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Thousands will now die of starvation and disease in Gaza: Alex de Waal

‘The warnings could not have been clearer or more timely. The response is where the failure has been.’

This image is taken from a high angle and shows a woman cooking as she stands among the rubble of her home which was destroyed during Israel's military offensive. Mahmoud Issa/Reuters
Umm Nael al-Khlout, a Palestinian woman, cooks breakfast in the rubble of her house, destroyed by Israel's military campaign, in Beit Lahia, northern Gaza, on 13 March 2024.

That Israel’s destruction of essential infrastructure, siege, and obstruction of aid efforts in the Gaza Strip are causing severe hunger and starvation is no secret. But two new analyses released this week underscore the severity of the crisis – and how much worse it could get.

More than 670,000 people are already experiencing famine levels of food insecurity. If hostilities continue, that number is expected to rise by mid-July to 1.1 million – roughly half of Gaza’s population – with another 850,000 people at emergency levels, according to the Integrated Food Security Phase Classification (IPC), a group of international organisations and experts that monitors food insecurity.

Another group that assesses food insecurity levels, the Famine Early Warning System Network (FEWS NET), warned that famine in northern Gaza – which has been largely cut off from aid for months – is “imminent” and likely to occur by May. 

At least 27 children have reportedly died from malnutrition and dehydration in recent weeks in Gaza, and “the upward trend in non-trauma mortality is also expected to accelerate”, according to the IPC.

Gaza is really taking indifference to humanitarian norms to a level that I don’t think any of us ever expected, where the countries that considered themselves to be the champions of international humanitarianism are refusing to live by their own principles.

The New Humanitarian spoke in January with Alex de Waal, executive director of the World Peace Foundation at the Fletcher School of Law and Diplomacy at Tufts University in the US, and an expert on famine and humanitarian crises, about Israel’s starvation of Gaza.

Given the dire new projections, we turned to de Waal again for a greater understanding of what people in Gaza are confronting.

“In terms of the latest reports, this is the most clear and unequivocal indication of famine that has been issued either by IPC or FEWS NET for as long as they've been in existence,” he told The New Humanitarian. 

In the following interview, edited for length and clarity, we discuss what would need to happen to begin to reverse the situation in Gaza, and the implications of the failure of the United States, Britain, and others to pressure Israel into stopping this man-made famine. 

The New Humanitarian: When we spoke to you in January, UN officials were already saying they believed famine was taking place in parts of Gaza. What have we learned from the new IPC and FEWS NET analyses, and what is their significance? 

De Waal: Political commentaries have gotten very hung up on, “Is it famine? Is it not famine?”. And, frankly, even when it's not IPC level five (the IPC uses a five level scale to assess food insecurity), when all three indicators point to famine, and it is “only” level four, it is bad. It is truly bad. These are conditions under which large numbers of people, especially children, will be dying.

In terms of the latest reports, this is the most clear and unequivocal indication of famine that has been issued either by IPC or FEWS NET for as long as they've been in existence. FEWS NET has been going since the 1980s, and IPC has been around for nearly 20 years. There is no case that is as clear and categorical as this one.

In the closest case, in Somalia in 2011, there were 490,000 people in IPC level five. In Gaza as of a couple of weeks ago, there were 677,000. And that number is increasing every day. So this is the most severe food emergency, crisis, or famine on record.

There’s been ample warning of this. There was the Famine Review Committee report in December that said we need a ceasefire, or specifically, the end to the destruction of all the essential infrastructure, alongside the provision of essential services and humanitarian relief, and that if this is not done, then the scenario of relentless deterioration towards famine will unfold. Those things were not done, and that scenario has unfolded. So their analysis has been validated.

The New Humanitarian: UN relief chief Martin Griffiths has said there is still time to avert a famine declaration, while others in the aid sector are saying it is already too late. Where do you fall on that?

De Waal: It is too late to avert a humanitarian disaster that is going to kill thousands, if not tens of thousands, of people. That’s the bottom line. 

Humanitarian diplomats may judge it appropriate to say there is still time to avert famine or a famine declaration because they think that will help them leveraging assistance and not antagonising key actors, i.e. Israel and the United States. That’s their job.

The New Humanitarian: What needs to happen to reverse the food insecurity situation in Gaza? In the absence of an immediate ceasefire, what, if anything, can be done to avoid the worst-case scenario?

