Gaza Humanitarian Update: September 9

Summary

• Since famine was declared in Gaza City, Israel has launched a new offensive in the area and stepped up bombings across Gaza—hobbling the famine response, and re-displacing more than 76,000 people. 
• Although the IDF has demanded that people vacate Gaza City, its offensive is blocking many civilians seeking to flee through the Netzarim checkpoints, trapping them in an area where the Israeli Defense Minister has promised to open “the gates of Hell.” 
• While comprehensive mortality data remains unavailable due to violence and IDF restrictions on aid groups, reports of starvation deaths continue to grow, with 115 more since the IPC confirmed famine just over two weeks ago. Actual starvation deaths are likely higher. 
• More than 64,000 civilians have been killed over the past 23 months, including 610 civilians killed over the past two weeks. 

In the two and a half weeks since famine was officially declared in Gaza, the overall humanitarian situation has continued to deteriorate. There has been no significant improvement in access for the UN and international NGOs best qualified to lead the famine response. Instead of heeding growing calls for an immediate ceasefire and unhindered humanitarian access, Israel has intensified aerial bombardments and tank fire across Gaza and launched a ground invasion of Gaza City.

Aid access has been further cut off. Israel has blocked entry of assistance into northern Gaza and, through its military operations, has restricted aid deliveries to Gaza City, the epicenter of famine. Many civilians attempting to flee bombardments in Gaza City face IDF drone, tanks, and small arms fire before reaching IDF checkpoints along Netzarim Corridor, effectively preventing them from safely fleeing south. Since August 14, the UN has reported more than 76,000 new displacements across all of Gaza – with many people displaced multiple times. While a third of new displacements reached safer locations, sources on the ground estimate tens of thousands of civilians remain trapped along the highly congested Al-Rashid road west of Gaza City. 

These developments follow months of rising alarm despite repeated Israeli promises to ease humanitarian access. Earlier this year, Israel announced—through an agreement with the European Union—that it would relax obstructions on UN-led aid and introduce “humanitarian pauses” to facilitate delivery. Refugees International and others warned that these commitments were not being fulfilled. Unfortunately, those warnings proved accurate. None of the promised measures materialized, famine spread further, and Israel has since announced additional restrictions on aid entry.

According to the latest IPC analysis, if current levels of violence and bureaucratic obstruction continue, more than 640,000 people—one-third of Gaza’s population—will face famine by the end of September. Refugees International’s partners on the ground expect this number to rise with the ongoing invasion of Gaza City. Hospitals in Gaza recorded six more starvation deaths on September 8, including two children. This brings the total number of recorded starvation deaths to 393, including 140 children (this is likely an undercount due to the impossibility of comprehensive mortality screening in Gaza). In the 17 days since the IPC famine declaration, 115 people have died from starvation. 

There has been limited progress in some sectors of the relief operation, which is described in more detail in the full update below. However, that progress falls far short of what is required to stop the spread of famine. Without sweeping changes, this man-made disaster will continue to worsen, as it has over the last six months. The U.S. Congress should press for a ceasefire to allow a full famine response, use all of its leverage to push for unhindered access for UN and NGO actors, allocate emergency funds to fight famine, and hold accountable those responsible for perpetuating this crisis.

Food Security

• Nominal increases in food aid allowed to enter Gaza last week (1,100 MT) remain barely over half of the minimum emergency requirement—far from enough to reverse the famine.  
• Violence targeting aid trucks continues amidst Israel’s refusal to allow any organization but GHF to use the secure “Fence Road.” Convoy delays at IDF checkpoints remain a serious threat to safe aid operations.

The United Nations reports that, in August, more commercial and humanitarian supplies entered Gaza. This helped to bring down the price of some key staples like wheat flour (but still well above pre-war levels and inaccessible to the most impoverished Gazans). This also allowed aid groups to serve more meals each day at community kitchens across Gaza. According to UN data, about 33,000 metric tons of food supplies were brought in during August—roughly the same amount that had entered over the entire ten weeks between May 19 and July 30. 

Despite this increase, the amount of food coming into Gaza remains far below the 2,000 metric tons needed each day to cover basic needs. Serious delays also persist, with IDF restrictions forcing approved aid missions to wait for hours on roads that are dangerous, congested, or blocked. In addition, many supplies never reach their intended destinations, as desperate crowds seize them en route or, in some cases, armed groups loot them.

As of September 2, twenty UN humanitarian partners were providing 517,000 meals a day at 104 community kitchens—up from 453,000 meals at 99 kitchens the week before. Still, families face huge challenges in getting enough food. Shortages and limited purchasing power make it nearly impossible for most families to afford the limited staple items found in the market.

The Gaza Humanitarian Foundation (GHF), a U.S. and Israel–backed organization, reported that it has distributed over 140 million meals since beginning operations in May. However, widespread hunger and starvation persist across Gaza, suggesting that these distributions have had limited overall impact. The GHF distribution model has generated routine violence against aid seekers, with 2,158 people reported killed and more than 15,843 injured while attempting to access GHF sites since May 27. 

In an August 31 letter, Senior Democratic senators wrote to Secretary of State Marco Rubio calling for details on GHF financing and oversight, citing deaths near aid sites, coordination with the Israeli army, and use of private contractors. However, Israel has announced plans to open new GHF sites.

Health

• According to WHO, Gaza City hospitals provide roughly half of all hospital services in Gaza. If the IDF offensive proceeds, the population could lose access to these services.
• The arbitrary application of ‘dual-use’ medical supplies and medicines continues to slow delivery of health and nutrition supplies, preventing the treatment of routine illnesses. 

