As malnutrition deaths are reported and hunger grows, will ‘famine’ be declared in Gaza?

After months of warnings from aid groups that Palestinians in the Gaza Strip were at high risk of famine, many worry that famine is now reaching the northern part of the enclave, where children are beginning to die from malnutrition and dehydration.

Gaza’s Health Ministry said Wednesday that at least 20 people have died of malnutrition in hospitals and warned that it believes “dozens are dying in silence” because they cannot reach medical facilities. The World Health Organization visited northern Gaza last weekend and confirmed at least 10 child deaths from hunger at the time of the team’s visit.

Israeli officials have repeatedly said they are committed to providing humanitarian assistance to civilians and have not placed any restrictions on aid entering the Palestinian enclave.

A famine has not yet been declared in Gaza, but the Integrated Food Security Phase Classification initiative, or IPC, has activated its famine assessment committee to assess the situation.

Although hunger has long been a problem around the world, a declaration of famine is relatively rare.

What is famine?

The dictionary defines famine simply as an “extreme scarcity of food,” but among global aid agencies tackling food insecurity, it has a much clearer definition and specific guidelines for when a situation should be classified as such. According to the IPC, famine is a situation in which hunger and extremely critical levels of acute malnutrition are evident.

“It’s a technical term that summarizes a set of terms,” said Tobias Stillman, director of technical services and innovation at Action Against Hunger. “So very significant food insecurity, which means that people don’t have enough food to meet their physiological needs… so in many cases they experience hunger as well as physiologically, which compensates for the lack of food.”

Palestinians line up for free meals in Rafah, Gaza on February 16.Fatima Shbair / AP file

What drives food insecurity to a famine declaration?

The IPC and the World Food Program provide a mathematical threshold for what constitutes a famine for the population of a specific area: 20% of households are extremely deprived of food, 30% of children suffer from acute malnutrition and 2 in 10,000 people die per year. day “due to outright famine or due to the interaction between malnutrition and disease.”

Established in 2004 by the Food and Agriculture Organization of the United Nations, the IPC works with more than a dozen organizations around the world, as well as governments, to examine food insecurity using evidence-based analysis.

The five-stage index measures food insecurity, with stage 5 being catastrophe or famine. Gaza is in the ’emergency phase’, one step below famine.

“While levels of acute malnutrition and non-trauma-related mortality may not yet have exceeded famine thresholds, these are typically the consequences of long-term and extreme shortages in food consumption,” the website says.

A well-known IPC representative said its experts were working on an upcoming report on Gaza and were not available for interviews.

Who declares a famine?

Declaring a famine is a multi-step process for the IPC, Stillman said, and requires full consensus from five people on the independent commission.

A group of 25 to 30 people are reviewing data from Gaza to submit their recommendation to the famine assessment committee for analysis. If there is a specific point of contention about a particular data point, it will be noted in a manner similar to what someone might see in the U.S. Supreme Court, Stillman said.

“If the five of them fail to reach a consensus – for example, if one of them strays – they can draw up a different statement, so that the committee still comes up with a general recommendation or a general classification, but there can be a different voice,” he said.

After the assessment committee makes its appointment, the analysis is sent to the IPC’s global steering committee, of which Action Against Hunger chairs, to make the official declaration of famine.

Those who work on hunger and food insecurity understand that it is a complex system, Stillman said. But the teams working on the statements “will justify their conclusions every step of the way.”

“It has to be complicated because it is so incredibly important,” Stillman said. “And you know, famine has such important political connotations that no one wants to take that lightly. … It’s very, very process-oriented.”

How is hunger in Gaza assessed?

The situation in Gaza has presented unique challenges as limited access has complicated the usual process. But teams are collecting real-time data to provide to the IPC, Stillman said.

Normally, the larger country-level committee, made up of government representatives, aid groups and other partners, would meet in person to discuss the data. However, the Gaza team has had to meet virtually and work anonymously, he said.

“It’s never been done this way before,” Stillman said. “And the reason it was done that way is because of the very sensitive nature of what’s happening out there.”

Decisions are based on a series of studies looking at factors such as malnutrition diagnoses and mortality rates. In Gaza, adjustments have been made to the way some data is collected due to limited access.

“There are people in Gaza right now who are measuring malnutrition, and they are not using the traditional method of weight and height,” Stillman said. “They use the circumference of the mid-upper arm.”

While it is faster, he said, the method is not the best standard for data collection by IPC standards. Information is also more readily available in some parts of Gaza than in others.

If the committees don’t have full confidence in the data collection, or if all the information indicates catastrophic conditions but doesn’t quite meet the specific thresholds for famine, the IPC can declare a “probable famine,” Stillman said.

“And that probably means that there are very strong arguments that there is actually a famine, but they don’t have all the data they need to really classify it as a famine,” he said.

What is the current situation in Gaza?

Since shortly after the Hamas-led attacks on October 7, Gaza has been effectively cut off from the outside world as Israel enforces its blockade on the strip, restricting access to food, fuel and running water. Only two weeks after the start of the war did aid convoys enter the Palestinian enclave via the shared border with Egypt.

From the start, the UN and aid agencies warned that the convoys were unable to meet the needs of more than two million people with the most basic needs.

The US urged Israel to open access to a commercial border crossing, Kerem Shalom, to help streamline the process. Kerem Shalom has been used to conduct security screenings, but Israeli citizens have protested at Kerem Shalom to try to prevent aid from entering Gaza.

The famine is most visible in northern Gaza, where convoys have had inconsistent access and civil order has collapsed. A number of deaths were reported last week after witnesses claimed the Israeli army opened fire on a crowd surrounding an Israeli aid convoy.

The IDF has denied the accusation, saying a crowd overran the trucks and soldiers fired “warning shots” in a failed attempt to disperse the group before withdrawing. Israel attributed most of the deaths to crushing and stampede during the chaos surrounding the convoy.

The incident prompted the US to drop thousands of ready-made meals as convoys repeatedly face problems traveling from the southern border to the north.

On Tuesday, the World Food Program announced that the IDF had rejected its first northbound convoy since February 20. Food supplies could be air-dropped with help from the Royal Jordanian Air Force, said Carl Skau, the group’s deputy director. director.

“Airdrops are a last resort and will not prevent famine,” Skau said. “We need access points to northern Gaza so we can deliver enough food to half a million people in desperate need.”

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