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00:00 Hundreds of thousands of Palestinians in Gaza are living under the never-ending threat of
00:06 famine because of the shortage of humanitarian aid.
00:10 Is the starvation of civilians being used by Israel as a weapon of war?
00:14 This is Inside Story.
00:21 Hello, welcome to the program.
00:34 I'm Hashim Ahl-Barra.
00:36 The United Nations is warning that hundreds of thousands of people in Gaza are on the
00:41 brink of starvation.
00:43 Acute levels of hunger are facing around 2 million Palestinians after many of them lost
00:48 their homes and livelihoods.
00:50 Westbirds people unable to feed themselves or their children are living in famine-like
00:54 conditions, some resorting to eating animal feed and weeds to survive.
01:00 Is a strangling of food, medicine and other humanitarian supplies being used as a weapon
01:05 of war by the Israeli government?
01:07 We'll be discussing all this and more with our guests shortly.
01:11 But first, Malikha Bimotsepe reports on the widespread suffering with no end in sight.
01:19 Surrounded by the ruins of what used to be their homes, Om Jamil is among the estimated
01:24 300,000 Palestinians who stayed in the isolated area of northern Gaza.
01:29 People there have not been receiving deliveries of food because international aid trucks are
01:34 being denied access to the areas in need.
01:37 Some residents in Jabalia say they have faced prolonged periods without food or access to
01:41 water.
01:43 To survive, they've resorted to picking weeds to cook for their children and turning animal
01:47 feed into flour.
01:51 As you can see, our conditions are difficult.
01:53 Everything is closed here and there is danger all around us when collecting the weeds.
01:57 But we have no other choice but to ensure that the children receive food in any way
02:01 possible so they don't have to endure hunger.
02:07 We come to this mill to grind barley and corn and everything that can be ground, even animal
02:11 feed.
02:12 We are forced to eat everything because of hunger.
02:15 We asked the Arab countries and all other countries of the world to secure the entry
02:19 of aid to our people who have no help.
02:21 As you can see, this is animal fodder.
02:26 An estimated 580,000 Palestinians in Gaza are facing catastrophic levels of hunger.
02:33 The World Food Programme is warning that there's acute shortages in northern Gaza.
02:38 Unless we get significant volumes on a regular basis to people in the most food insecure
02:45 areas of Gaza, that we would have famine conditions in place by May or June of this year.
02:52 We are not getting significant amounts of aid in.
02:55 We are not doing it every day as we need to do.
02:59 Since the start of Israel's war, convoys of humanitarian aid have been delayed, denied
03:04 permits and sometimes attacked.
03:06 Israeli soldiers screen everything and seize items deemed useful to Hamas.
03:11 More recently, a group of Israeli protesters demanding the release of captives set up barbed
03:16 wire at the Kerem Shalom border crossing to stop trucks entering Gaza.
03:21 I cannot understand why a country at war is bringing humanitarian aid over enemy lines
03:29 and fueling the war.
03:31 Every truck that goes in is another day of war for both sides.
03:36 Israel's bombardment of southern Gaza is forcing more than two million displaced people to
03:40 head back north in search of shelter, pressuring many into making a choice of potentially dying
03:46 from hunger in the north or being killed by Israeli bombing in the south.
03:51 Malakha Ben Motebe, Al Jazeera, for Inside Story.
03:56 Hani Mahmoud sent us this report from Rafah, where many Palestinians are struggling to
04:01 secure food.
04:04 Since the beginning of this genocidal war on Gaza, living conditions have become increasingly
04:10 difficult for people here, overcrowded Rafah, where there is a real struggle for food and
04:17 water and almost a famine taking place in the northern part of Gaza.
04:23 This is the daily normal defined by displacement, terror and hunger, where the vast majority
04:29 of displaced families forced out of their homes from the north and more recently from
04:35 the central area and the city of Khan Yunis are now hungry with little financial capabilities
04:43 as depletion of basic necessities and food supplies, an ongoing blockade on humanitarian
04:49 aid causing prices to double and triple for some goods.
04:54 The unusual scene of people queuing in line for a bowl of soup, it just become or has
05:04 become the major feature of people living in Rafah city since the beginning of the war.
