Survival at stake: Displaced civilians in Gaza battle starvation, disease, and winter hardships
Displaced civilians in Gaza, including those sleeping on the streets, face the looming threat of death by airstrikes, starvation, and disease as winter arrives With no winter clothes and limited shelter, their struggle for survival intensifies
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Salwa Tibi remembers trekking for miles on foot in southern Gaza, desperately seeking blankets and sheets to keep her four children and other young relatives warm at night.
The 53-year-old aid worker told CNN that she and her husband were filled with fear as they went out to purchase supplies for the upcoming winter season in Rafah, taking the risk of potential Israeli airstrikes. "I felt sorry for the kids, they had no way to stay warm and we were struggling with the cold at night," Tibi shared. She works at the humanitarian agency CARE International and is staying in a rented house with at least 20 relatives, including eight children and babies, the youngest being three months old.
She exclaimed that the children had been crying from hunger all day long. According to aid workers and civilians enduring continuous bombardment, Gaza experiences brutal living conditions, limited access to warm clothing, and disease outbreaks in overcrowded makeshift shelters during the harsh weather conditions from November to February. The scarcity of food, fuel, and water, along with the soaring prices of remaining supplies, further exacerbate the situation.
Displaced Palestinians in Khan Younis, Gaza, have constructed makeshift shelters at a United Nations Relief and Works Agency (UNWRA) camp. The Israel Defense Forces has recently issued warnings to the city's residents, prompting them to evacuate the southern area. Photographer: Ahmad Salem/Bloomberg via Getty Images
Ahmad Salem/Bloomberg/Getty Images
Bloody diarrhea, jaundice, hepatitis: Thousands fall ill in war-ravaged Gaza amid spike in infectious diseases
The Hamas-controlled Health Ministry in Gaza reported that the number of people killed in Israeli attacks since October 7 has now reached 18,412. CNN has not been able to verify these numbers independently. The Israel Defense Forces (IDF) announced that they have struck over 22,000 targets in Gaza since October 7 as a response to Hamas attacks on Israel, resulting in over 1,200 deaths and 240 people taken hostage. Senior US officials have advised Israel to reduce civilian casualties in the south and have criticized their intensified military operation targeting Hamas, especially after urging Gazans to flee there from the north of the strip.
Tibi, along with other civilians who have been displaced multiple times due to the ongoing fighting, were once again forced to pack up their belongings and travel further south, near the border with Egypt. This was in response to Israel's evacuation orders issued on social media on December 3, ahead of the planned expansion of their ground offensive throughout the territory. CNN previously reported on Palestinian civilians who followed these orders and were later killed by Israeli strikes.
Speaking to CNN, several Palestinians expressed their current plight, with some forced to sleep on the streets without any shelter. They are facing the constant threat of imminent death, whether by airstrike, starvation, or untreated disease. The impending rainy season will only add to the challenges faced by these civilians, who are already exhausted by the war that has torn apart their homeland.
"If the situation stays this tragic, then Gaza is going to starve," said Tibi.
Forcibly displaced Palestinians could not flee with winter clothes
Islam Saeed Muhammad Barakat was unable to gather the necessary belongings for his family before fleeing their home in Gaza City for the winter. "I feel anxious because we don't have enough blankets and warm clothes," said the 48-year-old displaced civilian in messages relayed to CNN by Walid Mahmoud Nazzal, an NGO worker based in Ramallah, as he resides in Khan Younis, located in southern Gaza.
In December, the average temperature in Gaza drops to a range of 10°C to 20°C (50F to 68F), and in January it can get a few degrees cooler. The rainy period usually occurs from November to February, with January being the most rainy month. One weather station near the southern border of Gaza and Israel reported almost double the average rainfall, while neighboring stations to the north received less rain than usual. Following his communication with CNN, Barakat and his family had to leave and take shelter with ten relatives in Rafah.
In Khan Yunis, southern Gaza, Palestinian children seek refuge at a UNRWA-operated school as the arrival of winter poses an additional threat to the survival of displaced civilians, as reported by CNN on November 15th.
Since the start of the conflict, the UN Relief and Works Agency for Palestine Refugees (UNRWA) reports that almost 1.9 million people, which accounts for over 85% of the enclave's entire population, have been forced to flee their homes.
Over 1.1 million people are currently seeking shelter in facilities in central and southern Gaza, such as Khan Younis and Rafah, where attacks have been documented, according to UNRWA.
According to civilians and aid workers interviewed by CNN, most of these individuals fled their homes with only the clothes on their backs. Others who managed to bring belongings say they had to abandon them during the exhausting journey on foot from northern Gaza to the south.
