The Blockade’s Toll: How War Is Deepening the Humanitarian Crisis in Gaza

As of the fall of 2025, the Gaza Strip is in the grip of a profound humanitarian crisis. After nearly two years of conflict, which began in October 2023, the toll on civilians is catastrophic. Weakened by a long blockade, the enclave’s population now stands on the brink of humanitarian disaster: tens of thousands of people dead, mass displacement, collapsing infrastructure, famine and outbreaks of disease.

Despite their political engagement, neither Russia nor China nor the countries in the Global South had the necessary instruments to alter the trajectory of the conflict. At the same time, their consolidation around the humanitarian agenda and criticism of Israel’s campaign became an indicator of broader shifts in the international arena in terms of the balance of power and the growing agency of the Global South as an autonomous actor in world politics.

Overall, the international response to the crisis in Gaza remains fragmented. International organizations continue efforts to mitigate the impact, but their operations are constrained by the blockade and ongoing hostilities. External powers have taken divergent positions, making it impossible to forge a unified and effective strategy for crisis response. As a result, the international system has revealed its inability to act collectively. Despite the scale of the tragedy, no coherent approach or meaningful measures have materialized.

Two years of war and blockade have brought about the systemic collapse of Gaza's basic systems. Mass civilian casualties and repeated displacement have been compounded by the breakdown of healthcare, food security and water and energy supply—a situation that has already evolved into an officially recognized famine and poses long-term risks for the territory’s demographics and human capital. Humanitarian access remains fragmented and politically constrained, while the international response is divided, making it impossible to move from ad hoc relief efforts to genuine stabilization. The legal framework continues to be systematically violated; the UN commission’s finding the situation as bearing elements of genocide has raised the stakes dramatically but has yet to translate into effective enforcement mechanisms. Without a sustained ceasefire, guaranteed access to fuel and aid, and a coordinated international reconstruction strategy, the crisis will deepen further, entrenching a “new normal” of chronic humanitarian catastrophe.

As of the fall of 2025, the Gaza Strip is in the grip of a profound humanitarian crisis. After nearly two years of conflict, which began in October 2023, the toll on civilians is catastrophic. Weakened by a long blockade, the enclave’s population now stands on the brink of humanitarian disaster: tens of thousands of people dead, mass displacement, collapsing infrastructure, famine and outbreaks of disease.

Conflict dynamics

The war in Gaza began on October 7, 2023, with Hamas's surprise attack on Israel. In response, the Israeli army launched a large-scale military operation in the Gaza Strip and imposed a complete blockade on the territory. Within the first months of hostilities, the humanitarian cost was severe: by late 2023, the death toll had reached into the thousands, while the infrastructure of essential services—the power plant, water supply and hospitals—had suffered significant damage. Even before the war, Gaza was grappling with a humanitarian crisis: 15 years of humanitarian blockade had resulted in chronic poverty, unemployment, and shortages of water and electricity. According to UN data, as of 2023, some 80% of Gaza’s population depended on international aid, and 58% required humanitarian assistance. The war has further compounded these vulnerabilities.

In 2024, the conflict entered a protracted phase. Israeli forces carried out a series of ground operations in the northern part of Gaza, combined with relentless airstrikes on densely populated areas. By mid-2024, much of the population had been displaced by the fighting. International pressure occasionally produced short-lived ceasefires—the longest, between January and March 2025, allowed for a partial increase in aid deliveries and a hostage exchange. However, in March 2025, fighting resumed with renewed intensity, and in summer the Israeli army concentrated its main operations on Gaza City, the enclave’s largest urban center. In August, the Integrated Food Security Phase Classification (IPC) found that famine has been confirmed in Gaza City. In early September, Israel ordered all residents of the city to evacuate south and doubled down on that with intensive airstrikes. Two years into the war, Gaza was effectively split in two: the northern areas lay in ruins, while most of the population was crowded into the south under extremely constrained conditions, and the humanitarian situation was described as catastrophic.