05:12 Hani Mahmoud for the Inside Story, Al Jazeera in southern Gaza.
05:23 Let's bring in our guests in our studio in London.
05:26 Omar Abdelmanan is a paediatric neurologist who co-founded the doctor's help group called
05:32 Health Workers of Palestine.
05:34 From Rafah in Gaza, Fida Al Araj is a food security and livelihood coordinator at Oxfam,
05:41 also in London.
05:42 Donatella Rivera is senior crisis response advisor at Amnesty International.
05:47 Welcome to the program.
05:48 Let me start with Fida.
05:49 You are in Rafah where people are struggling on a daily basis to secure food for themselves,
05:55 for their loved ones, for their children.
05:58 Give us a sense of what is happening particularly in the central and northern part of Gaza where
06:03 many say that's where we have the biggest humanitarian crisis.
06:10 Actually, as you said, it's not only about Rafah.
06:17 It's all across Gaza Strip.
06:19 You have the whole population of over two million people at imminent risk of famine.
06:26 The numbers say that more than 370,000 of these people are at the huge risk, immediate
06:35 risk of starvation with exhaustive, where they have exhausted their coping mechanisms
06:41 also so they are about to die from hunger.
06:44 This is how it looks like in Gaza now, more specifically in the north and the central
06:49 parts of Gaza with a huge no access of food aid or any food items to those parts.
06:58 People are suffering.
06:59 They are looking for essential goods for any kind of food commodities with no luck to find
07:05 them at all.
07:06 Here in Rafah, the situation is worsening as well with the cut of the entering of the
07:13 aid trucks and with the scarcity of the food commodities to start with before all of this
07:19 even started.
07:21 Donatella, what is the biggest obstacle to the steady flow of aid into Gaza?
07:28 Is it logistical?
07:29 Is it the long security screening of the material?
07:32 Or is it simply a politically motivated thing?
07:36 It is beyond doubt that there is a lack of political will.
07:43 Especially from the Israeli authorities, they are the occupying power and they are the ones
07:49 who control access to the Gaza Strip and they are the ones that have been restricting the
07:54 entry of both humanitarian aid and commercial imports, not just from the 7th of October,
08:01 but for the past 16 years.
08:05 That is in itself a breach of international humanitarian law.
08:11 Israel has not been complying with its obligation.
08:14 Just to be very, very clear, if there is a need for humanitarian aid in Gaza, it is because
08:20 Israel as the occupying power has not been fulfilling its obligation.
08:27 It's not the duty of the international community to provide food, water, medical care, education,
08:35 all that the population under occupation needs.
08:38 That is the duty and the obligation of the occupying power.
08:42 Not only Israel has not been doing that, but it has constantly restricted the entry of
08:49 humanitarian aid, of imports, of medicines, of absolutely everything that the civilian
08:56 population requires for the essential needs of daily life.
09:02 Now since the 7th of October, that level of restriction has increased exponentially.
09:08 And in addition, the wholesale destruction, including the deliberate distractions of road,
09:16 wanton destruction not required by military necessity, that kind of distraction is also
09:24 creating logistical problem, because especially now that people are escaping Rafa and moving
09:31 towards the middle area of Gaza, hoping to find safety, even though that's obviously
09:37 not possible at the moment.
09:42 But that means that people are going to an area where there is nothing, and where getting
09:47 the aid from the southern border of Gaza to those areas is going to be even more difficult
09:53 because of the state of the roads as a result of the Israeli military operation.
09:59 OK, Omar, you must be in touch with medics on the ground.
10:07 How are children coping with this horrible situation unfolding in Gaza?
10:15 Thank you Hashim.
10:16 I think the reality is no one is coping with the situation in Gaza, because as we have
10:22 seen time and time again, the Israeli occupation forces determined to bomb and target hospitals
10:28 and health care facilities.
10:30 What that means is the acute starvation that many of these children are being exposed to.
10:35 And let us not forget there are cases of Merasmus and Kwashiorkor coming into hospitals in Gaza,
10:41 which is the immediate effects of acute malnutrition, things that we saw in Somaliland or Somalia
10:48 in the '90s, but we are now seeing in Gaza in 2024.
