Starvation in Gaza: Firsthand Account of Extreme Hunger, Health Crises, and Loss of Life

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Noor Hammad encounters many of her patients on the brink of death early in life.

The 26-year-old clinical nutritionist dedicates her time to Acción contra el Hambre (Action Against Hunger), a global NGO focusing on helping malnourished children and expectant mothers who are slowly wasting away in Gaza.

She outlines the severe impact of starvation on the human body: as muscles and fats diminish, bones become visible under rust-colored skin; hair and nails fall off, and the abdomen swells due to fluid retention — a haunting contrast on such a weakened body.

“Patients experience extreme thinness, a pale appearance, inability to walk or even speak or engage in play, along with severe anaemia, marasmus [extreme undernutrition] and kwashiorkor [critical protein depletion],” Hammad tells SBS News.

“We have several cases of malnourished children and women dying. Some pregnant women who suffer from malnutrition have miscarried their foetuses due to a lack of food,” Hammad says.

“We lost many patients before our eyes. I was unable to help them at all; I felt helpless.”

Hammad treats hundreds of children suffering from malnutrition every week. But the first child she nursed, just months into the war in Gaza, was her own daughter, Hour.

“I couldn’t find food or clean water for her,” she recalls, adding that Hour was a newborn at the time.

Hammad was pregnant when the conflict escalated and gave birth in January 2024.

A woman wearing a black hijab takes a selfie with a man holding a small child in a pink frock. They are on a beach with the sea in the background

Noor Hammad, her husband Ahmed and daughter Hour visited the beach often during the two-month ceasefire between January and March. Source: Supplied

She was able to keep her daughter alive, but Hour remains malnourished.

The pair, along with Hammad’s husband, live in a small tent “not fit for human habitation” in al-Mawasi — an airport-sized strip of desolate, sandy terrain near Khan Younis in Gaza’s south.

Al-Mawasi was declared a “humanitarian zone” by the Israel Defense Forces (IDF) in December 2023 and, according to United Nations figures, now shelters more than 47,700 people per square kilometre.

The flow of humanitarian aid into al-Mawasi has also been stymied.

“We have not received any aid for six months,” Hammad says.

“But this month, goods have started entering at very high prices.”

We buy a little of it so that we do not die of hunger.

Truckloads of essential supplies — including food and medications — remain stationary just kilometres from the camp, beyond Gaza’s southern border with Egypt.

“When I know that food aid is on the other side of us … it makes me feel that the world is negligent,” Hammad says.

“I do not know how they do this to us while we are innocent.”

Food aid ‘stranded in warehouses’

Almost every calorie in Gaza must now come from outside the besieged enclave.

In what was once a thriving agricultural hub, cropland has been widely decimated due to aerial bombardment, and the fishing industry has collapsed as a result of attacks on fishers and restrictions imposed by Israel since October 2023, according to the UN’s Food and Agriculture Organization.

Israel says it enforces restrictions along Gaza’s coast for security reasons, and alleges Hamas attempted to use fishing boats during the October 2023 attacks.

Despite the dearth of available food sources, Israel has heavily restricted the entry of aid into Gaza since late May. Before that, aid was barred entirely from 2 March, when talks to extend a tenuous ceasefire broke down.

Noor Hammad is a clinical nutritionist in Gaza, volunteering for Spanish hunger relief organisation Acción contra el Hambre. Source: Supplied

In a statement to SBS News, a spokesperson for the IDF denied aid has been blocked, saying: “The IDF forcefully rejects the allegation of deliberate starvation of the civilian population.”

“The IDF is allowing the entry of humanitarian aid into the Gaza Strip in line with the government’s directives, and allows international organisations to carry out its distribution. Even today, there is still humanitarian aid, which it’s [sic] entry was facilitated by the IDF, that remains uncollected.”

Since October 2023, there have been 227 malnutrition-related deaths, including 103 children, according to the UN’s Office for the Coordination of Humanitarian Affairs.

The World Food Programme (WFP) says over 320,000 children — the entire population under five in the Gaza Strip — are at risk of acute malnutrition.

Head of the UN Palestine refugee agency, Philippe Lazzarini, has described the situation as “the latest in the war on children and childhood in Gaza”.

Last week, more than 100 humanitarian organisations, including Oxfam and Médecins Sans Frontières (Doctors Without Borders), signed a joint statement calling on Israel to stop the “weaponisation of aid” and demanding that it flows unencumbered.

It noted that most major organisations have been unable to deliver a single truck of life-saving supplies since 2 March, and are increasingly being told they are “not authorised” to deliver aid unless they comply with strict regulations, including providing lists of their donors and Palestinian staff for vetting.

“This blockade has resulted in millions of dollars’ worth of food, medicine, water, and shelter supplies being left in storage across Jordan and Egypt,” reads a joint statement.

While several countries have started parachuting food, medicine and other supplies into Gaza from the sky, it’s a fraction of the 500-600 trucks daily the UN says is necessary to sustain the enclave’s starving population.

Aid drops also pose a physical risk in such a densely populated area — and can be fatal. Earlier this month, 14-year-old Muhannad Eid’s family said he was crushed by a pallet of aid that was parachuted in.

Sean Carroll, CEO of American Near East Refugee Aid, a signatory to the letter, said: “At this point, everyone knows what the correct, humane answer is, and it’s not a floating pier [or] airdrops.”

“To save lives and maintain basic humanity, the borders must be opened around the clock to allow access for thousands of trucks carrying millions of meals and medical supplies waiting nearby.”

