A panel of United Nations-affiliated experts has warned that the people of the Gaza Strip are at imminent risk of famine, with more than 90 percent of its 2.2 million people facing “acute food insecurity” and a quarter part of the population experiencing “a catastrophic situation.” hunger levels.”
Even before the war between Israel and Hamas, nearly 70 percent of Gazans relied on humanitarian assistance for food because the territory has been under an Israeli and Egyptian blockade since 2007. Now, only between 20 and 30 percent of what people need. the border with Gaza, according to the World Food Program. Lack of electricity and fuel and the inability to travel safely have compounded the challenges of producing food or getting it to people. Most people go a day or more without eating, the expert panel said.
As in the vast majority of other food crises that the panel, the Famine Review Committee, has assessed in the 20 years since its creation, the situation in Gaza is not environmental but man-made. But Gaza is unusual for the speed with which people have been pushed into malnutrition.
In interviews, nutrition experts and doctors described what can happen when people can't get food.
Children usually fail first
Children, pregnant and lactating women, people with medical conditions, and older adults often succumb first to acute malnutrition. How long they can survive under conditions of extreme hunger will vary.
“It depends on the age of the person,” said Zita Weise Prinzo., Senior nutritionist at the World Health Organization. “It depends on your state of health. It depends on whether they have access to liquids or some type of food, even if it does not cover all their nutrient needs.”
UNICEF, the humanitarian aid organization that focuses on children, is particularly concerned about babies, said Anuradha Narayan, the agency's senior adviser on child nutrition in emergencies. Before the war, about 60 percent of Gaza's babies were formula-fed. Their families now have little or no access to any food supply.
“We know there are many families who probably cannot feed their children infant formula,” she said.
For families who have found formula, the challenge is finding clean water to prepare it; It is estimated that 1.6 liters of drinking water per person is currently available in Gaza (compared to the minimum of 15 liters per day recommended by the WHO).
Progression towards severe malnutrition is rapid
Narayan said the agency estimated that between 7,000 and 8,000 children are so severely malnourished that they risk dying without immediate treatment, but the active conflict in Gaza was making it difficult for aid agencies to assess the situation.
“We expect that those numbers could increase quite dramatically in the next two to three weeks,” he said.
Ms Narayan said that in her work in other food security crises, such as in Ethiopia, it was typical to see a child fall ill and progress to severe malnutrition and wasting within days.
For Gaza, he said, “It's harder to predict, but if there is almost no food to feed young children and there are diseases involved, I would say it could be exactly the same. You go from reasonably well to some level of malnutrition, maybe not very wasted, but wasted, in the span of a few days. “Especially for young people, under 2 years old, that will certainly be the case.”
The trajectory of people with some access to food would be different, said Dr. Stanley Zlotkin, a professor of nutrition at the University of Toronto and an expert on the effects of critical food shortages. An adult can survive for a long period with only intermittent access to calories or only foods that offer limited nutrients, he said. In a situation like Gaza, where there is still sporadic availability of some foods, most adults could survive for some time, but that would not be enough for children to avoid a progression towards malnutrition.
what happens in the body
A malnourished body first burns fat reserves, said Heather Stobaugh, a nutrition and emergency expert at the relief agency Action Against Hunger, until they are depleted. Then, “the body will resort to using muscles and eventually vital organs will start to break down,” she said. “In the most severe forms of malnutrition, immune systems weaken and vital organs begin to shrink: the heart, lungs, etc.”
“When a child or adult reaches this point,” he added, “their body is literally wasting away.”
Mrs. Weise Prinzo stated that in this state people minimize energy expenditure. “They stop any movement that is not necessary for immediate survival, but also within the organs there are changes in the functioning of the heart and liver,” she said. “They really try to manage it, but eventually one or the other of the systems starts to fail.”
At this point, a starving person suffers a series of physical degradations, including extreme fatigue, inability to regulate temperature, and emotional deterioration.
“We say 'acute malnutrition' and Acute means it could occur in a short period of time,” Dr. Stobaugh said. “It doesn't always have to be months of slow degradation.”
Malnutrition and disease drive a dark cycle
A malnourished person is vulnerable to disease due to a weakened immune system and conflict conditions, where there is a lack of clean water and sanitation facilities and people often live in overcrowded shelters.
A malnourished body's defenses (epithelial cells, which form the surface of the skin and barrier tissues in places such as the intestine) break down and white blood cells function poorly.
“Then when you get sick, the body uses all the protein and energy reserves you have to try to fight the infection, and that cycle of infection and malnutrition is what quickly causes wasting,” Narayan said. This process is faster in children, he said.
Dr. Zlotkin said the disease spreads rapidly in situations like the current one in Gaza, where 90 percent of people have been displaced and are sheltering in tents or other temporary structures, and there are few latrines or washing facilities. suitable. Pneumonia and gastrointestinal. Infections are the leading cause of death among malnourished people.
“There are outbreaks of illnesses like extreme diarrhea in combination with a lack of health care services, food and clean water,” Dr. Stobaugh said. “This kind of perfect storm of adverse environmental and health conditions is going to exacerbate the rate at which a body becomes malnourished and can ultimately reach the brink of death quite quickly.”