"Hazem Saeed Al-Naizi, director of a Gaza City orphanage, described how he had to discard the bag he was carrying. As he headed south with a group of people, he noticed others doing the same, tossing their bags aside. Forced to flee to Rafah, Al-Naizi brought 40 individuals under his care, mostly children and infants with disabilities. He recollected feeling too exhausted to manage the bag, which was filled with baby milk, biscuits, dates, diapers, water, and clothing, while also carrying 8-year-old orphan Ayas."
"The road was littered with bags, causing people to trip and fall," he explained. Rebecca Inglis, an ICU doctor from Britain who frequently visits Gaza to teach medical students, noted that civilians did not anticipate being displaced into the winter months without access to their homes. Some have been forced to search among the rubble of destroyed buildings for blankets and other necessary items.
"They are woefully, woefully underprepared," Inglis told CNN. "This degree of forcible displacement is new."
Seeking shelter from the rain
Shadi Bleha is without a roof to shield himself from the deteriorating weather. Instead, he is seeking refuge in the school's courtyard.
"We are currently residing in a makeshift tent crafted from assorted pieces of nylon," the 20-year-old student, who was displaced from northern Gaza to Rafah, reported to CNN. Bleha shared that he and at least 23 relatives, including five children aged 5 to 12, were living inside the makeshift tent. Some nights, he mentioned that he would sleep outside next to a fire due to insufficient space for everyone.
"We attempt to entertain ourselves by playing games and singing with my family to bring them some happiness, even if only for a little while."
According to Mohammed Ghalayini, 44, many people are sleeping in school courtyards in Khan Younis. He visited local schools where people are taking shelter and observed that some had used sand or cement to reinforce the base of their tents in an effort to prevent flooding.
Amidst the area, patches of ground have transformed into expansive tent camps, housing thousands of civilians in overcrowded conditions. Sudden flooding from heavy rains results in the overflow of garbage and sewage onto the roads, polluting the limited food and water resources of the people.
Palestinians who have been displaced by Israeli airstrikes are seeking refuge from the rain at a UN tent camp in Khan Younis, located in southern Gaza. Large areas of land in Gaza have now been transformed into tent camps, where numerous civilians are residing in crowded and unhygienic conditions.
- Fatima Shbair/AP
In a tent camp in Deir Al-Balah, southern Gaza, children displaced by the conflict were playing in the water after heavy rain. However, 13-year-old Rana Al-Najjar, who walked around barefoot, expressed that she did not find any joy in the rain when speaking to CNN.
I see people starving
"There are nine of us crammed into this tent. The water is rising, my siblings are shivering, and we're at a loss. We just want to get back to our homes and not be swept away," she said.
Israel's Coordinator of Government Activities in the Territories (COGAT) is working to support the civilian population in Gaza by facilitating humanitarian aid initiatives. This includes allowing aid deliveries, conducting security checks, providing water, and helping to establish field hospitals. On Tuesday, COGAT allowed four tankers of fuel, two tankers of cooking gas, and 195 trucks of humanitarian aid to enter Gaza. However, displaced Palestinians continue to struggle with limited access to essential goods, which are both scarce and expensive. Many people have to walk for hours or wait in long lines to purchase food and fuel, according to civilian reports to CNN.
The diminishing supplies have caused a surge in the price of food and water, resulting in widespread hunger and dehydration. On December 5, the World Food Programme declared a "catastrophic hunger crisis" in Gaza. The relief organization was compelled to close its last remaining bakery due to lack of fuel or gas, despite operating 23 bakeries before the war.
The Kamal Adwan Hospital in Beit Lahia, Gaza, suffered severe damage to its infant intensive care unit after being targeted by the Israeli army on November 19, 2023. (Abdulqader Sabbah/Anadolu via Getty Images)
Israeli forces have taken Gaza healthcare workers, leaving hospitals in horrendous conditions, according to a doctor. With reduced daylight hours, reliance on solar power for necessary generators is limited. Tibi, a mother in Rafah, saves mineral water for her children and relies on water sent through aid trucks, noting that it is not completely clean.
Adults are limiting their meals to ensure the children do not go hungry. "I see people starving, literally starving," said Bleha, who only eats once a day.
Civilians informed CNN about the recent increase in costs. For instance, the price of 1.5 liters of water has risen from two shekels (about 50 cents) to five shekels, said Ghalayini. A kilogram of cucumbers, which used to cost one shekel, could now go for five or six shekels. Additionally, the price of flour, typically 40 shekels per 25-kilogram bag, has soared to 200 shekels in recent weeks. A displaced family in Deir Al-Balah reported paying 140 shekels ($38) for 1,000 liters of non-drinkable water.
