Gaza Is Starving

Last month, a United Nations report on hunger described a catastrophic situation in Gaza, where more than ninety per cent of the population has been facing “acute food insecurity,” and where “virtually all households are skipping meals every day.” Much of Gaza is at risk of famine in the next several months. Parents have been going without food to insure that their kids have at least something to eat; where food is available, moreover, prices have skyrocketed, making it inaccessible even for middle-class families. The report noted, “This is the highest share of people facing high levels of acute food insecurity” ever recorded “for any given area or country.” I recently spoke by phone with Arif Husain, the chief economist at the United Nations World Food Program, which was one of the partner organizations that compiled the report. The W.F.P. also collects data on hunger around the world and delivers food to needy people. During our conversation, which has been edited for length and clarity, we discussed what the people of Gaza are currently facing, the reasons many cannot access food, and why this crisis is so unprecedented.

Could you describe the food-access situation in Gaza right now?

The bottom line is that, in Gaza, pretty much everybody is hungry at the moment. In the food-security-analysis business, we do something called I.P.C., or Integrated Phase Classification. This is an exercise that has about twenty-three partners, including nineteen U.N. agencies and international N.G.O.s and about four donors. This group analyzes the food-security situation. And, on the basis of that, it presents a report, which is independent. It is not one agency or one entity. There’s a consensus-based analysis. This exercise is done in between forty and fifty countries worldwide that may have a food-security issue, whether it is because of conflict or climate or anything else. What an I.P.C. does in any given location is put people in five different classifications. I.P.C. Phase 1 is that everything is fine; I.P.C. Phase 2 is that people are stressed in terms of their food-security situation; I.P.C. Phase 3 is that people are, in fact, in a food-security crisis; I.P.C. Phase 4 is that people are in food-security emergencies; and the last phase is called the famine, or catastrophe, phase. Now, the same analysis was done for Gaza, which came out in December, and, according to that, pretty much the entire population of 2.2 million people is in a food-security crisis or a worse situation.

Can you describe the difference between crisis, emergency, and famine?

It is a scale that looks at people’s food security and consumption, how they’re able to access food, and what type of coping strategies they use. It also looks at other indicators, including socioeconomic indicators. We ask, what is the situation now, and, also, what would you expect in the next, let’s say, few months? Classification on those three thresholds, as the severity increases, is different: crisis; then, if it’s worse than crisis, it turns into emergency; and then, if it’s worse than emergency, it turns into famine or catastrophe.

But let me give you the criteria for famine: It’s essentially that, in any given place in the geographic unit, twenty per cent of the population must be starving—that’s criteria No. 1. Criteria No. 2 is that thirty per cent of the children must be severely malnourished or wasted. And then the third criteria is that the mortality rate, the death rate, should be double the average, meaning, for adults, from one per ten thousand a day to two per ten thousand a day. And, for children, from two per ten thousand a day to four per ten thousand a day. When these three conditions come together in a single place, it’s a famine.

So the bottom line is that you hope not to say, “O.K., let’s act because there is a famine.” You need to act to avoid a famine, right? Because if you say, “O.K., let’s act when there is a famine,” that means you’re saying people have already died, children are already wasted, people are already starving. That’s not the point. The point is that we should never let a population reach that state.

Now, in the case of Gaza, a quarter of the population is already in that state, meaning they’re in catastrophic levels of hunger. We don’t call it a full famine. Why? Because they haven’t met the other two conditions, meaning it’s very hard to say whether thirty per cent of the children over there are already wasted or whether their death rate has doubled. Why? Because their health systems are broken. But what the report says is that, if what is happening continues or worsens, pretty soon—within the next six months—we will have a full-fledged famine.

How does Gaza seem similar to other conflict zones, and how does it seem different?

I’ve been doing this for the past two decades, and I’ve been to all kinds of conflicts and all kinds of crises. And, for me, this is unprecedented because of, one, the magnitude, the scale, the entire population of a particular place; second, the severity; and, third, the speed at which this is happening, at which this has unfolded, is unprecedented. In my life, I’ve never seen anything like this in terms of severity, in terms of scale, and then in terms of speed.

There have been reports that in some places in Gaza food has become really expensive. Can you talk about what we’re seeing in Gaza specifically?

