CNEWA

At Death’s Door

Gazans’ struggle to survive famine deployed as a weapon of war.

The streets of Gaza are quieter than they used to be — not because peace has returned. The deep silence of hunger has replaced the noise of daily life. Every corner bears the marks of a deepening humanitarian catastrophe: gaunt faces of children, long lines at makeshift aid points and parents who have nothing left to give but words of comfort and prayer.

The humanitarian collapse in Gaza did not happen overnight. On 2 March 2025, the Israeli Defense Forces sealed all crossings into the enclave — 16 days before the collapse of the temporary cease-fire between Israel and Hamas. With borders sealed, the already limited flow of food, medicine and fuel stopped entirely. Within weeks, hunger and malnutrition spread at an unprecedented pace. Preventable diseases began to take hold. By early August, the Hamas-run Ministry of Health in Gaza reported 201 people had died from famine and malnutrition since the start of the war, including 98 children. Those numbers rise daily.

In the middle of Gaza City, amid rubble and market stalls selling a handful of overpriced simple popular sweets, 35-year-old Ahmed Al-Sawafiri describes the reality of survival:

“Out of poverty, we have children we want to feed — nothing more or less,” he says. “The situation in general is really difficult, really tragic, and we hope from God things get better.” 

Hunger, he adds, is now part of everyday life. “The famine is great; children sometimes sleep without eating. What can we do? We just need to get by. It’s all in God’s will.”

For Mr. Al-Sawafiri, faith is both a comfort and a lifeline. “Hopefully for the better,” he says, glancing at the street around him. “We ask God that things get better.”

A few steps away, a boy in a small stall, barely tall enough to see over the market crowd, spends his days trying to earn enough to support his eight siblings, “so we can eat and live, and feed my little siblings.” Abdul Rahman Barghouth, 12, dreams of school, but for now his hope is that “the war ends, and prices go down.”

Many people wait in line with containers amid destroyed buildings.
Families wait in line for safe drinking water that, as with everything else in Gaza, is increasingly rare. (photo: Diaa Ostaz)

Faith runs through these conversations as naturally as breath. People speak of God’s will even as they recount the impossible choices they face, whether to send a child to line up for aid despite the risk of shelling, whether to sell the last piece of jewelry for a bag of rice, whether to skip their own meal so a child can eat.

For 54-year-old Mozayal Hassouna, those choices leave deep emotional scars. “Some days we spent four days without bread,” she says. “My youngest son tells me, ‘You let me go to sleep hungry, Mom.’ But I can’t provide anything. My husband is 65 and sick; he can’t run after trucks for aid. We lost our stall in the market; our house was bombed like others. We have no income, nothing left to sell, but we do not object to God’s will.”

Her son has developed a stutter, which a doctor says is the result of trauma from bombardment. Now they live in a tent, displaced for two months. “I hope the war ends all over Gaza,” she says. “Let us live, and the children live a little.”

No story captures the cruel intersection of war, siege and hunger clearer than that of 2-year-old Muhammad Al-Mutawaq. His mother, Hidaya, has been displaced seven times since the war began. Her husband was killed early in the conflict in Jabalia, leaving her alone with four children. Before the recent escalation, Muhammad weighed 20 pounds. Today, he weighs just 13. “There is no aid entering Gaza,” she says. “Borders are closed; prices are very high. His only cure is to eat and drink.”

She has tried hospitals, aid groups and community kitchens, but nothing has been enough. “I registered in many associations as a mother of orphans, but I didn’t benefit at all,” she says. “I got really tired going to hospitals, associations, schools, trying to find something for him.”

Muhammad suffers from muscle relaxation, worsened by malnutrition. Physical therapy has helped, but without proper food, recovery is impossible. “Since I lost my husband, these are all God’s tests,” she says. “We will be patient, and hopefully it will end, and Muhammad will be like he used to be.”

UNICEF spokesperson Salim Oweis calls the situation “a man-made catastrophe.” He warns hunger is now killing children in staggering numbers. “Over 90 have died from malnutrition since the war began — a staggering increase of more than 50 percent in less than three months,” he says. “We are witnessing a generation growing up with toxic stress, deprivation and trauma that will probably last a lifetime.” 