It is important to note that the humanitarian crisis in Gaza stemmed not only from the fighting itself but also from the strategy of total blockade, which Israel employed from the outset of the conflict. Deliveries of fuel, food, medicine and other essentials were restricted or cut off entirely, crippling the enclave’s economy and basic public services. For example, back in the fall of 2023, the Gaza Strip lost centralized electricity after its only power plant shut down due to fuel shortages. The water supply and sewage systems have practically stopped functioning. As a result, Gaza’s population now faces not only wartime destruction but also the prolonged “strangulation” of civilian infrastructure. Against this backdrop, leading international human rights organizations have argued that Israel’s isolation of Gaza and its conduct during the conflict may amount to collective punishment and a grave violation of international humanitarian law.

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Key humanitarian indicators

The current humanitarian situation in Gaza is critical across nearly all principal indicators: mortality and injury rates, displacement figures, the condition of the healthcare system, levels of food insecurity, access to water, sanitation and energy, the scale of housing destruction, and the particular vulnerabilities of women and children.

Palestinian casualties in Gaza have reached devastating levels. According to the Gaza Health Ministry, from the start of the conflict on October 7, 2023, through September 2025, more than 63,000–64,000 Palestinians have been killed and around 160,000 injured. In other words, about 3% of Gaza’s population have been killed, and roughly 8% have been killed or injured—a figure that illustrates the extraordinary scale of violence against civilians. The death toll among children is particularly harrowing: as of September 2025, the number of children killed was estimated at over 20,000, with the actual figure likely higher due to unaccounted-for missing persons and the inability to promptly identify bodies.

A joint investigation by several media outlets, based on leaked Israeli intelligence data, found that as many as five out of six people killed in Gaza were civilians. Israeli military tallies indirectly corroborate this figure: they estimate that over the course of 19 months of war, around 8,000–12,000 militants were killed, against more than 60,000 total deaths—pointing to an exceptionally high incidence of collateral civilian deaths.

Beyond those killed, a vast number of people have sustained injuries, many of them permanent. According to the UN Committee on the Rights of Persons with Disabilities, about 40,000 children have suffered war-related injuries, with over 21,000 of them left with disabilities, meaning more than half of the injured children face lifelong physical limitations. Overall, a quarter of all injured Gaza residents, or around 40,000 people, suffered traumas that led to amputations or comparably grave outcomes. These statistics underscore that, in addition to direct fatalities, the conflict has created an entire generation of individuals with special needs who will require long-term rehabilitation and support.

Exodus with no way out

Nearly the entire population of Gaza has experienced forced displacement. Since the outbreak of hostilities, at least 1.9 million people, close to 90% of all Gaza residents, have fled their homes at least once, compelled by relentless airstrikes, Israeli offensives and official evacuation orders covering entire neighborhoods.

Most of Gaza’s population is now concentrated in the south of the enclave, in relatively safer areas. Al-Mawasi, a narrow coastal strip in the southwest, near Rafah, designated by Israeli authorities as a “humanitarian zone.” Residents of Gaza City also fled there following evacuation orders issued in September 2025. In practice, however, this zone cannot be considered safe amid regular strikes and severe overcrowding. Hundreds of thousands of people are living under the open sky in makeshift tent camps, deprived of privacy and often forced to sleep on the ground due to a shortage of tents. The temporary camps are hit by strikes from time to time, while the absence of basic hygiene services and space dramatically heightens the risk of infectious disease.

Movement within the Gaza Strip is also fraught with danger and enormous cost. Essentially, there are only two routes from the north—the Salah al-Din road and the coastal Al-Rashid highway—both subject to shelling and airstrikes. Even if families are willing to evacuate, many cannot afford it, as the cost of travel soared to an astronomical $1,000–1,500 per trip between governorates. Relocation has thus become a punishing ordeal in its own right, and a significant number of Gaza City residents have chosen not to leave, unconvinced by assurances of safety up south. Many evacuees have eventually returned, compelled by the unlivable conditions and lack of space in the camps. This creates a vicious circle: there is nowhere to go, yet remaining in place is deadly. As a result, nearly two million people have become internally displaced, without reliable shelter on a narrow strip of land. Moreover, the chaos of evacuations has torn apart tens of thousands of families. The European Commission estimates that at least 17,000 children have been separated from their parents or are unaccompanied, and some 35,000 have lost one or both parents during the conflict.