Access comes in two types: one is physical access to food, and the other is economic access to food—food has to come, and supply chains need to work. And then, if the food is there, is it affordable? It’s always first and foremost about whether a population or community is able to access food. The same story is applicable in Gaza. What is happening in Gaza is that it’s reliant on imports of food and other essential commodities, right? That was the case before the war, and it is the case now.

One thing that must happen is: food needs to come in regularly through different border crossings. But, when I say food needs to come in, other essential commodities, like water, like medicine, like fuel—all of these things need to come in, and they need to come in adequate amounts. The second thing is that people need to have access to that food, whether it is through humanitarian aid or commercial channels. People need to be able to secure it. This is why, for us, what’s critically important is not only the ability to actually bring in these commodities but also the ability to actually take it to the people, wherever they are. It’s not good enough to say, “Here’s the food, and it is in the country.” If we cannot reach the people where they are to provide that assistance, it’s not going to work. And this is why people keep talking about having a humanitarian ceasefire, which would allow us not only to bring in food and other essential commodities but also to actually distribute them in a safe way. If you have food coming in but you cannot distribute it, it’s as good as food not coming in.

Gaza needs more food coming in. On a good day, aid groups are bringing in maybe twenty-five to thirty per cent of what they need. So, obviously, a lot more food, fuel, medicine, water need to come in. But they need to be distributed as well. They need to go to where the people are. And I don’t know how you can do that without a humanitarian ceasefire.

Let’s return to the question of how you put this report together with a bunch of different organizations. It’s incredibly hard for the media, for human-rights workers, to be on the ground in Gaza. Can you talk about how a report like this is created given those conditions?

For the Gaza report, there were seventeen different agencies that came together. This was a combination of U.N. agencies and international N.G.O.s. They relied on the latest information that was available to them. We were able to do two mobile surveys in which we called people. In one case, it was about four hundred completed surveys. This was done during the pause, to check on people’s food-security situation, both in the north and in the south. Then there was another survey, which was done for about a hundred and fifty households, after the end of the pause. This is just one type of information, but, remember, you have UNICEF, you have others who are also collecting all of this data.

The other thing, which is really important in this type of exercise, is that whenever there is a situation that is bad enough that it could be a famine, you call in experts. It is called the Famine Review Committee of the I.P.C., which, in this case, included five different experts who look at that data, look at the validity of that data, and validate the results that were put together by these analysts from these seventeen different agencies. It’s like a check on the quality of the data, as well as the validity of the analysis. They’re the ones who said that if the crisis worsens or continues at the pace at which it is, that it is likely we will have a full-fledged famine within the next six months.

You mentioned how there are different standards for measuring hunger or starvation for kids and adults. Can you talk about why that’s the case, and can you also talk about the specific things facing children who lack access to food?

Children are always the most vulnerable, and, when you’re looking at food security, what are the essentials there? You have to look at whether there’s food, whether there’s water, whether there’s sanitation, whether there’s shelter, whether there’s medicine. And you also have to look at the environment in which people are surviving, both adults and children. And when we are looking at Gaza, and if we believe the data that we have from the World Health Organization, there is one shower for every forty-five hundred people, there is one toilet for every two hundred and twenty people. More than 1.5 million people are staying in a very congested place. This is a recipe for a pandemic, too. Now, who’s the most vulnerable to something like this? Obviously, it’s the children.

Remember, the second condition of famine means that thirty per cent of the children must be wasted. When you see these kids who don’t weigh enough for their height, and kids who look really, really, really thin—the term for that is “wasted.”

But let me now give you one other statistic, which maybe could be helpful. If you look globally, worldwide, right now, there are about a hundred and twenty-nine thousand people who are in I.P.C. Phase 5, meaning a catastrophic type of hunger. A hundred and twenty-nine thousand. In Gaza, there are five hundred and seventy-seven thousand. If you add these two numbers together, you can say that you have about seven hundred thousand people in the world who are in I.P.C. Phase 5, of which five hundred and seventy-seven thousand are in Gaza. That means that eighty per cent of the people, or four out of five people, in famine or a catastrophic type of hunger are in Gaza right now. This is also what makes it unprecedented.