“We expected that one of us would die by bombing or be killed by bullets,” her father, Tawfiq al-Zebdda, 27, told The Washington Post in a phone interview. “We did not know that the baby girl who was born and died during the war would die of hunger.”
Post reporters found the families in this story through doctors at hospitals in northern Gaza, which aid experts say is nearing a dangerous tipping point: 1 in 6 children under age 2 are acutely malnourished, according to the World Health Organization, triple the levels seen in the south, where more food assistance has arrived. Without a cease-fire and a dramatic increase in aid, humanitarian officials warn that malnutrition and disease are likely to claim a growing number of lives, in a war the Gaza Health Ministry says has already killed more than 30,000 people.
“The child deaths we feared are here,” Adele Khodr, UNICEF regional director for the Middle East and North Africa, said in a statement Sunday.
At least 16 children have died of malnutrition, according to local health officials, all but one of them in the north — where Israeli forces have wrapped up their ground offensive but where the arrival of aid trucks remains severely constrained. Infants, the elderly and the infirm are particularly vulnerable.
“It’s kids under the age of 2 who are most at risk of acute malnutrition,” said Rick Brennan, WHO regional emergencies director.
Humanitarian officials say the hunger crisis in the north, still home to an estimated 300,000 people, is a man-made disaster, the result of limited entry points for aid, a time-consuming Israeli inspection process, and Israeli attacks on U.N. aid convoys and the police who had protected them.
Israel denies limiting the flow of aid to Gaza. It accuses the United Nations of failing to distribute it to those in need — or diverting it to Hamas.
President Biden has called on Israel to do more to facilitate aid deliveries and announced Friday that the United States would begin airdrops over Gaza to ease the suffering. “Innocent lives are on the line and children’s lives are on the line,” he said.
A first tranche of 38,000 meals was dropped on Saturday. The number of aid trucks entering the enclave has also ticked up in recent days, though it is still a fraction of what aid groups say is needed.
At Kamal Adwan Hospital in Beit Lahia, Hussam Abu Safiya, a physician and the hospital’s director, said Sahar was one of four children to die from the effects of malnutrition at the hospital in recent days. Four more with hunger complications were in critical condition, he said.
“Minutes ago, I closed the eyes of a child,” Abu Safiya told The Post, speaking of a 2½-year-old boy who he said had lost about a third of his body weight.
“Malnutrition makes the body open to a string of potential fatal failures, including heart and kidney failure. … The quickest one would be sepsis, bacterial infection,” said John Kahler of MedGlobal, an aid group that recently set up a nutritional stabilization center in Rafah, in the south.
Whole families are fading together. Mohammad Abu Sultan, 40, is sheltering with his wife and five children in a destroyed house in the north. He said he scrounges all day for wild herbs or rabbit feed to grind for bread and has lost about 40 pounds. On the night he spoke to The Post, the only thing he could feed his crying 12-year-old daughter was a slice of lemon with salt, he said.
But it is Diala, born in August, for whom the family is most scared. Her mother’s milk began to dry up as food and clean water became harder to find. The infant’s ribs grew more pronounced and her eyes began to bulge, Abu Sultan said, both signs of acute malnutrition. A clinic prescribed hydrating solutions and antibiotics — for the tapeworm that infected both mother and child, probably from contaminated water — but there was nowhere to get them.
“We have nothing more to offer her,” her father said.
Infants are most at risk, physicians said, because of the burden war places on pregnant women and new mothers. Stress from bombings can cause high levels of cortisol production that harms fetal development before birth. Stress and a lack of food can also inhibit breastfeeding.
“Newborns come out more vulnerable both from the standpoint of nutrition and from the standpoint of immunity protection, because the breastmilk also acts as a good source of immunity for babies,” Kahler said.
Zebdda’s wife, Amany, was six months pregnant on Oct. 7, when Hamas-led fighters from Gaza stormed nearby Israeli towns, killing about 1,200 people and sparking a war.
Intensive Israeli bombings chased the Zebdda family from their house in Gaza City’s Daraj neighborhood. Amany was too pregnant to join the flow of refugees walking to the south, her husband said, so they moved from shelter to shelter. They had to dodge Israeli tanks when she went into labor, he said, hiding in a building until daylight before walking to al-Sahaba Hospital.
Sahar was born on Jan. 11, delivered by Caesarean section conducted under battery-powered lights. The doctors told them the baby was underweight and suffering from a chest infection but that she couldn’t stay — the nursery was needed for sicker kids.
Food was becoming scarce. In mid-January, Zebdda said he could still find a carton of formula for about $5. Within weeks, as supplies dwindled in the north, it cost $22, beyond the reach of Zebdda, an out-of-work marble worker. In the less than seven weeks his infant daughter was alive, he was only able to secure three cartons of formula, he said.
He searched every day for food for the whole family. But Amany had little to eat and was able to breastfeed only fitfully, he said, and soon not at all. For two weeks in late February, Sahar never nursed.
“We began to notice that there was a clear change in the baby’s appearance,” Zebdda said. “Her weight decreased sharply.”
They took her to a clinic, which immediately sent her to Kamal Adwan Hospital. Her facial features were distorted, he said, her lips became blue and her eyes stood out. Doctors told him that she was acutely malnourished, that her immunity was badly compromised and that the infections had worsened. They told him to pray.
After a few days, she died.
There was no time to mourn. His three other children were still hungry. Hours after burying Sahar, he went to a traffic circle in Gaza City. More than 100 people had died there the day before, the Gaza Health Ministry said, after desperate crowds rushed an aid convoy and Israeli troops opened fire. Israeli and Palestinian officials have offered contradictory accounts of what caused the deaths.
Zebdda had heard rumors that more aid could come. None did.
“We are surrounded by hunger and bullets from everywhere,” he said.
A few days later, The Post reached Abu Sultan to ask if there were photographs he could send of his family. It wasn’t possible, he said; he had sold his smartphone for food.
Harb reported from London. Claire Parker in Jerusalem contributed to this report.