A photographer in Gaza has told the story of how he captured a series of harrowing photographs, showing an emaciated child.

Ahmed al-Arini told BBC Newshour that he wanted to “show the rest of the world extreme hunger” that babies and children are experiencing in the Gaza Strip.

Global food security experts have not yet classified the situation in Gaza as a famine, but UN agencies have warned of man-made, mass starvation taking hold.

They have blamed Israel, which controls all supplies entering the Palestinian territory, but it has denied responsibility.

Israel blames Hamas for any cases of malnutrition.

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Gazans facing starvation and Israeli aggression say they are afraid to walk the distance to an aid center out of fear that they may “die on the way or be shot,” says Mara Kronenfeld, executive director of UNRWA USA, which provides support for the humanitarian work of the United Nations Agency for Palestine Refugees.

“They are having to make that choice: Do I risk death or do I try to find some food to feed my children?” she said.

Neighbors are fainting in the streets and aid workers themselves don’t have enough food to get energy to continue the work they are doing, she said.

Kronenfeld criticized Israel’s response on the starvation crisis as “disingenuous at best and dark and cynical at worst.”

Israel has denied creating famine in Gaza and accused Hamas of “engineering” food shortages.

“UNRWA has the equivalent of 6000 trucks of aid, emergency aid and medicine sitting just outside the border. Let that aid in,” Kronenfeld said.

Israel’s blockade is creating a restriction on food and aid availability, which is increasing food prices and the “possibility that people might hoard it,” she noted.

One in five children in Gaza City are facing malnutrition, she said, describing “a catastrophic, indescribable situation on the ground in Gaza.”

Kronenfeld also said that the aid distributed by the Gaza Humanitarian Foundation “is a drop in the bucket.” It has four distribution sites in southern Gaza, so the sick, elderly, young and disabled people have walk far to get that aid, which has resulted in deaths and injuries, she pointed.

Meanwhile, UNRWA has 400 sites and they distribute aid to people where they are with “transparency, integrity and with the dignity of those who are receiving aid,” Kronenfeld said.

Editor’s note: This gallery contains disturbing images. Viewer discretion is advised.

Food markets are empty. Human waste is piling up. Illness is spreading. And people in Gaza are “collapsing on the streets from hunger and dehydration.”

That’s the stark warning issued by more than 100 international humanitarian organizations on Wednesday, in a joint statement calling on Israel to end its blockade, restore the full flow of food, clean water and medical supplies to Gaza, and agree to a ceasefire.

“Every day without a sustained flow of aid means more people dying of preventable illnesses,” said the statement, signed by Doctors Without Borders (MSF), Save the Children, the Norwegian Refugee Council and dozens of other NGOs. “Children starve while waiting for promises that never arrive.”

Scores of people — most of them children — have died of malnutrition since the conflict began in October 2023, the Palestinian health ministry says.

Israel has previously blamed Hamas for its decision to halt aid shipments, alleging the militant group was stealing supplies and profiting from it. Hamas has denied this allegation.

Israel has said it is allowing ample aid into the besieged Palestinian territory, but aid agencies and multiple Western nations say the amount of food reaching Gaza’s population under strict Israeli control is a fraction of what is needed.

The United Nations World Food Program has warned that famine is looming and that 70,000 children in Gaza need urgent treatment for acute malnutrition.

Images of gaunt children and families clutching empty pots are painting an increasingly grim picture of Gaza, where hunger is now claiming lives.

Human rights groups are growing increasingly alarmed over the humanitarian situation in Gaza, which has been under Israeli bombardment since 7 October 2023 after Hamas — the political and military group that rules Gaza — launched a surprise attack on southern Israel — marking a significant escalation in a long-running conflict.

More than 100 international aid organisations and human rights groups on Wednesday said in a joint statement that “mass starvation” is spreading in Gaza and urged governments to step in and “stop waiting for permission to act”.

“The hunger situation in Gaza is deteriorating at a pace we have never seen before,” Unni Krishnan, the global humanitarian director of Plan International, which was among the signatories of the statement, told SBS News.

“Mothers are telling us that they are often forced to choose which child to feed.

“We are talking about hundreds of thousands of people, especially the most vulnerable, such as children and pregnant women, at extreme risk. This must stop.”

On Wednesday, it was reported that 15 people, including a six-week-old baby, starved to death in 24 hours in Gaza , according to doctors, linking this to a wave of hunger that persisted for months.

Since the October 7 attack, at least 101 people, including 80 children, have died from hunger, with most fatalities occurring in the last few weeks, according to Palestinian officials.

On the weekend, the United Nations (UN) World Food Programme (WFP) warned that “Gaza’s hunger crisis has reached new levels of desperation”.

“Malnutrition is surging with 90,000 women and children in urgent need of treatment. Nearly one person in three is not eating for days,” the WFP said.

The reports came amid UN officials, aid groups and experts’ warnings in recent months that Palestinians are on the brink of famine.

How is famine declared?

