With virtually no food allowed into the northernmost part of Gaza for the past month, tens of thousands of Palestinians under Israeli siege are rationing their last lentils and flour to survive. As bombardment pounds around them, some say they risk their lives to search for cans of food in the rubble of destroyed homes.
Thousands have staggered out of the area, hungry and thin, into Gaza City, where they find the situation little better.
"We are being starved to force us to leave our homes," said Mohammed Arqouq, whose family of eight is determined to stay in the north, weathering Israel's siege. "We will die here in our homes."
Medical workers warn that hunger is spiraling to dire proportions under a monthlong siege on north Gaza by the Israeli military, which has been waging a fierce campaign since the beginning of October, saying it's rooting out militants.
Hamas militants, who are still holding hostages inside Gaza, have regrouped in the area and have been carrying out hit-and-run attacks from tunnels and bombed-out buildings. The military has severed the area with checkpoints, ordering residents to leave. Many Palestinians fear Israel aims to depopulate the north long-term.
On Friday, experts from a panel that monitors food security said famine is imminent in the north or may already be happening. The growing desperation comes as the deadline approaches next week for a 30-day ultimatum the Biden administration gave Israel: raise the level of humanitarian assistance allowed into Gaza or risk possible restrictions on U.S. military funding.
The U.S. says Israel must allow a minimum of 350 trucks a day carrying food and other supplies. Israel has fallen far short. In October, 57 trucks a day entered Gaza on average, according to figures from Israel's military agency overseeing aid entry, known as COGAT. In the first week of November, the average was 81 a day.
The U.N. puts the number even lower — 37 trucks daily since the beginning of October. It says Israeli military operations and general lawlessness often prevent it from collecting supplies, leaving hundreds of truckloads stranded at the border.
U.S. State Department spokesperson Matthew Miller said Israel had made some progress by announcing the opening of a new crossing into central Gaza and approving new delivery routes.
But he said Israel must do more. "It's not just sufficient to open new roads if more humanitarian assistance isn't going through those roads," he said.
A trickle of food has reached Gaza City, but as of Thursday, nothing entered the towns farther north for 30 days, even as an estimated 70,000 people remain there, said Louise Wateridge, spokesperson for the U.N. agency for Palestinian refugees, speaking from Gaza City.
The Israeli government acknowledged in late October that it hadn't allowed aid into Jabaliya because of military "operational constraints" in response to a petition by Israeli human rights groups. On Saturday, COGAT said it allowed 11 trucks of food and supplies into Beit Hanoun and Jabaliya. But Alia Zaki, a spokesperson for the U.N.’s World Food Program, said Israeli troops at a checkpoint forced the convoy to unload the food before it could reach shelters in Beit Hanoun. It was not clear what then happened to the supplies.
Palestinians in the north described to The Associated Press a desperate daily struggle to find food, water and safety, as strikes level buildings, sometimes killing entire families.
Arqouq said he goes out at night to search bombed-out buildings: "Sometimes you find a half-empty package of flour, canned food and lentils."
His family relies on help from others sheltering at a Jabaliya school, he said, but their food, too, is running low.
"We are like dogs and cats searching for their food in the rubble," said Um Saber, a widow.
She said she and her six children had to flee a school-turned-shelter in Beit Lahiya when Israel struck it. Now they live in her father-in-law's home, stretching meager supplies of lentils and pasta with 40 others, mostly women and children.
Ahmed Abu Awda, a 28-year-old father of three living with 25 relatives in a Jabaliya house, said they have a daily meal of lentils with bread, rationing to ensure children eat.
"Sometimes we don't eat at all," he said.
Dr. Rana Soboh, a nutrition specialist at Gaza City's Patient Friend Benevolent Hospital, said she sees about 350 cases of moderate to severe acute malnutrition daily, most from the north but also Gaza City.
"The bone of their chest is showing, the eyes are protruding," she said, and many have trouble concentrating. "You repeat something a number of times, so they can understand what we are saying."
She cited a 32-year-old woman shedding weight in her third month of pregnancy — when they put her on the scale, she weighed only 40 kilograms.
"We are suffering, facing the ghost of famine that is hovering over Gaza," Soboh said.
Even before the siege in the north, the Patient Friend hospital saw a flood of children suffering from malnutrition — more than 4,780 in September compared with 1,100 in July, said Dr Ahmad Eskiek, who oversees hospital operations.
Soboh said staff get calls from Beit Lahiya and Jabaliya pleading for help: "What can we do? We have nothing."
