Around 166 million people worldwide need urgent action against hunger, according to the Integrated Food Security Phase Classification (IPC), a global partnership that measures food insecurity.
This includes almost all people in the Gaza Strip, where the Israeli army launched an offensive in October after Hamas militants attacked Israel. More than one million residents of Gaza are facing the most severe form of malnutrition – classified as a ‘disaster or famine’ by the IPC.
Seven-month-old Majed Salim is one of them.
The baby, born on November 1, three weeks after Israel launched its offensive, was being treated for a chest infection in the neonatal intensive care unit of Kamal Adwan Hospital in northern Gaza on May 9. The nurse caring for him said he was suffering from severe malnutrition.
His mother, Nisreen al-Khatib, said Majd was born at a healthy weight of 3.5 kilograms (7.7 pounds).
By May, when he was six months old, he weighed barely 3.8kg — about 3kg less than the expected weight for a child his age, she said.
Majd, whose eyes watched anxiously for journalists visiting the ward, was to be given antibiotics for an infection and fortified milk to gain weight, his mother said. Reuters has been unable to locate him since May 21, when the hospital was evacuated after an Israeli raid.
The United Nations child rights agency UNICEF, citing figures from its partners, said one in three children in northern Gaza is acutely malnourished or wasted. Ismail al-Thawabta, director of the Hamas-run government media office, said their records showed 33 people had died from malnutrition in Gaza, including 29 children, but said the number could be higher.
COGAT, an Israeli Defense Ministry agency tasked with coordinating aid distribution in the Palestinian territories, did not respond to a request for comment for this story. In late May, Israel’s Foreign Ministry issued a detailed statement questioning the methods of the IPC’s analysis, which it said omitted measures taken by Israel to improve access to food in Gaza. The IPC declined to comment.
The plight of Gaza’s children is part of a larger trend. Globally, more than 36 million children under the age of 5 were acutely malnourished last year, including nearly 10 million who were severely malnourished, according to the Global Report on Food Insecurity, a joint analysis on food insecurity by 16 international organizations.
Food shortages in Gaza are particularly widespread, and come amid a widespread rise in extreme hunger as conflicts intensify around the world.
In two other countries – South Sudan and Mali – hundreds of thousands of people are living in areas listed as famine-affected areas on the IPC website. In another 35 – including Sudan, Nigeria and the Democratic Republic of Congo – many people are in the IPC’s next most severe category of food deprivation.
The IPC, a group of UN agencies, national governments and non-governmental organisations, is expected to update its assessment of the picture in war-torn Sudan in the coming weeks. A preliminary estimate reported by Reuters earlier this month said 756,000 people in Sudan could face catastrophic food shortages by September.
Gaza’s hunger crisis is also a result of the war. On October 7, the Israeli army attacked the Strip in response to a cross-border attack by Hamas on Israel. Since then, more than 37,000 Palestinians and about 1,500 Israelis have been killed, according to Gaza and Israeli figures.
The Israeli offensive has destroyed large parts of Gaza’s agricultural land. In the early days of the war, Israel imposed a complete blockade on Gaza. It later allowed some humanitarian supplies to enter, but still faces international calls for more supplies.
Last month, International Criminal Court prosecutors sought arrest warrants for Israeli and Hamas leaders, accusing Israeli Prime Minister Benjamin Netanyahu and Defense Minister Yoav Galant of starving civilians as a method of war, among other alleged crimes. Netanyahu called the move a “moral outrage of historic proportions,” saying Israel was fighting in full compliance with international law and taking unprecedented steps to deliver aid to those in need.
Israel has accused Hamas of stealing the aid, which Hamas strongly denies. Israel has also said that any distribution problems in Gaza are the fault of international agencies.
Nutrition experts say that even when children survive, deprivation of food in the early years can cause long-term damage.
A child’s brain develops fastest in the first two years of life. So even if they don’t starve to death or die from disease because of their weakened immune systems, children may suffer developmental delays, said Ashima Garg, a consultant on nutrition at UNICEF for the Middle East and North Africa.
“They survive, but they may not develop as well during childhood and beyond,” he said.
Three families in Gaza told Reuters about their daily diets, and four global health experts explained how such shortages affect growing bodies. They said the damage done in a few weeks can last for years.
“This can have long-term effects on their immune system, their ability to absorb good nutrition, and their cognitive and physical development,” said Hannah Stephenson, global head of nutrition and health at the nonprofit Save the Children.
first day
Gaza has the highest number of families globally experiencing extreme levels of food poverty, according to the IPC, which classifies hunger levels into five categories, the worst of which is famine.
Cindy McCain, executive director of the World Food Programme, said on May 5 that families in northern Gaza, where Majd lives, are already suffering from full-blown famine.
It may take months for the international measurement system to declare a famine. But the first damage to a child’s body is counted in days.
A survey conducted by UNICEF in late May found that 9 out of 10 children aged 6 months to 2 years in Gaza are living in severe child food poverty. That means they are eating two or fewer servings from food groups a day, which UNICEF’s Garg said means cereal or some kind of milk.