10:52 On top of that, you have targeting of health care facilities, which means these same children
10:56 that are starving and are at risk of long-term negative health sequelae are not able to gain
11:04 access to care, to re-nutrition, to the right treatment for that.
11:10 And only yesterday I was talking to colleagues within the Nasser Medical Hospital Complex,
11:17 and we saw children being shot at, killed by snipers inside the hospitals from Israeli
11:24 drones and quadrops with machine guns on them.
11:27 So the reality is it's all well and good talking about malnutrition and lack of aid, but the
11:33 real root cause is currently that there is an ongoing bombing, bombardment, continual
11:40 attacks on hospitals, destroying and decimating any sort of health care facility that could
11:44 actually salvage some of these children.
11:46 And this is 100 percent man-made.
11:48 This is created by the Israeli states, by the Israeli occupation forces, and it's been
11:52 compounded by the Egyptians not allowing aid in as well and closing up the borders at Rafah.
11:58 We have to remember that this is multi-pronged.
12:00 There are numerous agents at play here.
12:03 And whilst the Israelis are the perpetrators, they are being egged on by the UK, the US,
12:10 and some of the Arab countries, unfortunately.
12:12 Fida, if you were to give us a list of the top priorities for the people of Gaza in terms
12:18 of humanitarian aid, what would be the main material that you would like to see coming
12:24 to Gaza now?
12:26 Actually, it's a package of priorities, let's say, because after all of this time of stopping
12:37 all kinds of aid to enter, then the priorities are accumulating, if you want.
12:42 But the first and foremost priority is food.
12:45 People need to eat.
12:46 People need to drink.
12:47 People need to eat something beyond the canned food that's trickling in through the aid trucks.
12:54 People need fresh vegetables, fresh fruits, eggs, poultry, things that have a nutritional
13:03 value to it, not just to stave their hunger.
13:07 So the quality of the food to enter Gaza is essential.
13:13 And of course, the priority is more and more and more quantities of food to enter Gaza
13:17 because the need is huge and the need is unmet, and for people on the verge of starvation,
13:24 of a famine.
13:25 So it's very essential how much food enters, not only what food does enter.
13:30 Plus, there is a need for clean drinking water, for medication, if you want, because of the
13:37 nutritional problems caused by the lack of food.
13:42 We face so many diseases, so many health complications that need treatment as well.
13:48 They will not be treated by food entry alone.
13:51 So this, and combined with the fuel, the cooking gas, equipment to be used also to cook the
13:59 food, because when you look at the ground, you don't find anything.
14:04 There is no setup, or there is a very -- we are reduced to a very primitive setup of making
14:09 food, actually.
14:10 So it's not enough to get the materials or the ingredients to make a meal.
14:15 It's important to provide everything that you need to make an actual meal and put it
14:21 in front of a family or a starving kid.
14:25 Donatella, human rights groups have been accusing Israel of using starvation as a method of
14:31 war.
14:32 What can be done now in terms of international humanitarian law to stop this practice from
14:40 continuing for the upcoming days and weeks?
14:45 I mean, the legal tools are there.
14:48 Israel's obligations are absolutely clear.
14:52 What is required is political will at the level of the international community.
14:56 First of all, for those countries, and the United States is obviously the key one, but
15:02 there are others, too, that are providing weapons to Israel that allow the continuous
15:11 bombardment of civilians and civilian infrastructures, the weapons that are fueling the conflict.
15:18 So those weapon imports should be stopped at once, because there is ample evidence that
15:24 they're being used in a manner that contravenes international humanitarian law.
15:29 Secondly, again, those that are that have the influence on the Israeli authorities need
15:36 to put pressure to force Israel to comply with its obligation to allow both humanitarian
15:43 aid and imports into Gaza to stop targeting food production places, such as fields where
15:57 food is being grown, factories where food is being processed, bakeries, all the civilian
16:05 infrastructure that has been a target from day one, from the 7th of October, but also
16:11 from long before.
16:13 The population of Gaza was already in a very, very dire humanitarian situation before the
16:20 7th of October.
16:21 And so the rate at which the situation has deteriorated is all the greater.