Mohamed Duar, Amnesty International’s spokesperson for the occupied Palestinian Territory, also a signatory to the letter, tells SBS News: “We are witnessing an engineered and manmade famine at a scale, speed and severity that we have never witnessed in modern history.”

“Israel sidelined UN agencies, including UNRWA, with the Gaza Humanitarian Foundation [GHF]. The project has been a complete disaster,” he says.

“Palestinians are faced with an unimaginable choice to die of starvation or die trying to access food aid for themselves and their families,” Duar says.

An IDF spokesperson rejected the assessment of numerous human rights groups it is blocking aid and medicine in Gaza, saying: “Israel does not operate to hinder access to medical care nor does it prevent the entry of medical supplies into the Gaza Strip, including medications, such as antibiotics.”

“The IDF tirelessly collaborates with aid organizations and the international community to provide ongoing medical services, maintaining regular coordination with hospital representatives in Gaza and humanitarian groups to meet the health and humanitarian demands of hospitals — including medicine and necessary medical devices,” according to the spokesperson’s statement.

The GHF is ‘killing us every day’

Hammad’s husband, Ahmed Elfaleet, is also a clinical nutritionist.

The couple met while studying at al-Azhar University in Cairo and dream of one day opening a clinic together.

But during the war, Elfaleet has instead turned his energy to keeping his family alive.

Dozens of parachutes falling from a plane.

Some nations have begun air-dropping food, medicine, and other essentials into Gaza, but the UN warns it’s only a small portion of the aid required to support the strip’s starving population. Source: AAP / Haitham Imad

That was until Elfaleet was shot in the foot at a GHF aid site in June. Without access to medical treatment, he cannot leave the tent, Hammad explains.

“We lost him for several hours because he was unconscious. Then some people found him and took him to … the Red Cross Hospital in Rafah,” she says.

They [the GHF] claim to be helping us, but they are actually killing us every day.

The GHF is a startup organisation that employs United States mercenaries. Its four “mega-sites”, which opened in May, replace 400 non-militarised aid points previously run by a UN agency.

Israel said those aid points were to be shut down because Hamas had corrupted the supply chains, accusing it of stealing and stockpiling aid.

Internal analysis by the US Agency for International Development found no evidence of systematic aid diversion by Hamas. Separately, the European Commission made a similar finding.

The GHF sites — at Khan Younis, Tel al-Sultan, Saudi neighbourhood and Wadi Gaza — are reportedly open for just minutes at a time. The official Facebook page warns aid seekers not to approach the sites until a stipulated opening time, as “the IDF may still be in the area”.

Once operational, the aid retrieval process culminates in a desperate dash to secure a box. It’s a perilous challenge taken mostly by young men, who are often the most physically capable in their families.

Images posted to social platform X by the GHF and the Coordination of Government Activities in the Territories (COGAT) display the contents of a food aid box. They appear to include dried food items such as pasta, chickpeas, lentils and wheat flour.

However, Palestinians have shared images showing GHF-marked boxes containing a smaller selection of items.

Like Elfaleet, many risk their lives to bring a basic meal back to their starving families.

“They run on the sand and rubble … and are sniped while they run, causing many injuries and deaths,” Hammad says.

SBS News put these allegations to GHF. A spokesperson denied that aid seekers are being targeted, saying: “GHF team members have not fired a single shot at any civilians. Period.”

“Not even when Hamas threw a grenade at and injured two of our security workers,” the spokesperson said, referring to an incident that took place last month in Khan Younis.

“According to the UN’s own data, nearly 500 civilians have been killed along UN/WFP convoy routes over the last three weeks. That [is] more than twice the number they allege are linked to GHF sites.”

Israel also rejects the figures, but does not provide its own data on deaths.

SBS News has fact-checked this claim against UN data, which shows that since 27 May, 514 Palestinians have been killed along the routes of food convoys while seeking food. However, the data does not support the second part of GHF’s statement, instead showing a significantly higher number of deaths — 859 — have occurred in the vicinity of GHF sites, bringing the total to 1,373 deaths.

Men kneel beside two large white body bags.

According to the UN, 859 Palestinians have been killed near GHF sites since May, a figure the GHF denies. Source: AAP / Mariam Dagga

In early June, 171 organisations called for GHF to be shut down for putting civilians at risk of injury and death.

“Humanitarian principles require that aid is never politicised or weaponised. Its delivery must be adequate, impartial, and responsive to the scale of devastation and starvation,” Duar says.

Even the staff of international agencies, including our own field workers, are starving.

“They are no longer able to carry out their work.”

‘I don’t see any end to it’

Hammad and Elfaleet’s daughter, Hour, has only known life inside a tent.

“I felt wonderful when I found out I was pregnant with my first daughter,” Hammad says.

“But when the war began, I couldn’t find anything to eat. I began to suffer from malnutrition, and I was afraid of giving birth to my daughter in a tent … but unfortunately, this is what happened.”

Next month, the clinical nutritionist hopes to take her now eighteen-month-old daughter — and her story of survival amid medical shortages and nutritional collapse — to Australia on a speaking tour.

That will require a Temporary Activity visa, subclass 408, which permits participation in events endorsed by the Australian government.

Hour has experienced malnutrition at different levels of severity over her short life. Source: Supplied

Hammad says she wants to share her lived experience of pregnancy and birth under threat of war and extreme malnutrition, including how “hunger and prolonged stress affect child development” and the “breakdown of caregiving structures under siege”.

Until then, she says her hope is waning.

“I wish to God that this war would end, but I don’t see any end to it.

“I don’t know if I will stay alive until tomorrow.”

This story has been updated to include statements from the IDF received after the publishing deadline.