He said this has been the case since December 2023, with a slight improvement in April 2024. 85% of children of all ages did not eat at least one meal throughout the day in the three days before the survey was conducted.
The main cause of acute malnutrition in northern Gaza is a lack of diversity in the diets of children and pregnant and breastfeeding women, according to a February 2024 report by the Global Nutrition Cluster, a group of humanitarian agencies led by UNICEF.
Inadequate intake before and during pregnancy and while breastfeeding harms both mothers and babies.
Abed Abu Mustafa, a 49-year-old father of six, was still living in Gaza City in early April. He said people there had “eaten almost every green plant we could find” and had not eaten meat or chicken for at least five months.
In Rafah to the south, Mariam, a 33-year-old mother of five, is living in a school with two dozen of her relatives. She described a typical meal for her family before the conflict and what they are currently eating, shown below.
Before the war, Majd’s mother said the average family meal consisted of rice, chicken or meat, along with vegetables such as okra, cauliflower or peas. During the war, a shortage of flour forced the family to make bread from animal feed. Recently, bread and canned goods such as tuna and beans have started to appear again, but these are not widely available.
Unable to find food at the start of the war and forced to flee Israeli bombing, Khatib said she had difficulty breastfeeding Majd.
She said they could find neither good-quality infant formula nor clean water to mix it, so they fed him a variety of powdered diets mixed with rainwater or saltwater from Gaza’s polluted wells, causing him to suffer from diarrhoea.
He said, “It is not possible to find proper food for breast feeding, there is no meat, no protein, no calcium, and no elements that can produce good milk for the baby.”
UNICEF advisor Garg said that the nutrition of lactating mothers in Gaza is seriously affected, and along with it their milk production capacity is also getting affected.
“They’re not eating fruits and vegetables. They’re not eating meat. They’re not drinking much milk,” he said. Lack of nutrients causes the quality of breast milk to deteriorate. Diluted formula is not safe and carries the risk of diarrhea, which in itself can be life-threatening.
Moderately malnourished mothers can still breastfeed, as their bodies effectively sacrifice their own nutritional needs to protect the baby. But severely malnourished women struggle.
Ahmed al-Kahlout, the unit’s head nurse, said Majd’s infection was caused by malnutrition.
“There is no immunity to it, so if children living in shelter homes get any disease…the child gets a severe lung infection,” he said.
Susceptibility to infection usually increases after two weeks due to inadequate feeding.
Muscle tissue is destroyed as the body consumes fat reserves, which is why aid workers in the field use simple tape measures to assess the severity of children’s conditions.
The mid-upper arm circumference (MUAC) measuring tape has been used for decades. If the upper arm circumference for a child aged 6 months to 5 years is 11.5 cm (4 1/2 inches) or less, the child may be suffering from severe acute malnutrition, according to standards formulated by the United Nations.
The UN humanitarian agency OCHA said MUAC screening data in Gaza from mid-January showed that as of 26 May, more than 7,000 children aged 6 months to 5 years were already acutely malnourished.
It looks like this.
Gaza has the most people at risk of starvation, but according to the IPC classification, millions more are a step behind in food poverty across the region.
The IPC grades the severity and scale of food insecurity and undernutrition. A reading of 3, 4 or 5 on a five-grade scale requires immediate action.
The IPC says households in Stage 3 are in “crisis.” They have severe or above-normal levels of acute malnutrition, or they can meet their minimum food requirements only by selling assets or through crisis measures.
Stage 4 is an “emergency”. Households either have “very high” acute malnutrition and mortality or are only able to compensate for food shortages by taking emergency measures and selling assets.
Stage 5 is “disaster” or “famine”. Households are acutely short of food and/or other basic necessities, and levels of starvation, death, deprivation, and extremely severe acute malnutrition are evident. An entire region is classified as experiencing famine only when high food insecurity is accompanied by some level of acute malnutrition and mortality.
For the IPC, famine-stricken areas meet at least two of the following three criteria:
* At least 20% of households in the region are facing acute food shortage,
* Nearly one in three children there suffers from acute malnutrition,
* Every day, two adults or four children per 10,000 die from starvation or malnutrition and disease.
The IPC report released in March estimated that the entire population of the Gaza Strip would fall into Phases 3 to 5 between March and July. UN officials told Reuters they expected the next IPC analysis on Gaza to be released on June 25.
Based on the IPC’s latest published analysis, South Sudan and Mali are two other countries whose families are estimated to fall into the same Phase 5 category as Gaza.
Overall, the three countries with the most people at Stage 3 and above are Nigeria (25 million), the Democratic Republic of the Congo (23.4 million) and Sudan (17.7 million), according to the IPC website.
The IPC said its latest analysis on Sudan, conducted in December, was so out of date that it could not be included in the tables used by Reuters for this chart.
Severe malnutrition results in various complications.
This is the impact of hunger after just three weeks. Like many children in Gaza, Majd has struggled with not having enough food for months.
(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)