Aid workers have reported that they are surviving on a diet consisting of canned beans, bread, and hummus due to a lack of fuel for cooking. Some have resorted to makeshift cooking facilities using clay ovens and open fires, burning solid fuels like plastic, wood, garbage, and cardboard instead of using electricity or gas. Additionally, some use tin rocket stoves to reduce smoke fumes. However, the use of solid fuels for heating indoor spaces poses a risk of carbon monoxide poisoning. Street vendors are also using burnable waste for fuel, which releases toxic fumes. Furthermore, cars powered by cooking oil or corn oil are emitting large amounts of black smoke into the atmosphere. This situation presents serious health and environmental hazards.
The cost of transportation for vehicles has surged six times, as stated by Jamal Al Rozzi, executive director of the National Society for Rehabilitation, who has relocated to Bani Suhelia in the south to ensure the safety of his children. Additionally, he mentioned that the expenses for transporting goods using carts pulled by horses or donkeys have tripled.
Diseases spread like wildfire
Those who are already finding it difficult to stay safe, warm, and well-nourished face an increased risk of illness.
In compromised shelters that are unable to provide basic sanitation and hygiene, diseases can rapidly spread, according to Inglis, the intensive care physician.
Anticipating an increase in upper respiratory tract infections due to the rapid spread of coughs, colds, and viruses in crowded areas with poor ventilation, civilians are at risk of exposure to other illnesses such as diarrhea, hepatitis A, body lice, and scabies. WHO officials reported a significant rise in diarrhea cases among children under five, while the Gaza health ministry recorded thousands of respiratory infections, skin rashes, chickenpox, lice, and scabies.
In southern Gaza, Inglis mentioned that her colleague had informed her about the dire situation of treating individuals with wounds "full of maggots" and elderly suffering from "dehydration and exhaustion" after migrating from the north to the south.
In Khan Younis, southern Gaza, a man is seen using a wheelbarrow to transport his daughter through the flooded streets of a UN displacement camp on November 19. The area is facing an outbreak of infectious diseases such as diarrhea, jaundice, acute hepatitis, and respiratory infections. This photo was taken by Fatima Shbair.
The most vulnerable populations, such as malnourished children, pregnant and menstruating women, and people with disabilities, are at higher risk of untreated symptoms. Israel's blockade and limitations on aid entering Gaza have resulted in decreased drug supplies, leaving healthcare workers unable to assist many sick patients or treat those injured in the bombings, increasing their susceptibility to infection.
Barakat, from Khan Younis, stated: "My children and I have fallen ill with various viruses that have been spreading recently, including the flu, colds, and other painful and contagious illnesses."
Displaced Palestinians queue for food donations in Rafah, in southern Gaza, on November 30. Rampant food, fuel and water shortages have led to spiraling prices.
Inglis stated that the blockade has hindered access to treatment, making civilians with chronic illnesses such as diabetes and high blood pressure more susceptible to winter illnesses. According to Mohammed Abed/AFP/Getty Images.
Al Rozzi told CNN that hospitals are facing a shortage of medication, resulting in widespread suffering. According to WHO, Gaza has over 2,000 cancer patients, 1,000 people with kidney disease, 50,000 with cardiovascular disease, and 60,000 diabetes patients. Inglis added that poorly controlled Type 2 diabetes can lead to serious complications, and treatable cancer patients are facing fatal outcomes.
Approximately 359 patients are utilizing dialysis units in southern Gaza, according to the Hamas-run Ministry of Health. Patients in need of dialysis typically require treatment two to three times per week. The largest dialysis unit at Al-Shifa hospital was temporarily closed following an Israeli military raid but has since reopened on a limited capacity. The World Health Organization reported a decrease in functioning hospitals from 36 to 11 along the strip.
Inglis stated that the conflict has systematically destroyed the whole system, making it a lengthy process to rebuild. Al-Rozzi expressed that Palestinians are experiencing fear, anxiety, and pain, feeling worthless and lacking clarity about the present and future.
Barakat urged the global community to safeguard the lives of Palestinians, in the belief that peace could be restored in Gaza.
"We have endured enough siege, enough starvation, enough killing, enough abuse. We deserve the right to live," he emphasized. "And our children deserve the right to play."
CNNs Ibrahim Dahman, Abeer Salman, Mostafa Salem, Kareem Khadder, Eyad Kourdi, Derek Van Dam and Niamh Kennedy contributed reporting.
