Israel-Hamas: How two years of war destroyed Gaza - BBC World Service

Key Concepts

• Hamas attack
• Israeli military campaign
• Humanitarian crisis
• Famine (IPC classification)
• Malnutrition
• Aid blockade
• Gaza Humanitarian Foundation (GHF)
• Controlled demolitions
• Severe food insecurity
• Agricultural devastation
• Healthcare system collapse

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Overview of the Gaza Conflict and its Aftermath This report provides a comprehensive assessment of the human cost, destruction, and humanitarian crisis in Gaza two years after the war began on October 7th, 2023. The conflict initiated after Hamas attacked Israel, resulting in approximately 1,200 deaths and 251 hostages taken, with 47 remaining in captivity (20 believed alive). Israel responded with a massive military campaign aimed at destroying Hamas and recovering hostages.

I. The Enormous Human Toll The war has exacted a devastating human toll.

• Death Toll: Gaza’s Health Ministry reports over 60,000 people killed as of early September. While the ministry does not differentiate between fighters and civilians, it states 30% of the dead were children and 16% were women. Israel disputes these figures, citing the ministry's Hamas affiliation, but the UN previously considered their data reliable.
• Expert Analysis: The Lancet, a respected medical journal, analyzed the Health Ministry’s figures and estimated the real death toll to be 40% higher, with most casualties being women, children, and the elderly.
• Historical Comparison: Some experts and military historians compare the intensity of destruction and the percentage of the population killed in Gaza to World War II. They note that the bombing and invasion of Gaza have killed between 3% and 5% of its population, exceeding the 3% of the German population killed during the worst civilian punishment campaign by a Western democracy in WWII.

II. Escalating Humanitarian Crisis and Confirmed Famine International attention is increasingly focused on widespread hunger and malnutrition.

• Famine Confirmation: UN-backed experts from the Integrated Food Security Phase Classification (IPC) confirmed famine in northern Gaza in a late August report, stating it is expanding. The report indicates half a million people are facing starvation and death, and over 100,000 children are threatened by malnutrition. Israel dismissed the report as false and biased, a claim rejected by the IPC.
• Aid Agency Warnings: More than 100 aid agencies issued a joint statement warning of mass starvation spreading and people "wasting away." The World Health Organization (WHO) explicitly described the situation as "man-made mass starvation."
• Personal Testimony: A father, Naim Ibrahim al-Najjar, shared the tragic loss of his five-year-old son to starvation, challenging those who deny the famine to "come and see."

III. Critical Challenges in Aid Delivery The humanitarian crisis is exacerbated by a severe lack of food reaching Gaza.

• Dramatic Drop in Aid: Before the conflict, Gaza received an average of 500 truckloads of aid daily. This average plummeted to around 116 trucks per day in the first 16 months of the war. Following the takeover by the US and Israeli-backed Gaza Humanitarian Foundation (GHF) in May, the average dropped further to 60 trucks per day, according to Israeli figures—an 88% reduction compared to pre-war levels.
• Risks at Aid Sites: The GHF operates only four sites, located in militarized zones, requiring Palestinians to travel long, risky distances. Since late May, the UN has recorded at least 1,000 Palestinians killed near GHF sites while attempting to obtain food, with the majority reportedly shot by Israeli troops, a claim Israel denies.
• Aid Blockade: Earlier in the year, Israel imposed a near three-month total aid blockade starting in March, citing pressure on Hamas for hostage release and insisting there was sufficient food inside Gaza. While additional truckloads entered Gaza in late July after Israel promised more routes, humanitarian agencies warn that vastly more aid is needed to prevent starvation.
• Distribution Difficulties: The extensive destruction and displacement of Gaza’s population make distributing any incoming aid extremely challenging. There are 100,000 children suffering from severe food insecurity, requiring immediate intervention with nutritional supplements and medicines to prevent further deterioration.

IV. Unprecedented Scale of Destruction Satellite imagery and expert analysis reveal widespread devastation across Gaza.

• Building Damage: Analysis by satellite data experts at Oregon State University estimates nearly 60% of buildings in the Gaza Strip are destroyed or damaged. Other estimates, including the UN, place this figure higher, with 92% of homes reportedly destroyed.
• Visual Evidence: Aerial drone footage of Gaza City and Khan Younis before and after the conflict vividly illustrates the extent of the destruction, with entire towns and suburbs leveled.
• Controlled Demolitions: Satellite images show massive destruction in areas under Israeli control, with Israeli forces carrying out controlled demolitions on tower blocks, schools, and medical centers. An Israeli Defense Forces (IDF) spokesperson stated operations adhere to international law, claiming Hamas concealed "military assets" in civilian areas and that property destruction is only performed when "imperative military necessity is demanded."
• Pre-Offensive Destruction: Israel destroyed more buildings in northern Gaza in early September, ahead of its Gaza City ground offensive, claiming the city was a Hamas base.

V. Collapse of the Healthcare System Gaza’s healthcare system is on the verge of collapse due to extensive damage and shortages.

• Hospital Functionality: According to the WHO, only 18 of Gaza’s 36 major hospitals remain open, and they are only partially operational due to serious damage.
• Nasser Hospital: This hospital came under Israeli fire on August 25, killing at least 20 people, including five journalists. The attack drew international condemnation. Israel claimed it was targeting a Hamas-operated camera but provided no evidence. Doctors report the hospital, once serving hundreds of thousands, is overwhelmed with mass casualties and struggling with critical shortages of fuel, beds, medication, staff, and food.
• Al-Aqsa Martyrs Hospital: This hospital faces similar challenges, having treated numerous children injured in an Israeli strike while queuing for nutritional supplements. Doctors report critical shortages of essential medicine and equipment, including painkillers and bandages, forcing them to prioritize life-saving operations and postpone others, leading to patient deterioration and loss of life.

VI. Devastation of Food Production and Infrastructure The war has nearly wiped out Gaza’s local food production and severely damaged vital infrastructure.

• Agricultural Ruin: While Gaza relied on food aid before the war, 44% of its agricultural commodities came from local production (Palestinian Bureau of Statistics). Satellite images analyzed by agricultural experts confirm the devastation of key farmland areas, likely sustaining long-term damage. The UN reports 86% of Gaza's farmland has been damaged, with less than 2% now accessible to farmers.
• Water Infrastructure: The enormous damage extends to water systems. UNICEF reported in June that only 40% of Gaza’s drinking water infrastructure remained functional.
• Darkened Life: A night-time satellite view of Gaza before and after the conflict starkly illustrates how two years of intense bombardment have severely darkened life for its people, with many vital community and societal elements lying in ruins.

Conclusion The conflict in Gaza has resulted in an unprecedented humanitarian catastrophe, marked by a staggering death toll, confirmed famine, and a near-total collapse of essential services. The drastic reduction in aid, coupled with widespread destruction of infrastructure, homes, and agricultural land, has created a "man-made mass starvation" crisis. The healthcare system is overwhelmed and barely functional, struggling with critical shortages. The scale of destruction and human suffering is described by some experts as worse than any conflict since World War II, underscoring the urgent need for massive humanitarian intervention and a cessation of hostilities.