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Healthcare system stretched to the limit

The healthcare system in the Gaza Strip is effectively collapsing. Israeli bombardments and shelling have damaged nearly all medical facilities. The World Health Organization (WHO) reported that 94% of hospitals in Gaza were damaged or destroyed as of September 2025. Of the 20 hospitals that existed before the war, only a handful remain functional in some way or another, and even those operate under severe constraints. The largest hospitals, Al-Shifa and Al-Ahli in Gaza City, have been running far above capacity in recent months: built for hundreds of patients but forced to accommodate thousands spilling into corridors and courtyards. Overall, all remaining clinics are overcrowded; the healthcare system is unable to handle the constant flow of wounded from recurrent “mass casualty incidents.”

Health services face a critical shortage of medical supplies and equipment: the blockade halted deliveries of medicines and disposable items, 52% of essential drugs and almost 70% of medical disposables were at zero stock, and in July 2025, the WHO’s main warehouse in Deir al-Balah was destroyed in an Israeli strike. With fuel supply cut off, power disruptions occur: generators are running out, which forces the shutdown of surgeries, intensive care units and neonatal incubators—causing deaths from the failure of life-support and oxygen systems. NGO field hospitals partly fill the gap but operate intermittently due to security concerns.

Medical personnel have also suffered heavy losses: since October 2023, at least 540 healthcare and humanitarian workers have been killed. Ambulance crews have repeatedly been denied safe passage, disrupting rescue operations. Within the healthcare system, exhaustion and burnout are rampant, doctors often work for days without sleep, many themselves suffering from hunger and dehydration. Medical staff are forced to follow strict triage protocols, prioritizing patients with the greatest chance of survival, as there are simply not enough resources to save everyone.

The situation in maternal and child health is a particular source of concern. Gaza has traditionally had a high birth rate, where thousands of women are pregnant at any given time. The war, however, has made pregnancy and childbirth extremely difficult: overcrowded inpatient clinics discharge women only hours after delivery; in the first seven months of 2025, over 465 deliveries were reported to have taken place outside hospitals, including in shelters and streets. The absence of proper care has led to a surge in pregnancy complications. According to a UN Women survey, around 68% of the sampled pregnant women had experienced medical complications (infections, anemia, hypertensive disorders, preterm labor, and more). Reliable figures on maternal mortality are unavailable amid the chaos, but indirect indicators are alarming: in July 2024, maternal health experts reported that the rate of miscarriage in Gaza had increased by up to 300% compared to prewar levels due to chronic stress, malnutrition and lack of medical aid. Furthermore, childbirth amid widespread malnutrition threatens to leave an entire generation of newborns with lifelong developmental impairments.

Breakdown of essential services

Food security in Gaza has collapsed to levels consistent with officially recognized famine, leaving more than half of the population on the brink. Deaths from starvation are being documented, particularly among children and the elderly. As of September, over 500,000 people were assessed to be in the catastrophic phase of food insecurity, meaning they are literally starving—while another 1.07 million (54% of the population) were in the emergency phase, just short of famine, and nearly all others remained in crisis conditions. Data on deaths caused by malnutrition corroborates these findings: WHO monitoring reported 361 deaths due to malnutrition, including 130 children. Humanitarian organizations warn that famine is already claiming children’s lives, with some 130,000 now on the verge of severe wasting. The United Nations Children’s Fund (UNICEF) estimates that as of late 2024, tens of thousands of children under the age of five required treatment for acute malnutrition, while thousands of pregnant and breastfeeding women were in need of urgent nutritional support.

The famine in Gaza has been driven by two interlinked factors: the meltdown of the economy and logistics due to hostilities and Israel’s tight restrictions on food imports. After October 2023, the number of trucks carrying goods into Gaza dropped from hundreds per day to only a few, and deliveries stopped almost entirely in the first months of the war. By 2025, the situation had only deteriorated—spring saw a near-total blockade lasting more than two months. It was only in May 2025 that Israeli authorities caved in to international pressure and allowed limited food shipments to resume. Domestic food production has meanwhile vanished: agriculture, animal farming and fishing have come to a complete halt. Most farms were either destroyed by bombardments or abandoned as farmers fled; livestock died of starvation, and fields remain unirrigated. Fishing has been banned by the Israeli navy since the start of the fighting, depriving tens of thousands of coastal residents of this source of livelihood.

