shriveled to his skull.

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Dr. Jabr al-Shair, head of the children’s emergency department at Abu Youssef Najjar Hospital, stated that the individual passed away as a result of severe muscle degeneration triggered mainly by malnourishment.

One day, approximately 80 undernourished children filled the hospital’s rooms. Aya al-Fayoume, a 19-year-old mother who had been displaced to Rafah, brought her 3-month-old daughter, Nisreen, who had lost a significant amount of weight during the winter and was suffering from persistent diarrhea and vomiting. Al-Fayoume mentioned that due to her mainly canned food diet, she struggles to produce enough breast milk for Nisreen.

She mentioned that all the things she requires are either costly or not available.

The number of fresh food options in Rafah has decreased, as the population has grown to over 1 million due to displaced inhabitants. The primary sources of food are canned goods, which are frequently included in aid bundles.

Dr. Ahmed al-Shair, deputy head of the nursery unit at Emirati Hospital, stated that the recent fatalities of premature infants were due to inadequate nutrition in expectant mothers. Both malnutrition and high levels of stress can contribute to premature and low-birth-weight deliveries, and medical professionals have observed an increase in such cases during the conflict, although this data is not officially recorded by the United Nations.

According to Al-Shair, infants born prematurely are given medical treatment for multiple days in order to increase their weight. However, after this they are sent home, typically to a tent lacking adequate warmth, with mothers who are malnourished and unable to breastfeed. Obtaining milk can also be challenging. In some cases, parents resort to giving their newborns plain and possibly unsanitary water, resulting in diarrhea.

In a matter of days, the infants are returned to us in a dire condition. Some were already deceased upon arrival,” stated al-Shair. He reported that 14 newborns passed away in the month of February, and an additional two have died thus far in March.

At present, the hospital has 44 newborns less than 10 days old. These babies weigh as little as 2 kilograms (equivalent to 4 pounds) and a few require life support. Due to overcrowding, each incubator is housing three premature babies, increasing the chances of infection. Al-Shair expressed concern that upon being discharged, some of these infants may face a similar fate.

“He stated that we are currently providing them with treatment, but only God knows what may happen in the future.”

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This report was contributed by Sam Magdy and Sarah El Deeb in Cairo, both writers for the Associated Press.

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