Nearly two billion Muslims worldwide are preparing to observe Ramadan, a holy period of fasting marking the ninth month of the Islamic calendar.
A key part of Ramadan is a nightly shared meal, iftar, to mark the breaking of the fast that day.
But in Gaza, — the majority of them Muslim — one of its most vulnerable populations is struggling to survive.
Gaza's children are starving.
The death of the 10th child by starvation was officially registered at a local Gaza hospital, .
In the statement, the United Nations health agency spokesperson Christian Lindmeier called this situation "a very sad threshold … [but] the unofficial numbers can unfortunately be expected to be higher".
On 3 March, Gaza's Health Ministry stated that 15 children had died of malnutrition or dehydration at Kamal Adwan Hospital in northern Gaza, where the lack of food is said to be most extreme.
Palestinians in Gaza hold out containers for food. Source: Getty / Anadolu
Aid blockade leads to severe food shortage
Photos of Palestinian children in Gaza with hollow, emaciated faces and bodies have highlighted how serious the situation is on the ground.
Carl Skau, deputy executive director of the World Food Programme (WFP), described northern Gaza in particular as "the worst level of child malnutrition anywhere in the world."
The Israeli government implemented a blockade of food, fuel, water and energy on the Gaza strip after the 7 October Hamas attacks, only allowing aid after increasing international pressure.
Human Rights Watch has accused the Israeli government of "using the starvation of civilians as a method of warfare".
The WFP said on 5 March its first attempt in two weeks to bring food to northern Gaza was blocked by Israeli troops, while air drops of food by countries such as the US are being criticised for being well below what is needed to stave off the catastrophic situation unfolding.
A famine has not yet been declared in Gaza, but the Integrated Food Security Phase Classification initiative, or IPC, has activated its famine review committee to assess the situation. Source: SBS News
"The IDF is continuously coordinating the entry of humanitarian aid to Gaza," the statement reads.
Israeli forces have also been accused of , claims they have downplayed — attributing deaths, in what was described by the Gaza Health Ministry as a 'massacre', to a stampede.
However an Israeli military official later said soldiers also fired in the air and "then fired towards those that posed a threat and did not move away".
A scathing report released on Thursday by independent humanitarian organisation Refugees International found that Israel has "consistently and groundlessly impeded aid operations within Gaza, blocked legitimate relief operations, and resisted implementing measures that would genuinely enhance the flow of humanitarian aid into Gaza".
Israel has continuously denied the dire situation facing Gaza is due to its actions — blaming the UN, its partners and other aid agencies for creating logistical challenges, resulting in the bottleneck.
The UN disputes these claims.
Israel has bombarded Gaza since the 7 October attack in which more than 1,200 people were killed and over 200 were taken hostage, according to the Israeli government.
Since then, more than 30,410 people have been killed, according to the health ministry in Gaza.
How much aid is getting into Gaza?
Getting an accurate picture of how much aid is actually reaching Palestinians in Gaza is difficult, as assessments between the UN and other humanitarian agencies and Israeli officials differ.
The UNWRA, the UN's main aid agency in Gaza, said 500 trucks a day are need to meet basic needs, but there are days when fewer than 10 trucks pass through. On other days as many as 200 are allowed in,
Israel's Coordination of Government Activities in the Territories, a unit that oversees aid getting into Gaza, publishes its own tallies of what aid it has let through which at times contradicts the UNWRA's numbers.
The WFP said in a report last month the number of food trucks entering Gaza has dipped from an average of 150 trucks per day between January and September 2023, to an average of 59 trucks per day between 7 October and January 2024.
Starvation, charity and empathy
Ihsan Yilmaz is a research professor and Chair of Islamic Studies at the Alfred Deakin Institute for Citizenship and Globalisation at Deakin University, Melbourne.
"Ramadan is about two major things — first, self-discipline in terms of God's grace and bounties that humans have been enjoying," Yilmaz told SBS News.
"When we abstain from these things people can reflect upon them … the second major aspect is empathy with others."
Part of that empathy is a focus on charity, but also recognising the reality facing those who are poor and persecuted around the world.
Yilmaz said the plight of the Palestinians in Gaza will most likely be top of mind of Muslims observing Ramadan, pointing out how "cruel" the situation of having a religious period devoted to fasting must be to a population starving in the streets.
"Palestinians are having miserable times now, it's terrible, their children are being killed," he said.
"Nothing can compare … Ramadan is a time to reflect on all these things."
Suffering and survival
Nurse Rana Mahmoud from the US was on the ground in Gaza from 22 January to 5 February at the European Hospital as part of a medical team from the Palestinian American Medical Association.
She told SBS News the reality of the situation in Gaza is "a lot worse" than what the public can see on the news or social media.
"I saw a pregnant woman who said it took her 14 years to get pregnant — extremely malnourished," Mahmoud said.
"I saw children eating out of garbage cans, I saw an elderly man begging for food."
Those suffering from dehydration and malnutrition were in "survival mode" she said, with "no strength to hold a cup or pen in their hand."
Slow and sure death
Starvation is not a fast process.
When the body does not receive enough food, it begins attacking itself, first burning its fat reserves, carbohydrates and protein in tissue.
When those are exhausted, the body begins to prioritise the survival of the brain.
Eventually, the heart gives out.
"I saw a lot of patients that were at that point," Mahmoud said.
She spoke of a 13-year-old boy, once a thriving football player, suffered from hallucinations and seizures due to severe dehydration and starvation.
He was admitted to the ICU, but there were no supplies or medication available to treat his seizures.
Forty-eight hours later, he was dead, Mahmoud said.
"I am praying to God that people are not aware of how bad the situation is in Gaza, because if they're aware and they’re staying quiet – that would be so inhumane."
Calls for ceasefire continue
The onset of Ramadan is also being used as a benchmark for a ceasefire agreement between Hamas and Israel to be implemented.
Despite multiple rounds of talks and rejections on both sides, US State Department spokesman Matthew Miller said Washington believes an agreement could be reached before the start of the holy month early next week.