Israel’s Gaza Offensive Threatens to Create Famine as Aid Restrictions Intensify

In Gaza City, the looming military offensive by Israeli forces threatens to exacerbate an already dire humanitarian crisis, with aid organizations warning of a potential catastrophe. The Israeli military’s plans for displacement have left residents with little choice but to move south, yet there is no guarantee of safety, food, water, or shelter in these areas.

The International Committee of the Red Cross and other humanitarian groups have labeled the evacuation orders for Gaza’s civilians as “incomprehensible.” After nearly two years of conflict, the healthcare system has collapsed while the number of injured, ill, and starving Palestinians continues to soar. The U.N.-backed global panel on hunger declared in August that conditions in Gaza City and northern regions had reached levels of famine, with central and southern Gaza expected to follow suit by the end of this month if no action is taken.

Aid providers accuse Israel of imposing strict restrictions on food and medicine entering Gaza, exacerbating the crisis. Amande Bazerolle, emergency director for Doctors Without Borders in Gaza, states that there is not enough aid entering and that the number of patients is growing exponentially.

Israel has recently halted all aid deliveries to Gaza City as it escalates its attacks, citing its fight against militant group Hamas. Bazerolle notes that, in addition to Israeli restrictions on medical supplies, Israel’s July attack on a warehouse of the U.N.’s World Health Organization in Gaza further depleted resources.

The WHO reports that it lost most of its stock in the strike, including surgical and trauma supplies, medication, and treatment for malnourished children. Israel claimed at the time, without providing evidence, that it was responding to a militant threat when it hit the warehouse.

Aid groups attribute the famine to Israel’s halt of all aid to the Gaza Strip for almost three months this year, starting in March. Upon resumption, aid was sidelined by a controversial U.S.-backed Israeli distribution system overseen by armed military contractors, effectively excluding the United Nations.

The World Health Organization states that 94% of all hospitals in the Gaza Strip have been either damaged or destroyed in Israeli airstrikes. There are no operating hospitals in Rafah, the city near the Egyptian border destroyed by Israel where displaced Palestinians are expected to be concentrated.

Gaza health authorities report that over 160,000 Palestinians, many of them women and children, have been wounded in Israeli attacks since the beginning of the conflict two years ago. They claim over 63,000 have died. Israel states that nearly 1,200 Israelis and others were killed in the Hamas-led attack in October 2023.

The biggest impending threat is Israel’s demand that aid groups operating in Gaza re-register under new regulations. The rules require providing personal data on all local and international staff and their families, a requirement most organizations have rejected. Aid organizations that do not comply with Israel’s September 9 deadline risk being shut down next week.

“Gaza’s health system is already on the brink,” the World Health Organization stated in response to NPR’s questions. “If the lifesaving support of NGOs and emergency medical teams is compromised, health care services will be severely reduced, and more lives put at risk.”

The WHO notes that NGOs are the “backbone” of healthcare, keeping hospitals running and providing critical treatment. Bazerolle, of Doctors Without Borders, states that with many healthcare workers killed by Israel, organizations are concerned Israel could use the personal details to target staff.

Israel has also been accused of using new regulations to potentially deny aid to groups that criticize Israeli policy. Israel accused NGOs that refuse to provide details of staff and their families of possibly being tied to Hamas. The World Health Organization reported in July that Israel rejected requests by 29 NGOs it said were not authorized to send humanitarian supplies to Gaza, preventing delivery of lifesaving aid. This move had the greatest effect on women, children, the elderly, and people with disabilities.

Israel has argued that restrictions are aimed at stopping Hamas from seizing food and medicine. However, aid groups and an internal U.S. government assessment state there is no evidence of widespread looting by the group. Aid groups claim that flooding Gaza with aid is not just necessary to avoid preventable deaths but would also reduce the black market sale of food as prices would significantly decrease.

Cindy McCain, head of the U.N.’s World Food Program, called on Israel to allow WFP to restart its 200 food distribution points across the Gaza Strip along with community kitchens and bakeries. The WFP, which has operated for six decades, is the world’s biggest humanitarian aid organization.

Israel’s replacement for the U.N., the Gaza Humanitarian Foundation (GHF), operates just three distribution sites in Gaza, a six-hour walk from major population centers. The group behind the famine report states that GHF aid distribution lasted on average just 23 minutes per day.

In Jordan, aid convoys face increased difficulty and costs due to Israeli restrictions. Jordanian communications minister Mohammad Al-Momani told NPR that Israel has recently begun imposing customs fees of between $300 and $400 per truck for aid transiting through Israel to Gaza. He stated that Israel’s arbitrary delays, rejection of some shipments, and attacks by Israeli settlers trying to prevent food from reaching Gaza have turned a three-hour drive into an up to 36-hour ordeal for some convoys.

Bazerolle states that the uncertainty and restrictions have sharply increased the difficulty and cost of getting aid into Gaza, most of it donated by foreign governments and private donors. Israel last month began requiring NGO aid convoys on the main route to Gaza to use Israeli military escorts to ensure that nothing is added to the shipments after Israeli-compliant inspections in Jordan, a requirement rejected by most groups. Another aid official with knowledge of logistics confirmed this new requirement.

Bazerolle says that, due to these challenges, Doctors Without Borders is facing a situation where they will need to position three times the amount of stock they normally would because they cannot count on routes being accessible. The heat also shortens the shelf life of shipments held up often near borders. Israel did not respond to requests for comment on the customs charges and the military escorts.

Israel has also been accused of maintaining an opaque list of equipment and supplies that it rejects as having the potential to be used by militants. This often includes almost anything with metal, including tent poles or wheelchairs, according to U.N. officials. Israel refused to provide NPR with a current list of banned items. Bazerolle states her organization is struggling to bring in an operating table as well as desperately needed external fixators for setting bones, autoclaves, sterilization supplies, and water desalination equipment.