Gaza is already the scene of the most intense famine in recent decades. The number of deaths from hunger and disease could soon exceed those killed by bombs and bullets.
The Famine Review Committee reported this week that Gaza faces “impending famine”.
The Integrated Phase Classification (IPC) system, established 20 years ago, provides the most reliable assessments of humanitarian crises. Its numbers for Gaza are the worst on record by any metric. It estimates that 677,000 people, or 32% of all Gaza residents, are in “catastrophic” conditions today, and a further 41% are in “emergency” conditions. He expects at least half of Gazans, more than a million people, to face a “catastrophe” or “starvation” within weeks.
A parallel report from the Famine Early Warning System Network of the US Agency for International Development sounds the same alarm. This is the clearest warning the network has ever given in its 40-year history.
Typically, “disaster” or “famine” conditions mean a daily death rate from hunger or disease of two people in 10,000. About half are children under the age of five. The calculation is simple. For a population of one million, that’s 200 deaths per day, or 6,000 per month.
For comparison, the worst famine ever recorded by the IPC hit Somalia in 2011, following a combination of war, drought and aid cuts. At its lowest, 490,000 people were in “disaster” conditions and a larger number in “emergency” conditions. An estimated 258,000 people died in 18 months.
The only other occasion when IPC data showed famine was in South Sudan in 2017. The civil war plunged half of the country’s 10 million people into a food crisis, with 90,000 people suffering of famine. Around 1,500 people died of starvation in the two famine-devastated districts, but four years of the wider food crisis have claimed the lives of around 190,000 people.
The “starvation” threshold is arbitrary. At the most severe stage, “emergency” conditions, children are already starving. When experts first developed a prototype “famine scale,” they had a lower bar for declaring famine, roughly equivalent to the IPC “emergency,” and included categories of famine “severe” and “extreme” which correspond to the IPC “famine” conditions. . They also included a measure of magnitude – the total number of people affected and dying – and later they also considered duration. A few food crises have occurred in recent years, with death tolls accumulating slowly, without ever crossing the IPC “starvation” threshold.
Famine has never been declared in Yemen. But the food crisis that affected millions of people during the war years caused up to 250,000 deaths from starvation. In the Tigray region of Ethiopia, the situation is similar.
We are on the verge of the most intense famine since World War II. It will not be the most serious, because the famine is limited to the 2.2 million inhabitants of the Gaza Strip.
Our image of starvation is of a wasting thin child, whose eyes appear swollen while his skin shrinks to his bones. Some children suffer from kwashiorkor, an acute malnutrition characterized by a telltale swollen belly.
As the body starves, its immune system begins to fail. Malnourished people fall prey to waterborne infections and suffer from diarrhea, leading to devastating dehydration. Other communicable diseases – which today could include Covid – are also ravaging communities. The most common cause of death in famine is disease, not famine itself.
“Starvation” is defined in international criminal law as the act of depriving a person of objects essential to their survival. This includes not only food, but also medicine, clean water, sanitation, shelter, cooking fuel and maternal care for children.
When people are forced from their homes into overcrowded camps, when water supplies are scarce or unsanitary, when toilets are non-existent or unsanitary, when injuries go untreated, epidemics become more frequent and more deadly.
Lacking shelter and exposed to cold and rain in winter and heat and dust in summer, people succumb more quickly to hunger and disease. Without electricity or cooking fuel, mothers cannot prepare meals that young children can easily digest.
Epidemiologists in London and Baltimore generated projections of the likely number of deaths in Gaza from all causes in the months leading up to August. Including outbreaks, their “business as usual” scenario projects a range of 48,210 to 193,180 deaths, while in the “escalation” scenario these numbers are even higher.
The health crisis in Gaza has its own appalling momentum. Even if the shooting stops today and the aid trucks start rolling, the dying will continue for some time.
And even as the number of people dying needlessly declines, the scars of famine will remain.
Small children who survive famine face lifelong deprivation. They tend to become smaller than their peers and suffer from reduced intellectual abilities. The World Health Organization warns of an “intergenerational cycle of malnutrition” in which low-birth-weight infants or undernourished girls become smaller, less healthy mothers. The damage caused by the Dutch famine winter of 1944 can still be seen generations later.
Famine is also a social trauma. It tears communities apart and destroys livelihoods. People are forced into the worst indignities, breaking taboos on what they can eat and how they can obtain basic necessities. Mothers must ration the food they give to their children. They chase hungry neighbors out of their homes. Families sell their most precious heirlooms for a pittance to buy a meal.
What consolation is there in telling the parents who buried their child that it was not their fault? The anguish of survivors lasts a lifetime.
The persistent sense of shame is such that people cannot speak openly about the famine, sometimes for generations. It took almost 150 years before Ireland began to publicly commemorate the Great Famine of the 1840s.
All this is known. And in Gaza, there is no room for doubt.
In most famines, there is some uncertainty in the predictions because people may find unexpected sources of food or money. In some rural parts of Africa, grandmothers may know about roots and edible wild berries, or migrant workers may find creative ways to send money home to their families. In Gaza, Israel knows every available calorie. In 2008, the coordinator of government activities in the territories calculated every aspect of Gaza’s food production and consumption, down to the smallest detail, and extracted the “red lines” necessary to keep Palestinians under what he called a “diet”, just before starvation.
Until October 7, 2023, Israel was, according to its own analysis, on the right side of international laws prohibiting famine. Around 500 truckloads of essential goods came in each day to supplement local farms, fisheries and livestock. In recent months, less than a third of that number has been allowed in, while local food production has been reduced to almost zero.
Israel was widely warned of what would happen if it continued its campaign of destruction of everything necessary for life. The December 21 IPC Famine Review Committee report authoritatively warned of famine if Israel did not stop destruction and allow large-scale humanitarian aid. Israel’s own judge appointed to the International Court of Justice, Aharon Barak, voted with the court’s majority in favor of “immediate and effective measures to enable the provision of the basic services and humanitarian assistance we need.” an urgent need.”
Israel has not changed course. Supplies entering Gaza fall woefully short of the calorie minimum specified by Israel before the war. American supply drops and a relief port are only a pitiful semblance of a substitute.
Famine rages today in Gaza. We shouldn’t have to wait until we count children’s graves to say his name.
Alex de Waal is a writer on humanitarian issues, conflict and peace, and an expert on the Horn of Africa. He is executive director of the World Peace Foundation and a research professor at the Fletcher School of Law and Diplomacy at Tufts University in Massachusetts.