Water supply and sanitation infrastructure in the Gaza Strip has been virtually destroyed, triggering outbreaks of infectious diseases. Without electricity or fuel, desalination plants and pumping stations have shut down, leaving little safe water available. Sewage overflows into streets, while wastewater seeps into the sea and groundwater. In overcrowded shelters, water is distributed only every few days—quantities insufficient even for drinking, let alone hygiene. As a result, there has been a sharp rise in waterborne and hygiene-related illnesses, such as diarrhea, hepatitis, and dysentery.

The situation is compounded by the near depletion of water treatment chemicals and fuel required for pumping. Some important components for water purification are classified as “dual-use” items, subject to strict import restrictions. This means that even when funding is available, pumps, pipes, chlorine for disinfection and other necessary supplies cannot enter Gaza without special permits, which are almost never granted.

Gaza’s power supply has been devastated by war and blockade. After external power lines were cut and the enclave’s only power plant shut down, the territory is suffering from a permanent blackout. Medical facilities now operate mostly on backup generators and dwindling diesel supplies. When they fail, incubators and life-support systems stop functioning, and operating rooms have to run in emergency mode, forcing doctors to perform procedures under minimal lighting. The energy crisis has rippled through other essential services. Bakeries are forced to halt production, pumping stations are going silent, and refrigeration units for medicines and vaccines have broken down. In daily life, electricity is available only for a few hours of dim lighting from small private generators—owned by only a minority of households. The rest rely on rare public charging points for phones and other devices or live in complete darkness.

Gaza’s housing and social infrastructure have suffered extensive destruction. By some estimates, as of July 2025, 97% of all school buildings in Gaza had sustained damage, with 92% of them requiring major repair or full reconstruction. In the northern areas, entire neighborhoods have become uninhabitable; surviving buildings are structurally unsound and offer no protection. Most schools are damaged, while those still standing serve as shelters for displaced families, making regular education impossible. Educational infrastructure and administrative buildings have likewise been destroyed. Seasonal rains and cold weather exacerbate the hardship in displacement camps. The scale of devastation is so huge that even if hostilities were to stop immediately, clearing debris and rebuilding homes would take years. For now, however, reconstruction is virtually impossible due to the absence of resources—and, above all, of security.

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The role of international organizations and external actors

The humanitarian crisis in Gaza has been at the center of international attention from the very first day of the war. Yet the responses of external actors have been far from uniform: while some states and organizations are making efforts to provide assistance and mediate a settlement, others are, in effect, enabling the violence to continue.

The United Nations serves as the primary coordinator. The Office for the Coordination of Humanitarian Affairs (OCHA) leads situation monitoring and organizes aid deliveries, though it regularly faces access restrictions. The UN Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) has opened hundreds of housing centers during the war, which hosted hundreds of thousands of people, but has suffered unprecedented losses among its staff and a depletion of resources. UNICEF focuses on water supply, sanitation, and child protection; the WHO on medical supplies and the evacuation of critical patients; and the World Food Programme (WFP) on food distribution, which only partially meets the actual needs.

Other international organizations, including the International Committee of the Red Cross (ICRC), Médecins Sans Frontières (MSF), and a number of NGOs, operate in extremely insecure conditions, with no guarantees of safety or access. Aid operations are unstable, with frequent delays, route disruptions and reported attacks on staff and storage facilities. These organizations provide emergency medical care and support to temporary hospitals while urging both sides to respect international humanitarian law. Nevertheless, Israel has often denied entry permits to humanitarian personnel, and the movement of aid convoys is tightly controlled and frequently delayed.

Regional actors in the Middle East have played an ambivalent role, combining political condemnation of Israel’s military campaign with ad hoc humanitarian efforts, which do not go beyond diplomatic and financial initiatives. Egypt has emerged as a key player in both humanitarian logistics and political mediation. The Rafah crossing serves as the main entry point for aid, as Israel has kept its border checkpoints closed to humanitarian shipments since October 2023. Deliveries remain limited—roughly 100–120 trucks per day—well below the population’s needs. Cairo points to technical and security considerations, fearing destabilization in the Sinai Peninsula and potential mass displacement of Palestinians. Egypt also admits the wounded for treatment and facilitates the transit of international aid, but its broader policy is cautious, balancing support for Palestinians and relations with Israel and the West.

