Yasmine, a 22-year-old Palestinian mother, holds her malnourished 2-month-old daughter Teen as they await treatment at the Nasser Hospital in Khan Younis in the southern Gaza Strip on July 2I

AFP via Getty Images

Before the genocide, malnutrition was a rare diagnosis.  Now more than 2 million Gazans are forced to survive on nothing.  

By Hend Salama Abo Helow / Truthout

Malnutrition, as defined by the World Health Organization, is a deficiency, excess, or imbalance in a person’s intake of energy and nutrients. It may be caused by reduced dietary intake, malabsorption of macro- and micronutrients, or increased energy expenditure related to disease. But in Gaza, the meaning of malnutrition has been forcibly redefined — it is systematically human-made and weaponized. It is no longer just a health condition, but a calculated strategy. Since March 2, Israeli forces have sealed off the borders and imposed what may be the tightest blockade in our history of struggle, deliberately restricting food access.

Before the genocide, malnutrition was a rare diagnosis. Today, more than 2 million Gazans are forced to survive on nothing. Flour is scarce. Canned food is consumed while fresh vegetables remain a distant dream, unavailable or unaffordable. Aid parcels — meant to save lives — may cost a Palestinian their life, as Gaza’s humanitarian “relief” system has become a death trap disguised as mercy.

We have been forced not only to skip meals, but also to skip entire days of eating, exposing our bodies to lethal complications. Acute malnutrition is not just about hunger or weight loss. It attacks every organ system, bringing severe risks of illness and death — especially for the young and the elderly. My nephews, born and raised under genocide, have had no chance to build strength or immunity. Pale and emaciated, with fragile bodies, they fight disease with nothing but weakness.

Malnutrition impairs the immune system, leaving us defenseless against disease. I, myself, became vulnerable to the simplest infections — bedridden for days, even weeks, unable to function. Malnutrition doesn’t just cause illness, it prolongs it. It adds layers to our suffering, and offers no escape from its vicious cycle.

Malnutrition also attacks the cardiovascular system — decreasing cardiac output, disrupting blood flow, and causing arrhythmia, low blood pressure, and even heart failure.  I suffered tachycardia (a too-fast heart rate), nausea, and fainting spells caused by severe deficiency.  For the elderly — especially those with preexisting heart conditions — this is a death sentence.

Deficiencies in essential vitamins and minerals impair memory, concentration, and cognition. I suffer these effects daily, trying to study while living under the shadow of death.

The gastrointestinal system suffers too, if not immediately, then over time. Malnutrition impairs the intestines’ ability to absorb nutrients and regulate electrolytes. Living off canned food for nearly two years has inflamed my peptic ulcers and worsened my colitis.

As a medical student, I knew what might help even a little. I once kept a supply of supplementary vitamins, but now due to Israel’s blockade, vitamins are impossible to access.

Recently, a diabetic patient died during a hypoglycemic attack — his family couldn’t find a single sweet to save him. Mothers across Gaza are unable to breastfeed their starving infants — because they themselves are starving. UN agencies have distributed therapeutic food, but it’s nowhere near enough. Most mothers give it to their children and go hungry themselves.

Malnutrition doesn’t stop at the body — it invades the mind. It disrupts serotonin production, causing severe depression, anxiety, and emotional instability. Deficiencies in essential vitamins and minerals impair memory, concentration, and cognition. I suffer these effects daily, trying to study while living under the shadow of death. My memory falters, my thoughts scatter. Children deprived of nutrition face lifelong consequences to their growth, both mental and physical.

Malnutrition also delays healing and worsens clinical outcomes. I spoke to Rawan Y., a fellow medical student and survivor of a genocidal injury. She told me: “I got injured on March 2 and was discharged on March 17. Back then, we were on the edge of famine. Then famine invaded. I underwent three surgeries. I was supposed to get the nutritious food I needed for recovery — but the reality was the stark opposite.”

She paused, her voice cracking.

“I live with the torment of knowing what’s happening inside my body. I know the damage. I had spleen and kidney injuries, first-degree burns, and three broken ribs. It’s been four months — and my wounds remain unhealed, painful, and persistent.”

Dr. Mohammed Altalla, who works as a doctor in a surgical department in Gaza and also serves as a teaching assistant in the faculty of medicine at Gaza’s Al Azhar University, confirmed the devastating toll of malnutrition on recovery:

“One of the major consequences of malnutrition is delayed healing. Proteins, vitamins, and zinc are simply unavailable. Surgical site infections have surged – we deal with them daily,” he told me.

“People collapse in the streets, rushed to hospitals. The life-saving intervention in many cases is as simple as glucose. But even that is running out.”

I also spoke with Shaimaa Bashir, a clinical nutritionist working with a humanitarian organization on the ground in Gaza. She told me that acute malnutrition has risen by 146 percent in just three months. “Hundreds of thousands of patients are hospitalized daily with complications from malnutrition — irregular heartbeats, dangerously low blood pressure,” she said. “Many were already vulnerable even before their injuries — now it’s far worse.”

Moreover, Bashir notes: “Since mid-May 2025, Gaza has been in an unprecedented severe food emergency. Ninety-three percent of the population faces food insecurity. Twenty-two percent are now in phase five — the catastrophic phase — of hunger. If no aid arrives, we expect the entire population will fall into phase four — acute severe malnutrition — by September 2025.”

Meanwhile, 17,000 women who are pregnant or breastfeeding desperately need medical nutrition, but none is available due to severe drug shortages and constant displacement. A malnourished mother may pass her malnutrition to her infant — or face miscarriage.

Bashir added that feeding options for patients are almost nonexistent. “We have no access to therapeutic food, IV nutrition, or nasogastric tubes,” she said. “The only remaining source is supplementary sweets for children — and even that is in short supply.”

“People collapse in the streets, rushed to hospitals. The life-saving intervention in many cases is as simple as glucose. But even that is running out,” Altalla said.

Then he paused, his voice quieter: “It’s not just the patients. We — the medical staff — are barely functioning. We struggle to stay focused ourselves.”

“The food situation is so dire that every day the question arises whether the patients in the hospitals we support and the medical staff who care for them will be able to eat anything at all,” echoed Caroline Willemen, a project coordinator in Gaza City for Médecins Sans Frontières (Doctors Without Borders), in a statement. “We are desperate. As an occupying power the Israeli authorities have an obligation to provide aid to people in Gaza. Right now, they are deliberately starving them.”

The health of more than 2 million people hangs in the balance, clinging to the hope of aid trucks that never come.

Each delay is a death sentence.

Each denied truck is a stolen chance at survival.

Malnutrition is preventable. It is reversible.

But not under Israel’s siege.

The only way to stop this engineered starvation is to open the borders — to let food in, to let Palestinians live.

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Hend Salama Abo Helow

Hend Salama Abo Helow is a researcher, writer and medical student at Al-Azhar University in Gaza. She is also a writer with We Are Not Numbers and has published in the Washington Report on Middle East Affairs, Institute for Palestinian Studies, Mondoweiss and Al Jazeera. She believes in writing as a form of resistance, a silent witness to atrocities committed against Palestinians, and a way to achieve liberation.