We Have Faced Hunger Before, But Never Like This

Malak A Tantesh in Gaza and Emma Graham-Harrison in Jerusalem report on the grave impact of food shortages, starvation, malnutrition and Israel's deadly attacks on aid hubs

- Malak A Tantesh in Gaza and Emma Graham-Harrison in Jerusalem

Mohammed's skeletal arms stick out of a romper with a grinning emoji-face and the slogan "smiley boy", which in a Gaza hospital reads as a cruel joke. He spends much of the day crying from hunger or gnawing at his own emaciated fingers.

At seven months old, he weighs barely 4kg and this is the second time he has been admitted for treatment. His face is gaunt, his limbs little more than bones covered in baggy skin and his ribs protrude painfully from his chest.

"My biggest fear now is losing my grandson to malnutrition," said his grandmother, Faiza Abdul Rahman, who herself is constantly dizzy from lack of food. The previous day the only thing she ate was a single piece of pitta bread, which cost 15 shekels (£3).

"His siblings also suffer from severe hunger. Some days they go to bed without a single bite to eat."

Mohammed Aliwa was born healthy but his mother was too malnourished to produce breast milk. The family has only been able to get two cans of baby formula since. The ward at the Patient Friends Benevolent Society Hospital is crowded with other skeletal children, some doubled up on the 12 beds. Only two functioning paediatric teams remain in Gaza City. As many as 200 children turn up seeking treatment every day.

Doctor Musab Farwana spends his days trying, but often failing, to save them. Then he goes home to share meals that are too small with his own hungry sons and daughters.

The whole family are losing weight fast, because his salary buys almost nothing, and he doesn't want to risk the deadly race for supplies handed out by the Gaza Humanitarian Foundation (GHF) after another medic, Dr Ramzi Hajaj, was killed trying to get food at one site.

Gaza has never been hungrier, despite several warnings about impending famine over the course of nearly two years of war.

Over just three days this week public health officials recorded 43 deaths from hunger; there had been 68 in total before that.