16:27 And there is only one thing, you know, there is only really one side that can change this
16:34 equation, and that is for Israel to be forced to comply with its obligation by its international
16:42 allies that are providing it with economic, military and political support, because clearly
16:48 the Israeli authorities have shown that they are not complying with international law and
16:56 that they are violating international law on a daily basis.
16:59 Omar, you touched on the children malnutrition.
17:02 We're talking about more than a million people are stuck or stranded in the southern part
17:05 of Rafah, living in tents with the risk of more disease spreading.
17:12 Do you have any concerns that if there's no intervention in the upcoming days, the situation
17:16 could just further degenerate and become and spin out of control?
17:21 Absolutely.
17:23 Like I said, we are seeing already the acute effects of malnutrition of children having
17:28 to eat animal feed in the north and middle of Gaza.
17:33 This is, you know, these are deplorable conditions, but they have been created by the Israeli
17:38 state.
17:39 Now, the other thing to note, and this is a really important point, people do not die
17:43 from starvation instantly.
17:45 People when they are starved and stressed at long periods of time, especially children
17:49 under the age of two, they end up having essentially immunocompromised.
17:55 Their immune system is compromised.
17:57 They are at much greater risk of dying from diarrheal illnesses like cholera, which for
18:01 sure is spreading in Gaza, even if we cannot test for it.
18:05 They die from hepatitis.
18:06 They die from pneumonia or chest infections.
18:09 The simple illnesses that should be preventable and should not lead to death become lethal
18:13 in these conditions.
18:15 So the excess mortality rates, which I suspect will number in the hundreds of thousands when
18:20 the dust settles, if the dust settles, then I think this is where my greatest concern
18:26 as a paediatrician is.
18:27 And also it's important to know any child who under the age of two goes through this
18:32 period of acute malnutrition, whether it's as a fetus or as a child, they are essentially
18:38 limited in terms of their long-term health outcomes.
18:42 These children will have lasting, final impacts on their cardiovascular health, on their risk
18:47 of cancer, on their risk of, you know, their ability to grow.
18:51 This is a lost generation of wounded children with no surviving family and children that
18:55 have been stunted, that have been malnutritioned, that have been cognitively destroyed essentially
19:02 by the Israeli war machine.
19:05 Aid agencies are basically saying that there's been no trucks into Gaza for about a week
19:13 and that even during the deal between Hamas and Israel, 95 trucks were allowed when in
19:20 normal times, particularly before the war, 500 commercial and aid trucks were allowed
19:27 into the Strip to deal with the needs of the people.
19:31 Give us a sense of what are the local and international aid agencies doing now when
19:37 basically they have nothing to offer to the hundreds of thousands of people who are so
19:42 desperate and anxious about what happens tomorrow.
19:46 Actually, what we're trying to do as humanitarian workers is limited because all of our aid
19:58 is coming from outside of Gaza.
20:01 What we're trying to do is to get basically the most important thing for us is to try
20:05 to get what we have in the Egyptian side into Gaza, to be able to organize distributions
20:12 to people, to be able to serve the people that we work with and that, as you said, are
20:17 desperate for support and for help.
20:20 What we're trying to do collectively is try to coordinate whatever small means we have
20:29 from previous aid entries into Gaza and to be able to reach as much as possible.
20:37 But I can frankly tell you it's nowhere near enough.
20:43 We need an essential route solution, if you want, for all of this.
20:50 There is a huge need for immediate release of the aid stuck into the Egyptian border.
20:57 And before that, and more important than that, there is a huge need to cease fire, to stop
21:02 all of that, so that we can reach people that we are unable to reach, whether they are in
21:07 the north of Gaza, in the Gaza city, or in the border areas.
21:12 There is a need also to be able to mobilize the local market or the local production of
21:17 food, because that also is a resource that's completely cut since day one of the war.
21:24 People aren't able to reach their lands, aren't able to cultivate.
21:28 There is not enough water.
21:29 There is not enough fuel to operate the bombs and the equipment they need for the agriculture.
21:37 So all of the local food production is almost reduced to zero.
21:43 So there is a need to support that.
21:45 And of course, we are trying to raise our voices.
21:48 We are trying to collectively tell the stories of the starving people.
21:52 It's not a completely humanitarian story.
21:56 It's a humanitarian result of a bigger war that's raging against the people of Gaza.
