As the World Health Organization warns that Gaza is facing mass starvation caused by a blockade on aid into the Palestinian enclave, aid experts say malnutrition is already threatening the immediate and long-term health of thousands, especially young children.

"We're seeing one in four of our kids being treated in our clinics with malnutrition," said pediatrician Dr. Amber Alayyan, with Doctors Without Borders/Médecins Sans Frontières, which she said has scores of people working in Gaza. "We are used to working in Congo or in Central African Republic, in Nigeria - you see far lower rates of malnutrition, and it's a problem. It's...it's desperate. But to see 25% is shocking."

Gaza's food stocks have run out since Israel, at war with Palestinian militant group Hamas since October 2023, cut off all supplies to the territory in March and then lifted that blockade in May - but with restrictions that it says are needed to prevent aid from being diverted to militant groups. As a result, international aid agencies say that only a trickle of what is needed is currently reaching people in Gaza, leading to malnutrition, which hits young children especially hard.

"Malnutrition is one of the worst things that can happen to a child point-blank," said Kirk Prichard, a longtime humanitarian aid worker and Vice President of Programs at the aid group Concern Worldwide. "They're the most vulnerable to the consequences."

Israel says it is committed to allowing in aid but must control it to prevent it from being diverted by militants. It says it has let enough food into Gaza during the war and blames Hamas for the suffering of Gaza's 2.2 million people.

DESCRIPCIÓN DE IMÁGENES

BEIT LAHIYA, GAZA (FILE - APRIL 3, 2025) (REUTERS - Access all)

1. VARIOUS OF PALESTINIANS, CHILDREN HOLDING OUT POTS, RECEIVING MEALS

KHAN YOUNIS, GAZA (FILE - MAY 1, 2025) (REUTERS – Access all)

2. MOTHER OF FIVE-YEAR-OLD OSAMA AL-REQEP, MONA AL-REQEP, STANDING NEXT TO HER SON AT NASSER HOSPITAL WHERE HE IS RECEIVING TREATMENT FOR MALNUTRITION

3. VARIOUS OF OSAMA IN HOSPITAL BED / MONA SITTING NEXT TO HIM

NEW YORK, NEW YORK, UNITED STATES (JULY 24, 2025) (REUTERS - Access all)

4. (SOUNDBITE)(English) KIRK PRICHARD, VICE PRESIDENT OF PROGRAMS AT CONCERN WORLDWIDE, SAYING:

"So the the majority of the cases of malnutrition are children under five years of age. Those are the most vulnerable. They're also the most vulnerable to the consequences. So the kind of downstream consequences of malnutrition, the increased disease and the mortality also that goes with that. Once you hit five, you're not completely out of the woods and there is, as I said, there is adult and elderly acute malnutrition as well. But once you hit five, you're much less likely to have morbidity and mortality related to malnutrition. So essentially to die of malnutrition once you hit five."

KHAN YOUNIS, GAZA (JULY 23, 2025) (REUTERS - Access all)

5. VARIOUS OF MOTHER OF MALNOURISHED CHILD SEELA BARBAKH, NAJAH BARBAKH, REMOVING HER DAUGHTER'S CLOTHES AS SEELA LAYS ON BED

6. VARIOUS OF NAJAH SITTING ON HOSPITAL BED NEXT TO SEELA WHO IS DRINKING FROM BABY FEEDING BOTTLE / NAJAH HOLDING SEELA'S HEAD

NEW YORK, NEW YORK, UNITED STATES (JULY 24, 2025) (REUTERS - Access all)

7. (SOUNDBITE)(English) KIRK PRICHARD, VICE PRESIDENT OF PROGRAMS AT CONCERN WORLDWIDE, SAYING:

"Malnutrition is one of the worst things that can happen to a child point-blank. And the range of effects go from mortality - it does kill children - point blankly. But it also - I mean, there's something called the thousand days window which looks at nutrition in the period of time from conception to two years of life. And there's lots of studies out there. There's lots of data about how important good nutrition is during that time. And if you're severely, acutely malnourished during that time, or even if you're moderately acutely malnourished at that time, you're going to have a lower IQ likelihood. You're going to have lower height, you're gonna have lower weight. It's gonna affect you for the rest of your life. That's kind of the longer term, but there is additional short term things that you're talking about. If you're malnourished, you're much more susceptible to even common ailments like diarrhea. One of the things we're really worried about in malnourished children is diarrhea, which can actually then go on to kill them as well. Your immune system starts to shut down, you know, so you can't fight off basic infections. Your organs are affected. Everything about - especially once you get to that severe acute malnutrition aspect of things - every aspect of a child is affected by it. Their cognitive development, their brain development, everything."

GAZA CITY, GAZA (JULY 23, 2025) (REUTERS - Access all)

8. VARIOUS OF CROWDS GATHERING IN FRONT OF SOUP KITCHEN TO RECEIVE FOOD, HOLDING BOWLS AND POTS

NEW YORK, NEW YORK, UNITED STATES (JULY 24, 2025) (REUTERS - Access all)

9. (SOUNDBITE)(English) KIRK PRICHARD, VICE PRESIDENT OF PROGRAMS AT CONCERN WORLDWIDE, SAYING:

"And the more chronic malnutrition, malnourished mothers, especially teenage mothers and some of younger mothers, will give birth to children that are lower birth weight, you know, and this kind of trickles down that as well. You also, I mean, if it gets bad enough and the moms are malnourished and whatnot, you have to worry about a decrease in the quantity and quality of breast milk."

