The Dissection of Starvation in Gaza

September 1, 2025

"This is the moment when children stop crying," a doctor in Gaza described the final moments of starvation, when the body no longer has enough energy left even to shed tears. It is a silence heavier than any scream, a stillness of souls from which life is being drained, drop by drop.

Doctors know that hunger is different from starvation. Hunger is a transient pain, but Starvation is the moment when the body begins to devour itself: Blood sugar plummets, muscles dissolve, immunity collapses, wounds cease to heal, and even the heart disintegrates, converting itself into energy. Parents describe their children wasting away right in front of them, their voices fading as though life itself is being drained from them.

What is happening in Gaza is not a natural tragedy, but a deliberate crime. It is a live autopsy of starvation, witnessed in homes, clinics and camps. Every physical symptom is also a measure of a systematic Israeli policy of deprivation, targeting an entire community in its most basic needs for survival: Food.

The First Indicators: The Body in Decline

Starvation begins quietly. Weight slips away unnoticed, strength fades, and exhaustion settles in. Blood sugar drops, causing people to collapse into dizziness or unconsciousness, both in hospitals and on the streets. The body cools quickly, and in Gaza's harsh nights, shivering becomes torment, as the body can no longer generate warmth.

Doctors in Gaza witness this decline everyday. Dr. Hassan Khalaf,  an internist at al-Helo Hospital in Gaza City, says, "Patients who were stable have begun to detoriate, and they are now on the brink of collapse." Insulin-deprived diabetics arrive in a fatal state of ketoacidosis, in which the blood turns into an acidic medium when the body burns fat instead of sugar. Their lives are saved for hours or days, but they are discharged from the hospital without medication, only to relapse again.

What is happening in Gaza is not a natural tragedy, but a deliberate crime. It is a live autopsy of starvation, witnessed in homes, clinics and camps. Every physical symptom is also a measure of a systematic Israeli policy of deprivation, targeting an entire community in its most basic needs for survival: Food

Even immunity breaks down. Colds are prolonged, minor infections resist treatment, and small wounds turn into permanent disabilities. These are the daily realities of two million people in Gaza. Starvation begins subtly, and quickly turns into a slow erosion of health and dignity.

Fragile Souls: Children and Mothers

Children are the first victims. Their metabolic needs are greater, and their developing bodies cannot withstand prolonged deprivation. Protein-energy malnutrition halts growth, weakens immunity, and delays motor and cognitive development. A child deprived of food in their early years bears an indelible mark: Stunted growth, vulnerability to diseases, a shorter life expectancy, and impaired memory and learning abilities.

Hedaya al-Muta'wisays, "My son Mohammed, 18 months old, is malnourished and weighs no more than 6 kilograms. He is weak, and can no longer stand or sit because of food scarcity." Her words are a harbinger of the destruction of an entire generation.

Starvation is also devouring mothers. Breastfeeding depends on the availability of protein and calories, and when these are absent, milk dries up. Infants who are entirely dependent on breastfeeding then spiral into malnutrition. Doctors Without Borders  field clinics in Gaza report that more than a quarter of children under five and pregnant or breastfeeding women are currently suffering from acute malnutrition.

Here, the line between mother and baby fades away: Both are exhausted by the same deprivation, bound in a single, unrelenting cycle of hunger, where each body consumes the other. And when the mother's body can no longer give, the infant's body begins to wither.

System Breakdown: Healthcare on the Brink

As starvation deepens, the collapse of the immune system accelerates. Minor respiratory infections develop into chronic diseases, untreated skin infections spread, and diarrhoeal diseases that usually resolve within days become life-threatening. Protein deficiency halts the production of antibodies and white blood cells, leaving the body defenseless. Minor wounds that once healed quickly turn into ulcers or gangrene, leading to permanent disability or death

In Gaza's hospitals, this decline is compounded by exhaustion and depletion of resources. Dr. Hassan Khalaf warns that medical teams "work while hungry and exhausted, in inhuman conditions and without basic resources, threatening the collapse of what remains of hospitals." So how can a doctor examine the very hunger that he himself suffers from?

Even immunity breaks down. Colds are prolonged, minor infections resist treatment, and small wounds turn into permanent disabilities. These are the daily realities of two million people in Gaza. Starvation begins subtly, but it soon turns into a slow erosion of health and dignity.

The few food supply centers are barely holding on. Fuel is scarce, incubators and monitoring equipment are down, and the shelves that should be stocked with therapeutic milk or high-energy biscuits are empty. Mothers carrying skeletal infants are told that there is nothing available. Under these dire circumstances, it’s impossible to even begin the protocols for treating severe malnutrition

As for those with chronic diseases, starvation hastens their deaths. Maysa Eliyan Kamel Eliwa, a 38-year-old leukemia patient, says, "My health has deteriorated severely due to starvation and lack of treatment. I lost 20 kilograms in one month... The hospital no longer provides me with treatment, not even painkillers. My son risks his life every day to bring me and his siblings a loaf of bread from the Gaza Humanitarian Foundation's distribution points." 

