Evidence suggests the Gaza Humanitarian Foundation was designed to deflect international pressure while serving as another tool in Israel’s campaign of genocide

Testimonies from healthcare workers and displaced people reveal a horrifying picture of acute starvation and desperation in Gaza

‘With no aid getting in, you feel like as a hospital you only patch up the wound but eventually it will burst again’ - Dr. Maarouf in Gaza

‘Not only has the international community failed to stop this genocide, but it has also allowed Israel to constantly reinvent new ways to destroy Palestinian lives in Gaza and trample on their human dignity’ - Agnès Callamard

Evidence gathered by Amnesty International shows that, more than a month after introducing its militarised aid distribution system, Israel continues to use the starvation of civilians as a weapon of war against Palestinians in the occupied Gaza Strip - deliberately imposing conditions intended to destroy Palestinian life, as part of its ongoing genocide.

Testimonies from medical staff, parents of malnourished children, and displaced Palestinians struggling to survive reveal a horrifying picture of acute starvation and desperation in Gaza.Their accounts provide further evidence of the catastrophic impact of Israel’s ongoing restrictions on life-saving aid, its deadly militarised aid system, mass forced displacement, relentless bombardment, and the systematic destruction of essential infrastructure.

By continuing to prevent the UN and other key humanitarian organisations from distributing certain essential items including food parcels, fuel and shelter within Gaza and by maintaining a deadly, dehumanising and ineffective militarised ‘aid’ scheme, Israeli authorities have turned aid-seeking into a booby trap for desperate starved Palestinians. They have also deliberately fueled chaos and compounded suffering instead of alleviating it. The aid delivered is also way below the humanitarian needs of a population that has been experiencing almost daily bombings for nearly two years.

Agnès Callamard, Secretary General of Amnesty International, said:

“Israel’s genocide has continued unabated in Gaza including creating a deadly mix of hunger and disease pushing the population past breaking point.

“In the month following Israel’s imposition of a militarised ‘aid’ scheme run by the Gaza Humanitarian Foundation, hundreds of Palestinians have been killed and thousands injured either near militarised distribution sites or en route to humanitarian aid convoys.

“As the occupying power, Israel has a legal obligation to ensure Palestinians in Gaza have access to food, medicine and other supplies essential for their survival. Instead, Israel has continued to restrict the entry of aid and impose its suffocating cruel blockade and even a full siege lasting nearly 80 days. This must end now. Israel must lift all restrictions and allow unfettered, safe, and dignified access to humanitarian aid throughout Gaza immediately.”

Amnesty interviewed 17 internally displaced people (10 women and seven men) as well as the parents of four children hospitalised for severe malnutrition, and four healthcare workers, across three hospitals in Gaza City and Khan Younis in May and June.

Devastating impact on children

Even before the imposition of a total siege on 2 March, slightly but insufficiently eased 78 days later, Israel’s deliberate and calculated decision to destroy Palestinians had a particularly devastating impact on young children and pregnant and breastfeeding women.

Since October 2023 at least 66 children have died as a direct result of malnutrition-related conditions. This figure does not include the many more children who have died as a result of preventable diseases exacerbated by malnutrition.

The victims include a four-month-old baby, Jinan Iskafi, who tragically died on 3 May due to severe malnutrition. According to her medical report, which was reviewed by Amnesty, Jinan was admitted to the Rantissi pediatric hospital due to severe dehydration and recurrent infections. She was diagnosed with Marasmus, a severe form of protein-energy malnutrition, chronic diarrhoea, and a suspected case of immunodeficiency. The pediatrician treating her told Amnesty that she required a specific lactose-free formula, which was not available due to the blockade.

Gaza’s decimated health sector, already overwhelmed with the volume of injuries, is struggling to deal with the influx of infants and children hospitalised for malnutrition. According to the UN Office for the Coordination of Humanitarian Affairs, as of 15 June, a total of 18,741 children were hospitalised for acute malnutrition since the beginning of the year.

The vast majority of children suffering from malnutrition, however, cannot reach any hospital due to displacement orders and heavy bombardment and ongoing military operations.

Numbers barely scratch the surface of the suffering in Gaza

Accounts from healthcare workers and displaced people paint an even more harrowing picture. Susan Maarouf, a nutritional expert at the Nutrition unit in the Patient Friend Benevolent Society hospital in Gaza City, supported by the organization MedGlobal, said that in June 2024 the hospital opened a dedicated department for children aged six months to five years to manage cases of severe malnutrition. 

Maarouf said:

“Back then, Gaza City and the North Gaza governorate were hit by malnutrition [as a result of the tight blockade]. But this year for us, the situation began to drastically get worse again in April. Since then, out of approximately 200-250 children we have screened daily for malnutrition, nearly 15% showed signs associated with severe or moderate malnutrition.”

In the worst cases visible signs include pale skin, hair and nail loss, and alarming weight loss. She expressed the profound helplessness of offering nutritional advice amid severe shortages of food, with fruit, vegetables and eggs only available at exorbitant prices, if at all:

“In an ideal world, I would recommend the parents to provide the child with nutritious food, rich with protein. I would advise that they maintain a hygienic environment for their children; I would stress the importance of clean water… In our situation… any recommendation you give … sometimes you feel like you are rubbing salt into these parents’ wounds.”