10. WHITE FLASH

11. (SOUNDBITE)(English) KIRK PRICHARD, VICE PRESIDENT OF PROGRAMS AT CONCERN WORLDWIDE, SAYING:

"And I think the thing that gets you the most when you see it first hand is how quiet they are. You can have 32 one-year olds in a clinic and you can hear a pin drop and it's just because....it's, it's absolutely eerie and it's, it's heartbreaking to hear that the quietness of it. You don't hear crying, you don't hear playing, you don't hear any of this. And it really shows just how all impactful malnutrition can be on a child and their family, and it's just devastating."

GAZA CITY, GAZA (JULY 22, 2025) (REUTERS - Access all)

12. VARIOUS OF TENTS FOR DISPLACED PALESTINIANS

13. PEOPLE INSIDE TENTS

14. WOMAN INSIDE TENT NEAR KETTLE

15. CLOSE-UP OF KETTLE ON FIRE

ARLINGTON, VIRGINIA, UNITED STATES (JULY 24, 2025) (REUTERS - Access all)

16. (SOUNDBITE)(English) DR. AMBER ALAYYAN, OF DOCTORS WITHOUT BORDERS, SAYING:

"It was just today that we found out that we had the numbers released. That we're seeing one in four of our kids, you know, being treated in our clinics with malnutrition. It just seems to get worse."

17. WHITE FLASH

18. (SOUNDBITE)(English) DR. AMBER ALAYYAN, OF DOCTORS WITHOUT BORDERS, SAYING:

"Just to give some sort of like context, one in four severe acute malnutrition - this is 25%. I mean we normally are seeing something like 8% in in in areas like sub-Saharan Africa and even like in South Sudan you see like

20% and you're just it's jaw-dropping, but in places where we are used to working in Congo or in Central African Republic, or in Nigeria, you see far lower numbers of like rates of malnutrition and it's, and it's a problem. It's...it's desperate. But to see 25% is shocking."

GAZA CITY, GAZA (JULY 22, 2025) (REUTERS - Access all)

19. CHILDREN SITTING BY A DAMAGED BUILDING

20. PEOPLE, INCLUDING CHILDREN, GATHERING WITH EMPTY POTS

ARLINGTON, VIRGINIA, UNITED STATES (JULY 24, 2025) (REUTERS - Access all)

21. (SOUNDBITE)(English) DR. AMBER ALAYYAN, OF DOCTORS WITHOUT BORDERS, SAYING:

"It can have....one of two effects, either short or long term and short - I don't mean in a couple of days - I mean over a few weeks or months -one is a term that we call like wasting or marasmus. Then the other one is is known as stunting or kwashiorkor - they completely depend on sort of what types of deficiencies you face when not getting the appropriate nutrition. So when people think of wasting, it's often like the very, very, very skinny, emaciated children and and the kwashiorkor, the stunted kids happen to be sort of shorter in stature over the long term. They may have a really big belly and those come from like not being able to absorb protein or not getting enough protein and then not absorbing well."

22. WHITE FLASH

23. (SOUNDBITE)(English) DR. AMBER ALAYYAN, OF DOCTORS WITHOUT BORDERS, SAYING:

"If they're very sick, some of them can't tolerate oral intake. They don't. You know, they're not. It's not as simple as just giving them the food. It's a medical condition. So they have to be effectively resuscitated back to health before they can start properly eating again. So some kids can eat and we have to give them the sort of pasty like, it's almost like a peanut butter or substance that we give them. It's full of protein and fats and calories and various micronutrients. And those are for the kids who can't actually eat, even if it's less. But they can actually swallow. And the other kids who are so sick that they can't eat, whether they're sick because of the malnutrition or whether they're sick because they have a respiratory condition that makes them breathe so fast that they that it would be dangerous to them to eat by mouth. And so we have to give them food via liquid form like a milk form that goes in like what's called the nasogastric tube. So it's a tube that goes into the nose and down to the stomach to be able to give them food enterally. That's what we call it."

24. WHITE FLASH

25. (SOUNDBITE)(English) DR. AMBER ALAYYAN, OF DOCTORS WITHOUT BORDERS, SAYING:

"The biggest issue that's very acute in the childhood period though is is things like developmental delays. So it stunts their growth and it stunts their their brain growth as well. So they can have issues with speech delays or reading delays or even just like relationship delays with their parents. And there is another component of that which is the bonding between parents and children that there is, there is a break in that bond somehow due to some of these developmental delays in early childhood malnutrition."

BEIT LAHIYA, GAZA (FILE - APRIL 3, 2025) (REUTERS - Access all)

26. VARIOUS OF CROWDS SCRAMBLING FOR FOOD

ARLINGTON, VIRGINIA, UNITED STATES (JULY 24, 2025) (REUTERS - Access all)

27. (SOUNDBITE)(English) DR. AMBER ALAYYAN, OF DOCTORS WITHOUT BORDERS, SAYING:

"The problem with malnutrition again is that it's a disease. It's a medical pathology. It's an issue. And so not only do they need, they eventually need food, but immediately they need certain types of medical substances like the milk that I talked about or like it's a specific formula of milk or the, what we call Plumpy'Nut, or sort of paste. It's got this almost peanut buttery taste to it specifically formulated to treat malnutrition. So they have to start with that before food will even help. If you're on the border and not quite malnourished then yeah, food aid is what's absolutely necessary."

GAZA CITY, GAZA (JULY 22, 2025) (REUTERS - Access all)

28. VARIOUS OF PEOPLE HOLDING OUT POTS FOR FOOD