Israel's blockade-turned-siege of Gaza – one of the deadliest offensives in recent history – has made the Palestinian enclave into a death zone.
As the war between Israel and Hamas entered a third month, the only certainty for Gaza at the start of 2024 is more hunger, death and misery.
"Gaza has simply become uninhabitable. Its people are witnessing daily threats to their very existence while the world watches on," said Martin Griffiths, the U.N.'s head of humanitarian affairs and emergency relief coordinator.
On Friday, Griffiths told the U.N. Security Council that for nearly 100 days what has been unfolding in Israel and Gaza is a war conducted with "almost no regard for the impact on civilians."
"In Gaza, the situation remains horrific as relentless Israeli military operations continue," he said. "We can see this in the tens of thousands of people killed and injured, the vast majority women and children."
But there's a sliver of hope from the international community. After months of impasse, the 15-nation council sent a message to Israel and Hamas that they must take "urgent steps" to immediately allow humanitarian aid to flow into Gaza.
That led to the appointment of Netherlands' Deputy Prime Minister Sigrid Kaag as the U.N.'s Senior Humanitarian and Reconstruction Coordinator for Gaza. She is expected to start the new job on Monday.
Kaag, who has extensive work and academic experience in the Middle East, must implement the council's demand for "urgent steps to immediately allow safe, unhindered and expanded humanitarian access, and also for creating the conditions for a sustainable cessation of hostilities" in the Gaza Strip, where all 2.2 million inhabitants face a crisis-level lack of food or worse. All aid deliveries not sent by the warring parties are to be verified as legitimate humanitarian goods.
International aid organizations struggle to meet a daunting demand for help while beseeching Hamas and Israel to come to a lasting cease-fire. The Israeli army's chief spokesperson, Rear Adm. Daniel Hagari, however, marked three months of war by vowing to keep fighting and free all the Israeli hostages taken by Hamas.
“We have completed the dismantling of Hamas' military framework in the northern Gaza Strip and will continue to deepen the achievement, strengthening the barrier and the defense components along the security fence. Now, we are focusing on dismantling Hamas in the central and southern Gaza Strip," Hagiri told reporters on Saturday night.
"The fighting will continue throughout 2024, as we work according to a plan to achieve the war's objectives," he said. "To dismantle Hamas in the center and south and to continue with every intelligence, operational effort, and military pressure to return the hostages."
Eighty-five percent of Gaza's population, or 1.9 million people, are displaced, according to Griffiths' U.N. Office for the Coordination of Humanitarian Affairs.
At least 23,385 people – 22,185 Palestinians and 1,200 Israelis – have been killed in the war since Hamas militants' Oct. 7 surprise attack on Israel, OCHA reported. Another 62,466 people, mostly Palestinians, have been injured.
Israel’s three-month-0ld retaliatory campaign in Gaza is one of the deadliest and most destructive military campaigns in recent history, AP reported. Griffiths called on Hamas and Israeli combatants to meet their obligation to protect civilian lives.
“The humanitarian community has been left with the impossible mission of supporting more than 2 million people, even as its own staff are being killed and displaced," he said.
Phone and internet blackouts continue, roads are damaged or destroyed, and relief convoys are targeted, leaving supplies vital to survival virtually non-existent. Overcrowded shelters and overflowing sewers spread infectious diseases. Amid this chaos, an average of 180 Palestinian women a day are giving birth and people are facing the highest levels of food insecurity ever recorded.
"Famine is around the corner," said Griffiths. "For children in particular, the past 12 weeks have been traumatic: No food. No water. No school. Nothing but the terrifying sounds of war, day in and day out."
Most children receiving only bread or milk
The health of 155,000 pregnant women and breastfeeding mothers is of special concern, as well as that of 135,000 children under the age of two whose nutritional needs are not being met. Aid workers, already pushed to the limits, are eyewitnesses to nightmarish conditions.
The children of Gaza, traumatized by months of fighting and worsening living conditions, face a triple threat to their already tenuous lives: the spread of disease, starvation and even more violence.
Cases of diarrhea in children not yet five years old increased to 71,000 during the week before Christmas, up from 48,000, UNICEF said. That's 3,285 new cases a day and a 2,000% increase from before the escalation in hostilities.
"Their lives are increasingly at risk from preventable diseases and lack of food and water,” said Catherine Russell, UNICEF's executive director.
Meeting even the basic nutrition needs for children is proving largely impossible. UNICEF says most children are getting only grains, such as bread, or milk, a diet that meets the definition of “severe food poverty."
Everyone is going hungry
The World Food Program, struggling to get basic supplies through clogged and closed checkpoints, says “everyone in Gaza” is skipping meals and going hungry.
Half of Gaza’s population is starving, WFP says, with 9-in-10 Palestinians eating less than one meal a day and struggling to find clean, drinkable water. Weak with hunger and compromised immunity, many Palestinians are susceptible to disease.
Less than a week into 2024, Cindy McCain, WFP's executive director, pleaded from Egypt's Rafah border crossing for safe, expanded humanitarian access to Gaza.
"Parents in Gaza do not know whether they can feed their children today and whether they will even survive to see tomorrow," she said. "The suffering just meters away is unfathomable standing on this side of the border."
McCain met with Egypt's President Abdel Fattah El-Sisi and senior government officials, and visited the Egyptian Red Crescent's humanitarian staging hub. She also inspected the rapid expansion of logistical operations and monitoring systems at Rafah that are needed to help people within Gaza.
"The crisis in Gaza is not just a local tragedy, it's a stark reminder that our global food crisis is worsening," she said. "Not only does this crisis threaten regional peace and stability, it undermines our collective efforts to combat hunger worldwide."
The Israeli military's attacks on hospitals and other health care facilities are pushing people in Gaza to the breaking point, according to the World Health Organization.
More than 600 people have been killed and 770 others injured inside Palestinian health facilities. Gaza has 13 partially functioning hospitals, two minimally operating, and 21 completely out of commission, WHO says.
As the United Nations and other international aid organizations continue to look for a path to end the fighting, fears mount that the conflict could engulf the region. WHO staff said they saw tens of thousands of people fleeing heavy strikes by foot, on donkeys and in cars as makeshift shelters were being built along the road.
“WHO is extremely concerned this fresh displacement of people will further strain health facilities in the south, which are already struggling to meet the population’s immense needs,” said Dr. Rik Peeperkorn, WHO's representative for the West Bank and Gaza.
“This forced mass movement of people will also lead to more overcrowding, increased risk of infectious diseases," he said, "and make it even harder to deliver humanitarian aid.”
This story has been updated with additional details.
