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Gaza: ‘How do we escape the slow death of starvation?’

‘We may survive the bombs, but we’ll pay for it with our health.’

People queue for bread in front of a bakery that was partially destroyed in an Israeli strike, in the Nuseirat refugee camp in the central Gaza Strip, on November 4, 2023, as battles continue between Israel and the Palestinian Hamas movement. Majdi Fathi/NurPhoto
In the Nuseirat refugee camp in the central Gaza Strip, Palestinians queue for bread on 4 November in front of a bakery that has been partially destroyed by an Israeli strike.

Gaza has been under total Israeli siege for over a month now, with only a trickle of humanitarian aid being allowed in to provide for the needs of a population living under heavy bombardment, the majority of whom have been forced to flee their homes. Aid and human rights groups, including Oxfam International, are accusing Israel of using starvation as a weapon of war against civilians in the embattled enclave.

The New Humanitarian spoke to dozens of civilians in Gaza, many of whom said they are falling sick and experiencing exhaustion and fatigue as they struggle to find clean drinking water and enough food to eat for themselves and their families. They also said they’re often unable to cook the little food they do have due to shortages of electricity and gas for stoves.

"We may survive the bombs, but we’ll pay for it with our health. How do we escape the slow death of starvation?” asked Ahmed Saeed, a 42-year-old farmer from Khan Younis who is providing shelter to 60 extended family members displaced from northern Gaza. 

Israeli bombardment has killed more than 10,000 people – around 70% of them women and children – and wounded nearly 26,000 since 7 October, according to the Health Ministry in Gaza, which is governed by Hamas. Out of a population of around 2.3 million in the enclave, about 1.5 million people have been displaced from their homes, according to the UN’s emergency aid coordination body, OCHA.

The bombardment began after the Palestinian political and militant group Hamas launched an attack into Israel on 7 October, which left around 1,400 people dead, many of them civilians, and injured around 4,500 others, according to Israeli authorities. Hamas also took around 240 hostages back to Gaza, according to the Israeli military. 

On 9 October, Israel announced it was imposing a total siege on Gaza, cutting off the enclave’s electricity and water supplies – which are largely controlled by Israel – and blocking the entry of food, fuel, medical supplies, and other essential items.

Since then, only 526 trucks carrying aid have been allowed to enter the enclave through the Rafah border crossing with Egypt, but this doesn’t reach parts of northern Gaza where supplies are dwindling since the enclave was cut in two by Israeli forces.

Map of Gaza showing Khan Younis and the evacuation zones as well as access points.

Israel continues to ban the delivery of fuel to Gaza, which is desperately needed to run generators to power hospitals, bakeries, and other essential services, and the distribution of the little aid that has arrived to northern Gaza has been almost entirely halted in recent days due to ongoing hostilities, according to OCHA. 

Prior to the siege, an average of 500 trucks carrying supplies entered Gaza every working day, including over 100 carrying food.

Just 2% of the food that would normally be delivered has entered the enclave since Israel imposed the total siege, according to Oxfam. The average Palestinian in Gaza is now living on just two loaves of Arabic bread per day, according to Thomas White, the director of the UN’s Palestinian refugee agency, UNRWA, the largest aid organisation in Gaza. 

All bakeries in the north of Gaza, where the Israeli military has been conducting ground operations since 27 October, have stopped working due to damage and a lack of fuel, Gaza’s interior minister said on 7 November. 

Lack of clean drinking water also continues to be a problem.

An estimated 50,000 pregnant women in Gaza – and mothers of newborns – are particularly vulnerable to the effects of limited food and inadequate drinking water, according to the World Health Organization (WHO). And an estimated 52,500 infants “are currently at risk of starvation, death, dehydration, and other health hazards”, according to Euro-Med Monitor, a human rights group. 

Eighteen UN agencies and humanitarian organisations issued a joint statement on 5 November calling for an immediate humanitarian ceasefire to allow more aid to enter Gaza, including food, water, medicine, and fuel. “Enough is enough. This must stop now,” the statement said. 

‘Everyone has lost weight, especially the children’

When the Israeli military ordered more than one million people to evacuate northern Gaza on 13 October, Muhannad al-Alan, 34, followed the instruction. He was among the hundreds of thousands of people who headed south under heavy bombardment and in anticipation of an Israeli ground invasion, which began two weeks later.

Leaving behind their home in Beit Lahia, a border town in northern Gaza, al-Alan, his parents, his wife, and their child were uncertain if they would ever return. Now, the family is one of hundreds living in a shelter run by UNRWA in the southern town of Khan Younis.

The shelter is set up in what used to be a vocational training centre and is hosting more than 22,000 displaced people, making it the most overcrowded facility run by UNRWA.

Al-Alan and his family are living in a small tent, partially separated from other tents by a patchwork of tattered fabric covered in reinforced nylon. Al-Alan said the family left their home because of the intense bombing, and because “food and water were running low and we had no other choice”.

