NEARLY 166 million people worldwide are estimated to need urgent action against hunger, according to the Integrated Food Security Phase Classification (IPC), a global partnership that measures food insecurity.
That includes nearly everyone in the Gaza Strip, where the Israeli military launched an offensive in October following an attack on Israel by Hamas militants. More than one million of Gaza’s inhabitants face the most extreme form of malnutrition — classified by the IPC as ‘Catastrophe or Famine.’
Seven-month-old Majd Salem is one of them.
Born on Nov. 1, three weeks after Israel launched the offensive, the child was being treated for a chest infection in the neonatal ICU at Kamal Adwan Hospital in northern Gaza on May 9. The nurse caring for him said he was suffering from severe malnutrition.
Majd was born at a healthy weight of 3.5 kg (7.7 pounds), said his mother, Nisreen al-Khateeb.
By May, when he was six months old, his weight had barely changed to 3.8 kg, she said — around 3 kg less than would be expected for a baby his age.
Majd, whose eyes keenly followed visiting reporters in the ward, had to be given antibiotics for the infection and fortified milk to boost his weight, his mother said. Reuters was unable to trace them after May 21, when the hospital was evacuated following an Israeli raid.
One in three children in northern Gaza are acutely malnourished or suffering from wasting, according to the U.N. children’s agency UNICEF, citing data from its partners on the ground.
Ismail Al-Thawabta, director of the Hamas-run government media office, said their records showed 33 people had died of malnutrition in Gaza including 29 children, but added that the number could be higher.
COGAT, an Israeli defense ministry agency tasked with coordinating aid deliveries into Palestinian territories, did not respond to a request for comment for this story. Israel’s foreign ministry in late May issued a detailed statement questioning the IPC’s methods of analysis, which it said omitted measures Israel had taken to improve access to food in Gaza. The IPC declined to comment.
The plight of Gaza’s children is part of a bigger trend. Globally last year more than 36 million children under 5 were acutely malnourished, nearly 10 million of them severely, according to the Global Report on Food Crises, a collaborative analysis of food insecurity by 16 international organizations.
The food shortage in Gaza, while particularly widespread, comes amid a broader spike in extreme hunger as conflicts around the world intensify.
Two other countries — South Sudan and Mali — each have thousands of people living in zones listed on the IPC website as facing famine. Another 35 — including Sudan, Nigeria and the Democratic Republic of Congo — have many people in the IPC’s next-most acute category of food deprivation.
The IPC, a grouping of United Nations agencies, national governments and non-governmental organizations, is expected to update its assessment of the picture in war-torn Sudan in the coming weeks. A preliminary projection reported by Reuters earlier this month said as many as 756,000 people in Sudan could face catastrophic food shortages by September.
Gaza’s hunger crisis is also a product of war. The Israeli military invaded the Strip in response to the Oct. 7 cross-border assault by Hamas on Israel. More than 37,000 Palestinians and nearly 1,500 Israelis have been killed since then, Gazan and Israeli tallies show.
The Israeli assault has destroyed swathes of Gazan farmland. In the early days of the war, Israel imposed a total blockade on Gaza. It later allowed some humanitarian supplies to enter but is still facing international calls to let in more.
The International Criminal Court’s prosecutor, in seeking arrest warrants for Israeli and Hamas leaders, last month accused Israeli Prime Minister Benjamin Netanyahu and Defense Minister Yoav Gallant of using starvation of civilians as a method of warfare, among other alleged crimes. Netanyahu, calling that move “a moral outrage of historic proportions,” said Israel is fighting in full compliance with international law and taking unprecedented measures to ensure aid reaches those in need.
Israel has accused Hamas of stealing aid, which Hamas strongly denies. Israel has also said any distribution problems within Gaza are the fault of the international agencies.
Even when children survive, nutrition experts say food deprivation in the early years can do lasting damage.
A child’s brain develops at its fastest rate in the first two years of life. So even if they don’t starve to death or die from illness due to their weakened immune system, children may face delays in growth and development, said Aashima Garg, adviser on nutrition at UNICEF for the Middle East and North Africa.
“While they may be alive, they may not thrive that well in childhood and beyond,” she said.
Three families in Gaza told Reuters about their day-to-day diets, and four global health experts explained how such deprivation affects the growing body. Damage done in weeks manifests over years, they said.
“It can have a long-term impact on their immune system, their ability to absorb good nutrition, and on their cognitive and physical development,” said Hannah Stephenson, global head of nutrition and health at Save The Children, a non-profit.
First days
Gaza has the most households globally in the most extreme stage of food poverty, according to the IPC, which classifies levels of hunger into five categories, the worst of which is famine.
Households in North Gaza, where Majd lives, are already suffering a full-blown famine, Cindy McCain, Executive Director of the World Food Programme, said on May 5.
It can take months for the international measurement system to declare a famine. But the first damage to a child’s body is counted in days.
Nine out of 10 children aged 6 months to 2 years in Gaza live in severe child food poverty, a UNICEF survey in late May found. This means they are eating from two or fewer food groups a day, which UNICEF’s Garg said means grains or some form of milk.
This has been the case since December 2023, with only a slight improvement in April 2024, she said. As many as 85% of children of all ages did not eat for a whole day at least once in the three days before the survey was conducted.
The main cause of acute malnutrition in North Gaza is a lack of diversity in the diets of children and pregnant and breastfeeding women, according to a report in February 2024 from the Global Nutrition Cluster, a group of humanitarian agencies led by UNICEF.
This deficient intake, both prior to and during pregnancy and breastfeeding, harms both mothers and infants.
Abed Abu Mustafa, 49, a father of six, was still living in Gaza City in early April. He said people there already had eaten “almost every green plant we could find” and he hadn’t had meat or chicken for at least five months.