Dr. Richard Peeperkorn, WHO Representative in the occupied Palestinian territory, described the facility as “one massive trauma ward,” with patients spread across every available space. Hospitals in Gaza City are operating at 300 percent capacity due to the constant flow of trauma injuries and famine victims. WHO further reports that if people and aid agencies are forced to flee or shelter in place in Gaza City, Gaza would lose nearly half of its bed capacity.

Nutrition

• Partners on the ground project severe malnutrition could surpass 1 million people—50 percent of Gaza—if violence continues to target and affect civilians and aid agencies. 
• At least 115 people are confirmed to have starved to death since IPC declared famine, despite very little tracking of mortality possible in the worst-affected areas. Actual starvation deaths are likely higher.

The delivery of specialized foods in Gaza remains far below what is needed despite small recent improvements. These are nutrient-dense therapeutic products, such as fortified pastes and milks, used to treat children suffering from acute malnutrition. Between August 17 and 30, aid groups distributed just over 2,270 cartons of such foods—enough to treat about 3,000 children with acute malnutrition for six weeks. Yet the United Nations estimates that more than 320,000 children under the age of five are at high risk. Plans exist to expand the number of stabilization centers from five to eight, but these efforts hinge on security and access. 

According to Save the Children, between August 1 and 16, 61 percent of pregnant women and new mothers screened at its clinics in Khan Younis and Deir al-Balah were malnourished—nearly seven times higher than in early March before aid was cut off. Doctors at Save the Children’s clinics are treating around 100 patients per day, double the recommended caseload, to conduct malnutrition screenings, and provide medical interventions—if and when available.

Water and Sanitation

• Water borne disease, widespread across Gaza, is a primary vector for malnutrition-related deaths. Restrictions on replacement parts severely restrict UN and NGO capacity. 
• Repaired piped water from Israel and Egypt is routinely attacked and forced offline. 

On August 21, Médecins Sans Frontières (MSF) warned that the lack of equipment and fuel to repair and operate damaged water pipes and desalination plants is making it impossible for people in Gaza to access sufficient clean water. This is contributing to the spread of disease. Water-borne diseases are a leading cause of illness and are particularly dangerous for the severely malnourished. Since June 2024, only one in 10 import requests for desalination equipment submitted by MSF has been approved by Israeli authorities. 

Ongoing military operations and bombardments have further disrupted services, forcing MSF to halt water provision at 137 distribution points in 2025. Conditions in northern Gaza, particularly Gaza City, threaten the operation of the few facilities still serving nearly 1 million people. On August 29, the UAE inaugurated a 6.7 km pipeline from its Egypt-funded desalination plant to Khan Younis, with capacity to supply 10,000 cubic metres of water daily to over 1 million people. Damaged two days later, the pipeline remains highly vulnerable.

Emergency Shelter

• ICRC describes Israeli demands for mass evacuation of Gaza City as unfeasible and constitute violations of international law. 
• The Al-Mawasi ‘humanitarian zone’ identified for the forced displacement out of Gaza City has none of the space needed to absorb more displaced families. 

The Shelter Cluster reported that hundreds of thousands of families across Gaza remain in overcrowded, unsafe, and undignified displacement sites, where available space has dropped to less than 30 square meters per person. Although Israeli authorities recently issued limited approvals for shelter materials, no items have yet been allowed to enter Gaza. Refugees International’s humanitarian partners on the ground report that requests for shelter items are routinely rejected at the pre-clearance stage, before reaching Israeli territory, leaving millions exposed to harsh environmental conditions or sheltering in unstable building remnants.

Access

• Aid agencies continue to face major challenges in bringing aid into Gaza.
• Arbitrary application of NGO registration laws continue to hamper NGOs in Gaza.  

UN agencies continue to face heavy obstacles in bringing aid into Gaza. These include limited access points, delays in loading and unloading trucks, sudden rule changes, restrictions on road use, and invasive inspections of drivers already cleared by the Israeli military. Most major international NGOs have also been unable to move lifesaving supplies. Anera’s CEO noted that the organization has over $7 million in food and medicine ready for delivery, including 744 tons of rice—enough for 6 million meals—currently stuck at Ashdod, only kilometers from Gaza. 

Part of the problem stems from new NGO regulations Israel introduced in March 2025 to increase pressure on NGOs. The laws include punishment for advocacy seen as “delegitimizing” Israel, including statements on famine in Gaza, publication of images of starving children, to past or present statements critical of Israel. Since the IPC declared famine, and as the invasion of Gaza City approaches, partners report that threats against NGOs have sharply increased.

Recommendations for the U.S. Congress:

• Demand a full ceasefire on humanitarian grounds and support for the UN-led aid architecture: Congress should call for an immediate ceasefire to allow a full famine response. Past ceasefires and the loosening of restrictions have shown that a UN-led aid system in Gaza can reverse catastrophic humanitarian indicators.

• Shield NGOs and journalists: Congress should demand the removal of restrictive NGO registration rules that silence civil society, put staff at risk, and violate international law. Congress should also demand accountability for the killings of journalists and push for access for international media in Gaza.

• Launch a full oversight investigation of the GHF: Congress should investigate and hold an oversight hearing of the GHF and the U.S. decision to fund it, building on the queries set out in the August 31 Senate letter. Congress should call for a halt in U.S. funding for the GHF pending the outcome of that congressional review.

• Direct emergency funds for famine response: Congress should ensure that available IDA and MRA funds are used to support a UN-led famine response across all sectors outlined above. Funds should go to agencies and frontline NGOs with proven ability to deliver aid and respect humanitarian principles.