Twelve-year-old Rahaf Ayad is so malnourished she can barely speak. Her hair is falling out. Her ribs protrude. She can hardly move her limbs. She blinks slowly, her eyelids heavy.

Originally from Al-Shuja’iya in eastern Gaza City, Rahaf now lives with her seven family members in a single room in a relative’s house in the city’s Al-Rimal neighborhood. 

Shurooq, Rahaf’s mother, explained that her daughter’s health began deteriorating rapidly due to the lack of food.“If anyone touches her, or she tries to move her arms or legs, she just cries out in pain,” she told +972. “She says it feels like her body is burning from the inside. She asks for chicken, meat, or eggs — but there’s nothing in the markets.”

Shurooq and her 45-year-old husband, Rani, have gone from clinic to clinic in search of treatment, supplements, or even advice, but Gaza’s devastated healthcare system offered little help. “Doctors told us there are hundreds of children like Rahaf, and the only thing that can save them is proper food,” she said. “I bought her vitamins from a pharmacy, but when I returned to buy more a week later, they ran out.”

Rahaf’s siblings help with her care: feeding her, bathing her, taking her to the bathroom, and changing her clothes. When food is available, the family puts her needs first. “We eat only after she’s eaten,” said Shurooq. “When we have money, we buy whatever [food] she asks for. But now, there’s nothing — and when we do find something, we can’t afford it.”

Even when Shurooq manages to find and prepare some of the few staples still available in Gaza, like rice, lentils, or pasta, Rahaf cries for chicken, meat or eggs — anything with the protein her body so desperately needs. Eventually, hunger wins out and she eats whatever is available.

“I tell her the border will open soon, and I’ll bring her whatever she wants,” Shurooq said, holding back tears. “Rahaf’s health is collapsing every day. She’s dying in front of my eyes, and we can’t do anything.”

Rahaf loves the English language. She once dreamed of studying English in university and becoming a teacher. But her life — like those of hundreds of thousands of children in Gaza — has been shattered beyond recognition by Israel’s ongoing war.

“I wish my hair would come back,” Rahaf whispered. “I want to walk and play with my siblings like I used to.”

The silent killer

For a little over two months, Israel has prevented all food, goods, and medical supplies from entering the Gaza Strip. The consequences have been catastrophic: According to Gaza’s Government Media Office, over 70,000 children are now hospitalized with acute malnutrition, and 1.1 million lack the daily minimum nutritional requirements for survival.

The Palestinian Health Ministry in Gaza reported that, as of May 5, at least 57 children have already died from malnutrition-related health complications since the start of the war, and another 3,500 under the age of five face imminent risk of death from starvation.

“Over the past two weeks, the famine intensified significantly,” Dr. Ahmed Al Faraa, director of the maternity and pediatrics department at Nasser Hospital, told +972. “In that period, we have treated approximately 10 children suffering from very serious malnutrition.”

Dr. Ahed Khalaf, a pediatric specialist at Nasser Hospital, told Al Jazeera recently that they have never seen such severe cases of malnutrition in children. “They are suffering from blood poisoning, organ failure, liver and kidney damage, bacterial and microbial infections, and weakened immunity.”

Shortly after Israeli Defense Minister Israel Katz declared on April 16 that “no one is currently planning to allow any humanitarian aid into Gaza,” local and international food distributors, once a lifeline for hundreds of thousands, started shutting down one by one. On April 25, the World Food Program announced it had run out of its remaining food stocks. On May 7, World Central Kitchen announced that it “no longer has the supplies to cook meals or bake bread in Gaza.”

“The siege on Gaza is the silent killer of children [and] older people,” UNRWA spokesperson Juliette Touma said in a press briefing on April 29. “We have just over 5,000 trucks with lifesaving supplies that are ready to come in. This decision [not to let them in] is threatening the lives and survival of civilians in Gaza, who are also going through heavy bombardment day in, day out.”

‘Everyone I know is broke’

Ibrahim Badawi, 38, needs at least four kilos of flour a day to feed his family of nine. These days, he struggles to find even one kilo. “I feel helpless when my children ask for bread and I have nothing to give them,” he told +972. “Sometimes, I wish my children and I would die in an airstrike together — to be spared the pain of starvation and this continuous agony.” 

Badawi, who was displaced from Beit Hanoun in northern Gaza, is living in a makeshift shelter of tarps and blankets on the shore of Gaza City. Since Israel shattered the ceasefire in March, Badawi has not received a single food parcel. 

Badawi and his wife, along with their eldest son Mustafa, 15, have grown accustomed to going to bed hungry so the younger children can eat the small portions of rice or lentils they occasionally receive from the community kitchen. “My youngest, Abdullah, who is four years old, cries from hunger, saying his stomach hurts. I lie and tell him I’ll bring flour soon just so he can sleep,” Badawi lamented.

