U.N. says ‘famine is imminent’ in northern Gaza as Israel launches another raid on the main hospital

RAFAH, Gaza Strip — The U.N. food agency said Monday that “famine is imminent” in northern Gaza, where 70% of the remaining population is experiencing catastrophic hunger, and that a further escalation of the war could push around half of Gaza’s total population to the brink of starvation.

The alarming report came as Israel faces mounting pressure from even its closest allies to streamline the entry of aid into the Gaza Strip and open more land crossings. Deliveries by air and sea that the U.S. and other countries have turned to in recent weeks are too slow and too small, aid groups say.

The European Union’s top diplomat said the impending famine was “entirely man-made” as “starvation is used as a weapon of war.”

Israeli forces meanwhile launched another raid on the Gaza Strip’s largest hospital early Monday, saying Hamas militants had regrouped there and had fired on them from inside the Shifa Hospital compound.

Clashes continued all day in and around the hospital, where Palestinian officials say tens of thousands of people have been sheltering. The Israeli military said troops had killed 20 people it identified as Hamas militants and one of its own solders was killed, though its identification of the dead as militants could not be confirmed. Among those killed was a senior commander in Gaza’s Hamas-led police forces who Israel said was hiding in the hospital but who Gaza officials said was coordinating protection of aid convoys.

The army last raided Shifa Hospital in November after claiming that Hamas maintained an elaborate command center within and beneath the facility. The military revealed a tunnel leading to some underground rooms, as well as weapons it said were found inside the hospital. But the evidence fell short of the earlier claims, and critics accused the army of recklessly endangering the lives of civilians.

The World Food Program on Monday released the latest findings of its Integrated Food Security Phase Classification, or IPC, an international process for estimating the scale of hunger crises.

It says virtually everyone in Gaza is struggling to get enough food, and that around 677,000 people — nearly a third of the population of 2.3 million — are experiencing the highest level of catastrophic hunger, meaning they face extreme lack of food and critical levels of acute malnutrition. That includes around 210,000 people in the north.

Outright famine is projected to occur in the north anytime between now and May, it said. An area is considered to be in famine when 20% of households have an extreme lack of food, 30% of children suffer from acute malnutrition and at least two adults or four children per every 10,000 people die daily.

The report said the first condition has been fulfilled and it is “highly likely” the second has as well. The death rate is expected to accelerate and reach famine levels soon, it said.

It warned that if Israel broadens its offensive to the packed southern city of Rafah, as Prime Minister Benjamin Netanyahu has vowed, the fighting could drive over a million people — half of Gaza’s population — into catastrophic hunger and potentially cause famine in the south.

“This is the largest number of people facing imminent famine in the world today, and it has only taken five months to occur,” said Matthew Hollingworth, the acting World Food Program country director for the Palestinian territories.

“It’s still possible to turn this around but there has to be a cease-fire and there has to be massive amounts of food aid to flow consistently, and people need to have access to clean water and health care,” he said.

Jamie McGoldrick, the U.N. humanitarian coordinator for the Palestinian territories, called for “all roads” to be opened for aid, including into northern and central Gaza. The WFP report said aid from airdrops is “negligible” compared to what is brought on trucks.

Northern Gaza, including Gaza City, was the first target of the invasion and entire neighborhoods have been obliterated. It is now the epicenter of Gaza’s humanitarian catastrophe, with many residents reduced to eating animal feed. At least 27 people, mostly children, have died from malnutrition and dehydration in the north, according to the Health Ministry.

Israeli authorities say they place no limits on entry of aid and say U.N. bodies fail to distribute it in a timely manner. Aid groups say distribution is impossible in much of Gaza because of hostilities, the difficulty of coordinating with the military and the breakdown of law and order.

Alex de Waal, the executive director of the World Peace Foundation at Tufts University and an expert on global famines, said Israel has had “ample warning” that if it continued to launch massive operations that destroy key infrastructure, displace large numbers of people and obstruct aid operations, the results would be catastrophic.

“In failing to change course, it is culpable for these deaths,” he said.

EU foreign policy chief Josep Borrell said it was up to Israel to facilitate more aid.

“Israel has to do it. It is not a question of logistics. It is not because the United Nations has not provided enough support,” he said. “Trucks are stopped. People are dying, while the land crossings are artificially closed.”

The raid on Shifa Hospital began before dawn, when Israeli forces backed by tanks and artillery surrounded the complex and troops stormed into a number of buildings.

“We’re trapped inside,” said Abdel-Hady Sayed, who has been sheltering in the facility for months. “They fire at anything moving.” In the evening, he said tanks were still in the hospital yard and he could see three bodies outside the gates. “We can’t retrieve the dead,” he said.

Gaza’s Health Ministry said around 30,000 people are sheltering at the hospital, including patients, medical staff and people who have fled their homes seeking safety. The war has displaced around 80% of Gaza’s population.

Rear Adm. Daniel Hagari, the chief Israeli military spokesperson, said senior Hamas militants had regrouped in the hospital and were directing attacks from inside.

Among those killed in the raid was Faiq Mabhouh, a senior officer in the Gaza police, which is under Gaza’s Hamas-led government but distinct from the militant group’s armed fighting wing. The Israeli military said he was armed and hiding in Shifa, and that weapons were found in an adjacent room.

The Gaza government said Mabhouh was in charge of protecting aid distribution in the north and coordinating between aid groups and local tribes. Aid groups say Israeli strikes on police are one reason public order has collapsed, leading to desperate Palestinians overwhelming aid trucks on the road.

Hagari said the patients and medical staff could remain in the medical complex and that a safe passage was available for civilians who wanted to leave.

Israel accuses Hamas of using hospitals and other civilian facilities to shield its fighters, and the Israeli military has raided several hospitals since the start of the war.

The Gaza Health Ministry said Monday that at least 31,726 Palestinians have been killed in Israel’s offensive. The ministry doesn’t differentiate between civilians and combatants in its count, but says women and children make up two-thirds of the dead.

Palestinian militants killed some 1,200 people in Hamas’ Oct. 7 attack into southern Israel that triggered the war, and took another 250 people hostage. Hamas is still believed to be holding about 100 captives, as well as the remains of 30 others, after most of the rest were freed during a cease-fire last year.