More than half a million people in the northern part of the Gaza Strip are officially experiencing famine, a United Nations-backed food security initiative announced on Friday. This classification comes nearly two years into Israel’s war with Hamas, a Palestinian terrorist organization that has governed Gaza since 2007 and launched an attack against Israel on Oct. 7, 2023, killing more than 1,200 Israelis, mostly civilians. During the ongoing conflict, Israel has blocked most food and aid from entering the Palestinian territory, leading to famine in Gaza.
According to the Integrated Food Security Phase Classification (IPC), a system that measures food insecurity and malnutrition, 32 percent of the population of Gaza City and the surrounding areas “are facing catastrophic conditions characterized by starvation, destitution and death.” The remainder of the 1.47 million residents of the southern part of the Gaza Strip are experiencing extreme hunger and malnutrition. Conditions in those areas are expected to worsen, with the region projected to be under an official famine by the end of September.
To be considered a famine by IPC standards, 20 percent of the households in an area must face an extreme lack of food, while 30 percent of its children suffer from acute malnutrition, and at least two adults or four children out of every 10,000 people die every day from starvation, malnutrition, or disease. An estimated 132,000 children aged six months to five years are projected to suffer from acute malnutrition through June 2026, including 41,000 with severe cases, according to the IPC report.
According to Alex de Waal, an anthropologist at Tufts University, executive director of the World Peace Foundation, and the author of 2017’s Mass Starvation: The History and Future of Famine, the famine in the Gaza City region hasn’t played out like those in other parts of the world — mostly because of how quickly it began, and how quickly it could end with Israel’s cooperation. “Before Oct. 7, the Gaza Strip as a whole had a very unusual food security profile because the rates of child malnutrition were extremely low — developed country levels — and the quality of child health and health overall was actually very high,” de Waal tells Rolling Stone.
De Waal explains that there wasn’t much local food production in Gaza, so the population was highly dependent upon commercial food and Israeli-controlled food aid. “What that meant was that while the situation was, generally speaking, good, it was also precarious, because as soon as Israel imposed a blockade [of aid to Gaza], things deteriorated very fast,” he explains.
Rolling Stone recently spoke with de Waal to find out more about the ongoing famine in Gaza, how it got to this point, and how it might end.
What happened after the Israeli blockade?
So there were the Oct. 7 [2023] Hamas attacks, atrocities and hostage-taking. In about six weeks, from Oct. 7 to the end of November, there was a complete siege [on Gaza] and blockade, and a massive attack by Israel, which includes attacks on basic health infrastructure, water, sanitation, housing — everything that makes life normal and livable.
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And because the population was so dependent upon imported food, you had a very rapid increase in food insecurity, and, to some extent, malnutrition, straight off the bat. A lot of people suddenly had no employment, they had no rations, their houses had been destroyed. They were suddenly very desperate for food. And that steep decline is something that is very unusual. In other famine or food crisis situations, it usually takes a lot longer to unfold.
Then, at the end of November [2023], there was a ceasefire, and the first humanitarian aid was allowed in with the exchange of hostages. And that was when the IPC made its first assessment. Over the following 12 months, we saw a pattern: the situation in Gaza was going up and down, pushing the threshold of famine, but not crossing it. It would get worse when Israel restricted supplies, or when there were military offensives that displaced lots of people or destroyed lots of infrastructure, and it would get less bad — I hesitate to say ‘better,’ because it was pretty miserable, even when it was less bad — when more aid was allowed in. That was from about March to May of last year, and that was because the Biden administration put a lot of pressure on Israel to allow more significant improvement.
How does the conflict create the conditions for famine?
First of all, there’s the blockade. If the intention of the blockade was to starve Hamas, that would be a war crime [according to the Geneva Conventions]. And in my opinion, it has crossed that threshold into being a war crime. The rationale for that is that if you have a civilian population, and you have an armed unit in it, and you want to starve the armed men, you have to starve all the civilians first. The last people to go hungry are the men with guns. That was the underlying rationale for the Geneva Conventions banning starvation — which they only got around to doing in 1977. It wasn’t banned after World War II, because the British and Americans had been using starvation in the war and didn’t want to be called out on it.
The other element of causation here is destroying objects indispensable to survival. That’s actually the definition of the war crime. So it’s not just food, but it’s also water, sanitation, health care, shelter, fuel, etc.