22:02 People are being killed by so many means, one of which is the starvation of people.
22:07 It's been used as a weapon of war since the start, and it only continues so.
22:14 Donatella, the Israeli government has a unit, the Kogut, which liaises with the United Nations
22:20 when it comes to the aid.
22:22 And they say that basically they're not blocking aid, but they're making sure that the aid
22:27 is not going to end up being in the hands of Hamas, and that they also would like to
22:32 ensure that the dual-usage material does not enter into Gaza.
22:38 And can you believe it?
22:39 Power generators, crutches, field hospital kits are considered dual-usage material.
22:46 Is this against the law?
22:51 The prevention of entry into the occupied territory by the occupying power of the means
23:01 for essential requirements for the civilian population, that is a breach of international
23:07 humanitarian law.
23:09 It's a war crime.
23:11 As I said, it's not only since the 7th of October that these restrictions have been
23:17 imposed.
23:18 They have been imposed continuously for the past 16 years.
23:21 They have generally been increased at times when the violence and the confrontation has
23:27 increased.
23:29 But those restrictions, unwarranted, have been in place for 16 years.
23:37 And that's why Gaza was already in a coma situation when the 7th of October situation
23:43 changed with increased restrictions.
23:46 So COGAT knows perfectly well what it should and should not be doing.
23:55 The requests have been ongoing.
23:58 The details about the terrible consequences for the civilian populations are extremely
24:06 clear.
24:08 So water, medicines, food cannot be considered something that can be withheld from the civilian
24:21 population.
24:24 Israel has the possibility to check everything that goes into Gaza.
24:30 It is what it has been doing.
24:32 The fact that it is just not allowing what is required is completely unacceptable.
24:38 I have many other issues to discuss with you, so I appreciate if you can give me some short
24:43 answers.
24:44 Omar, the health system has been completely decimated.
24:47 When United Nations and international agencies are saying we need urgent action to deal with
24:53 the health system, what do they mean by that?
24:59 What they should be meaning is that there needs to be a ceasefire, an immediate and permanent
25:03 ceasefire now to allow hospitals and hospitals to be rebuilt, supplies to go back in, medical
25:10 personnel to come in and help the exhausted medics who are being targeted, 400 of whom
25:15 have been killed and 100 are still in illegal detention and have been tortured when they've
25:20 been detained, as you must be aware.
25:24 So what they mean is that we need supplies.
25:27 We need an end to the violence which is preventing these supplies from making it in.
25:32 I think, building on Donatella's point, it is crucial to understand that the US and the
25:38 UK are literally sending those arms that are bombing the hospitals.
25:42 So they are complicit in this genocide.
25:45 These are war crimes and that complicity will come back to haunt them.
25:49 Donatella, with the future of UNRWA uncertain, what kind of impact if it shuts doors in the
25:57 future, what kind of impact would that have on the humanitarian aid operations in Gaza?
26:03 Well, any withdrawal of services, help, humanitarian aid, education to what is actually the majority
26:13 of the population in the Gaza Strip would have absolutely disastrous consequences.
26:19 Again, I go back to the point that ultimately Israel as the occupying power is legally required
26:26 to provide all of the services.
26:29 Israel has not been doing so.
26:31 The international community, mostly through UNRWA but also through international aid organization
26:36 has been doing that.
26:40 Preventing that from continuing to happen would have absolutely disastrous consequences
26:47 on the population, adults and children especially, because as the point was made already, children
26:53 are being impacted massively, their future is being destroyed.
26:59 The equivalent of 10 children a day have lost a limb, about 1000 children have lost limbs
27:08 since the beginning of this crisis.
27:11 So you can imagine what the requirements are.
27:15 Unfortunately, we'll have to leave it there.
27:18 Donatella, Rovera, Omar, Abdelmanan and Fidel, I really appreciate your time and insight.
27:23 Thank you.
27:24 And thank you too for watching.
27:26 You can see the program again anytime by visiting our website aljazeera.com.
27:30 For further discussion go to our Facebook page, that's facebook.com/AGAinsightStory.
27:33 You can also join the conversation on X, our handle is @AGAinsightStory.
27:41 From me, Hashim Ahalbaba and the entire team here in Doha.
27:44 Bye for now.
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