Islam Qudeih shows her severely malnourished shirtless, 2-year-old daughter, Shamm, to journalists at Nasser Hospital in Khan Younis, southern Gaza Strip, Saturday, Aug. 9, 2025. Doctors said Shamm may have a genetic disorder that affects muscle and bone development, but there is no way to test for it in Gaza. On Tuesday, August 12, her family was granted permission to travel to a hospital in Italy. (AP Photo/Mariam Dagga)2025-08-14T14:41:17Z KHAN YOUNIS, Gaza Strip (AP) The dead body of 2 1/2-year-old Roa Mashi lay on the table in Gazas Nasser Hospital, her arms and rib cage skeletal, her eyes sunken in her skull. Doctors say she had no preexisting conditions and wasted away over months as her family struggled to find food and treatment.Her family showed The Associated Press a photo of Roas body at the hospital, and it was confirmed by the doctor who received her remains. Several days after she died, Israeli Prime Minister Benjamin Netanyahu on Sunday told local media, There is no hunger. There was no hunger. There was a shortage, and there was certainly no policy of starvation. In the face of international outcry, Netanyahu has pushed back, saying reports of starvation are lies promoted by Hamas. However, U.N. spokesman Stephane Dujarric this week warned that starvation and malnutrition in Gaza are at the highest levels since the war began. The body of 5-year-old Jamal al-Najjar is placed on the ground atop bricks before a funeral prayer after he died at Nasser Hospital in Khan Younis, southern Gaza Strip, Tuesday, Aug. 12, 2025. The head of Nassers pediatrics unit said Jamal, who was born with rickets, died from severe malnutrition. (AP Photo/Mariam Dagga) The body of 5-year-old Jamal al-Najjar is placed on the ground atop bricks before a funeral prayer after he died at Nasser Hospital in Khan Younis, southern Gaza Strip, Tuesday, Aug. 12, 2025. The head of Nassers pediatrics unit said Jamal, who was born with rickets, died from severe malnutrition. (AP Photo/Mariam Dagga) Share Share Facebook Copy Link copied Print Email X LinkedIn Bluesky Flipboard Pinterest Reddit Read More The U.N. says nearly 12,000 children under 5 were found to have acute malnutrition in July including more than 2,500 with severe malnutrition, the most dangerous level. The World Health Organization says the numbers are likely an undercount. The past two weeks, Israel has allowed around triple the amount of food into Gaza than had been entering since late May. That followed 2 1/2 months when Israel barred all food, medicine and other supplies, saying it was to pressure Hamas to release hostages taken during its 2023 attack that launched the war. The new influx has brought more food within reach for some of the population and lowered some prices in marketplaces, though it remains far more expensive than prewar levels and unaffordable for many. While better food access might help much of Gazas population, it wont help the children who are severely malnourished, said Alex DeWaal, executive director of the World Peace Foundation at Tufts University, who has worked on famine and humanitarian issues for more than 40 years. When a person is severely malnourished, vital micronutrients are depleted and bodily functions deteriorate. Simply feeding the person can cause harm, known as refeeding syndrome, potentially leading to seizures, coma or death. Instead, micronutrients must first be replenished with supplements and therapeutic milk in a hospital.Were talking about thousands of kids who need to be in hospital if theyre going to have a chance of survival, DeWaal said. If this approach of increasing the food supply had been undertaken two months ago, probably many of those kids would not have gotten into this situation.Any improvement is also threatened by a planned new Israeli offensive that Netanyahu says will capture Gaza City and the tent camps where most of the territorys population is located. That will prompt a huge new wave of displacement and disrupt food delivery, U.N. and aid officials warn. Preexisting conditions The Gaza Health Ministry says 42 children died of malnutrition-related causes since July 1, along with 129 adults. It says 106 children have died of malnutrition during the entire war. The ministry, part of the Hamas-run government, is staffed by medical professionals and its figures on casualties are seen by the U.N. and other experts as the most reliable.The Israeli military Tuesday pointed to the fact that some children who died had preexisting conditions, arguing their deaths were unrelated to their nutritional status. It said a review by its experts had concluded there are no signs of a widespread malnutrition phenomenon in Gaza.At his press briefing Sunday, Netanyahu spoke in front of a screen reading Fake Starving Children over photos of skeletal children with preexisting conditions. He accused Hamas of starving the remaining Israeli hostages and repeated claims the militant group is diverting large amounts of aid, a claim the U.N. denies.Doctors in Gaza acknowledge that some of those dying or starving have chronic conditions, including cerebral palsy, rickets or genetic disorders, some of which make children more vulnerable to malnutrition. However, those conditions are manageable when food and proper medical treatments are available, they say. The worsening shortages of food led to these cases swift deterioration, said Dr. Yasser Abu Ghali, head of Nassers pediatrics unit. Malnutrition was the main factor in their deaths.Of 13 emaciated children whose cases the AP has seen since late July, five had no preexisting