Adam has been on my mind lately, more so than usual.

I met Adam in 2018 in the Yemeni port city of Hodeidah, which was then under siege and heavy bombardment. In the dilapidated hospital ward, there lay Adam: 10 years old and weighing just over 10 kilograms. Unable to speak or cry, all he could do was make a hoarse sound with every breath. A few days later, Adam died of malnutrition.

A couple of years before that, my colleague Hanaa called from Syria late one night. She was in tears and could barely say a word. Eventually she told me that Ali, a 16-year-old boy, had died — he, too, of malnutrition, in yet another besieged town, caught in a war not of his making. 

The following morning, my supervisor, an epidemiologist, said: “For a boy of 16 to die of malnutrition, that says a lot. He’s practically a man. It means there’s no food at all in that part of Syria.”

Back in Yemen, in one of the few functioning children’s hospitals in the capital city of Sana’a, I remember walking through the children’s ward during the height of a cholera outbreak. Boys aged 15 or 16 were fighting to survive. They were so weak and emaciated, they could barely turn in their beds.

These images and stories haunted me over the years, as they have for many of us who have worked in severe hunger or famine-like situations.

In 2022, when I could still visit Gaza regularly, I would stop by UNRWA schools and meet children — immaculately dressed, healthy looking, smiling, eager to learn, jumping up and down in the school playground to the sound of music.

Back then, Gaza had already been under blockade for more than 15 years. Still, food was available; imported through Israel or grown locally. UNRWA was also providing food aid to more than a million people.

And so, images of Adam and Ali were pushed to the back of my mind — until they came rushing back.

How much longer?

A few weeks ago, our teams in Gaza started sending alarming photos of emaciated babies. More than 50 children died of malnutrition during Israel’s total blockade between March and May, according to the WHO, and malnutrition rates are still rising rapidly. Since January 24, UNRWA has screened over 242,000 children at its clinics and medical points, covering more than half of Gaza’s under-5 population. One in 10 children screened is malnourished.

One of them is Ahlam, only seven months old. Her family has been displaced every month since the war began, always searching for safety that doesn’t exist. Like many babies in Gaza, her tiny body is weakened; her immune system has been damaged by trauma, repeated displacement, lack of clean water, poor hygiene, and very little food.

Yet despite this, Ahlam can survive. But will she?

In Gaza, therapeutic food and medicine are in desperately short supply. Israeli authorities have imposed a tight siege, blocking the entry of food, medical supplies, nutritional aid, and even hygiene items like soap. Although the blockade is sometimes eased, the UN Relief and Works Agency (UNRWA), the primary humanitarian organization in Gaza, has not been allowed to bring in aid for over four months. 

Last week, Salam, another baby girl, died of malnutrition. She was only a few months old. By the time she reached our clinic, it was too late.

On July 10, eight childrenwere killed when an Israeli airstrike hit the clinic where they were queuing for nutritional assistance. One of my colleagues drove past the clinic a few minutes later. She told me she saw mothers weeping silently, looking out into the abyss, just as Adam did.

Why should babies die of malnutrition in the 21st century, especially when it’s entirely preventable?

At UNRWA, we have over 6,000 trucks full of food, hygiene supplies, and medicine waiting just outside of Gaza’s borders. We also have over 1,000 health workers who can provide lifesaving nutritional services to boys and girls across the Strip. We are ready to move in to help little children like Ahlam.

Amid the daily livestream of horrors from Gaza, one cannot help but ask: How many more Ahlams and Salams must die before the world acts?

How much longer must we wait for a ceasefire, so that bombs stop falling on emaciated, dying children?

A version of this article was first published on UNRWA’s blog. Read it here.