Now that there is a ceasefire, Gaza faces another war: against hunger.
Experts from the UN and aid agencies told The National that reversing famine in the Strip will require more than food trucks and pledges.
They outlined what must be immediately done to stop famine, already declared by the UN in Gaza due to Israeli restrictions.
A UN study released last week showed that 54,600 children under five in Gaza are “acutely malnourished and face increased risk of death if untreated”. At least 463 people, including 157 children, have died from hunger-related causes since the war began, Gaza's Health Ministry says.
The UN agency for Palestinian refugees, UNRWA, the largest aid provider in Gaza, has so far been banned from sending its lorries into the strip. It says it has enough supplies to feed its residents for three months.
Speaking to The National from Gaza city, where the UN declared a famine in August, Tess Ingram, communications manager for Unicef Middle East and North Africa, said screening, response, prevention and consistency are central to handling the current situation.
Since the start of the ceasefire in Gaza on Friday, freedom of mobility has improved. Aid organisations no longer require Israeli permission for every mission they carry out, as had largely been the case over the past two years, enabling them to reach areas that have long been inaccessible.
Among the increased aid supplies to the strip as a result of the ceasefire are items vital for the treatment and prevention of malnutrition.
“We need to fight famine by increasing the volume of food and making sure the food meets the nutritional needs of the population,” Ms Ingram said. This includes bringing in items that have been unavailable in Gaza due to Israel's restrictions on aid and commercial goods, like meat and chicken, a variety of fruit and vegetables and dairy.
“We also provide preventive liquid nutrient supplements, a paste with micronutrients for pregnant women and children,” Ms Ingram said.
These can be accessed in screening centres where parents send their children for testing and treatment of malnutrition. Ms Ingram said there is a need to rebuild those centres, especially in places where they had largely been abandoned or destroyed.
“In Gaza city, we had 45 outpatient treatment centres in August, but by the beginning of October that number had gone down to seven.”
With more than 300,000 people moving from southern to northern Gaza in the past few days, according to the UN, there is a need to screen as many people as possible for malnutrition and provide them with treatment, which could mean moving existing centres to areas where people are returning to, she added.
None of this is new to Unicef, which has dealt with famines across the world, as well as the changing conditions in Gaza during the past two years.
In general, the operating conditions are looking better, and while Ms Ingram remains optimistic, she said that dealing with such large-scale malnutrition will take time.
“We are still cautious about the volume of aid that's coming in and we have not seen the big increase sustained yet. We need to see hundreds of lorries coming in consistently to feel confident,” she said.
More lorries carrying aid have entered the strip than Israel had been allowing in recent months, but one of the largest suppliers of assistance, UNRWA, remains banned from bringing in lorries or goods under its name.
“The active deprivation or refusal to allow aid in at all for three months meant that the population who were in already in extremely dire straits were pushed into a famine situation,” said UNRWA spokesman Jonathan Fowler.
He said bringing the aid operation back to the scale required would take time, which is why the work needed to be multiplied, and that one way to do so would be by allowing UNRWA lorries into Gaza.
