In Gaza, famine looms, hungry children crowd hospital wards

Six-year-old Fadi al-Zant, severely malnourished, his ribs protruding beneath his leathery skin, lay in a hospital bed at Kamal Adwan Hospital in northern Gaza, which is facing famine.

Fadi’s slender legs could no longer support him in walking.

Photos of Fadi before the fight show a smiling, healthy-looking child wearing blue jeans standing next to his taller twin, his hair slicked back. A brief video clip shows him dancing with a little girl at a wedding.

Fadi has cystic fibrosis. Before the conflict, according to his mother, Shimaa al-Zant, he was taking medication that his family could no longer find and eating a variety of carefully balanced foods that were no longer available in the Palestinian enclave .

“He’s getting worse. He’s getting weaker. He keeps losing the ability to do things,” she said in a video obtained by Reuters from a freelancer. “He couldn’t stand up anymore. I helped him stand up, and he fell down.”

Doctors and aid agencies say shortages of food, medicine and clean water are widespread in the Gaza Strip more than five months after Israel launched a ground and air campaign in response to an Oct. 7 attack by Hamas.

The health ministry in Hamas-controlled Gaza said most of the 27 children who died of malnutrition and dehydration in recent weeks were treated at Kamal Adwan Hospital, which cares for Fadi.

The Defense Ministry said people also died at Shifa hospital in Gaza City and in the southernmost city of Rafah, where the U.N. aid agency said more than a million Palestinians have sought refuge from Israeli offensives.

When Reuters visited the al-Awda health center in Rafah last week, it saw 10 severely malnourished children and caregivers who arranged for the news agency to have unhindered access to the wards. Reuters could not independently verify the death toll reported by the ministry.

Without urgent action, famine will break out in northern Gaza, where 300,000 people are trapped by fighting, between now and May, the world hunger watchdog Integrated Food Security Phase Classification (IPC) said in a commentary on Monday.

The review’s most likely scenario is that more than two-thirds of people in the north are about to face “extremely severe acute malnutrition and death.” The IPC is made up of United Nations agencies and global aid groups.

Israel’s COGAT, the military agency responsible for handling aid transfers to Gaza, did not respond specifically to Reuters’ questions about children dying from starvation and dehydration. Israel has no limits on the amount of aid that can come in, the statement said.

After the IPC review, Israeli government spokesman Eylon Levy posted on X that the number of food trucks had increased in March and that Israel was taking steps to increase “delivery efforts” to the north.

“This is a poor assessment based on outdated pictures,” he said of the review.

USAID Administrator Samantha Power said in a public statement that the IPC assessment marked “a terrible milestone.” She called on Israel to open more land routes and operate crossings at full capacity.

In response to Reuters questions about the IPC report, senior Hamas official Sami Abu Zuhri said Israeli Prime Minister Benjamin Netanyahu “contempts the world and seeks to kill with bombs and starvation” The Palestinian People in Gaza.”

U.S. authorities did not immediately respond to a request for comment.

The U.N. aid agency said “enormous obstacles” to delivering aid to northern Gaza can be overcome only by a ceasefire and the opening of crossings that Israel closed after October 7.

Displaced

In good times, Fadi’s favorite food was chicken shawarma, a Levantine barbecue dish, and he ate a lot of fruit and drank a lot of milk, his mother said.

She said the family fled their home in Gaza City’s Nasr district after the war began, and the area suffered extensive damage from bombing. She added that they had been displaced four times before arriving in Beit Lahiya.

About two months ago, Fadi’s condition began to deteriorate and he was admitted to Kamal Adwan Hospital, Zant said. Creon — a drug that cystic fibrosis patients need to supplement pancreatic enzymes that help digest food — wasn’t available at the time. Sometimes, Fadi has diarrhea 10 times a night.

Before the war, the child weighed 30 kilograms (66 pounds). His mother said he now weighs just 12 kilograms (26 pounds).

“He was eating well before. He was able to receive treatment. His face was full. He was a child who didn’t look sick. He went to kindergarten with his brother,” she said.

