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The humanitarian situation in Gaza has been dire throughout Israel\u2019s 22-month war against Hamas, but the crisis has reached new heights in recent months amid ongoing Israeli restrictions on aid. The world\u2019s leading global hunger monitor warned<\/a> last week that the \u201cworst-case scenario of famine\u201d is playing out in Gaza, and the World Food Program (WFP) recently said<\/a> that 1 in 3 people in the enclave are going multiple days in a row without anything to eat.<\/p>\n Caroline Willemen, a project coordinator at the Doctors Without Borders (Medecins Sans Frontieres, or MSF) clinic in Gaza City, painted a grim picture of what she\u2019s witnessed in the Palestinian territory since arriving roughly six weeks ago.<\/p>\n \u201cIt\u2019s completely dystopian,\u201d Willemen told Foreign Policy<\/em>. \u201cI\u2019ve been doing this work for nine years. I\u2019ve never in my life seen a scale of destruction and desperation like what I\u2019ve seen here.\u201d<\/p>\n Israel has faced rising global condemnation as Gazans, including children<\/a>, die from malnutrition amid near-daily reports of fatal incidents involving Israeli forces opening fire on desperate Palestinians seeking aid. These deadly shootings have been linked to a controversial aid system run by the Gaza Humanitarian Foundation (GHF), a recently formed organization backed by the United States and Israel.<\/p>\n \u201cWhat we are witnessing is a genocide. Hunger is part of that,\u201d Willemen said, describing the situation as \u201capocalyptic\u201d and \u201cengineered chaos.\u201d<\/p>\n \u201cWe don\u2019t use the word \u2018genocide\u2019 lightly at all, but here we use it because of what we see\u2014people being starved on purpose, people being shot at when they look for food, people being deprived of sufficient water<\/a>,\u201d she added. Israel maintains that there\u2019s no policy of starvation in Gaza, though the hunger crisis comes at a time when far-right Israeli cabinet ministers are openly calling for depopulating<\/a> and resettling<\/a> the Palestinian territory.<\/p>\n Amid the mounting international criticism over the crisis, including from some of its closest allies, Israel recently said<\/a> it would take steps to allow more aid into Gaza. But the United Nations and other humanitarian groups are raising alarm bells that what\u2019s coming in is still not nearly enough while warning that the airdrops that Israel has recently permitted are ineffective, costly, and dangerous. Palestinians in Gaza have been injured or killed<\/a> by airdrops at various points in the war.<\/p>\n \u201cWhen there is an airdrop, my colleagues at the field hospital get their emergency room ready to receive patients,\u201d Willemen said.<\/p>\n Meanwhile, there is a lot of disinformation swirling around the hunger crisis as well as competing claims about who or what is to blame. Gaining a clear picture of the conditions on the ground can also be difficult\u2014particularly given that, with rare exceptions, Israel has barred foreign media<\/a> from reporting in Gaza over the course of the war.<\/p>\n To break through the noise, it\u2019s helpful to examine what we know\u2014and don\u2019t know\u2014about the humanitarian crisis in Gaza right now based on the available information.<\/p>\n <\/p>\n Many of Israel\u2019s claims about the humanitarian situation, such as Prime Minister Benjamin Netanyahu\u2019s recent assertion<\/a> that there is \u201cno starvation in Gaza,\u201d are contradicted by data and other evidence.<\/p>\n The World Health Organization said this week that roughly 12,000 children<\/a> under the age of 5 are suffering from acute malnutrition. Nearly a quarter of Gaza\u2019s population\u2014approximately half a million people\u2014are facing famine, according<\/a> to the WFP. The Gaza Health Ministry said<\/a> on Thursday that 197 Palestinians, including 96 children, have died from malnutrition since the war began.<\/p>\n The prices of basic goods in Gaza have also increased exponentially<\/a>. Sugar, for example, reportedly now costs $106 per kilogram (2.2 pounds) on average as of late July. By comparison, it was just 89 cents before the war.<\/p>\n It\u2019s not possible to fully verify all of the numbers coming out of Gaza at present. But even the Trump administration, which continues to be supportive of Israel more broadly, has disputed <\/a>\u00a0Netanyahu\u2019s claims.<\/p>\n \u201cYou\u2019ve got little kids who are clearly starving to death,\u201d U.S. Vice President J.D. Vance recently said<\/a> to reporters.<\/p>\n Accounts from aid workers on the ground also undermine Israel\u2019s efforts to downplay the extent of the problem. More and more patients are entering the malnutrition program at MSF\u2019s Gaza City clinic, Willemen said, but none are exiting it. \u201cWe can hardly discharge anyone because they\u2019re simply not eating enough to be able to be considered cured of their malnutrition,\u201d she said.