Humanitarian Crisis Deepens in Northern Gaza
Famine has reached the northern part of Gaza, signaling the peak of food insecurity. In this situation, at least 20% of households experience extreme deprivation and severe malnutrition, with hunger-related deaths no longer rare. This assessment came this week before the United States Congress from the head of USAID, the agency responsible for international development. She stated that aid has not arrived in sufficient quantities to prevent imminent famine in the south or the rising child deaths in the north. When pressed, she confirmed the assessment. A few days earlier, USAID circulated an internal memo to several government agencies warning that the speed at which hunger and malnutrition are advancing in Gaza is unprecedented in modern history, according to a cable published by HuffPost.
Nothings here are accidental. Imagery of malnourished children and gaunt bodies underscores a harsh reality. As the secretary-general of the United Nations, Antonio Guterres, recently put it, this is a disaster entirely of human making. The initial cause was the complete closure of Gaza’s borders after Hamas’s October 7 terrorist attack, followed by Israel’s restrictive access for humanitarian aid, attacks on aid convoys and distribution centers, and actions that disrupt orderly relief. In the north, aid often arrives by air alone. People flee, scramble, and compete in a chaotic scramble to survive. Some even resell goods for other essentials. Others, unfortunately, exploit the chaos through black market dealings. Humanitarian shipments by air may bolster public image, but some NGOs estimate they cover less than 1% of the population’s needs.
The northern region, described as hell on earth, is the most devastated by bombardments and the focal point of competing strategic interests. Israel has isolated the north from the rest of Gaza, including its capital, from the early days of the conflict. A NGO worker in Gaza explains that when the army expelled residents, humanitarian agencies and UN offices had to relocate their operations to central and southern Gaza. Offices, warehouses, provisions, and vehicles were abandoned or destroyed as Israel refused to acknowledge the inviolability of certain facilities such as UN headquarters.
Roughly 300,000 residents reportedly resisted or failed to comply with orders to evacuate. This population has been increasingly squeezed. A UN source notes that most requests to deliver aid to the north are rejected. Since the conflict began, just over 60 aid trucks have arrived, a figure initially unverified by this newspaper. Before October 7, Gaza saw about 500 trucks entering daily; since the war began, and up to April 1, seven NGO workers were killed, and no week exceeded an average of 170 trucks, conditions that persisted even during a ceasefire.
All aid convoys enter Gaza from the south after inspection by Israeli forces, which maintain lists of prohibited items that donors struggle to predict. Oxygen bottles, anesthetics, dressings, water filtration systems, cancer treatments, and sleeping bags are among the goods often blocked. AIA CEO of Save the Children in the United States notes that barriers to humanitarian aid have rarely been seen at this scale. In February and March, the UN reported that 40% of aid convoy permissions for food distribution were denied.
When aid does get through, it does not always reach those in need. Israeli attacks on humanitarian convoys have been longstanding, as have assaults on populations awaiting relief. A legal expert from a Gaza-based organization argues that international humanitarian law protects these convoys, yet in many cases they are attacked deliberately. It has taken six months and a strong rebuke from the Biden administration to prompt Israel to establish a humanitarian coordination unit for the first time. Meanwhile, nearly 200 humanitarian workers have been killed in these conflicts.
One convoy attack—known locally as the “massacre of the flour”—resulted in the deaths of 112 Palestinians. Just days ago, UNICEF’s convoy to the north, carrying food and medicines to the Kamal Adwan hospital where children are dying of hunger, was struck by gunfire, forcing a return. Public perception of Israeli actions varies; a February survey found that 68% of the Jewish population in Israel opposed all transfers of aid to Gaza.
Distribution chaos continues. Military forces have not only refrained from attacking caravans and the hungry population but have also targeted those trying to impose order on distribution. A Gaza City resident, who asked to remain anonymous, reports that after local police were killed and left vulnerable in civilian clothing, attempts to restore order faced deadly resistance. Israeli officials claim some of these actors are terrorists or affiliated with Hamas, arguing that disruption is intended to erode civil order.
New organizing approaches emerged after the police collapsed, including civil volunteer committees and clan-based leadership structures. Some of these groups are reportedly being recruited by Israel to eventually supplant Hamas as Gaza’s authority. A high-ranking Palestinian official told Associated Press that Israel aims to identify cooperative clans for pilot projects as an alternative to Hamas, though resistance factions remain the sole credible authorities in the field.
Since the assault on José Andrés’ NGO and threatening remarks from Washington about conditioning aid on Israel, Israel has pledged to flood Gaza with relief through various measures. Yet progress remains elusive. The UN’s Jamie McGoldrick, the agency’s humanitarian coordinator for the occupied territories, cautions that change will only be real when actions replace words, noting sustained pressure to show tangible results.