DUBAI: Two months into Gaza’s fragile ceasefire, children in the besieged enclave continue to bear the brunt of a deepening humanitarian crisis, with aid agencies warning that Israel’s continued restrictions on relief supplies are exposing the population to malnutrition and disease. 

Despite the Oct. 10 ceasefire, humanitarian groups say convoys carrying much-needed aid remain stuck at border crossings. Meanwhile, thousands of families displaced by two years of war are now enduring heavy rains in overcrowded shelters, heightening the risk of disease. 

For displaced children, limited access to medical care and vaccinations could have long-term, irreversible consequences. Without timely medical intervention and proper nutrition, healthcare workers warn that children are far more vulnerable to illness and death. 

The UK-based charity Medical Aid for Palestinians has reported a rise in cases of child malnutrition, with medical facilities facing “critical shortages” of supplies needed to treat postwar health complications. 

“While the number of severely malnourished patients has decreased compared with the peak of the famine, cases are still regularly presenting to hospital emergency departments and medical points,” Rohan Talbot, MAP’s director of advocacy and campaigns, told Arab News. 

In November, the organization’s nutrition cluster identified 575 children with acute malnutrition, including 128 with severe malnutrition, out of 7,930 children screened. The highest rates were in Gaza City, where almost 10 percent of children screened were malnourished. 

“We have also seen birth defects attributed to poor nutrition in mothers and lack of access to proper food and medical care,” said Talbot, warning that malnutrition could have long-term effects on children, leaving them at risk of stunting, poor development, and recurrent infections. 

Last week, MAP reported that three of Gaza’s largest hospitals — Al-Shifa, Nasser and the Patient’s Friends Benevolent Society — remain overwhelmed with critically injured and malnourished patients. 

Staff are unable to provide adequate care or carry out surgeries postponed during the war, with some patients dying as a result. 

Medical supplies have not “meaningfully increased” since the ceasefire began, leaving a collapsed healthcare system with little capacity to recover, the organization said. 

According to the UN, only half of Gaza’s 36 hospitals are currently partially operational, and not a single hospital in the enclave is fully functional.  

The Patient’s Friends Benevolent Society Hospital, the main pediatric facility in northern Gaza, has reported critical shortages of essential drugs, medical supplies, cleaning materials, and sterilization equipment. 

On Nov. 14, the hospital — already damaged in the fighting — was flooded by heavy rain, trapping children and their families on the ground floor. 

“Medical intervention was not enough to save the lives of children, so we lost a large number of them in the intensive care unit,” Dr. Majd Awadallah, the hospital’s medical director, said in a statement. 

“These problems are unsolvable without opening the crossings and allowing the unconditional entry of essential materials, especially medicines. How can a hospital operate in surgical and maternity cases without cleaning materials?”   

On Monday, the UN Relief and Works Agency accused Israel of blocking around 6,000 aid trucks carrying food, medicine, tents and blankets — enough to sustain the enclave for three months. 

The organization warned that 1.5 million people urgently need shelter after heavy rains in November flooded displacement camps and damaged at least 13,000 tents. 

Israel’s military operation in Gaza, triggered by the Hamas-led Oct. 7, 2023, attack, has displaced about 2.1 million Palestinians — roughly 95 percent of the population — and destroyed nearly 78 percent of the enclave’s 250,000 buildings, according to UN figures. 

Most of the displaced now live in makeshift tents, some erected over the rubble of their former homes, without proper sanitation, clean water, insulation or sewage systems, contributing to the spread of infectious diseases. 

The World Health Organization has reported a rise in cases of Guillain-Barre Syndrome, acute watery diarrhea, and acute jaundice syndrome, the latter of which can be linked to hepatitis A. 

Though more aid has been reaching the devastated enclave since the ceasefire, humanitarian organizations warn this is insufficient to meet the population’s needs. 

Under the US-brokered truce, at least 600 aid trucks were expected to enter Gaza daily. However, Gaza’s Government Media Office said the enclave has received an average of just 145 trucks a day since the agreement began. 