<\/p>\n The hunger crisis has gotten \u201csignificantly worse\u201d in the past six weeks, Willemen said, adding that MSF now has five times more patients in its malnutrition program\u2014including children under 5 as well as pregnant and lactating women\u2014than it did in May.<\/p>\n The lack of food has also exacerbated the problems surrounding Gaza\u2019s health system, and experts have emphasized the need for more intensive care supplies.<\/p>\n Many of the patients seen in MSF\u2019s Gaza City clinic with wounds such as burns or orthopedic injuries are unable to heal because of the lack of food. \u201cThey\u2019re not eating properly, and so their bodies can\u2019t heal themselves,\u201d Willemen said.<\/p>\n Though there is widespread agreement among humanitarian workers and experts that Gaza should be flooded with food, they also warn that conditions have deteriorated to a point where this won\u2019t be enough.<\/p>\n In more severe cases of malnutrition, Willemen said that food alone can\u2019t solve the problem.<\/p>\n \u201cThey need highly specialized medical care,\u201d she said, because the vast majority of them are children, and their bodies \u201ccan\u2019t take in the food anymore.\u201d But flooding Gaza with more food supplies is still vital \u201cbecause it could stop more people from reaching that stage,\u201d she added.<\/p>\n Even before the war, Israel\u2019s yearslong blockade on Gaza made life difficult for Palestinians, and food insecurity<\/a> was already a problem. Restrictions on goods and services into Gaza rose dramatically after the Hamas-led attack on Israel on Oct. 7, 2023, with then-Israeli Defense Minister Yoav Gallant ordering<\/a> \u201ca complete siege on Gaza\u201d on Oct. 9.<\/p>\n \u201cThere will be no electricity, no food, no water, no fuel. Everything is closed,\u201d he said.<\/p>\n Throughout the war, Israel has consistently faced pressure from the international community to allow more aid into the enclave; in January 2024, for instance, the International Court of Justice ordered<\/a> Israel to \u201ctake immediate and effective measures to enable the provision of urgently needed basic services and humanitarian assistance.\u201d And in March of that year, the court ordered Israel to take additional measures<\/a> \u201cto address famine and starvation\u201d in Gaza, including working with the United Nations and opening additional land crossings into the enclave.<\/p>\n Israel responded by allowing in additional aid, but observers maintained<\/a> that it was not nearly enough to address the situation. And then, after a cease-fire collapsed in March of this year, Israel again imposed an 11-week blockade on all aid into Gaza. This exacerbated the already challenging humanitarian situation and is directly tied to the current crisis. Israel lifted the blockade in May, but aid has still been slow to make its way into the territory. (More on that below.)<\/p>\n Experts also contend that the steps that Israel has taken to upend the humanitarian system that\u2019s operated in Gaza for years, which are linked to the country\u2019s contentious dynamic with the United Nations<\/a>, have worsened the situation.<\/p>\n \u201cThe U.N. and so many other aid organizations have been doing humanitarian relief work in the [Gaza] Strip for a long time. They know how to operate in these situations. They have experienced staff, and that\u2019s just been wiped out by all of this,\u201d Rebecca Wolfe, a conflict and humanitarian response expert at the University of Chicago, told Foreign Policy<\/em>. Israel\u2019s sidelining of the U.N. means that \u201cthe actual knowledge about how to do it right\u201d is not being put to good use, Wolfe said.<\/p>\n In January, Israel imposed a ban on the U.N. Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), which has long been the primary U.N. aid agency for Palestinians. UNRWA is now prohibited from operating on Israeli soil, and Israeli authorities are barred from cooperating with the agency. Israel has accused<\/a> UNRWA of being \u201cinfiltrated by Hamas\u201d and alleged that employees of the agency were involved in the Oct. 7 attack. A U.N. investigation found that nine staffers (out of roughly 30,000 total employees)\u201cmay have\u201d had ties to Hamas, and those employees were dismissed.<\/p>\n But UNRWA has vehemently rejected the notion that it\u2019s an arm of Hamas, and the agency continues to urge Israel to resume cooperation with it. A number of countries that stopped providing funds for UNRWA after Israel initially made the allegations of ties to Hamas have since reversed course. (The United States is not among them.) And Western governments, including France, the United Kingdom, and Germany, have expressed serious concerns<\/a> over Israel\u2019s UNRWA ban.