According to the Integrated Food Phase Security Classification (IPC), the leading global hunger monitoring body, famine is defined as “extreme food deprivation”.

The IPC defines five distinct phases of food security, ranging from minimal (Phase 1) to famine (Phase 5).

Robyn Alders, a food security expert and honorary professor at the Australian National University (ANU), told SBS News: “This is how it’s been defined in order to help international agencies make decisions about how they allocate their resources to deal with priorities.”

Famine, the most severe form of food insecurity, is only declared when at least two people per 10,000 die daily of starvation, 20 per cent of households face extreme food shortage, and 30 per cent of children are acutely malnourished.

“Famine is basically a response to severe and widespread food shortages. It’s about hunger, amount, nutrition, and characterised by death, as in a population.” — Amra Lee, humanitarian practitioner and researcher at ANU. Source: AAP / Hasan Alzaanin/TASS/Sipa USA Last year, the IPC announced that a region can be deemed to be in “famine with reasonable evidence” if two out of the three criteria have been met and it is likely that the third has also been crossed.

While the IPC serves as a mechanism to assess whether a famine is occurring or likely to occur, it generally does not issue official declarations. Instead, UN officials and governments usually release formal statements based on IPC analyses.

Alders said the definition “is independent of the driver” of famine.

“There can be natural disasters that lead to failure of food production … Or as we know, if we read history, that food shortages have been used as weapons of war, basically over thousands of years.”

Last year, famine was declared in parts of North Darfur, Sudan. Previously, Somalia experienced a famine in 2011, and South Sudan faced similar crises in 2017 and 2020.

Why has famine not been declared in Gaza?

In war-torn Gaza, which is in a deep humanitarian crisis, famine has not been declared yet.

The IPC had previously forecast that from May to September, 470,000 people in Gaza would face famine (Phase 5), one million would experience emergency food security levels (Phase 4), and the remaining 2.1 million people would be in crisis (Phase 3).

Krishnan from Plan International said the lack of declaration of famine in Gaza is related to the lack of accessibility to data.

“The definition of famine is based on data. The data is not available right now, but there is no conclusion that the data doesn’t exist, except that we are not able to collect it,” he said.

“Because the absence of people who could collect primary data who are not allowed to go in [Gaza], resulting in a situation where they’re not able to declare [famine].”

Some experts argue that, despite a lack of data, famine already exists in Gaza.

Amra Lee, a humanitarian practitioner and researcher at ANU, told SBS News: “Given the data on a hundred dying of starvation over the past or since May, we can assume, and experts have already assessed, that famine is happening in Gaza.”

“The problem right now in Gaza is not the declaration of famine. The problem right now in Gaza is that insufficient aid is getting into the strip [and] Israel, preventing the aid, getting into the strip,” the former head of program for the WFP Pacific said.

“I can see the famine risk has been there for a while, and it’s important, but we need to look at what’s not being done to avert the famine.”

Food supplies ’20 minutes’ away from Gaza

Lee said one of the reasons behind the worsening situation for Palestinians is the Gaza Humanitarian Foundation (GHF) program , which started in May after Israel halted all aid deliveries to Gaza in early March.

The GHF bypasses traditional aid channels, including the UN, which says the US-based organisation is neither impartial nor neutral.

On 15 July, the UN said it had recorded 875 people who had been killed in Gaza while trying to get food in recent weeks, with 674 of them killed in the “vicinity of GHF sites”.

Earlier that month, Israel acknowledged “incidents in which harm to civilians who arrived at distribution facilities was reported”.

It said Israeli forces had been issued new instructions following what it called “lessons learned” .

“As many have warned and have since been proven, this foundation did not have a humanitarian character. It is serving a political and military agenda,” Lee said.

“We need specialised experts who know how to do this … [and] sort of reinforce national health systems to avert the famine that is occurring at risk of deepening.

“We need to revert to principled aid delivery, the blockade needs to be lifted, and aid needs to reach the strip at the scale needed.”

The US-based Gaza Humanitarian Foundation, which has been disavowed by the United Nations, started delivering aid to Gaza in May following a two-month blockade by Israel. Source: AP / Abdel Kareem Hana In their joint statement, the humanitarian and aid organisations also criticised the GHF and said that “tons” of aid were in warehouses just outside Gaza, but Israel’s government was restricting its entry.

Krishnan told SBS News: “On the other side of Rafah and Gaza in Egypt and elsewhere, there are hundreds of trucks that are waiting with food supplies, which could get into Gaza within 20 minutes.”

“Hunger has always been a solvable problem … Except [for] the complete siege that has been going on from the Israeli Defence Forces.”

On Wednesday, Israeli government spokesperson David Mencer rejected such claims and accused the UN and its partners of not collecting the large quantities of food and other essentials that were cleared and waiting on the Gaza side of the border, saying “aid has been flowing into Gaza”.

He also said there was “no famine caused by Israel” and alleged that there was a “man-made shortage engineered by Hamas”, who he accused of stealing aid — a claim that the establishment of the GHF was in part based on and one Hamas has denied.