De Waal: I think the first thing to say is that air drops and this floating harbour [that the US is building] are theatrics. They're not going to stop starvation. If their purpose is to press Israel to take some serious action, then they have a virtue. If their purpose is to substitute for serious action, then it’s absurd to pretend that they are anything other than a fig leaf.

The ceasefire question is a key one. Is it possible for the widespread, systematic destruction of objects indispensable to survival to cease in the absence of a ceasefire? Can Israel continue to conduct hostilities of any sort without creating conditions under which life is impossible in Gaza? If the answer to those questions is ‘no’, then there has to be a ceasefire. That is the single most important thing.

Without a ceasefire, there can’t be the provision of essential services, and those are essential, not just for everyday life, but for survival. And then humanitarian assistance is the third component. I think there is a misconception that humanitarian aid can be effective when those other two things are not present. You cannot have a significant, life-saving humanitarian operation unless you have essential services and unless you have an end to the destruction of everything that is essential to survival.

The New Humanitarian: Is it fair to say at this point that a ceasefire is required to end the destruction of infrastructure that is essential for sustaining life in Gaza? 

De Waal: Yes. 

The New Humanitarian: The picture has been clear in terms of the severity of food insecurity and what is needed to reverse at least since December. What does it say that the US, UK, and other foreign countries that have leverage haven’t been willing or able to use it to pressure Israel to take action to change the situation?

De Waal: It tells you that the US, Britain, and a handful of others are ready to tolerate the deliberate creation of famine, even when there has been ample warning that it is going to happen. It illustrates both double standards and a sense of impunity. And both those things are deeply troubling. 

The New Humanitarian: Even if there is a ceasefire soon, what is the best-case scenario we can hope for at this point? And what would be needed to begin to bring that population in Gaza back from the current situation? 

De Waal: So much of the essential infrastructure has been destroyed or damaged to a point where it's scarcely usable. So it’s likely that for weeks, probably months, people will be in very substandard accommodation, have very poor water and sanitation and a lack of electricity and essential fuels for cooking, let alone good healthcare services. 

The nature of a crisis such as this is that once the human ecology has been disrupted to the degree that it has been, there will be a vicious interaction between malnutrition and infectious disease and unsanitary, overcrowded living conditions that will drive health crises, epidemics, et cetera. So, even if the killing stops, the dying will continue for some time.

The New Humanitarian: The allegation that Israel is intentionally starving people in Gaza is central to South Africa’s case at the ICJ, and there seems to be a bit more momentum now around the International Criminal Court investigation into war crimes in the Palestinian territories. What’s the significance of the new IPC and FEWS Net analyses in those contexts? 

De Waal: Starvation crimes need an element of intent, and that can be controversial. But there’s a key element here which is knowledge of outcomes. One of the things that distinguishes the war crime of starvation and the starvation element in the crime of extermination from other crimes is that the time period over which it unfolds means that if due warning is given of the outcome, i.e. starvation, there is time for the perpetrator to change the course of action. That means that if there is no change in the course of action, then attributing intent is relatively straightforward. There is culpability for not changing course when you have been warned in an authoritative way that this will be the outcome of what you are doing.

The New Humanitarian: The systems for determining food insecurity levels globally seem to be poorly understood and tend to spur action once crisis levels have already been reached. Do the systems need to be overhauled to communicate the level of risk earlier?

De Waal: I think both these systems have functioned as well as could be expected, and they've given timely warnings ahead of time. This is a crisis that was not anticipated, and it unfolded extraordinarily rapidly. It would be unfair to judge these systems overall on the Gaza case, given that it is so atypical. But even in this case, the technical systems have worked. What has not worked is the political response to those warnings. The warnings could not have been clearer or more timely. The response is where the failure has been. 

The New Humanitarian: You’ve worked on food insecurity and famine for decades. How does the political failure to respond to the warnings in Gaza compare to what you have seen in other contexts? 

De Waal: In the last few years we’ve been seeing a trend towards inaction and impunity. We saw feeble action in Yemen and Nigeria. We saw extremely feeble action in Tigray. Sudan is a tough case because the belligerents have been the main obstacle, more so than the internationals. But Gaza is really taking indifference to humanitarian norms to a level that I don’t think any of us ever expected, where the countries that considered themselves to be the champions of international humanitarianism are refusing to live by their own principles.

Edited by Andrew Gully.

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