‘This is famine': children starve as Gaza aid can only trickle in
In the last week, though, graphic images made the onset of starvation impossible to ignore.
In one, the emaciated corpse of 12-year-old Abdeljawad al-Ghalban, little more than a collection of stick-like bones, lay on a mortuary trolley. He had suffered from cerebral palsy, and his family had been unable to get hold of the specialist treatment he needed.
'He needed a specific kind of milk and food,' his father, Abdelhamid, said. 'He was already sick, but the malnutrition made his condition worse.'
Not all the children affected by hunger were sick before. Two-year-old Yazan Abu Foul is clearly wasting away.
'Yazan doesn't suffer from any diseases,' his father, Mahmoud, said on Friday. 'His condition is purely from hunger. Over the past months, I noticed his weight dropping more and more. I took him to several doctors. They all told me the same thing: this is famine.'
The United Nations says it is finding it particularly difficult to supply specialist foodstuffs needed for sick and already malnourished children. But it says the general situation has been worsening rapidly for all of Gaza's 2.1 million residents for months, since Israel imposed an aid blockade in March.
That was lifted in May, and a new organisation, the Gaza Humanitarian Foundation (GHF), a US-backed startup, was brought in to be the leading aid provider. But neither it nor the UN agencies have managed to restore aid deliveries to their former level and, with much of the Gaza strip levelled by the war, the population is dependent on that aid.
'As the Israeli government's siege starves the people of Gaza, aid workers are now joining the same food lines, risking being shot just to feed their families,' a joint statement by 100 aid agencies including Christian Aid, Médecins Sans Frontieres and Mercy Corps said on Wednesday.
'With supplies now totally depleted, humanitarian organisations are witnessing their own colleagues and partners waste away before their eyes.'
Israel strongly rejects the accusation that it is responsible, accusing Hamas of looting aid and saying the UN warehouses are full of supplies if only they would deliver it.
'It is time for them to pick it up and stop blaming Israel for the bottlenecks which are occurring,' David Mercer, the Israeli government spokesman, said in reply.
While aid supplies have varied during the war, and the situation improved immensely during the ceasefire earlier this year, delivery has become increasingly difficult since the blockade.
• 'Mass starvation' across Gaza as US envoy opens ceasefire talks
UN agencies say that disinformation and lack of ability to monitor a violent and changing situation exacerbate confusion over how much aid is getting in. International journalists are unable to report first-hand as they are banned by the Israeli authorities from entering Gaza.
The agencies say the fact that their warehouses are full is exactly the point they are making. The obstacle is getting it through an Israeli-controlled war zone to the people who need it.
They deny that Hamas is responsible for taking aid, although there are certainly cases of local gangsters trying to loot it. The main problems, the agencies say, are the delays caused by the Israeli inspection process and that convoys are mobbed the minute they hit the road — an inevitable consequence of the desperation among the population.
'We have always been flagging that we have no systematic diversion by Hamas,' Antoine Renard, head of World Food Programme (WFP) operations in Gaza, said.
He drew attention to the delays affecting a WFP convoy on Sunday. He said it took 20 hours for 19 lorries to arrive at the warehouse on the Gaza side of the border crossing, load up, and begin delivery. The Israeli military took more than eight hours to inspect the lorries, a regular part of the process, though nothing untoward was found. Another six to seven hours was spent waiting for Israeli approvals to travel.
The UN estimates that between 500 and 600 lorries a day are needed to supply enough food for all Gaza's residents.
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The issue is not just with such delays. Both UN and GHF distributors face chaotic and dangerous supply routes, which are regularly overwhelmed by the people trying to reach distribution points.
WFP lorries are mobbed the minute they hit the road, which is often little more than a smashed-up track. Convoys have to take routes determined in advance by the Israeli military, and which residents are well aware of. When reaching GHF distribution points, residents are told to queue on specific routes, and those who stray risk being shot by Israeli forces who are still conducting military operations throughout the strip and guarding the aid sites.
In part, this is a result of the blockade in March and the shift of aid distribution by Israel away from the UN towards primarily the GHF.
The UN system focuses on distributing aid to kitchens and bakeries run by aid agencies. But when aid stopped getting into Gaza, that system collapsed. The few kitchens and bakeries that remain cannot find fuel and are often burning waste for their ovens instead.
Much aid is now distributed directly to families instead. This means every aid distribution operation becomes a steeplechase among the desperate, as the fittest compete to evade shooting, race to the aid points and grapple with each other for such food parcels as arrive.
In this Darwinian process, the sick, the elderly, and lone women with children to care for are left behind.
The GHF defends its provision of aid, and after a difficult start it has indeed handed out tens of millions of food packages. But unlike the UN, which provides large boxes of raw ingredients — flour, pasta, lentils and tomato paste — designed to feed a family for a month, the GHF distributes meals that it says will keep a family of five going for three or four days. Then the family's young men, if they have them, have to go risk their lives going back for more aid.
Renaud described an environment where, when aid deliveries resumed in May, the chaos had reached a tipping point. Beforehand, however poor conditions were, residents believed that the agencies would be able to supply food eventually. Now, that belief has gone, a vicious circle in which the harder it is to deliver food, the more desperate people storm the routes and the convoys, making the process even harder.
• Starvation and despair in Gaza: 'Aid is just another injustice'
Things can change, and may have already started to do so as this week's grim photographs started to emerge. Israeli inspections have eased in recent days. By Wednesday 150 UN lorries were able to get through, 93 for the World Food Programme alone — a sign of what is possible, though nowhere near enough.
Food supplied by agencies does sometimes end up on the local market, and the prices tell a story. During the ceasefire, a one-kilo bag of flour cost $1.50. That went up to $100 by last weekend. By the end of the week it was down to $15-20.
The question remains whether this marginal improvement will save Yazan and other children. Scores have died already this month.
As he treated Sila Barbakh, an 11-month-old girl who weighs just seven and a half pounds, Dr Ahmed Al-Farra, a paediatrician, said she was basically healthy.
'This is primary malnutrition,' he said. 'She has lost subcutaneous tissue, lost muscle mass. She needs vitamins. She needs supplementation. But if she gets good nutrition, she will survive.'
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