[24] By December, international aid organizations and relief workers sounded alarms of mass starvation, with the majority of households facing inadequate food consumption and a significant portion resorting to extreme measures to survive.

[28][29] The chief economist at the World Food Programme noted that the vast majority of people experiencing famine or catastrophic hunger worldwide were concentrated in Gaza, emphasizing the severity of the crisis.

[32] The international community expressed grave concerns, acknowledging the pervasive shadow of starvation looming over the people of Gaza and underscoring the urgent need for immediate humanitarian intervention to avert further tragedy.

[36] An independent study by researchers from Columbia University found that "sufficient amounts of food are being supplied into Gaza", though, "it may not always be distributed to people due to other factors, such as war and Hamas control".

[37] According to a letter sent to President Joseph R. Biden, Vice President Kamala D. Harris, and others on October 2, 2024 by 99 American healthcare workers who have served in the Gaza Strip since October 7, 2023, and cited in a study from the Watson Institute for International and Public Affairs at Brown University, based on starvation standards by the United States-funded Integrated Food Security Phase Classification, according to the most conservative estimate that they could calculate based on the available data, at least 62,413 people in Gaza have thus far died from starvation, most of them young children.

[78] As deaths and injuries in Gaza continue to rise due to intensified hostilities, intense overcrowding and disrupted health, water, and sanitation systems pose an added danger: the rapid spread of infectious diseases.

[108] In his address to the UN Security Council on 31 January 2024, Martin Griffiths, the UN under-secretary general for humanitarian affairs and emergency relief coordination, provided a comprehensive overview of the challenges currently confronting numerous individuals in Gaza.

The United Nations has observed that this ongoing blackout, along with the shutdown of communications and industrial fuel, is greatly impeding the aid community's ability to assess and effectively address the worsening humanitarian crisis.

[256] On 8 November, the Ministry of Defence of Italy announced it was sending a hospital ship to the coast of Gaza,[257][258] in order to guarantee Palestinian civilians access to health services, essential goods and medical drugs.

[258][g] By early-December, the medical staff started performing emergency surgical operations for injured Palestinian patients who were either at risk of amputation, or waiting to be moved to the Children Hospital in Doha.

[259] On 5 February 2024, it was announced that the Vulcano had returned to Italy and arrived at the seaport of La Spezia, carrying 60 Palestinian people,[260][261] 14 of which were children in need of specialized healthcare, although none of them suffered from life-threatening conditions or injuries.

[409][410][411] Lack of internet access has obstructed Gazan citizens from communicating with loved ones, learning of IDF operations, and identifying both the areas most exposed to bombing and possible escape routes.

[413] As a result, humanitarian groups, including UNICEF, WHO, the Palestine Red Crescent Society, Doctors Without Borders, American Friends Service Committee, Medical Aid for Palestinians, and ActionAid lost all contact with their staff.

[415] On 28 October, Elon Musk offered to provide humanitarian groups with Starlink access, but Shlomo Karhi stated Israel would fight it with every "means at its disposal” because Hamas will use it for terrorist activities.

[425] On 3 November, the BBC began broadcasting an emergency radio service on mediumwave from Cyprus in attempt to retain communications with Gazan civilians and support information-finding such as "where to access shelter, food and water supplies".

[441] In a statement, UNWRA stated, "Disruption of telecommunication services prevents people in Gaza from accessing life-saving information or calling for first responders, and continues to impede humanitarian response.

[453][454] On 18 October, Israel announced it would allow food, water, and medicine to be delivered to a "safe zone" in west Khan Younis in southern Gaza, distributed by the United Nations.

[470][471] On 28 October, The New York Times reported that Hamas had stockpiled food, water, medicine and sanitary products in underground caches, in amounts that would allow it to continue fighting for several months without resupply.

[504] A joint statement by the heads of UNICEF, WHO, and the World Food Programme stated the limited quantity of aid arriving in Gaza was unable to prevent the "deadly combination of hunger, malnutrition, and disease".

[517] Breakdown of deaths by age and gender (analysis by professors Michael Spagat and Daniel Silverman), November 2023[518] Due to over 40% of Gaza’s population being 14 or under, children have been notably impacted by Israel's attack.

[562] On 18 January 2024, Natalia Kanem, the executive director of the UN Population Fund, spoke at the World Economic Forum at Davos, stating the situation was the "worst nightmare" the UNPF representative had ever witnessed, as there were 180 women giving birth daily, sometimes on the streets of Gaza, as the territory's health system collapsed.

[570] In late October, Gaza's premature babies faced a critical situation as Medical Aid for Palestinians and UNICEF warned that 130 infants were at risk of death due to a hospital fuel shortage caused by Israel's siege.

"[587] A Doctors Without Borders video shared by Amnesty International head Agnès Callamard stated, "This brutal annihilation of an entire populations health system stretches beyond what humanitarian aid can fix.

[591] On 13 December, a group of Israeli human rights and civil society organizations, including B'Tselem, penned an open-letter to Joe Biden urging him to use his influence to help stop the "catastrophic" humanitarian crisis in Gaza.

[600] In response to a week-long communications blackout across Gaza in January 2024, the non-profit Access Now stated, "It is unconscionable to toy with connectivity amidst unprecedented violence and unfathomable human suffering.

If you add those who are likely to die of malnutrition or as a result of wounds inflicted by Israeli bombardments in the weeks and months to come, because of the risks of superinfection and because their pathology will be treated late, then yes, the figure of 186,000 deaths mentioned in The Lancet is credible.

[629] Speaking at the United Nations Security Council on 12 January, Martin Griffiths stated colleagues who had made it into northern Gaza in recent days had described "scenes of utter horror: Corpses left lying in the road.

[653] On 14 January, the Foreign Ministry stated, "The Israeli occupation has turned Gaza into an uninhabitable place, committed horrific crimes, and forcibly displaced approximately 2 million people".

[665] The US put forward a draft UN Security Council resolution which stated the "imperative" for "an immediate and sustained ceasefire", facilitating aid delivery, and supporting ongoing talks between Israel and Hamas, linked to the release of hostages.

[675] In a town hall meeting on March 25, 2024, the Republican US House representative Tim Walberg of Michigan stated that Palestinian civilians should have nuclear weapons used against them, "like Nagasaki and Hiroshima" (the Japanese cities where the US dropped atomic bombs at the end of World War Two, killing hundreds of thousands of people) in order to "Get it over quick.