conditions including three who died according to doctors. Abu Ghali spoke next to the body of Jamal al-Najjar, a 5-year-old who died Tuesday of malnutrition and was born with rickets, which hinders the ability to metabolize vitamins, weakening bones.In the past months, the boys weight fell from 16 kilograms to 7 (35 pounds to 15), said his father, Fadi al-Najjar, whose lean face showed his own hunger. Asked about Netanyahus claim there was no hunger in Gaza, he pointed at Jamals protruding rib cage. Of course theres famine, he said. Does a 5-year-old childs chest normally come to look like this? Islam Al-Najjar caresses the body of her 5-year-old nephew, Jamal al-Najjar, as his grandfather, Adnan Al-Najjar, carries him to be prepared for his funeral after he died at Nasser Hospital in Khan Younis, southern Gaza Strip, Tuesday, Aug. 12, 2025. The head of Nassers pediatrics unit said Jamal, who was born with rickets, died from severe malnutrition. (AP Photo/Mariam Dagga) Islam Al-Najjar caresses the body of her 5-year-old nephew, Jamal al-Najjar, as his grandfather, Adnan Al-Najjar, carries him to be prepared for his funeral after he died at Nasser Hospital in Khan Younis, southern Gaza Strip, Tuesday, Aug. 12, 2025. The head of Nassers pediatrics unit said Jamal, who was born with rickets, died from severe malnutrition. (AP Photo/Mariam Dagga) Share Share Facebook Copy Link copied Print Email X LinkedIn Bluesky Flipboard Pinterest Reddit Read More Skin and bonesDr. Ahmed al-Farra, Nassers general director of pediatrics, said the facility receives 10-20 children with severe malnutrition a day, and the numbers are rising.On Sunday, a severely malnourished 2-year-old, Shamm Qudeih, cried in pain in her hospital bed. Her arms, legs and ribs were skeletal, her belly inflated.She has lost all fat and muscle, al-Farra said. She weighed 4 kilograms (9 pounds), a third of a 2-year-olds normal weight.Doctors suspect Shamm suffers from a rare genetic condition called glycogen storage disease, which changes how the body uses and stores glycogen, a form of sugar, and can impact muscle and bone development. But they cant test for it in Gaza, al-Farra said.Normally, the condition can be managed through a high-carbohydrate diet.Her family applied a year ago for medical evacuation, joining a list of thousands the WHO says need urgent treatment abroad. For months, Israel slowed evacuations to a near standstill or halted them for long stretches. But it appears to be stepping up permissions, with more than 60 allowed to leave in the first week of August, according to the U.N.Permission for Shamm to leave Gaza finally came this week, and on Wednesday, she was heading to a hospital in Italy. Sitting next to her husband, Amin, and two of their children, Fatma Mashi shows a photo on her cellphone of the body of her 2-year-old daughter, Roa, who doctors say had no preexisting conditions and died of severe malnourishment, at their tent in Muwasi, southern Gaza Strip, Friday, Aug. 8, 2025. Experts say its not unusual for one family member to fare worse than the others. (AP Photo/Mariam Dagga) Sitting next to her husband, Amin, and two of their children, Fatma Mashi shows a photo on her cellphone of the body of her 2-year-old daughter, Roa, who doctors say had no preexisting conditions and died of severe malnourishment, at their tent in Muwasi, southern Gaza Strip, Friday, Aug. 8, 2025. Experts say its not unusual for one family member to fare worse than the others. (AP Photo/Mariam Dagga) Share Share Facebook Copy Link copied Print Email X LinkedIn Bluesky Flipboard Pinterest Reddit Read More A child died in her familys tentRoa was one of four dead children who suffered from malnutrition brought to Nasser over the course of just over two weeks, doctors say.Her mother, Fatma Mashi, said she first noticed Roa losing weight last year, but she thought it was because she was teething. When she took Roa to Nasser Hospital in October, the child was severely malnourished, according to al-Farra, who said Roa had no preexisting conditions.At the time, in the last months of 2024, Israel had reduced aid entry to some of the lowest levels of the war. The family was also displaced multiple times by Israeli military operations. Each move interrupted Roas treatment as it took time to find a clinic to get nutritional supplements, Mashi said. The family was reduced to one meal a day often boiled macaroni but whatever she ate, it didnt change anything in her, Mashi said.Two weeks ago, they moved into the tent camps of Muwasi on Gazas southern coast. Roas decline accelerated.I could tell it was only a matter of two or three more days, Mashi said in the familys tent Friday, the day after she had died. Mashi and her husband Amin both looked gaunt, their cheeks and eyes hollow. Their five surviving children including a baby born this year -- are thin, but not nearly as emaciated as Roa.DeWaal said its not unusual in famines for one family member to be far worse than others. Most often it will be a kid who is 18 months or 2 years who is most vulnerable, he said, while older siblings are more robust.But any number of things can set one child into a spiral of malnutrition, such as an infection or troubles after weaning.A very small thing can push them over.___Keath reported from Cairo. AP journalists Abdel-Karim Hana and Wafaa Shurafa contributed from Deir al-Balah, Gaza Strip. LEE KEATH Keath is the chief editor for feature stories in the Middle East for The Associated Press. He has reported from Cairo since 2005. twitter mailto RSShttps://feedx.net https://feedx.site