After five months of devastating conflict between Israel and Hamas in Gaza, the Palestinian enclave on the Mediterranean is enduring a humanitarian catastrophe, according to international aid groups.
The north of the strip in particular is on the verge of famine: children are dying from hunger, while families are eating weeds and animal feed, prompting international alarm.
As tough Israeli inspections slow the progress of aid through land crossings, the US and others plan to send humanitarian aid by ship into Gaza and are also dropping aid from the air.
But aid groups question whether that can reverse the growing hunger; Médecins Sans Frontières called the maritime efforts a “glaring distraction”, urging Israel to support the flow of trucks into the enclave.
Why is there not enough food in Gaza?
After Hamas’s October 7 attack, in which the Palestinian militant group killed 1,200 people and took 250 hostage, according to Israeli figures, Israel vowed “a complete siege” of Gaza.
Under US pressure, that policy shifted; international aid trucks began travelling from Egypt into Gaza via the Rafah border crossing. In December, Israel opened its own Kerem Shalom border crossing with Gaza.
At both crossings, Israel imposes a strict inspection regime that has often delayed the transfer of humanitarian supplies to the already impoverished enclave, where Israel’s offensive has killed more than 30,000 people, according to local health officials, and displaced 80 per cent of the population.
Ultranationalist protesters on the Israeli side of Kerem Shalom, who oppose the provision of any aid to Gaza, have also blocked trucks.
Over the past two months the largest obstacle to aid provision has been the breakdown of security and basic law and order inside Gaza, said international officials. Humanitarian convoys have come under fire by Israeli forces, while desperate locals and criminal gangs have looted trucks.
Food production in Gaza has also been severely curtailed as bakeries, factories and farms are destroyed or made off-limits by Israeli military operations.
Israeli military officials continue to insist there is enough food in Gaza and that the UN and other aid groups should improve their logistical capabilities inside the territory.
How much more is needed?
Before the war, an average of 500 truckloads of aid and fuel entered the Gaza Strip each day, five days a week, for a population already heavily dependent on aid, according to UN figures.
That number has fallen sharply. The highest daily number of trucks able to enter Gaza over the past five months has been 300, a figure reached just once. More often it has been well below 200 a day, according to UN figures.
The effects of lower levels of aid delivery have been compounded as each day’s shipments fail to compensate for previous shortfalls and the accumulated damage of the war.
Most hard-hit are the estimated 300,000 residents of north Gaza who stayed as the area bore the brunt of the initial Israeli ground offensive.
In recent months, people in the north have been reduced to eating livestock feed, weeds and cactuses. Jamie McGoldrick, UN humanitarian co-ordinator for the occupied Palestinian territories, warned last week that “children are dying from hunger”.
For north Gaza alone, 300 aid trucks per day were needed, he said.
UN and US officials said this month that a genuine solution would require “flooding” Gaza with aid, not only to help suffering Gazans but to undercut the black market. That would improve security for aid convoys by removing one incentive for looting.
Are airdrops helping?
More than 30 airdrops of aid have taken place over Gaza during the war, by countries including the US, Jordan, Egypt, France, Belgium, the Netherlands and the UAE.
Airdrops avoid the bottlenecks affecting overland routes — but they are inefficient and ineffective, say aid groups. Some packages have landed in the sea or blown into Israel.
On Friday, several Palestinians were reportedly killed by aid drops whose parachutes failed to open. When the material does land safely, eyewitnesses report that able-bodied men take possession of the packages, leaving questions over whether it will reach the most vulnerable.
The most pressing problem with sending supplies by air is the small amounts of aid it provides. According to the UN, one truck can deliver between 20 and 30 tonnes of aid, 10 times the amount carried by one aircraft.
“Airdrops are a last resort and will not avert famine,” Carl Skau, deputy executive director for the World Food Programme, said last week.
Who is trying to bring aid by sea?
Two maritime aid initiatives aim to ship aid from Cyprus, some 200km from Gaza in the eastern Mediterranean.
The first is a multinational route for commercial vessels between Larnaka in Cyprus and Gaza. A ship operated by humanitarian group World Central Kitchen was due to set sail this weekend with a “symbolic” 500 metric tonnes of aid, said Cypriot officials, equivalent to about 25 trucks.
The vessel was dragging a “fit-for-use” structure to unload cargo on the shore, due to the lack of a port in Gaza.
The second maritime initiative is led by the US military, which plans to build a floating pier off Gaza to receive much larger shipments. A US navy logistics support vessel set sail from Virginia with the first equipment at the weekend. The EU, UAE, UN and Cyprus are also involved in the initiative, which US officials said would take several weeks to set up.
Israel will retain a strict inspection mechanism in Cyprus for aid heading to Gaza, but it remains unclear who will secure and distribute the seaborne aid once it arrives.
Despite these efforts, Tor Wennesland, UN special co-ordinator for the Middle East Peace Process, said: “I think everybody is in agreement that the most effective way to get aid into Gaza is by trucks . . . even the people who would like to have this sea corridor.”
Could the Israelis do more?
Israel insists that, in the words of its chief military spokesman Daniel Hagari, “it puts no limits [on] the amounts of aid that can go into Gaza”. But even its allies reject this.
US President Joe Biden admonished the Jewish state’s leadership in last week’s State of the Union address, saying: “Humanitarian assistance cannot be a secondary consideration or a bargaining chip.”
Biden has also urged Israel to open a further overland border crossing with north Gaza. That would help circumvent the perilous routes from southern Gaza, say aid officials, while more land crossings would help to avoid delays and bottlenecks.
International aid groups want Israel to allow more communications equipment into Gaza for aid workers and drivers. They are also asking for better co-ordination with the Israeli military to avoid aid convoys being targeted.
Israel has begun working with local private groups in north Gaza to move aid in an attempt to circumvent Hamas civil control. But such initiatives are still small and face uncertain prospects.
A private aid convoy on February 29 descended into chaos and led to the deaths of more than 100 people as thousands of desperate Palestinians rushed the trucks and Israeli troops opened fire.
One person familiar with Gaza humanitarian efforts said they told Israeli officials that more aid would “save lives [in Gaza], and it will help you with growing international pressure so you can win the war”.
Additional reporting by Mehul Srivastava in Tel Aviv and Eleni Varvitsioti in Athens
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