“People with self-respect exhibit a certain toughness, a kind of moral nerve; they display what was once called character which is the willingness to accept responsibility for one’s own life.”

Dancing Club in Belgian Congo by Federico Patellani, 1957.

"There are children and elderly that are so starved that they can barely walk. These people cannot just relocate to another area, to so-called 'safe zones'. It is not possible," Alexandra Saieh, head of humanitarian policy from Save the Children, said. Several aid workers have expressed that there is no "safe" area in the Gaza Strip for people to relocate to. "The concept of safe zones is a lie," Helena Marchal, from Medecins du Monde, said. Restricted movement Aid workers also reiterated the difficulty of getting aid both into Gaza and then distributing it. Both the Rafah and the Kerem Shalom crossings, through which most aid reached the besieged Strip, have closed since Sunday evening. Roads across Gaza are largely destroyed or blocked by people sheltering, contributing to the difficulty of movement of both goods and people. Only a very limited number of routes, especially between the north and south, are available for humanitarian use, Jeremy Konyndyk, from Refugees International, explained.

Another issue is overcrowding. "In Deir al-Balah and the Mawasi area on the outskirts of the Rafah and Khan Younis governorates, there is barely any space. There are tents everywhere, on the beach, on the sidewalks, the streets, the graveyards, the courtyards of the hospitals, in the courtyards of the schools," Ghada Alhaddad, from Oxfam International, said. Saieh explained that it took her team six weeks and four failed attempts to move a couple of hundred food parcels from Rafah to the north of Gaza. "One litre of fuel cost $40 yesterday," according to Ranchal. Fuel enters through the Rafah crossing. "The whole aid operation runs on fuel. If the fuel is cut off, the aid operation collapses," Konyndyk said. Severe malnutrition Professor John Maynard, a surgeon from the UK who has spent the last two weeks operating on Palestinians in Gaza, highlighted complications from a direct result of malnutrition. "I had two patients, 16 and 18, both of whom had survivable injuries, [and] both of whom died last week as a direct result of malnutrition."

"It is at that time when infections and complications from malnutrition will start," he added. A famine, one aid worker explained, requires three thresholds: a sustained, severe lack of access to food, high levels of child malnutrition, and highly elevated mortality as a result of famine and disease. All thresholds have been passed in the north, Konyndyk stated. "If there is a Rafah invasion, this will certainly push things past the tipping point, and we will see a skyrocketing mortality related to the famine."