<\/p>\n \u201cThe manmade famine in #Gaza has been largely shaped by the deliberate attempts to replace the UN coordinated humanitarian system through the politically motivated \u2018GHF,\u2019\u201d UNRWA chief Philippe Lazzarini said in a recent post<\/a> on X, adding that UNRWA has now been prevented from bringing aid into Gaza for five months. Lazzarini said Israel\u2019s \u201cweakening\u201d of UNRWA is part of a \u201cdeliberate measure to collectively pressure & punish Palestinians for living in Gaza.\u201d<\/p>\n The U.N. and other humanitarian organizations\u2014such as MSF, Mercy Corps, and the International Rescue Committee\u2014all remain active in Gaza. But their operations are far more restricted and limited than in the past, and the previous U.N. humanitarian system\u2014which featured hundreds of aid sites<\/a>\u2014is no longer in place.<\/p>\n Since Israel ended its total blockade on aid in May, aid distribution in Gaza has primarily run through GHF\u2014a U.S.-funded organization<\/a> with a hazy background. GHF\u2019s executive director is Rev. Johnnie Moore, an evangelical Christian leader with close ties to U.S. President Donald Trump. The U.N. and other humanitarian organizations have boycotted GHF\u2014which is working with armed security contractors and coordinating with the Israeli military\u2014over concerns about neutrality and humanitarian principles.<\/p>\n The aid system under GHF has been marred by violence and chaos<\/a> from the start. Hordes of desperate Gazans have repeatedly flooded the group\u2019s few aid sites, making it difficult for them to receive proper assistance.<\/p>\n Hundreds of Palestinians have been killed, primarily by the Israeli military, in the vicinity of GHF sites, according<\/a> to the U.N. Israel has repeatedly said that its forces fired \u201cwarning shots<\/a>\u201d at Palestinians heading to the aid sites. But Israel Defense Forces (IDF) officers and soldiers told Haaretz<\/em><\/a> that they\u2019ve been ordered to fire at unarmed crowds near aid distribution sites, even in instances when they did not pose a clear threat. And in a recent report<\/a>, Human Rights Watch accused Israel of committing war crimes at GHF sites.<\/p>\n A retired U.S. special forces officer who worked with the GHF in Gaza, Anthony Aguilar, has also said<\/a> that he witnessed IDF and U.S. personnel fire at unarmed civilians near aid sites in Gaza. Aguilar said what he witnessed constituted \u201cwar crimes.\u201d GHF rejected Aguilar\u2019s allegations and has referred to him as \u201ca disgruntled former contractor who was terminated for misconduct.\u201d Aguilar denied this.<\/p>\n Part of the problem with the new system, experts say, is that the GHF system operates out of just four sites in militarized areas near Israeli troops. Experts say that this is unnecessarily dangerous and a recipe for disaster.<\/p>\n \u201cGenerally, in a war zone, you don\u2019t want people traveling far. That just makes it much more dangerous for them,\u201d Wolfe said. \u201cThe more time people spend on the road, the more at risk they are.\u201d Wolfe also highlighted that it\u2019s unusual to have a military force operating so close to aid distribution sites, which goes against humanitarian principles.<\/p>\n \u201cIt\u2019s a chaotic environment,\u201d Wolfe said, adding that there are no reasons to \u201chave guns there\u201d because it \u201ccreates a flash point that is unnecessary when people are starving.\u201d<\/p>\n People have also been crushed to death<\/a> in stampedes at GHF sites, which critics have decried as death traps<\/a>.<\/p>\n Experts have emphasized that many of the problems surrounding GHF\u2014and the chaotic scenes at its distribution sites\u2014are linked to a lack of experience in coordinating assistance in a conflict zone.<\/p>\n \u201cThis is why we\u2019ve been advocating that this should be coordinated by the U.N., like we do everywhere else in the world,\u201d Willemen said.<\/p>\n In a statement to Foreign Policy<\/em>, GHF conceded that \u201cit can be chaotic\u201d at its aid sites due to \u201cwidespread food insecurity.\u201d But GHF maintained that there has been \u201cno violence\u201d within its distribution sites and pushed back on the notion that it lacks expertise.<\/p>\n \u201cGHF consists of a robust team of career humanitarians on the ground in Gaza who are working hand-in-hand with local Palestinian aid workers to deliver on our mission of feeding people. These include former USAID [U.S. Agency for International Development] and United Nations (UN) personnel who helped develop GHF\u2019s humanitarian distribution model,\u201d the GHF statement read.<\/p>\n GHF said it\u2019s delivered more than 110 million free meals to Palestinians and called for the U.N. and other humanitarian organizations to begin working with it to \u201cscale even more aid across Gaza.