Together with Qatar and the U.S., Cairo has repeatedly mediated negotiations on humanitarian pauses and prisoner exchanges, and in March 2025 it convened an emergency Arab League summit calling for an immediate ceasefire. Qatar has cemented its role as the main intermediary thanks to its contacts with Hamas leadership alongside its partnership with Washington. Doha has financed a substantial share of UN humanitarian operations and hosted prisoner exchange talks. Turkey has taken the toughest stance toward Israel, condemning its actions as war crimes, severing trade ties and closing airspace, while simultaneously sending humanitarian aid to Gaza. Iran is providing political and material support to Palestinian resistance groups but stopped short of open military involvement, using rhetoric and indirect participation through proxy forces. The Gulf monarchies, particularly Saudi Arabia, have paused normalization efforts with Israel, extended financial assistance and supported medical initiatives in Gaza. Jordan and Lebanon have seen waves of public protests demanding a tougher stance; King Abdullah II has publicly warned of the risk of regional escalation. Overall, governments in the Middle East have combined political condemnation of Israel’s campaign with support of humanitarian initiatives, yet practical steps have remained limited and have not involved any meaningful instruments of pressure on Israel.

The policy of Western states toward the Gaza war has been inconsistent. The U.S., as Israel’s principal ally, backed its actions from day one, viewing them as an exercise of “self-defense.” Washington ramped up military and technical assistance and shielded Israel diplomatically in international forums, vetoing UN Security Council resolutions calling for an immediate ceasefire. Only under mounting domestic criticism did the White House begin to cautiously refer to the need for “humanitarian pauses,” yet its commitment to strategically supporting Israel remained unchanged. The result was a decline in U.S. standing and growing public pressure. By 2025, protests and academic and cultural boycotts were on the rise across the U.S. and Europe, with polls indicating broad support for curbing arms exports to Israel.

European countries initially struck a cautious balance—condemning Hamas attacks while recognizing Israel’s right to self-defense. As the humanitarian crisis deepened, their rhetoric hardened: several governments backed UN resolutions calling for humanitarian pauses, and the European Parliament urged an immediate ceasefire. Nevertheless, the EU’s key member states stopped short of sanctions and maintained trade and economic cooperation with Israel. The main focus turned to humanitarian assistance—EU contributions approached 500 million euros, alongside air bridge operations and medical evacuation programs. Politically, the EU reaffirmed its commitment to a two-state solution, yet its practical influence on the course of the conflict remained limited.

As permanent members of the UN Security Council, Russia and China took a critical stance toward Israel’s military campaign. Early in the conflict, Moscow expressed serious concern over civilian casualties and the destruction of infrastructure, condemned what it saw as disproportionate actions and called for an end to strikes on civilian targets. Russian discourse emphasized the West’s “double standards,” drawing parallels between the situation in Gaza and accusations against Russia in Ukraine. At the same time, Moscow maintained contacts with Israel, but relations had noticeably cooled by 2025. Beijing, for its part, called for a two-state solution, increased humanitarian contributions and dispatched a special envoy for mediation. Like Moscow, Beijing positioned itself as an advocate of a ceasefire and of efforts to alleviate the humanitarian crisis.

The Global South has emerged as a distinct voice in the international discourse surrounding the Israeli–Palestinian conflict. South Africa filed a case against Israel at the International Court of Justice, alleging violations of the Genocide Convention, a decision that resonated across the world and drew support from African, Asian and Latin American countries. This move further galvanized the countries in the Global South to rally behind the Palestinian cause. In December 2023, the UN General Assembly adopted a resolution demanding an immediate ceasefire and unimpeded humanitarian access. On September 12, 2025, the Assembly voted to endorse the New York Declaration, which calls for tangible and irreversible steps toward a two-state solution. The resolution simultaneously condemned Hamas’s October 7 attacks and Israel’s strikes on civilian infrastructure in Gaza. It was backed by more than two-thirds of UN member states, shedding light on the deepening divisions once again. Most African, Asian and Latin American countries stood together in opposition to Israeli policy, while the U.S. and a small cohort of its allies found themselves in isolation. Overall, the UN’s coordinated efforts to address the crisis in Gaza boil down to a series of General Assembly and Security Council resolutions calling for a ceasefire, civilian protection and humanitarian access. Despite their importance, implementation remains fragmented: humanitarian pauses have been short-lived, and key initiatives have been blocked by divisions among the Security Council’s permanent members.