Of the aid that has entered Gaza, only 5 percent of the trucks contained medical supplies, according to the UN. 

“The strain on Palestinians’ lives is only deepening,” said Talbot. “Even the most basic materials needed for shelter continue to be blocked by Israeli authorities.” 

Though food availability has slightly improved due to the entry of humanitarian and commercial trucks, aid organizations still report limited quantities and less diverse food in markets. 

The World Food Programme said food consumption remained below pre-conflict levels by mid-October, as meat, eggs, vegetables, and fruits remain unaffordable for many families. Talbot said the food shortages are affecting patient recovery and overall public health. 

“Local food production has been severely disrupted, and humanitarian access remains extremely constrained by Israeli restrictions, with a severe lack of properly nutritious food entering Gaza,” he said. 

The war has eroded purchasing power, leaving 95 percent of the population entirely dependent on aid, UNRWA said, urging Israel to facilitate rapid at-scale and unimpeded humanitarian access. 

Although the ceasefire was intended to bring relief, near-daily Israeli strikes have killed 347 Palestinians, including at least 67 children, and injured 889 others, pushing Gaza’s death toll to more than 70,000, according to the Ministry of Health. 

Gaza’s Government Media Office has documented 535 Israeli violations since the ceasefire began, while satellite imagery shows more than 1,500 buildings have been destroyed during this period. 

In a statement last week, rights monitor Amnesty International accused Israel of continuing to commit genocide in Gaza by severely restricting the entry of aid and blocking the restoration of services essential for civilian survival. 

Agnes Callamard, the organization’s secretary-general, said the ceasefire creates “a dangerous illusion that life in Gaza is returning to normal,” warning that the lack of proper food, water and shelter could lead to “slow death” of Palestinians in Gaza. 

This includes blocking equipment needed to repair life-sustaining infrastructure and to remove unexploded ordnance, contaminated rubble and sewage — all of which pose serious and potentially irreversible public health and environmental risks, she said. 

Israel denies accusations it is deliberately obstructing aid, and accuses Hamas of stealing humanitarian assistance. 

COGAT, the Israeli military arm that oversees humanitarian matters, insists that “hundreds of trucks” enter Gaza daily. 

In a Nov. 30 statement, the unit said it “approved 100,000 pallet requests submitted by organizations, of winter-related items, shelter equipment, and sanitation supplies.” 

“These supplies are ready and waiting for weeks for immediate coordination by the relevant organizations so they can enter Gaza,” the statement read. 

Israel and Hamas have continued to trade accusations of ceasefire violations as the first phase nears completion. 

Under this initial phase, Israel was required to withdraw its troops behind a temporary boundary known as the yellow line, while Hamas was to release all living and deceased hostages. 

The next stage of the Trump 20‑point Gaza peace plan, endorsed by the UN Security Council on Nov. 18, faces major obstacles, including Hamas disarmament, Israel’s full withdrawal from Gaza, governance of the enclave, and international security arrangements. 

Despite these obstacles, aid agencies are continuing live-saving work, stepping up efforts to provide essential health services, distribute clean water, support trauma and emergency responses, and offer mental health support. 

On Nov. 21, the WHO, UNRWA, and the UN children’s fund UNICEF, announced the completion of the first round of vaccinations, which immunized more than 13,700 children against measles, polio, mumps and rubella, hepatitis B, tuberculosis, rotavirus and pneumonia. 

The agencies are now preparing for rounds two and three after 1.6 million syringes procured by UNICEF entered Gaza in mid-November. 

The UN also distributed food parcels to more than 264,000 families in the same month. 

However, aid workers say that these efforts represent only a fraction of what is needed to mitigate the worsening humanitarian crisis and help the population recover. 

“A ceasefire must mean more than this; it must bring an end to Palestinians’ suffering and allow them to regain their dignity and safety,” said Talbot. 

“Without a flood of aid and assistance, we will see more avoidable deaths and deprivation.”