Dispatches from the Field—The Genocide Report
Washington, DC—22 May 2025
As the conflict in Gaza continues, the convergence of sustained military operations, restrictions on humanitarian access, and the prolonged blockade has produced conditions consistent with mass deprivation. The resulting humanitarian crisis raises urgent legal and policy concerns regarding the use of starvation as a method of warfare. These dynamics not only reflect immediate human suffering but also signal broader risks related to atrocity crimes, civilian protection, and the erosion of international legal norms.
When access to food, water, and aid is systematically constrained, starvation ceases to be a byproduct of conflict and becomes part of its strategy.”
Escalating Food Insecurity and Public Health Collapse
Conditions in Gaza have deteriorated into a severe and widespread food security crisis affecting more than 2 million residents. Humanitarian organizations report that a majority of the population is now food insecure, with children facing the most acute risks.
Malnutrition has reached critical levels, particularly among infants and young children. In northern Gaza, acute malnutrition among children under two has risen sharply, with severe acute malnutrition (SAM) increasingly reported. These conditions carry immediate mortality risk and long-term developmental consequences, including impaired cognitive function, chronic health conditions, and reduced life expectancy.
The crisis extends beyond caloric deprivation. Limited access to clean water, breastfeeding support, infant formula, and essential nutrients has compounded the impact on vulnerable populations. Micronutrient deficiencies, including widespread iron deficiency anemia, further weaken immune systems and increase maternal and child health risks.
At the same time, the spread of infectious diseases has accelerated. High rates of diarrhea, respiratory infections, and other preventable illnesses reflect the interaction between malnutrition, displacement, and inadequate sanitation. These conditions reinforce a cycle in which weakened populations become increasingly susceptible to disease and mortality.
Humanitarian Conditions and Civilian Vulnerability
The broader humanitarian environment in Gaza reflects systemic deprivation. A significant majority of the population is experiencing crisis-level hunger, with a substantial proportion facing catastrophic conditions.
Restrictions on the flow of essential goods—including food, fuel, and medical supplies—have significantly reduced the availability of basic necessities. Community kitchens are closing, markets have largely collapsed, and humanitarian organizations remain unable to meet escalating demand.
Children are disproportionately affected. Many face compounded vulnerabilities, including displacement, loss of caregivers, interruption of education, and lack of access to healthcare. The combined effects of physical deprivation and psychological trauma pose long-term risks to an entire generation.
Absent sustained intervention, current conditions are likely to result in increased mortality and irreversible public health consequences.
Collapse of the Healthcare System
Gaza’s healthcare system has been critically degraded. Facilities already weakened by years of blockade and limited resources are now overwhelmed by mass casualties, disease outbreaks, and severe supply shortages.
Damage to infrastructure, loss of medical personnel, and restricted access to fuel have significantly reduced operational capacity. Many hospitals have ceased functioning entirely, while others operate at minimal levels.
The situation in major facilities, including Al-Shifa Hospital, illustrates the severity of the crisis. Shortages of electricity, medical equipment, and essential medicines have resulted in preventable deaths and the inability to provide basic care. Reports from medical personnel describe extreme conditions, including surgeries conducted without adequate anesthesia and the loss of patients due to a lack of resources.
Overcrowded shelters and displacement sites, combined with insufficient sanitation and water access, have further accelerated the spread of disease, compounding the strain on an already collapsing system.
Collapse of the Healthcare System
Gaza’s healthcare system is nearing collapse. Facilities already weakened by years of blockade and underfunding are now overwhelmed by mass casualties and disease.
Infrastructure damage, shortages of medical supplies, and loss of personnel have critically reduced capacity. Approximately 1,000 healthcare workers have been killed since October 2023, further straining the system. Fuel shortages have caused widespread power outages, forcing hospitals to shut down essential services. By October 2024, more than half of Gaza’s hospitals had ceased operations, while the remainder functioned only partially.
The situation at Al-Shifa Hospital illustrates the severity of the crisis. As Gaza’s largest medical facility, it has faced repeated shortages of electricity, equipment, and essential medicines. In November 2023, the loss of generator power resulted in the deaths of premature infants and other patients. Reports from medical staff describe surgeries performed without adequate anesthesia, operating rooms lit by mobile phones, and preventable deaths due to a lack of basic supplies.
Overcrowded shelters and displacement camps, combined with limited access to clean water and sanitation, have accelerated the spread of infectious diseases, including diarrhea, respiratory infections, and skin conditions.
Humanitarian Access and Operational Constraints
Humanitarian access to Gaza remains inconsistent and heavily constrained. Aid deliveries are subject to delays, restrictions, and periodic suspension, limiting the ability of humanitarian actors to respond effectively.
Despite the availability of prepared aid shipments, access barriers have prevented the delivery of sufficient assistance to meet population-level needs. Intermittent resumption of aid has not been sufficient to reverse deteriorating conditions.
The absence of a sustained and protected humanitarian access framework leaves civilian populations without reliable support. International organizations have warned that without a significant and continuous increase in aid, the risk of famine will continue to escalate.
Starvation as a Method of Warfare: Legal and Policy Implications
The conditions observed in Gaza raise serious concerns under international humanitarian law. Starvation of civilians as a method of warfare is explicitly prohibited, including through the denial of humanitarian relief and the targeting or destruction of objects indispensable to civilian survival.
The scale and persistence of deprivation—combined with restrictions on aid—require careful legal assessment regarding whether these conditions meet the threshold of prohibited conduct. Beyond legal classification, the situation reflects broader risks to civilian protection norms and the enforcement of international law.
Humanitarian assistance, while essential, cannot substitute for structural and political solutions. Addressing the crisis requires sustained access to aid, restoration of critical infrastructure, and policy measures that prioritize civilian protection.
Photo Credit: palestine-gaza-good-aid-nuseirat-april-2025-eyad-baba-afp by coolloud. Licensed under CC BY NC ND 2.0
Atrocity Prevention Lens
The use or risk of starvation as a method of warfare is a recognized indicator of potential atrocity crimes. In Gaza, the convergence of mass deprivation, restricted humanitarian access, and the collapse of essential systems reflects conditions that elevate atrocity risk.
Failure to address these dynamics may contribute to the normalization of prohibited practices and weaken international accountability mechanisms. Preventing further escalation requires timely intervention, sustained monitoring, and reinforcement of legal norms governing civilian protection.
Legal Framework
International Humanitarian Law and the Prohibition of Starvation
International humanitarian law, including the Geneva Conventions and their Additional Protocols, prohibits the use of starvation of civilians as a method of warfare. This includes actions that impede access to food, water, and objects indispensable to survival.
War Crimes under the Rome Statute
The Rome Statute of the International Criminal Court classifies intentionally using starvation of civilians as a method of warfare as a war crime. This includes the deliberate obstruction of humanitarian assistance.
Protection of Civilians and Humanitarian Access
Parties to a conflict are obligated to allow and facilitate rapid and unimpeded humanitarian relief for civilians in need. Arbitrary denial or restriction of such access may constitute a violation of international law.
Right to Health and Adequate Standard of Living
International human rights law recognizes the right to food, health, and an adequate standard of living. Even in armed conflict, these rights inform obligations related to civilian protection and humanitarian access.
About TGR
The Genocide Report (TGR) publishes analysis and educational resources on conflict, international law, and atrocity prevention. Its work seeks to bridge academic research, field realities, and public understanding of mass violence and civilian protection.