Anyone of us of certain age can never forget the photos and film taken by U.S. soldiers as they entered concentration camps — the emaciated prisoners with the hollow eyes, little more than skin and skeleton. As a Jewish child, it affected me especially deeply. So it is more than a little ironic that the state founded, in part, as a reaction to the horror inflicted on the Jewish people, is inflicting this same horror on the Palestinian people.

Starvation is obviously a health problem. So what has the medical community said?
As early as January 2024, the World Health Organization, writing in the British Medical Journal, accused Israel of using starvation as a weapon of war. Using standardized questionnaires like the Household Food Security Survey Module, researchers in May-July 2024 found that 98% of the population of Gaza faced food insecurity. Average adult weight had dropped from 74.8 kg (164 lbs.) to 64.8 kg (142.5 lbs.). (The average adult in the U.S. weighs 185 lbs.)

And as we all know, since then, the problem has gotten much worse, especially since
Israels’ total blockade from March to May, the bombing of aid workers and food depots, and the isolated food distribution centers which are now chaotic killing fields. Oxfam announced recently that $2.5 million in humanitarian and food aid was prevented from entering Israel.

Israel’s blockade of international assistance has been condemned by 22 countries and the EU, and by every major non-governmental food, health, and humanitarian organization. Some skeptics have pointed out that starvation and armed conflict is not unique to Gaza. Hunger is all too common in the world, especially in Africa, and it has become more so since the pandemic. The prime reasons are armed conflict, climate emergencies, like drought and flooding, and the price and availability of food.

The Integrated Food Security Phase Classification (the IPC) partners with 21 NGOs,
including the WHO and UNICEF to monitor and respond to acute hunger around the world. In IPC Phase 1, there is usually enough nutritious food. In Phase 2, there is some stress on the system, like higher prices, which cause people to make choices between healthy food and paying the bills. This type of food insecurity affects as many as one in four Americans, and may often lead to obesity, as caregivers are forced to buy cheap, fast, fatty foods. Phase 3 describes a situation which may exist after a catastrophe like a crop failure, or a flood, where there is a real crisis, and people have to trade off their assets in order to have enough food, or people are simply eating less. Phase 4 describes a true emergency, where people have to eat fewer calories and less healthy food; malnutrition rates rise, and people have to trade off large parts of their property (car, cattle, home, for example) to survive. Phase 5 describes a famine. It is a catastrophe. Society’s infrastructure has deteriorated or is defunct. More than 2/10,000 people are dying a day from hunger, and malnutrition rates top 30%. Another way to track hunger is the prevalence of starvation deaths, per 100,000 people. It is 0 in the U.S, Canada, and Europe. South Sudan, Somalia, and Sierra Leone are hotspots of hunger, with starvation prevalence rates of 30-39/100,000, according to the most recent data.

As of Aug. 15, 2025, at least 281,00 people in Gaza were experiencing Phase 5 levels of hunger, and 468,000 phase 4, in a population of 2,000,000 (with some areas of the country off limits to researchers).This means the prevalence of starvation in Gaza is at least 56/100,000, meaning it has the highest rate of starvation in the world.

What is starvation like? We have all experienced hunger pangs when we’ve skipped a meal— due to the hormone ghrelin which sends signals to the brain and makes the stomach contract. In the early stages of starvation the victim also suffers headaches, nausea, and weakness. Malnutrition affects the immune system, making victims more susceptible to infectious diseases like malaria and pneumonia (not measles, which is so virulent it infects everyone who come in contact with it).

In the later stages of starvation, the body, like a vicious parasite in a sci-fi horror film, actually begins to consume its own muscle. This causes the wasting seen in the terrible pictures of children from Gaza. Children and the elderly are effected the most from starvation. Along with excruciating body wide pain, comes emotional distress, depression, and cognitive decline.

Death from starvation is equivalent to death in a torture chamber. What about those who survive starvation? Children who survive tend to have developmental, cognitive and growth delays (stunting). And study after study of children who survived the Great Famine in China in 1959-60, famine in the Netherlands during World War II, Stalin’s starvation of Ukraine, and famine in Biafra, have shown increased diabetes, stroke, hypertension, heart disease, kidney disease, arthritis. osteoporosis, frailty, depression, and cognitive decline in adulthood.

The harm might even be transgenerational, as children born to people who survived famine may suffer from some of these maladies. Ironically, one of the studies, of Holocaust survivors, which showed increased rates of cancer, hormonal abnormalities and mental health disorders among starvation survivors, was published by the Israeli Medical Association.

If medical science is used as the basis for Israel’s policy in Gaza, or ours, it is clear what
steps Israel, and the U.S. need to take today.

Dr. David Gottsegen is a pediatrician who focuses on the interrelationship between mind body and spirit. He lives in Belchertown.

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