“But even here, we lack basic nutritional needs because we can’t cook [due to the fuel shortages and long power cuts],” al-Alan told The New Humanitarian. “With no refrigeration, the food we receive from UNRWA – or the little we can buy – is unhealthy, insufficient, and unsuitable for long-term consumption.”

Unable to cook fresh food, their diet has consisted of dried or canned goods. Food supplies included in the limited aid that has been allowed to enter Gaza mostly consist of canned tuna and date bars, while flour has been provided to bakeries, according to OCHA.

In a corner of the tent, al-Alan’s 70-year-old father sat on a wheelchair. Fatigue and malnutrition have exacerbated his chronic digestive issues and diabetes.

"My father has been constipated since we arrived at the shelter,” al-Alan said. “Everyone has lost weight, especially the children. My own child, Abdel Moneim, who is barely nine years old, has lost more than six kilos.”

‘All I can do is try to distract them’

In a nearby tent, Um Mahmoud, 46, offers her children thyme on a piece of bread, which has become increasingly hard to come by.

“What else can you do to distract hungry, malnourished children?” she asked. “Their psychological condition has deteriorated because they are eating the same food every day. They are weak and have digestion issues. All I can do is try to distract them.”

Muhannad Alalan, 34, is pictured hugging his son Abdemoneim, 9.
Mohammed Soulaiman/TNH
Muhannad al-Alan, 34, was forced to leave his home in northern Gaza and now lives in an UNRWA-run shelter in Khan Younis further south. With little food available, his son Abdel Moneim, 9, has lost six kilos since the war began on 7 October.

Um Mahmoud said that even if her family could buy fresh vegetables, there is no stove or gas to cook them. They can’t clean dishes either because there’s no water. Canned food, a little thyme, and cracked wheat is all they have. But even this is not available to everyone.

“If we’re lucky enough to buy flour, we bake bread over a wood fire instead of waiting long hours queuing up at a bakery,” she said.

There are only nine bakeries in the south of Gaza providing bread to hundreds of thousands of people staying in shelters, according to OCHA, and whether they’re able to operate depends on the availability of flour and fuel. People queue for hours outside bakeries “where they are exposed to airstrikes”, the agency said in a 6 November situation report. 

Iyad Abu Shabab echoed the words of al-Alan and Um Mahmoud.

Abu Shabab, 48, was displaced from the northern part of Khan Younis with his family three weeks ago, heading further south to a shelter. “We were able to cook lentils twice since we got here, but the rest of the time we either ate bread with tea or some canned and dry food, occasionally tuna or jam,” he told The New Humanitarian.

Anger and sadness washed over him as he tried to start a fire with some straw to cook a handful of lentils in front of his tent.

"This isn’t real food. Some aid is provided every few days, but in limited quantities," he said. “The few times we can buy rice, we don't know how to cook it [because there is no fuel for stoves], or if it’s still safe to eat."

Those willing to risk getting caught in an airstrike go out in search of food but they find limited supplies and spiralling prices. Saeed, the farmer from Khan Younis, said he searched for several days for some canned fava beans and chickpeas to feed his family of six, but to no avail. When items are available at the large supermarkets, prices have multiplied.

“A 25-kilo bag of flour has tripled, from almost $11 to $30, if you can even find it,” Saeed said.

‘A few dates and a couple of oranges’

While the lack of food is dire, people are also becoming increasingly desperate for clean drinking water, according to White, from UNRWA.

Access to water fluctuates depending on several factors: the availability of fuel to run pumps and desalination plants; whether conditions are safe enough to transport it to various areas of Gaza; and whether the Israeli pipelines that feed the enclave are functioning.

At times over the past month, people in Gaza have had access to just one to three litres of water per day, compared to the minimum 50 per day the WHO says are needed to meet basic consumption and hygiene needs.

Crowded living conditions in shelters, combined with a lack of drinking water and water for bathing, is leading to the spread of gastrointestinal issues and concerns about the spread of infectious diseases such as cholera. In the Khan Younis training centre, where al-Alan and his family are sheltering, there is only one toilet for every 600 people, according to OCHA.

A landscape photo of Khan Younis, one of the largest UNRWA-run shelters in southern Gaza.
Mohammed Soulaiman/TNH
One of the largest UNRWA-run shelters, at Khan Younis in southern Gaza, houses thousands of displaced Palestinians who fled Israeli airstrikes in the north of the enclave.

“The lack of a balanced diet and clean water will have a long-term impact,” nutritionist Raed Abu Musa, who is based in Rafah in southern Gaza, told The New Humanitarian by phone.

"Malnutrition can lead to chronic diseases and anaemia, which was already high before the war,” Abu Musa added, referring to the effects of the 16-year blockade Israel maintained on Gaza prior to 7 October.

The lack of water for sanitation has also worsened the food and malnutrition crisis, as displaced families eat less to avoid waiting in line to use public restrooms, said an elderly man who preferred to remain anonymous.

“All I ate this week was a few dates and a couple of oranges,” the man said. “Many others my age are suffering. There are few restrooms and water is scarce, so we eat just to stay alive." 

This article is produced in collaboration with Egab. Edited by Eric Reidy and Rania Elmalky.

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