Gaza faces 'immediate possibility' of starvation as disease spreads, UN says

The UN has warned that Gaza’s civilians face the “immediate possibility” of starvation, and that overcrowding and lack of clean water are speeding the spread of diseases as winter approaches.

Deliveries of already scarce food and other supplies have been halted in recent days because of shortages of fuel for trucks and a communications blackout that has made it impossible to coordinate deliveries, aid agencies said. Palestinian network operators said they had no fuel to power phone and internet systems.

Fears are also growing for people crowded into the south of the Gaza Strip, as Israel’s military consolidates its control of the northern areas around Gaza City, and appears to be preparing to step up operations elsewhere.

Civilians in parts of south-east Gaza have been told in leaflets dropped by Israeli aircraft to move into a smaller “safe zone” in the coastal town of Mawasi, which covers just 14 sq km (5.4 sq miles), prompting warnings from the heads of 18 UN agencies and international aid groups.

“Without the right conditions, concentrating civilians in such zones in the context of active hostilities can raise the risk of attack and additional harm,” they said in a joint statement. “No ‘safe zone’ is truly safe when it is declared unilaterally or enforced by the presence of armed forces.”

There are already 1.6 million displaced people in Gaza, more than two-thirds of its population. Most fled the north after similar warnings that nowhere in or around Gaza City would be safe for civilians.

The United Nations Office for the Coordination of Humanitarian Affairs said on Friday that more than 800,000 internally displaced people were staying in at least 154 shelters run by UNRWA, the UN Palestinian refugee agency.

The UN is not able to provide them with adequate food, water or medical care. Even when food has made it through, deliveries are “woefully inadequate” to tackle desperate hunger, with nearly all of Gaza’s 2.3 million people needing aid.

Cindy McCain, the executive director of the UN World Food Programme (WFP), said: “Supplies of food and water are practically nonexistent in Gaza, and only a fraction of what is needed is arriving through the borders. Civilians are facing the immediate possibility of starvation.

“There is no way to meet current hunger needs with one operational border crossing. The only hope is opening another, safe passage for humanitarian access to bring life-saving food into Gaza.”

Less than half of the 1,129 trucks that have entered Gaza since the Rafah border crossing opened on 21 October have carried food, and the amount taken in is only enough to meet 7% of people’s minimum daily needs, according to the WFP.

“The food infrastructure in Gaza is no longer functional,” the WFP said. “Local markets have shut down completely. The small quantities of food that can be found are being sold at alarmingly inflated prices and are of little use without the ability to cook.”

The latest death toll from Israel’s military operations in Gaza is more than 11,470, 4,700 of them children, according to the Hamas-run Palestinian health authority. A further 2,700 people have been reported missing, believed buried under rubble.

That official count includes all dead, and Israel says it has killed thousands of militants in nearly seven weeks of war. The conflict was triggered by a Hamas attack on Israel on 7 October that killed more than 1,200 people, most of them civilians.

Related: Can hospitals be military targets? What international law says

The number of indirect casualties of the war is expected to rise without a rapid scaling up of humanitarian aid into Gaza.

The World Health Organization said it was “extremely concerned about the spread of disease when the winter season arrives” with diarrhoea and respiratory infections rising faster than expected in crowded shelters.

Sewage treatment and water pumping plants have been shut down because of fuel shortages, and winter rains bringing the risk of floods could exacerbate problems.

Pedro Arrojo-Agudo, UN special rapporteur on water and sanitation, called on Israel to allow water and fuel into Gaza to restart the water supply network.

“Every hour that passes with Israel preventing the provision of safe drinking water in the Gaza Strip, in brazen breach of international law, puts Gazans at risk of dying of thirst and diseases,” he said, according to Reuters.

On Friday, Israel’s military identified the body of a second hostage recovered near al-Shifa hospital as a 19-year-old soldier, Cpl Noa Marciano. Earlier, authorities named 65-year-old Yehudit Weiss, who had been taken from her kibbutz home near the border.

Israeli troops this week raided Shifa hospital, the biggest in Gaza. The Israeli military say the complex, and its doctors and patients, have been used as human shields to protect Hamas command and control centres hidden in tunnel networks underground, and as a holding area for some hostages.

It released satellite maps and a computer animation that claimed to detail Hamas networks and storage areas under the hospital. The US has said it has intelligence to support Israeli claims.

Since moving into the hospital Israeli forces have published images of what it claimed was a tunnel entrance and weapons found in a truck inside the compound, and took New York Times journalists to see the tunnel entrance.

The claims could not be independently verified and it has not provided further evidence of Hamas activity under the hospital. The health ministry in Gaza said Israeli forces had searched underground levels of the hospital and detained technicians.

Israel said it was consolidating control in northern Gaza. “We are close to dismantling the military system that was present in the northern Gaza Strip,” the chief of staff, Lt Gen Herzi Halevi said on Thursday.

Forces were preparing to move into more areas to target Hamas “systematically eliminating commanding officers and eliminating operatives, and eradicating the infrastructure,” Halevi added.

The broadening operation raises concerns about where civilians would find shelter. Egypt has said it will not allow an exodus on to its territory.

Despite urging civilians to move south for their safety, Israeli attacks have continued there, though with less intensity than in the north. A strike on a group of displaced people near the Rafah border crossing killed several people, the Palestinian news agency Wafa and Al Jazeera TV reported.