In July, nearly 12,000 children were diagnosed with acute malnutrition, compared with 2,000 in February.

The Integrated Food Security Phase Classification, a collaborative initiative of worldwide crisis relief organizations, including UNICEF, warned in mid-July that Gaza’s food consumption and nutrition indicators were at their worst since the war began. More than one in three people were going days at a time without eating, and half a million people — nearly a quarter of Gaza’s population — were enduring famine-like conditions. 

“Every hour we wait, more children will die — if not from bombs, then from the humanitarian crisis that follows them around every corner,” Mr. Oweis says. While some aid trickles in, he described it as “a drop in the ocean of needs.” 

Airdrops, though symbolic, are inefficient, expensive and dangerous, sometimes killing people in the scramble for supplies. “They don’t compare to what could come in through land routes if full and unimpeded access is allowed,” he says.

At Al-Ahli Hospital, medical director Dr. Maher Ayyad describes a health system on the brink of collapse. 

“Really, it is catastrophic,” he says. “We are short of medicine, supplies, equipment. Our machines are damaged, and there are no spare parts or engineers to repair them. We are dependent entirely on generators, needing about 238 gallons of fuel daily — often unavailable.”

Much of the hospital’s trained staff has fled or been displaced. 

“Sometimes we receive 400 casualties in a single day,” Dr. Ayyad says. “We cannot deal with all of these patients, and we are sorry to lose some because of shortages.” 

While Al-Ahli is primarily a surgical hospital, famine’s shadow is visible there, too. 

“We can see people are starving,” he says. “Some goods are in the market, but they are so expensive nobody can buy them.”

Dr. Ayyad expresses gratitude for the symbolic gestures of airdropped aid but warns that without stopping the war, relief will always fall short. 

“Please work for peace,” he urges. “Without stopping this war, the problem will go deeper and deeper.”

The layers of collapse in Gaza reach into every part of life. Drinking water is scarce, forcing people to drink untreated water that carries the risk of cholera and other diseases. Tens of thousands live in tents or overcrowded shelters, with no privacy and little safety. Livelihoods have been erased as markets are bombed, fishing is blocked, and farmland is inaccessible. Schools lie in ruins or serve as shelters, and many children have forgotten how to read or write under the weight of trauma. The Ministry of Health warns of a dangerous increase in Guillain-Barré syndrome and other diseases linked with poor nutrition and sanitation, calling the situation “a warning of a real, potential infectious disaster.”

The common refrain is not only that aid is scarce, but that it is uneven. “Some people eat and some don’t,” Mr. Al-Sawafiri says. 

Ms. Hassouna describes how her family cannot physically reach aid drops, either because they are too far or because the scramble is too dangerous. UNICEF’s Salim Owais confirms this, saying that security risks, coordination delays and desperate crowds make it almost impossible to distribute aid fairly. The difference between survival and starvation, he says, can come down to whether someone is young and strong enough to run for a bag of flour.

Despite the destruction, there is a shared refrain: “Alhamdulillah,” praise be to God. Faith becomes the language that fills the space where certainty used to be. 

For Mr. Al-Sawafiri, that means believing things will “get better and better.” For young Abdul Rahman, it means thanking God for whatever food comes. For Ms. Al-Mutawaq, it means viewing her son’s suffering as a test from God, one that will one day end. 

International agencies insist this crisis is not inevitable — it is preventable. UNICEF has called for an immediate and permanent cease-fire, unrestricted entry of humanitarian and commercial supplies, and protection for civilians and aid workers. Without these steps, the warnings are stark: Famine will deepen, disease will spread, and more children will die.

“All the help will not be enough without stopping this war,” said Dr. Ayyad. “The situation is catastrophic. I hope soon the leaders will reach comprehensive peace in this area.”

As Gazans wait for peace, Mozayal Hassouna repeats her faith-filled wish:

“We have no objection to God’s will. But I hope the war ends completely, so we can live, and the children can live a little.”

Click here to support CNEWA’s emergency campaign in Gaza. 

Journalist Diaa Ostaz reports from Gaza.

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