A group of experts affiliated with the United Nations warns that the population of the Gaza Strip is in danger imminent risk of faminewith more than 90 percent of its 2.2 million residents facing “acute food insecurity” and a quarter of the population experiencing “catastrophic levels of hunger”.

Even before the war between Israel and Hamas, nearly 70 percent of Gaza residents relied on humanitarian aid for food, as the territory has been under Israeli and Egyptian blockade since 2007. Today, only 20 to 30 percent hundred of what people need are allowed to feed themselves. the border with Gaza, according to the World Food Program. The lack of electricity and fuel and the inability to travel safely have compounded the challenges of producing food or getting it to people. Most people go a day or more without eating, the expert group said.

As in the vast majority of other food crises, the panel, the Famine Review Committee, has assessed in the 20 years since its creation, the situation in Gaza is not environmental but of human origin. But Gaza is unusual in how quickly people have been pushed toward malnutrition.

In interviews, nutrition experts and doctors described what can happen when people can’t get food.

Children, pregnant and lactating women, people with health problems and the elderly are usually the first to succumb to acute malnutrition. The length of time they can survive in conditions of extreme hunger varies.

“It depends on the age of the person,” Zita Weise Prinzo said., senior nutritionist at the World Health Organization. “It depends on their state of health. “It depends on whether they have access to fluids or some kind of food, even if it doesn’t cover all nutritional needs.”

UNICEF, the humanitarian aid organization that focuses on children, is particularly concerned about the plight of infants, said Anuradha Narayan, the agency’s senior adviser for child nutrition in emergencies. Before the war, about 60 percent of Gaza’s infants were formula-fed. Their families now have little or no access to food reserves for them.

“We know that many families are likely unable to formula feed their children,” she said.

For families who have found formula, the challenge is obtaining clean water to prepare it; It is estimated that around 1.6 liters of drinking water (compared to the minimum of 15 liters per day recommended by the WHO) is now available per person in Gaza.

Ms. Narayan said the agency estimates that 7,000 to 8,000 children are malnourished so severely that they are at risk of dying without immediate treatment, but the active conflict in Gaza makes it difficult for humanitarian agencies to assess the situation.

“We expect these numbers to increase quite dramatically over the next two to three weeks,” she said.

Ms Narayan said that in her work in other food security crises, such as in Ethiopia, it was common to see a child fall ill and progress to severe malnutrition and wasting within a few days.

For Gaza, she said: “It’s hard to predict, but if there is almost no food to feed young children and it involves illnesses, I would say it could be exactly the same.” You go from being reasonably well to some level of malnutrition, maybe not severely emaciated, but still emaciated, in the space of a few days. Especially for young people under 2 years old, this will certainly be the case.

The trajectory for people with some access to food would be different, said Dr. Stanley Zlotkin, a professor of nutrition at the University of Toronto and an expert on the effects of a critical food shortage. An adult may be able to survive for an extended period of time with intermittent access to calories or with only foods offering limited nutrients, he said. In a situation like that of Gaza, where there is still sporadic availability of food, most adults would be able to survive for some time, but this would not be enough for children to prevent progression to malnutrition.

A malnourished body first burns fat stores, said Heather Stobaugh, a nutrition and emergencies expert with the humanitarian agency Action Against Hunger, until those are depleted. Then, “the body will resort to using muscles and, eventually, vital organs will begin to break down,” she said. “In the most severe forms of malnutrition, the immune system is weakened and vital organs begin to shrink – the heart, lungs, etc. »

“When a child or adult reaches this point,” she added, “their body literally wastes away.”

Ms. Weise Prinzo said people in the state are minimizing their energy costs. “They stop any movement not necessary for immediate survival, but within the organs there are also changes in the functioning of the heart and liver,” she said. “They try really hard to manage, but eventually one or the other system starts to fail.”

At this stage, a starving person exhibits a range of physical impairments, including extreme fatigue, inability to regulate their temperature, and emotional disturbances.

“We say “acute malnutrition” and acute means it could happen in a short period of time,” Dr. Stobaugh said. “It doesn’t always have to be months of slow decay. »

A malnourished person is vulnerable to disease due to their weakened immune system and conflict conditions, where there is a lack of clean water and sanitation facilities, and where people often live in overcrowded shelters.

A malnourished body’s defenses – the epithelial cells, which make up the surface of the skin and barrier tissues in places such as the gut – deteriorate and white blood cells function poorly.

“Then when you get sick, the body uses whatever protein and energy reserves you have, to try to fight off the infection, and this cycle of infection and malnutrition is what quickly causes wasting.” , said Ms. Narayan. This process is faster in children, she said.

Dr. Zlotkin said the disease spreads rapidly in situations such as the current one in Gaza, where 90 percent of people have been displaced and are sheltering in tents or other temporary structures, and where there are few latrines or adequate sanitation facilities. Pneumonia and gastrointestinal Infections are the leading cause of death among malnourished people.

“You have outbreaks of diseases such as extreme diarrhea, coupled with the lack of health services, food and clean water,” Dr. Stobaugh said. “This kind of perfect storm of adverse environmental and health conditions will exacerbate the rate at which a body will become malnourished and can ultimately find itself on the brink of death quite quickly. »

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