HAIFA, Israel — Atef Abu Khater, 17, who was healthy before the Gaza Strip was gripped by war, lies in intensive care in a hospital in the north of the Palestinian enclave, suffering from severe malnutrition.
“He is not responding to the treatment,” said his father, A’eed Abu Khater, 48, who has been sheltering in a tent in Gaza City with his wife and five children. “I feel helpless,” he added in a phone call, his voice strained with grief. “We lost our income in the war. Food is unaffordable. There is nothing.”
Gaza’s hospitals have struggled since early in the war to cope with the influx of Palestinians injured and maimed by Israeli airstrikes and, more recently, by shootings meant to disperse desperate crowds as they surge toward food convoys or head to aid distribution sites.
Now, according to doctors in the territory, an increasing number of their patients are suffering — and dying — from starvation.
“There is no one in Gaza now outside the scope of famine, not even myself,” said Dr. Ahmed al-Farra, who leads the pediatric ward at Nasser Hospital in southern Gaza. “I am speaking to you as a health official, but I, too, am searching for flour to feed my family.”
The World Food Program, an arm of the United Nations, said this week that the hunger crisis in Gaza had reached “new and astonishing levels of desperation, with a third of the population not eating for multiple days in a row.”
Al-Farra said the number of children dying of malnutrition had risen sharply in recent days. He described harrowing scenes of people too exhausted to walk. Many of the children he sees have no preexisting medical conditions, he said, giving the example of Siwar Barbaq, who was born healthy and now, at 11 months old, should weigh about 20 pounds but is under 9 pounds.
After 21 months of devastating conflict set off by the deadly Hamas-led attack on Israel on Oct. 7, 2023, the lack of available food and water is taking a heavy toll on Gaza’s most vulnerable civilians — the young, the old and the sick.
The Gaza Ministry of Health has reported more than 40 hunger-related deaths this month, including 16 children, and 111 since the beginning of the war, 81 of them children. The data could not be independently verified.
Throughout the war, U.N. agencies and independent aid groups have accused Israel of allowing far too little food into Gaza, warning of impending famine for its more than 2 million people. For much of that time, Israel has said that enough food was reaching Gaza, blaming diversions by Hamas and mismanagement by aid groups for problems.
Hollow-eyed, skeletal children languish on hospital beds or are cared for by parents, who gaze helplessly at protruding ribs and shoulder blades, and emaciated limbs resembling brittle sticks. The haunting scenes are a stark contrast to the plenty that exists just a few miles away, across the borders with Israel and Egypt.
Mohammed Zakaria al-Mutawaq, about 18 months old, lives with his mother and brother in a tent on a Gaza beach.
Mohammed’s mother, Hedaya al-Mutawaq, 31, said the toddler’s father was killed in October when he went out to seek food.
“I walk the streets looking for food,” she said by phone, her voice barely audible. The charity kitchens she relies on to help feed Mohammed and his brother, Joud, 3, cannot always help, and they go hungry. “As an adult, I can bear the hunger,” she said. “But my kids can’t.”
Mohammed, she said, was born a healthy child. “I look at him and I can’t help but cry,” she said.
“We go to bed hungry and wake up thinking only about how to find food,” she added. “I can’t find milk or diapers.”
Mohammed was diagnosed with severe malnutrition by the Friends of the Patient clinic and Al-Rantisi children’s hospital, she said, but there was little they could do. On a recent visit to the clinic, she said, “they told me, ‘His treatment is food and water.’”
Yahia al-Najjar was 4 months old when he died of severe malnutrition Tuesday at the American Hospital in Khan Younis, in southern Gaza, his aunt, Safa al-Najjar, 38, said in an interview.
Yahia was born without serious health issues, but his condition soon deteriorated, she said.
The family has been sheltering under a tent made of a blanket held up by four poles. Yahia’s mother, subsisting on one meal of lentils or rice per day, could not produce enough milk to nurse him, though she had no problems nursing her previous three children. The family could not afford baby formula.
At the hospital, the doctors tried to help, but he was already in critical condition and had lost weight. He died shortly after, she said.
After Israel ended a two-month ceasefire in mid-March and resumed its military campaign in Gaza, it imposed a total blockade on the entry of goods for about 80 days to try to pressure Hamas into surrendering, exacerbating the already severe deprivation.
Now, aid enters in two ways. One is a new, much-criticized system run by private American contractors under the auspices of the Gaza Humanitarian Foundation, a private Israeli-backed group, which has a few set distribution sites in southern Gaza and one in the center of the strip. The other consists of convoys of aid brought in by independent international organizations.
Both systems have been plagued by worsening chaos and violence after months of siege, war, mass displacement and lawlessness. Most of the Israeli shootings, according to the United Nations, have occurred around the Israel-backed distribution sites.
The hunger crisis is the result of human failings, with each of the involved parties blaming someone else for the suffering.
Israel accuses Hamas of engineering a narrative of starvation by looting aid trucks and disrupting the distribution of aid. It also accuses the United Nations and other humanitarian organizations of failing to collect hundreds of truckloads of aid that have piled up on the Gaza side of the border crossings.
Aid groups blame Israel for laying siege to Gaza, restricting supplies and failing to provide safe routes for their convoys inside Gaza. The only solution, they have long said, is an extensive increase in food deliveries.
Israel countered the images of starving children this week with images of pallets of supplies lying uncollected on the Gaza side of a border crossing and footage of what the military described as Hamas terrorists enjoying platters of food and fresh fruit in the group’s underground tunnels. The military declined to say when the video was recorded.
Doctors warn that malnutrition in early childhood can have long-term effects, disrupting growth, cognitive ability and emotional development.
Mohammad Saqr, head of the nursing department at Nasser Medical Complex, said that on Monday afternoon alone, the hospital received 25 women and 10 children requesting intravenous glucose solution.
While the treatment may briefly relieve symptoms, Saqr warned, “they feel the hunger again soon after.” He added, “Some arrive shivering from hunger.”
The hospital’s limited supply of IV solution cannot meet the growing demand, he said, adding: “The team is exhausted from hunger. Yesterday, some staff members ate just 10 spoons of plain white rice.”
Shifa Hospital in Gaza City had recorded three deaths from malnutrition in the previous 36 hours, Dr. Mohammad Abu Salmiya, the hospital director, said in an interview Tuesday. One was a 5-month-old baby.