However, despite their political engagement, neither Russia nor China nor the countries in the Global South had the necessary instruments to alter the trajectory of the conflict. At the same time, their consolidation around the humanitarian agenda and criticism of Israel’s campaign became an indicator of broader shifts in the international arena in terms of the balance of power and the growing agency of the Global South as an autonomous actor in world politics.

Overall, the international response to the crisis in Gaza remains fragmented. International organizations continue efforts to mitigate the impact, but their operations are constrained by the blockade and ongoing hostilities. External powers have taken divergent positions, making it impossible to forge a unified and effective strategy for crisis response. As a result, the international system has revealed its inability to act collectively. Despite the scale of the tragedy, no coherent approach or meaningful measures have materialized.

Legal aspects and humanitarian access

The conflict in Gaza has exposed systemic violations of international humanitarian law. The Geneva Conventions mandate the distinction between combatants and civilians, proportionality in the use of force, and the protection of medical and humanitarian facilities. The scale of destruction, the high civilian death toll and repeated strikes on hospitals, schools, and markets indicate non-compliance with these principles. Particularly alarming is the use of starvation as a method of warfare: the blockade and restrictions on the entry of food and fuel have led to documented cases of famine, which constitutes a war crime under international law. Mass evacuations and the establishment of so-called “humanitarian zones” without guarantees of safety or adequate living conditions are viewed by experts as forced displacement, prohibited under the Fourth Geneva Convention. Attacks on medical facilities and the deaths of hundreds of aid workers demonstrate that there is no safe space for humanitarian operations. UN agencies and the ICRC have repeatedly reported grave violations, yet no tangible change has followed. Humanitarian access is tightly controlled by Israel: entry restrictions, inspection delays, and imposed distribution models mean that aid deliveries meet only a fraction of the population’s needs. Deaths of people waiting for food have become a direct outcome of these practices.

In September 2025, the UN Independent International Commission of Inquiry on the Occupied Palestinian Territory for the first time classified Israel’s actions as acts of genocide. The report highlighted that the combination of mass killings, the deliberate destruction of the infrastructure of essential services, the blockade of food and water supplies, and the forced displacement of civilians indicate an intent to destroy part of the Palestinian population in Gaza. It is a precedent-setting conclusion, as the UN had carefully shunned such a serious classification up to that point. The finding significantly increases political pressure on Israel and its allies, reframing the humanitarian crisis not merely as a byproduct of military operations but as a potential international crime of the highest order. It also bolsters the position of Global South countries and human rights organizations calling for sanctions and international intervention. However, from a legal standpoint, it is quite unlikely that accountability can be found anytime soon: Israel does not recognize the jurisdiction of the International Criminal Court, and U.S. political support in the UN Security Council shields it from meaningful consequences. Nevertheless, the genocide designation carries reputational costs for Israel and may shift the discourse within international organizations, deepening the country’s political isolation.

The ICC continues its investigation into the situation in Palestine, while the UN Human Rights Council documents violations committed by all parties, including Hamas. However, the scale of destruction and loss of life in Gaza has led the international community’s attention to focus primarily on Israel’s actions. As UNRWA Commissioner-General Philippe Lazzarini remarked, “Gaza is becoming a graveyard of international humanitarian law,” which raises questions about the resilience of the legal framework established after World War II.

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Two years of war and blockade have brought about the systemic collapse of Gaza's basic systems. Mass civilian casualties and repeated displacement have been compounded by the breakdown of healthcare, food security and water and energy supply—a situation that has already evolved into an officially recognized famine and poses long-term risks for the territory’s demographics and human capital. Humanitarian access remains fragmented and politically constrained, while the international response is divided, making it impossible to move from ad hoc relief efforts to genuine stabilization. The legal framework continues to be systematically violated; the UN commission’s finding the situation as bearing elements of genocide has raised the stakes dramatically but has yet to translate into effective enforcement mechanisms. Without a sustained ceasefire, guaranteed access to fuel and aid, and a coordinated international reconstruction strategy, the crisis will deepen further, entrenching a “new normal” of chronic humanitarian catastrophe.