![Gazan mother with her baby lives in a tent under difficult conditions](https://media.guim.co.uk/6f0a3142b91278b6debd04f57c76126e8cd3f026/0_181_3734_2240/1000.jpg)
One in five pregnant women treated at a central Gaza clinic are malnourished, doctors have warned, as fuel and medical supply shortages closed the last hospital operating in the north of the strip.
“Every day, we see women and children coming into our clinic suffering from acute malnutrition,” said Dr Maram, the lead physician for Project Hope.
The nonprofit organisation said 21% of pregnant women treated in the Deir al Balah clinic in the three weeks to 24 February were suffering from malnutrition, as were one in 10 of the children seen by its doctors there.
“As infectious diseases spread in crammed areas and food becomes even scarcer, we will see more and more people going hungry – including the health workers who are trying to help. I worry every day that I won’t find anything to eat,” Dr Maram said.
Only a trickle of aid is reaching Gaza, even after the UN warned of “pockets of famine” and widespread hunger across the enclave.
Over the past month, shipments have fallen by about half from January levels, to fewer than 100 trucks a day on average – or 2,300 for the whole month. The UN has said it is far short of the estimated 500 trucks needed each day to meet people’s basic needs.
The UN’s projections indicate that one in four households in Gaza, or more than half a million people, are “facing catastrophic conditions characterised by lack of food, starvation and exhaustion of coping capacities”.
Two children died in Kamal Adwan hospital in northern Gaza from malnutrition and dehydration, local health authorities reported on 27 February.
Hospitals and health workers have also been badly affected by restrictions on aid. Al-Awda hospital in Jabalia, northern Gaza, reportedly suspended medical services on Wednesday because of severe shortages of fuel and medical supplies.
It was the last functioning hospital in the area, and one of the senior managers, Dr Muhammad Salha, said its closure would lead to “a complete deprivation of basic health services for citizens, especially in light of the cessation of service by all hospitals in the north”, Al Jazeera reported. Salha urgently appealed for fuel and basic medical supplies.
Only a third of Gaza’s hospitals are even partially functional, according to UN figures, and those that are operating are overwhelmed with patients and short of supplies.
Fires also broke out at Nasser hospital on Wednesday after Israeli bombing raids, Al Jazeera reported. The largest hospital in southern Gaza is no longer functioning but still has 120 patients waiting for medical evacuation. It needs urgent repairs to restore power and running water, and to deal with disposal of sewage and solid waste.
The UN and humanitarian organisations say logistical obstacles including movement restrictions, border inspections and closure of crossings, along with a freeze on visas for many staff, hamper efforts to get aid into Gaza.
“It can take up to one month for supplies to enter Gaza, because each box in each truck is submitted to screening,” Médecins Sans Frontières said this week. Israeli authorities turn back an entire cargo if a single item is rejected during screening, but have not provided a list of restricted items.
Israel says it is not limiting aid shipments. It blames humanitarian agencies for failures to get more supplies into the territory after it launched strikes in response to the 7 October attacks by Hamas, in which 1,200 people were killed and another 200 were taken hostage.
The Palestinian death toll from Israeli attacks reached 29,954 on Wednesday, the majority of them women and children, health authorities in Gaza said.
In a televised speech from Beirut, Hamas leader Ismail Haniyeh urged Palestinians to march to the al-Aqsa mosque in Jerusalem to mark the start of Ramadanon 10 March, and called on the “axis of resistance” – Iranian allies including Lebanon’s Hezbollah, Yemen’s Houthis and the Islamic Resistance in Iraq – to step up efforts on behalf of Gaza’s people.
The calls are likely to add to concerns about clashes beyond Gaza during Ramadan if Israeli attacks continue.
The US president said earlier this week that a ceasefire deal could be reached ahead of Ramadan, but both Israel and Hamas have downplayed such hopes and Qatari mediators said there are still major differences.
Joe Biden’s support for Israel’s campaign may be increasingly tempered by concerns about the autumn presidential vote, after a stronger-than-anticipated protest vote in the Michigan primary over thewar in Gaza.
More than 10% of Michigan Democrats, 100,000 voters, cast a ballot for “uncommitted”, after a campaign by progressive democrats and Arab-Americans.
Netanyahu is under growing domestic pressure to reach a deal to free hostages, but has said he will not end the military campaign until Israel has achieved “total victory”.
Relatives and friends of those held in Gaza on Wednesday began a four-day march to Jerusalem from the site of the Nova festival, which had some of the worst bloodshed on 7 October.
Biden has repeatedly warned Netanyahu against a ground offensive into Rafah, where more than 1.5 million people have sought shelter, unless there is a credible plan to protect civilians.
The former Israeli prime minister, Ehud Olmert, has warned against an assault. “The patience of the international community has reached a point from where I don’t think they’ll be able to absorb it,” he told Bloomberg News in an interview. “This is a risk we cannot afford to take.”
Palestinian political factions are due to meet on Thursday in Moscow to discuss a possible unity government and the rebuilding of Gaza, days after Palestinian prime minister, Mohammad Shtayyeh, resigned, saying it was time for a comprehensive new approach.
Foreign minister Riyad al-Maliki said he did not expect “miracles” at the talks, which will bring together officials from Hamas and Fatah, which governs in the West Bank.