Dr. Maarouf described the relentless cycle of malnutrition stating that in some cases children were re-hospitalised after being discharged:

“We treated one little girl, aged six, for nutritional oedema, she had severe protein deficiency when she came in early May; with the treatment we gave her she showed signs of improvement, including gaining weight, becoming livelier… unfortunately she was recently admitted again because her condition relapsed. Like most families in Gaza, her family is displaced, they live in a tent, they have to rely on the lentils or rice they get from the community kitchen. It’s a cycle. With no aid getting in, you feel like, as a hospital, you only patch up the wound but eventually it will burst again.”  

Doctors have also warned that the lives of newborn babies are at risk amid acute shortages of baby formula milk, especially for children with lactose-intolerance or other allergies.

One doctor said:

“There is a milk crisis in Gaza overall. Also, we notice that new mothers, because they themselves are not eating properly or because of the panic, trauma and anxiety, are unable to breastfeed. So, to secure baby formula at all is a struggle. But if your child has allergies, it’s almost impossible to find special formula in any of Gaza’s hospitals and for infants the failure to secure special baby formula can be a death sentence.”

At Nasser hospital in Khan Younis in the southern Gaza Strip, Dr. Wafaa Abu Nimer confirmed the dire situation, reporting that by 30 June, nine children were still being treated for malnutrition-related complications at her facility alone. She described the scenes they have witnessed over the past two months as “really unprecedented” with severe cases of nutritional oedema or marasmus, muscle wasting. She also said that some are additionally suffering from injuries due to explosions from which they haven’t recovered.

Dr. Abu Nimer said that since Israel’s new aid distribution scheme began there has been no signs of improvement in the situation with hundreds of children screened for malnutrition on a daily basis in their pediatric emergency room. Mass displacement orders issued to the Khan Younis governorate in May made Nasser hospital out of reach for thousands of displaced families.

Dr. Abu Nimer described to Amnesty how the impact on children extends beyond the physical:

“One girl whose hair fell out almost completely as a result of nutritional oedema, kept asking me ‘doctor, will my hair grow again? Am I [still] beautiful?’. Even if these children recover completely, the scars will always remain with them. Medically we know that malnutrition amongst infants and small children may have long-term cognitive and developmental effects, but I don’t think enough attention is being given to the mental health and psychological impact [of starvation and war] on children and parents.”

She also conveyed the exhaustion felt by medical staff:

“We as doctors are also exhausted, we are malnourished ourselves, most of us are also displaced and live in tents, yet we do our best to offer medical care, provide nutrient supplements and as much support as we can. We try to save lives, we try to alleviate the suffering, but there is very little we can do after discharge.”

Weaponised aid

While Israeli authorities continue to impose their unlawful blockade on the entry of aid and commercial supplies into the occupied Gaza Strip, hundreds of aid trucks remain stuck outside Gaza, waiting for an Israeli permit to enter.

The UN Office for the Coordination of Humanitarian Affairs reported that as of 16 June, 852 trucks for UN and international humanitarian organisations - the majority of which carry food supplies - remain stuck in Al-Arish in Egypt, yet to receive a permit from the Israeli authorities to enter Gaza. The partial easing of the total siege on 19 May did not include easing restrictions on certain critical supplies, such as fuel and cooking gas, which have not been allowed into Gaza since 2 March. Without fuel, there’s no electricity so vital life-saving medical equipment cannot function.

Only a trickle of the extremely limited aid allowed by Israel into Gaza reaches those in need. It is either distributed through the inhumane and deadly militarised scheme run by the Gaza Humanitarian Foundation, or it is offloaded by desperate starved civilians, and in some cases, organised gangs. This grim reality is compounded by Israel’s deliberate destruction or denial of access to life-sustaining infrastructure, including some of Gaza’s most fertile agricultural land and food production sources, like greenhouses and poultry farms. 

The World Food Programme and local organisations were for the first time permitted to distribute flour in Gaza City on 26 June. The relatively smooth distribution that took place with thousands waiting their turn and no reported injuries is a damning indictment of Israel’s militarised Gaza Humanitarian Foundation scheme.  All the evidence gathered, including testimonies which Amnesty is receiving from victims and witnesses, suggest that the Gaza Humanitarian Foundation was designed to placate international concerns while constituting another tool of Israel’s genocide. 

Agnès Callamard added:

“Not only has the international community failed to stop this genocide, but it has also allowed Israel to constantly reinvent new ways to destroy Palestinian lives in Gaza and trample on their human dignity.

“States must cease their inertia and live up to their legal obligations. They must exercise all necessary pressure to ensure Israel lifts immediately and unconditionally its awful blockade and ends the genocide in Gaza. They must end any form of contribution to Israel’s unlawful conduct or risk complicity in atrocity crimes. This requires immediately suspending all military support to Israel, banning trade and investment that contribute to Israel’s genocide or other grave violations of international law.

“States should also adopt targeted sanctions, through international and regional mechanisms, against those Israeli officials most implicated in international crimes and cooperate with the International Criminal Court, including by implementing its arrest warrants.”