The head of the UN agency for Palestinians has said its staff are fainting from hunger as the starvation crisis in Gaza resulting from an Israeli blockade on most aid into the territory worsens.

“People in Gaza are neither dead nor alive, they are walking corpses,” Philippe Lazzarini, the head of the United Nations Relief and Works Agency (Unrwa) said in a post on X.

At least 113 people have died of hunger in Gaza, 45 of them in the last four days.

This deepening crisis is affecting everyone, including those trying to save lives in the war-torn enclave … When caretakers cannot find enough to eat, the entire humanitarian system is collapsing.

He added that Unrwa had the equivalent of 6,000 loaded trucks of food and medical supplies waiting in Jordan and Egypt and urged Israel to allow “humanitarian partners to bring unrestricted and uninterrupted humanitarian assistance to Gaza”.

Reports of people fainting and dropping dead of hunger have emerged in recent days. Civil defence workers have released pictures of gaunt bodies with little more than skin covering their bones.

Palestinians carrying pans gather to receive hot meals distributed by a charity organization in Gaza City, where residents are struggling to access food due to the ongoing Israeli blockade and attacks. Picture: Khames Alrefi/Anadolu via Getty Images

As international pressure mounted for a breakthrough to end nearly two years of devastating war, Hamas said it had sent its response on the latest ceasefire proposal to mediators. An Israeli official told the Associated Press that the latest Hamas proposal was “workable”.

The US envoy, Steve Witkoff, was scheduled to meet the top Israeli adviser, Ron Dermer, and the Qatari prime minister, Sheikh Mohammed bin Abdulrahman Al Thani in Sardinia, an Italian government source confirmed.

Mediators rejected a previous version of the deal, telling Hamas to come back with a more realistic proposal or risk jeopardising the negotiations.

A Palestinian official close to the talks told Reuters the Hamas response was “flexible, positive and took into consideration the growing suffering in Gaza and the need to stop the starvation”.

Israel’s prime minister, Benjamin Netanyahu, recalled the Israeli negotiators from Doha on Thursday for consultations. Israeli media reported that significant gaps remained between the two sides, including over to what point Israeli troops should withdraw during the ceasefire.

Israeli Prime Minister Benjamin Netanyahu. File Picture: AP Photo/Jacquelyn Martin

International pressure for a deal is growing, as images of starving Palestinians provoke global condemnation of the Israeli blockade of the strip. An EU commission spokesperson said all options remained on the table if Israel did not improve the humanitarian situation in Gaza. Israel had agreed to expand aid access with the EU earlier this month.

The deal under consideration is expected to involve a 60-day ceasefire during which Hamas would release 10 living hostages and the bodies of 18 others in exchange for Palestinian prisoners. Talks would be held during the ceasefire period to reach a lasting truce and aid supplies to the besieged strip would be increased.

It has only been since the end of the war between Iran and Israel war last month that the serious prospect of a ceasefire in Gaza has emerged. The outcome of the 12-day conflict has given Netanyahu domestic breathing space to push for a deal.

As negotiations continue, Israeli attacks have increased. At least 89 people were killed in the last 24 hours as Israeli airstrikes pounded central Gaza, health authorities said.

Israel says the global media is exaggerating the scale of the hunger crisis, even though aid groups and pictures coming from Gaza show clear evidence of starvation and doctors who treat malnourished children say they are unable to get enough to eat themselves.

Israel only lets a trickle of aid into Gaza, the vast majority of which is distributed by the Gaza Humanitarian Foundation (GHF), a private US firm. GHF operates four food distribution points staffed by US mercenaries, a system which has been described as a death trap.

More than 1,000 people seeking aid have been killed trying to access supplies in the nearly two months since GHF began operating in Gaza.

Aid used to be distributed through more than 400 distribution points under a UN-led system, but Israel has all but stopped UN aid into the territory since March. Israel accuses Hamas of stealing UN aid, a claim for which humanitarians say there is little evidence.

People wait to receive food from a charity kitchen in Gaza.

Palestinians hold onto an aid truck returning to Gaza City from the northern Gaza Strip. Picture: AP Photo/Jehad Alshrafi

Aid groups say GHF, which was meant to replace the UN, lacks the capacity to do so and that its militarised model violates key humanitarian principles.

Restoring the UN aid system as a part of a ceasefire deal is a key Hamas demand. Israeli negotiators have softened their stance on the issue as pressure grows even within Israel to stop the starvation crisis, which the World Health Organization director general, Tedros Adhanom Ghebreyesus, described on Wednesday as man-made.

Thousands of Israeli demonstrators carrying bags of flour and pictures of Palestinian children who died of starvation protested in Tel Aviv on Wednesday, calling for an end to the Gaza blockade.

Hamas is also calling for a ceasefire deal to include a permanent end to the Gaza war, something that Israel has refused. A ceasefire deal is unpopular among the more extreme members of Netanyahu’s cabinet and Israel has sought to keep open the possibility of restarting the war after the ceasefire period.

– The Guardian