\u201d<\/p>\n In late July, a group of Senate Democrats called on<\/a> the Trump administration to stop funding GHF and \u201cresume support for the existing UN-led aid coordination mechanisms.\u201d MSF and U.N. experts have also called for GHF to be shut down. In a scathing report<\/a> released this week based on medical data, patient testimonies, and accounts from witnesses at two Gaza clinics, MSF referred to GHF\u2019s distribution hubs as sites of \u201corchestrated killing.\u201d<\/p>\n When asked about the report, GHF said that MSF\u2019s allegations are \u201cfalse and disgraceful,\u201d accusing the organization of \u201caiding Hamas\u201d with its claims. The Israeli Defense Ministry did not respond to a request for comment.<\/p>\n The Israeli government has repeatedly made the case that the GHF-run system is necessary because Hamas steals aid, but it has not provided evidence that this is happening on a widespread scale. Israeli military officials have also pushed back on the assertion, and a USAID analysis<\/a> completed in late June found no evidence of large-scale aid theft by Hamas.<\/p>\n The pandemonium surrounding GHF\u2019s system has also raised questions about how it could verify who is receiving aid and avoid the problem that Israel has cited to justify backing the controversial group. The verification process under the United Nations is far more robust. U.S. Ambassador to Israel Mike Huckabee, who visited a GHF site in Gaza last week, acknowledged<\/a> in a recent interview that GHF \u201ccan\u2019t absolutely guarantee\u201d it\u2019s not giving out aid to Hamas.<\/p>\n There is also clear evidence of U.N. aid trucks routinely being looted<\/a>, including by criminal gangs<\/a>. But a lot of the looting appears to be a product of sheer desperation.<\/p>\n Willemen said that her clinic has treated patients who\u2019ve been among the \u201chungry individuals\u201d who\u2019ve been wounded as they stopped aid trucks near the Zikim border crossing. Last week, she spoke with a 22-year-old man who was desperate to get food for his family and suffered a \u201chorrendous\u201d leg injury when he was hit by an aid truck. The man told Willemen that seven young men he was with were run over by the truck and killed.<\/p>\n \u201cThe truck drivers get forced by the Israeli forces to continue driving,\u201d she said.<\/p>\n Critics of Israel\u2019s handling of the humanitarian crisis have said that significantly ramping up aid deliveries into Gaza and allowing more access for distribution would help address the looting problems by decreasing desperation.<\/p>\n As the humanitarian crisis in Gaza worsens, Israel has also accused the U.N<\/a>. of allowing huge amounts of aid to rot.<\/p>\n A U.N. official who spoke to Foreign Policy<\/em> on the condition of anonymity over concerns for the safety of their colleagues said that the organization is not deliberately allowing aid to fester, emphasizing that delivering assistance has become increasingly complicated and difficult due to an array of factors\u2014including the Israeli military often rejecting requests for access to delivery routes.<\/p>\n \u201cWe are as frustrated as anyone,\u201d the official said. \u201cIf aid is sitting at a gate somewhere outside of Gaza, there isn\u2019t anything that the U.N. hasn\u2019t done to get it inside. Once it\u2019s inside, there are really<\/em> bad days, there are bad days, and there are no good days. It\u2019s not easy anymore.\u201d<\/p>\n After cease-fire talks with Hamas collapsed once again, there are also growing concerns about the potential for conditions to get even worse\u2014including for the living hostages still held by the militant group\u2014now that Israel has announced that it will move to take over Gaza City and Netanyahu has expressed a desire to occupy all of Gaza.<\/p>\n \u201cI literally cannot fathom what that will mean here, because we cannot imagine how it can deteriorate even further,\u201d Willemen said.<\/p>\n Palestinians in Gaza generally cannot leave due to restrictions imposed by both Israel and Egypt. Israel controls almost all entry points into the enclave. Roughly 85 percent<\/a> of Gaza is either occupied by Israeli forces or under evacuation orders. Groups such as MSF have been operating in the remaining 15 percent of Gaza, in so-called \u201csafe zones.\u201d<\/p>\n \u201cIf the 15 percent gets even smaller, at some point, there will be hardly any space left for us to work, let alone for the 2 million people of Gaza to live,\u201d Willemen said.<\/p>\n<\/p><\/div>\nAre people starving in Gaza?<\/strong><\/h3>\n
How did the situation get this bad?<\/strong><\/h3>\n
What is the GHF?\u00a0<\/strong><\/h3>\n
What other factors are preventing aid from getting to Gazans?<\/strong><\/h3>\n