But even if flour were available, Badawi couldn’t afford it. Until late March, most Gazans survived on stockpiled bread and canned goods as prices soared. But then, the crisis deepened: when all 26 World Food Program bakeries closed due to flour and fuel shortages, white flour became impossibly expensive. A 25 kilogram sack of white flour which cost NIS 30 ($8.30) before the war, now costs a staggering NIS 1,500 ($416).

“I’ve borrowed money from neighbors and friends many times to buy flour,” Badawi said. “But now everyone I know is broke. My children suffer from colic and indigestion. If this famine continues, we will all die from starvation.” 

‘Neither Israel, Hamas, nor the world cares about us’

Hadia Radi, a 42-year-old mother of six, lives with her family in a makeshift tent on Gaza City’s Al-Wihda Street. Like countless other families in the enclave, they’ve been dealing with both hunger and bombardment for months. On April 15, an Israeli airstrike hit just meters from their tent, injuring several family members, including Hadia’s 7-year-old son Yamen, whose leg was broken when it was hit by shrapnel.

Now being treated at the Red Crescent’s Al-Saraya field hospital, Yamen’s recovery is complicated by severe malnutrition. “He’s lost 10 kilos in two months,” Radi told +972. “We’ve eaten nothing but rice since the blockade began. Without proper nutrition, our wounds won’t heal.”

Food is now so scarce that even small acts of kindness can be risky. Recently, a neighbor heard Yamen crying on the phone from his hospital tent, begging his mother for bread. The next morning, he brought the family ten pieces of bread, smuggled in a black bag to avoid attracting hungry eyes. Radi hid the bread in their tent like treasure. “Every day, I’d send one piece with my husband for Yamen. His siblings cried for some too, but I told them that the most injured must come first.”

Yamen keeps asking for his mother to visit, but Radi remains trapped by her own injuries from the blast — a broken leg that leaves her dependent on crutches. She’s equally powerless to reach her 13-year-old daughter Hannan, who is being treated at Al-Shifa Hospital’s overwhelmed wards.

Hannan was hit by shrapnel that took one of her eyes and left her unable to walk. The lack of food has made recovery extremely difficult. “She needs vegetables, healthy food, and special care to heal,” Radi explained. “But there’s no access to any of that here.”

Radi believes Israel is starving Gaza to pressure Hamas, but says it’s regular families paying the price. “We’re watching our children wither away, and neither Israel, Hamas, nor the world cares,” she lamented. “Why should my kids starve to death? What did we do to deserve this? If you can’t stop the war, at least open the borders. Don’t let us die from starvation.”

‘Netanyahu punishes us just for existing’

Heba Malahi, 41, has also lived in a makeshift tent on Gaza City’s Al-Wihda Street since an Israeli airstrike destroyed her home in Juhor ad-Dik in 2023. Now she and her 45-year-old husband Ribhi regularly skip meals so their seven children can eat.

Mahmoud, the couple’s six-year-old son, suffers from severe malnutrition. “He’s tired all the time. He doesn’t eat, his bones hurt, and his teeth are starting to fall out,” Heba told +972. “Last week he begged for tomatoes. We sold our last canned food just to buy a single kilo — we all shared that one meal.”

Their 17-year-old daughter Ruba desperately craves simple foods like potatoes, but at NIS 60 per kilo, they’re virtually unattainable. “Netanyahu punishes us just for existing,” Heba said. “Maybe someone like Trump could force him to open the borders before we all starve.

“If people imagined their own children in this state, perhaps they’d act,” she added.

Further south, In Khan Younis, Mona Al-Raqab has been sitting with her five-year-old son Osama for over a week in the Nasser Medical Complex. He currently weighs just nine kilograms (20 pounds). Displaced multiple times since the war began with little food or clean water, his digestive system has almost failed. “Doctors try feeding him nutrients,” Al-Raqab said, “but a growing child needs real food of different types.”

A few rooms over, 30-year-old Nagia Al-Najjar watches over her severely malnourished five-month-old baby Yousef in his crib. Her four other children remain with their father in their tent in the village of Abasan, after their home in Khan Younis’ Bani Suhaila neighborhood was destroyed. The hospital struggles to provide formula amid border closures. “I can’t breastfeed because I barely eat myself,” Al-Najjar told +972. “I can’t find the words to express how this feels as a mother.”

Dr. Al Faraa explained that the lack of food has been causing miscarriages and dangerously underweight newborns with severe deformities. Families now grind pasta — or even rice and lentils — into makeshift flour. “I don’t care if I starve,” Al-Najjar said. “But what did my children do to deserve this?”