And the underlying rationale there is that in any famine, starvation isn’t just people going without food. Starvation is a whole cluster of things that happen together, so that most of the children who die in a family — and other adults, too — don’t actually die of starvation as such.
So, if our kids get a tummy bug, they might have a day or two off school. If a child is malnourished, they may not recover [from illness]. Then if the child gets another infection and becomes dehydrated, they could die of an acute attack of diarrhea, for example. Or when you take a community out o its regular environment — you crowd them into an unsanitary, overcrowded place with sewage in the street — if one person gets an infectious disease, they’ll all get it.
When you’re measuring deaths in famine, you’re not just measuring the people who die of starvation: [In Gaza] there have been some 300. That will be a very small proportion of the number who actually die because of this deprivation and this hunger.
Is Hamas at all responsible for the famine?
Hamas has several issues of culpability, and is responsible for many crimes — including the atrocities of Oct. 7 — but I would argue Hamas is not specifically responsible for this famine.
But Hamas leadership has been incredibly reckless and disregarding of the lives of the Palestinians. Certainly they knew that the Israeli response would be massive. When you have a ceasefire, both parties have to sign it. It can’t be one-sided. And so Hamas, faced with this famine, really ought to be pleading for a ceasefire to save its people, and I don’t see them doing that.
How has the distribution of food and aid for those in Gaza City worked?
There’s an interesting twist to this, which is the Gaza Humanitarian Foundation. The kindest thing you can say about the GHF is that it was not set up by anyone who has any humanitarian experience.
When you see the crowds of people who go to the GHF sites, it’s like a survival of the fittest. It’s a mad rush, and the weaker, poorer people can’t get there. You have to walk for some distance, and when you get there, you’ll get shoved aside in this crowd. And they have no means of monitoring who’s actually taking the food. I’ve looked at some of the videos, and you see young men going in opening the boxes. They have sacks on their backs. They take the food commodities they want, put them in the sacks, and head off. And then you get others coming, picking up the leftovers — many of which have been spilled on the ground.
Now, who are those young men? We have no idea. They could be Hamas. The GHF can tell you that it has distributed 1.6 million meals, but it can’t tell you who’s eaten those meals. In any humanitarian aid distribution in a war zone, one of the things you do is take aid as close as possible to the people who need it, and set up an aid distribution system that maximizes the chance that the aid is getting into the hands, the mouth, the stomachs of the neediest.
Who is behind the GHF?
A private contractor, registered in the U.S. and Switzerland. Its client is the Israeli government, but it seems to be backed by U.S. money. But the best you can say about it is that it’s incompetently and dangerously designed. The worst you could say would be that it’s part of a military strategy to control and probably displace the Palestinian people of Gaza.
If you want to control an insurgency or a population, the classic way of doing it in counterinsurgency is to feed the population. But the way of feeding them is separating the civilian population from the armed men.
When the GHF was first set up, they planned to use bilateral surveillance: ID everybody and then allocate food to those who had been verified, and deny food to others. But it didn’t actually work out that way because they didn’t have the technology or the control to do it. And, by the time they introduced it, the population was so hungry that any attempts to do that kind of individual checking at the gates was impossible. There were too many people, and you could only have done that to control that hungry population.
So if you look at the locations of the four GHF [aid distribution] sites, the three main ones are in the far south of Gaza and Rafah. And when Israel talks about relocating the population, the most likely scenario is that they’ll want all the Palestinians to evacuate to that zone — basically to set up a tent city, or some encampment in the far south of Gaza, next to where these sites are. Then it would be possible to implement that kind of surveillance rationing. But that’s speculation. It hasn’t happened yet, but could be on the cards.
Are there any other contributing factors to the famine in Gaza?
An element that I would be particularly concerned about now is severely, acutely malnourished children. Until a few months ago, the rates of malnutrition of children in Gaza were actually surprisingly low, given the stress that the food system was under. Then, they began to shoot up. And that’s really when you saw that six-to-eight-fold increase in the number of children with severe acute malnutrition and began to think, ‘This is dangerous.’
Now, those kids cannot eat regular food. They have gotten to that stage of malnutrition where they are extremely vulnerable to even the slightest infection, but also when the body has consumed all the available fat, and it’s consuming muscle and the stomach lining. The various chemical and electrolyte imbalances in the body go way out of whack. Those children need to be in the hospital. And if you start giving them regular food, not only can they not digest it, but the body can’t respond. It’s called refeeding syndrome.
