By Guardian - Jason Burke in Jerusalem - Tue 16 Jan 2024

Aid officials in Gaza believe that pockets of famine already exist in the territory, with parents sacrificing remaining food for their children, an apple costing $8 (£6.30) and fuel for cooking almost impossible to find.

UN agencies issue joint plea for entry routes to Gaza, where Israel’s war with Hamas has damaged swaths of territory

UN agencies have said that Gaza urgently needs more humanitarian assistance as Palestinian authorities reported that the death toll in the territory during the Israeli offensive there had risen to more than 24,000.

The World Food Programme, Unicef and the World Health Organization said in a joint statement that new entry routes needed to be opened to Gaza, more trucks needed to be allowed in each day, and aid workers and those seeking aid needed to be allowed to move around safely.

The UN agencies did not directly blame Israel but said aid delivery was hindered by the opening of too few border crossings from Israel, a slow vetting process for trucks and goods going into Gaza, and continuing fighting.

Israel’s war against Hamas in Gaza, launched after the militant group’s 7 October attack on southern Israel which killed 1,200, mainly civilians, has led to massive damage to swaths of the territory and displaced most of Gaza’s 2.3 million population. Many have been forced to move five, six or seven times, losing most of their possessions and money as they seek safety.

In Rafah and Khan Younis, in the south of Gaza, tents and makeshift dwellings cover almost all available ground, with multiple families crammed into apartments, in UN-run shelters in schools or sleeping on the floors of hospitals.

“There’s no food, no water, no heating. We are dying from the cold,” said Mohammad Kahil, displaced from northern Gaza to Rafah.

Hussein Awda, 37, fled northern Gaza after his house was destroyed and had many relatives killed at the beginning of the war.

“It is horrible. We are having just one meal a day, of bread made with flour and salt. Maybe we can get some tinned beans if we can buy it on the black market. Otherwise we are hungry,” said Awda, who has been living with his family in a former vocational training school in Khan Younis that is now home to 35,000 displaced people.

“There is meant to be more aid coming in but we have not seen anything except some fruit, which is very expensive. There is nothing on the markets. We try to eat less because we don’t know when any more food will come.”

Doctors in Gaza said that children, weakened by lack of food, had died from hypothermia and that several newborn babies with mothers who were undernourished had not survived for more than a few days.

“We don’t have the numbers but we can say that children are dying as a result of the humanitarian situation on the ground as well as due to the direct impact of the fighting,” said Tess Ingram, a spokesperson for the United Nations Children Fund, who is in Rafah.

Many displaced people have no money left after three months of war and cannot afford even basics to make flat bread. Twenty-five kg sacks of flour now cost $50, six times their prewar price, salt has gone up 1,800%. The only fuel available is wood cut from live trees, which burns badly and is expensive.

Access for aid agencies to the north of Gaza, where 300,000 still live amid the ruins, has been made more difficult by continued fighting.

Aid officials said they strongly suspected that “pockets of famine” existed in northern Gaza, but that a lack of data on child malnutrition and child mortality meant formal criteria for declaring a famine had not been fulfilled. Images posted on social media on Monday showed hundreds rushing to a truck bringing food.

“Almost no aid at all has got up there and there are a lot of people who couldn’t or didn’t want to leave their homes and have been there since day one,” one official told the Guardian.

The UN said on Sunday that less than a quarter of aid convoys had reached their destinations in the north in January because Israeli authorities denied most access.

Israel has blamed the UN and other groups for the problems with aid delivery, claiming that supplies were “piling up” in Gaza. Col Moshe Tetro, the head of the Israeli army unit responsible for the delivery of humanitarian aid, said last week there was no food shortage in Gaza and “the reserves in Gaza are sufficient for the near term”.

UN officials said that although the logistic challenges of moving aid across Gaza means there were sometimes backlogs, their warehouses were almost empty at the weekend.

Experts from the Integrated Food Security Phase Classification Initiative (IPC), which measures famine risk around the world for the UN, NGOs and government, have forecast that at least one in four households in Gaza face “an extreme lack of food, starvation and exhaustion of coping capacities” within three weeks.

In a report published three weeks ago, they also concluded that Gaza will have “the highest share of people facing high levels of acute food insecurity … ever classified for any given area or country” by the agency.

Palestinian authorities said on Monday that the bodies of 132 people killed in Israeli strikes were brought to Gaza hospitals over the past day, raising the death toll from the start of the war to 24,100.

Officials from the health ministry, which does not distinguish between fighters and noncombatants in its tally, says two-thirds of those killed in the war have been women and children.

The Israeli military on Monday said its forces and aircraft targeted militants in Khan Younis, a current focus of the ground offensive, as well as in northern Gaza, where the Israeli military says it continues to expand its control.

The Hamas government media office said two hospitals, a girls’ school and “dozens” of homes were hit.

At al-Aqsa hospital in central Gaza, bodies were piled on a donkey cart on Sunday.

Hisham Abu Suweh, waiting outside the emergency ward where his wife was being treated, said his family had thought they would be safe as civilians.

“We were sitting peacefully when the missile hit us,” he said.

The Israeli military blames the high civilian death toll on Hamas, which it says deliberately operates out of civilian facilities and uses the population of Gaza as a human shield. Hamas denies the charge.