COGAT did not respond to questions about Creon supplies but said Israel “has not rejected any shipment of medical supplies.”

Reuters could not independently determine whether such shipments were blocked or verify with hospital officials the extent of the disruption to Creon supplies.

Gaza’s health ministry said a lack of medicine worsened the condition of the deceased child.

In addition to children like Fadi with existing health problems, the risk to many others in Gaza is rising rapidly, the U.N. agency said.

Nearly a third of children under two years old in northern Gaza are severely malnourished, double the number in January, Unicef ​​said on Friday.

The report said 4.5 per cent of children in shelters and health centers visited by UNICEF and its partners suffered from severe wasting, the most life-threatening form of malnutrition.

“Unless the fighting stops and aid agencies gain full access to all parts of Gaza, hundreds or even thousands of children may die of starvation.”

UNICEF Executive Director Catherine Russell said in a joint statement with the World Food Program on Tuesday.

The IPC report stated that if Israel continues its offensive in Rafah, it is expected that 1.1 million people in Gaza (accounting for half of the population of Gaza) will face extreme lack of food, and even every household will face starvation and death.

Last Thursday, COGAT’s Colonel Elad Goren told reporters that food supplies were stable in the south and center of the enclave.

Human Rights Watch said in late February that Israel was blocking the provision of basic services in Gaza, as well as the entry and distribution of fuel and life-saving aid. The statement said this was “collective punishment” and is considered a war crime under international humanitarian law.

COGAT told Reuters that Israel was making “widespread efforts to increase the amount of aid coming into Gaza” beyond its obligations.

“Any other claims, including those regarding collective punishment, are factually and legally baseless,” it said.
Rafah Airport

At the al-Awda Medical Center in Rafah, more than a dozen women sit or stand caring for malnourished children.

Relatives said most of the children in the ward already had health problems before the war, although photos of the parents of two shown to them by Reuters showed that they looked much healthier than they do now.

Yazan al-Kafarna, a 12-year-old boy with cerebral palsy, died on March 4 in southern Gaza, days after photos taken by Reuters showed him severely emaciated.

Amira Abu Juwaiyad, a ward nurse, said the hospital was unable to provide enough milk for babies and there were 10 to 15 cases a day in “catastrophic” situations. Abu Juwayad did not say how much milk was available before the war.

Umm Mesbah Heji holds her five-year-old daughter Israa, a quadriplegic who suffers from epilepsy.

Isla’s medication is no longer available and she has lost a lot of weight. Before the war, Heggie ate eggs and milk for breakfast, liver for lunch and rice for dinner, she said. Sometimes, she gives her yogurt and fruit.

“I know she’s hungry. There’s no food for her,” she said, adding that “I die a hundred times a day” feeling sorry for her daughter.

diarrhea

Disease exacerbated the severe lack of food. The World Health Organization says dehydration from diarrhea is rampant in large tent cities where displaced people are packed together without proper sewage or clean water, accelerating malnutrition.

One of the effects of severe hunger is lowered immunity against such stomach problems.

The World Health Organization said last month that 90% of children under 5 in Gaza are affected by one or more infectious diseases, and 70% of them have experienced diarrhea in the past two weeks, a 23-fold increase from before the war. .

Kerstin Hanson, an American doctor who works on nutrition research for the international charity Doctors Without Borders, described the physical symptoms of malnutrition and dehydration.

Children become lethargic and unresponsive. Their skin is no longer puffy, so if it gets squeezed out of shape, it may stay in its original position. The eyes will become sunken. Physical emaciation.

Even for children who were healthy before conflict, persistent malnutrition can stunt physical and brain development.

As severe malnutrition occurs, a child’s body stops growing, Hansen said. It then shuts down all but essential features. “Your heart and lungs will continue to function, but … there may not be enough energy to keep your immune system functioning,” she said.

The body then “starts feeding itself,” using muscle, fat, and wherever else it can find energy to keep breathing and pumping blood. Eventually, it will shut down.

Even if malnutrition does not reach dangerous levels, its impact on development may be irreversible if it persists, Hansen said. Children may never regain the lost centimeters of growth.