By Lara Kajs
Thinking Out Loud
This article examines the humanitarian crisis in the Gaza Strip during the Israel–Hamas war, focusing on displacement, famine risk, and the collapse of healthcare infrastructure. It also explores the legal and diplomatic efforts aimed at expanding humanitarian access and protecting civilians under international law.
For more than nine months, civilians in the Gaza Strip have endured one of the most severe humanitarian crises of the modern era. The war between Israel and Hamas has devastated the enclave’s infrastructure, displaced most of its population, and pushed the territory toward famine.
Aid agencies warn that Gaza’s humanitarian emergency is largely man-made and preventable. Thousands of tons of food, fuel, and medical supplies remain staged outside the territory, awaiting permission to enter.
Without sustained humanitarian access, the crisis continues to deepen.
A Collapsing Humanitarian Lifeline
In the early weeks of the war, humanitarian organizations estimated that roughly 100 aid trucks per day would be required for at least six months to stabilize conditions in Gaza.
Nine months later, the needs have grown dramatically. Aid agencies now estimate that up to 600 trucks per day may be required for a prolonged period simply to make the humanitarian situation manageable.
Yet access remains severely limited. In May, fewer than 400 trucks entered Gaza during the entire month.
Fuel shortages have compounded the crisis. Bakeries, water desalination plants, hospitals, and sanitation systems all depend on fuel to operate. At present, Gaza receives only a fraction of the resources required to maintain these essential services.
Without a significant increase in humanitarian access, many civilians face growing risks from starvation, dehydration, disease, and untreated injuries.
Mass Displacement
Before the war, Gaza’s population stood at approximately 2.3 million people, nearly half of whom are children. The territory itself covers an area roughly the size of Las Vegas, but with several times the population density.
In the early stages of the conflict, Israeli authorities instructed residents of Gaza City and northern Gaza to evacuate southward as military operations intensified. Over the following months, aerial bombardment and ground fighting devastated large parts of the north.
By early 2024, roughly 1.3 million people had sought refuge in Rafah, a city near the Egyptian border that quickly became the last major population center considered relatively safe.
In April, Israeli officials warned that Rafah could soon face a major military operation. The threat alone triggered the displacement of nearly one million people.
On 6 May, Israeli forces launched a ground offensive in the area and seized the Rafah border crossing the following day, temporarily halting aid deliveries through one of Gaza’s primary humanitarian entry points.
The International Court of Justice (ICJ) later ordered Israel to halt its military offensive in Rafah and to ensure humanitarian access. Despite the ruling, fighting and restrictions on aid deliveries have continued.
Today, nearly two million Palestinians—almost the entire population of Gaza—have been displaced, many multiple times. With large portions of the territory devastated, civilians have few places left to seek safety.
Famine Conditions
Food insecurity in Gaza has reached catastrophic levels.
Humanitarian monitors report that some areas are experiencing severe food shortages, while others show indicators consistent with famine conditions. Damage to agricultural areas, disruptions to food supply chains, and restrictions on aid deliveries have all contributed to the crisis.
The ICJ has ordered Israel to allow the immediate and unhindered delivery of humanitarian assistance, including food, water, medicine, and fuel.
The UN Security Council has also adopted resolutions calling for humanitarian pauses and expanded aid access. Resolution 2712 (2023) called for urgent humanitarian pauses and the creation of safe corridors for aid deliveries. Resolution 2720 (2023) established a UN humanitarian coordinator responsible for monitoring and facilitating aid deliveries to Gaza.
Despite these measures, aid organizations report that humanitarian access remains inconsistent and insufficient to meet the needs of Gaza’s population.
Across the territory, food is often unavailable or prohibitively expensive. Many families survive on a single meal per day, while others go days without food.
The impact on children and pregnant women has been especially severe. Malnutrition rates are rising, and medical providers report increasing cases of underweight newborns and pregnancy complications linked to food insecurity.
A Health System on the Brink
Gaza’s healthcare system is nearing collapse.
Hospitals face critical shortages of electricity, medicine, medical equipment, and staff. Damage to roads and infrastructure has made transporting patients and medical supplies increasingly difficult.
The lack of clean water and sanitation has also contributed to the spread of disease. Health officials report growing outbreaks of respiratory infections, diarrhea, hepatitis A, and other illnesses associated with overcrowding and poor sanitation.
According to humanitarian agencies, only a fraction of Gaza’s hospitals remain even partially operational.
Dr. Samer Attar of Northwestern Medicine, who volunteered in Gaza during the conflict, described the conditions bluntly:
“In many cases, all you can do is hold their hand, be with them, and support those left behind. That’s medicine in Gaza.”
For many patients, the greatest barrier to survival is not the severity of their injuries but the absence of functioning medical facilities and supplies.
In many cases, all you can do is hold their hand, be with them, and support those left behind. That’s medicine in Gaza.”
The Need for a Ceasefire
Humanitarian organizations widely agree that meaningful relief for Gaza’s civilian population will require three things: sustained humanitarian access, functioning medical infrastructure, and a halt in hostilities.
Without a ceasefire and expanded aid access, the humanitarian catastrophe in Gaza will continue to worsen.
The scale of suffering in the territory underscores a fundamental reality of modern conflict: civilians almost always bear the greatest cost of war.
Photo credit: Fars Photo of Casualties in Gaza Strip during 2023 War 05 by Saleh Najm and Anas Sharif. Licensed under CC BY 4.0
Published 24 June 2024
Author’s Note: I am sensitive to reposting photos of death and dying. These are people… humans… someone’s family. I appeal to people’s empathy and post photos of war and hope that they will understand, know, and feel the image that there is no way to escape death in buildings that are decimated. However, after nine months of war and conversations about war… I have not witnessed the empathy. This child died through no fault of his or her own. There are more than 38,000 casualties in the Israel-Hamas war taking place in Gaza – some 70 percent of those killed are women and children.
About Thinking Out Loud
Thinking Out Loud is a commentary series by Lara Kajs examining international law, humanitarian crises, and the prevention of mass atrocities. Drawing on field experience in conflict and displacement settings, the column explores the legal and policy challenges that shape contemporary conflicts
Lara Kajs is the founder and executive director of The Genocide Report, a Washington, DC-based educational nonprofit focused on atrocity prevention and international law. She is the author of several field-based books on conflict, displacement, humanitarian crises, and international humanitarian law, drawing on extensive research and field experience in Yemen, Syria, and Afghanistan. Her writing and public speaking focus on atrocity crimes, forced displacement, the protection of civilians, and the legal frameworks governing armed conflict.
I’ve been in #Gaza since November, along with colleague Chad Thornson. More than 38,000 deaths and at least 70 percent t are women and children. It is horrific and even that does not conjure enough. It needs to end now. There are enough mandates and mechanisms to force Israel to stop the #genocide of the #Palestinian people.