Subsistence Meals and Slow Death

Even when food is available in Gaza, it is often insufficient to keep one alive. In Gaza today, life relies on charity kitchens that distribute bowls of rice water or lentil broth. These meals offer only limited calories, but fall short on essential proteins or micronutrients. Prolonged dependence on them leads to severe nutrient deficiencies, anemia, vitamin A deficiency, and protein-energy malnutrition. The body barely survives, but it withers slowly.

Testimonies of displaced people reveal this decline. Salim Ibrahim Muslim Asfour, 75 years old, displaced in Khan Yunis, says: "Our meals mainly consisted of canned beans, peas, chickpeas, and lentils. And when bread was available, I would abstain from eating it and leave it for my children. I say to myself: I'm old, let the children live."

The line between mother and baby fades away: Both are exhausted by the same deprivation, bound in a single, unrelenting cycle of hunger, where each body consumes the other. And when the mother's body can no longer give, the infant's body begins to wither.

The shortage extends beyond the food itself, encompassing even the essential means to prepare it. Many families burn paper, old clothes, plastic, and even shoes to cook what little remains. The already scarce food deteriorates further when it is prepared over toxic smoke or not cooked whatsoever.

The results are seen in the rising mortality rates. Every month, more lives are claimed by starvation, most of them children. Some of them already suffered from pre-existing illnesses, a claim often repeated by Israeli officials, but that doesn't change the truth. The most vulnerable die first, like canaries in a coal mine, sending a warning of what awaits everyone.

The Final Stages of Starvation

Before the final breakdown, the body enters a stage of severe emaciation (cachexia), where muscles and fat waste away, leaving only the bones. Salim Asfour says, "I used to weigh 75 kilograms, I've lost 30, and now my bones are protruding... Starvation has devoured my body."

From here, the corrosion extends to the inner organs. After the body consumes fat and muscle, it begins to sacrifice its vital organs: The liver, kidneys, and even the heart. As proteins disappear from the blood, swelling develops in the legs and feet, the heart rate slows, and breathing becoms shallow. Life contracts to its most basic functions, and every movement becomes an exhausting struggle.

The most vulnerable die first, like canaries in a coal mine birds, sending a warning about what awaits everyone.

The psychological aspect also reflects this progressive physical deterioration. It begins with a food obsession, then despair, and finally silence when there is no energy left to fight starvation. Fathiya, the mother of the girl named Ahlam, says, "My daughter died while longing for food that she could not get and I could not provide." She was a child who had lived with thalassemia for years, but her condition deteriorated rapidly after the Israeli siege made blood transfusions impossible, and her diet was reduced to lentil bread and spices.

Even if the Siege Were Lifted Tomorrow

Even if the siege is lifted and food flows freely, recovery would not be as simple as feeding the hungry. Bodies that have reached advanced stages of starvation may face a fatal risk known as refeeding syndrome. After prolonged adaptation to severe nutrient deprivation, the body can collapse when carbohydrates and protein are reintroduced. Rapid shifts in electrolytes occur in the bloodstream, which can cause the heart to stop, causing the starving to die, not from starvation but from the food meant to save them.

Treating refeeding syndrome requires close monitoring and resources that are largely absent in Gaza. Daily lab tests, intravenous phosphate and potassium supplements, and intensive medical supervision. In well-equipped hospitals, these risks can be managed. But in Gaza's exhausted wards, crippled by fuel shortages, broken equipment, and insufficient staff, such care becomes almost impossible.

Starvation has its medical dictionary: Cachexia, organ failure, refeeding syndrome. But in Gaza, it has names and faces: A weak child unable to sit up, a mother whose milk has dried up, a patient losing weight as he loses hope, an elder skipping meals to leave food for his children. These are not scientific cases or abstract statistics, but lives collapsing under the deliberate food deprivation.

As for children whose growth has already been stunted, even an abundance of food cannot undo the damage. Nutrition can prevent further decline, but it cannot recover the lost years. A child who did not learn to crawl or speak at the right time will carry that developmental delay into adolescence and adulthood. Even if food were to arrive tomorrow, the scars of starvation will stay with Gaza's people forever.

A crime in plain sight of the world

Starvation has its medical dictionary: Cachexia, organ failure, refeeding syndrome. But in Gaza, it has names and faces: A weak child unable to sit up, a mother whose milk has dried up, a patient losing weight as he loses hope, an elder skipping meals to leave food for his children. These are not scientific cases or abstract statistics, but lives collapsing under the deliberate food deprivation.

Starvation is not merely a biological condition, but a form of Israeli violence etched into the body. To witness it is only the start. Understanding it medically may foster empathy, but stopping it remains the sole humanitarian duty.

Anis Germany is an Internal Medicine Physician and Health Systems Policy Researcher

Photo: UN News