One of the tragedies at the end of World War II is that when British and American troops liberated some concentration camps and saw these starving people, they immediately gave them their rations. But the concentration camp inmates couldn’t digest the food, and hundreds of them actually died from refeeding syndrome. They survived the Nazi concentration camp, and then they died of this.
One of the things that we’ve learned from other famines is that when kids are at this stage, they need to be in the hospital, with round-the-clock, specialized intensive care and full-time monitoring.
I’ve been trying to get figures for the number of hospital beds that are available for intensive therapeutic care for kids in Gaza. People have given me different numbers, but it’s dozens, at most hundreds, but we need thousands of [hospital beds]. And those hospitals need round-the-clock electricity, clean water, supplies, and nursing staff who are rested and not stressed. Of the 18 regular hospitals that are still functioning, 11 of those are in Gaza City. So if Israel orders an evacuation of Gaza City, we could lose most of the remaining intensive care capacity for starving kids.
So that’s specifically why the IPC called for a ceasefire. And of course, it also puts the onus on Hamas, because, as I said, a ceasefire needs two [parties].
You’ve mentioned a few examples, but is it common for starvation and blocking aid to be used as a weapon of war?
It is, unfortunately, quite common. About 10 years ago, I was very confident that famines would be consigned to history, but several cases have come up since then. In Syria, the Assad regime had this ‘surrender or starve’ set of blockades. In Yemen, there was a food blockade. It wasn’t terribly effective, but it caused huge amounts of suffering. The Ethiopian government used a very tight siege and destruction of essential infrastructure strategy. And then in Sudan today, which is the biggest and worst famine — numbers and intensity are much bigger than Gaza — both sides are using starvation as a weapon.
How does the famine in Gaza differ from other famines?
What’s unique in the case of Gaza, is that you have on standby, just a few miles away, United Nations agencies that were running a pretty good distribution system as recently as March. They have the supplies, they have the expertise, they have the plans, they have the funds, and they’re not being allowed to do it — in comparison to say, Sudan, where it would be very difficult to actually set up the system.
In Sudan, if the two warring sides were to agree to a ceasefire tomorrow, getting aid, etc., would take weeks — possibly months — because of the logistics [and] the distances. [Even if] the top generals have agreed, there are still a bunch of armed groups and warlords and rogue elements in the way that they would have to negotiate with, and infrastructure would take a long time. But in the case of Gaza, all that infrastructure is ready and available, and just waiting for an Israeli green light.
If the [Israeli] cabinet decides that this has gone too far and wants the food supply problem to be fixed, they know they have everything for all those kitchens to reopen. They could do it — maybe not tomorrow, but within a couple of days.
That’s what makes this really a uniquely troubling case of famine. It’s not that it’s unusual to have a manmade famine, to have an army creating — either deliberately or recklessly — a lot of hunger. What’s unique is that Israel could stop it if it wanted to, and it’s not doing much.
Where do things go from here?
It could go in any one of a number of directions. I think that the key here is what the U.S. is going to do. All European countries in the U.N. have said that this is really terrible, and action needs to be taken. So far, I haven’t heard anything out of the Trump administration. And that’s worrying, because Israel is denying [that there’s a famine in Gaza]. It’s challenging the IPC. I stand with the IPC on this. I don’t find the Israeli denials convincing.
So my worry is that if the current Israeli posture continues, which is that it continues to block the U.N. — the real humanitarian professionals — it will double down on the GHF. It has allowed more food in over the last few weeks. But if the offensive continues and the evacuation order is issued for Gaza City, then I think the famine will escalate. We will see the starvation rates, the death rates, continue to shoot up.
In the longer term, if the whole population is forced to relocate to a new zone in the south where these GHF sites are, we would have a situation where the population as a whole could be fed in something that is, frankly, a bit like a concentration camp. But there would be no mechanism for dealing with severely malnourished children who need specialized hospital care. That capacity isn’t there, and there’s no indication that it’s on the agenda, so most of those kids would die.
Is there anything else you’d like to mention about the famine in Gaza?
It’s terribly sad, and it’s such a stain on the reputation of Israel. When I was writing my book Mass Starvation 10 years ago, I started out with the starvation of the Jews in World War II. This is a part of the Holocaust that has really been forgotten. The Jewish people have been through so many catastrophes and it has so defined their identity. And for me, as someone who comes from a Jewish background, the idea that the Jews would be marked with the stain of having inflicted this kind of suffering on others is really painful.
From Rolling Stone US
