Gaza has been pushed to new depths of despair, civilians, medics and humanitarian workers say, by the unprecedented seven-week-long Israeli military blockade that has cut off all aid to the strip.
The siege has left the Palestinian territory facing conditions unmatched in severity since the beginning of the war as residents grapple with sweeping new evacuation orders, the renewed bombing of civilian infrastructure such as hospitals, and the exhaustion of food, fuel for generators and medical supplies.
Israel unilaterally abandoned a two-month ceasefire with Palestinian militant group Hamas on 2 March, cutting off vital supplies. Just over two weeks later, it resumed large-scale bombing and redeployed ground troops withdrawn during the truce.
Since then, political figures and security officials have repeatedly vowed that aid deliveries will not resume until Hamas releases the remaining hostages seized during the 7 October 2023 attacks that ignited the conflict. Israel’s government has framed the new siege as a security measure and has repeatedly denied using starvation as a weapon, which would constitute a war crime.
The blockade is now entering its eighth week, making it the longest continuous total siege the strip has faced to date in the 18-month war.
Firmly supported by the US, its most important ally under Donald Trump, Israel appears confident that it can maintain the siege with little international pushback.
It is also moving ahead with large-scale seizures of Palestinian land for security buffer zones, and plans to shift control of aid delivery to the army and private contractors, exacerbating fears in Gaza that Israel intends to maintain boots on the ground in the territory long-term and permanently displace its residents.
Many people the Observer spoke tosaid they are now more afraid of famine than airstrikes. “Many times, I have had to give up my share of food for my son because of the severe shortages. It is the hunger that will kill me – a slow death,” said Hikmat al-Masri, a 44-year-old university lecturer from Beit Lahia in north Gaza.
Food stockpiled during the two-month-ceasefire has run out, and desperate people across the territory are jostling at charity kitchens with empty pots and bowls. Goods at markets are now selling for 1,400% above ceasefire prices, according to the latest assessment from the World Health Organization.
An estimated 420,000 people are on the move again because of new Israeli evacuation orders, making it difficult to compile hard data on hunger and malnutrition, but Oxfam estimates that most children are now surviving on less than one meal a day.
About 95% of aid organisations have suspended or cut back services because of airstrikes and the blockade, and since February, Israel has tightened restrictions for international staff to enter Gaza. Basic medical supplies – even painkillers – are running out.
“Gaza City is packed with displaced people who have fled Israeli troops moving into the north, and they are living on the street or putting their tents inside damaged buildings that are going to collapse,” said Amande Bazerolle, the Gaza emergency coordinator for Médecins Sans Frontières, speaking from Deir al-Balah.
Bazerolle added: “There are not enough points of care for so many people. At our burns clinic in Gaza City, we are refusing patients by 10am and we have to tell them to come back the next day, as we are triaging to make our drug supplies last as long as possible.”
The siege has been accompanied by a fierce push by Israeli forces on northern Gaza as well as the entirety of Rafah, the strip’s southernmost city, cutting the territory off from Egypt.
According to the UN, approximately 70% of Gaza is now under Israeli evacuation orders or has been subsumed into expanding military buffer zones; the new Rafah security zone totals one-fifth of the entire territory.
The land seizures are pushing the 2.3 million population – and aid and medical efforts – into ever-smaller Israeli-designated “humanitarian zones”, although an Israeli airstrike last week on al-Mawasi, the biggest such zone on the coast of southern Gaza, killed 16 people.
As the space they can operate in shrinks, aid workers said they are worried that that the rules of engagement followed by the Israeli military have changed since the ceasefire collapsed, pointing to the recent bombings of Nasser hospital in Khan Younis and al-Ahli hospital in Gaza City.
Two people were killed in the Nasser attack, which hit a building where members of an international medical team were present. No casualties were reported in the al-Ahli strike, but the intensive care and surgery departments of the hospital were destroyed, medics said. In both cases, the Israel Defense Forces (IDF) said it had targeted Hamas militants.
“People in Gaza like having international staff around because they assume it affords them more protection and the IDF is less likely to attack the building or the area,” said a senior aid official, who asked not to be named so as to speak freely.
“In the beginning of the war, if there was an airstrike two kilometres away from our location, we would evacuate… eventually, that became 300 metres, and now it’s 30 metres, if [the IDF] hits the building next door.
“There are either no warnings, or sometimes 20 minutes, which is not enough time to evacuate sick people. Our exposure to risk is getting higher... We know the Israelis are trying to force us to work under their terms.”
In a statement in response to the aid worker’s allegations, the IDF said: “Hamas has a documented practice of operating within densely populated areas. Strikes on military targets are subject to relevant provisions of international law, including taking feasible precautions.” It referred questions about aid to the political echelon.
Israel has long alleged that Hamas siphons off large amounts of the aid that has reached Gaza, allowing the group to maintain its control by either keeping the aid for itself or selling it at marked-up prices to desperate civilians.
Last week, Israeli media reported that efforts to sidestep international agencies and create an Israeli-controlled mechanism to distribute aid using private contractors are under way but still in the “early stages”, with no timeframe for implementation. In the interim, the humanitarian crisis will only worsen, aid agencies say.
International mediators are attempting to revive ceasefire talks, but there is little sign either side has moved closer on fundamental issues such as the disarmament of Hamas and the withdrawal of Israeli troops.
Masri, the lecturer from Beit Lahia, said: “When the blockade was imposed again and the war resumed, I felt terrified. I constantly think about my little son, and how I can provide him with basic necessities.
“No one can imagine the level of suffering… Death surrounds us from every direction.”
