It is all too easy to trace the skull beneath the boy’s face, the pallid skin stretching tight over every curve of bone and sagging with every hollow. His chin juts with a disturbing sharpness. His flesh has shrunk and shriveled, life reduced to little more than a thin mask over an imminent death.

In one of a series of news photographs of the boy, Yazan Kafarneh, taken with his family’s permission as he struggled for his life, his long-lashed eyes stare out, unfocused. In that widely shared picture online, his right hand, bandaged over an intravenous line, contracts in on itself at an awkward angle, a visible marker of his cerebral palsy.

He was 10, but in photographs from his last days at a clinic in the southern Gaza Strip, he looks both small for his age and at the same time ancient. By Monday, Yazan was dead. The pictures of Yazan circulating on social media have quickly made him the face of starvation in Gaza.

Aid groups have warned that deaths from malnutrition-related causes have only just begun for Gaza’s more than 2 million people. Five months into Israel’s campaign against Hamas and its siege of Gaza, hundreds of thousands of Palestinians are close to starvation, UN officials say. Almost no aid has reached northern Gaza for weeks, after major UN agencies mostly suspended their operations, citing mass looting of their cargoes by desperate people in Gaza, Israeli restrictions on convoys and the poor condition of roads damaged during the war.

At least 20 Palestinian children have died from malnutrition and dehydration, according to Gaza health officials. Like Yazan, who required medicines that were in acutely short supply in Gaza, many of those who died also suffered from health conditions that further placed their lives at risk, health officials said.

“It’s often that a child is extremely malnourished, and then they get sick and that virus is ultimately what causes that death,” said Heather Stobaugh, a malnutrition expert at Action Against Hunger, an aid group. “But they would not have died if they were not malnourished.”

Gaza health officials said that two of the children who died from malnutrition were less than 2 days old. While cautioning that it was difficult to say what had happened without more information, Stobaugh said that malnutrition in pregnant mothers and the lack of formula could easily have led to the deaths of infants.

That dovetailed with an account given by an aid group, ActionAid, which said that a doctor at Al-Awda maternity hospital in northern Gaza had told the group that malnourished mothers were giving birth to stillborn children.

Yazan’s parents had struggled for months to care for their son, whose condition, experts say, would have meant he had trouble swallowing and needed a soft, high-nutrition diet. After the Israeli bombardment on Gaza following the October 7 Hamas-led assault on Israel, his parents fled their home, taking Yazan and their three other sons to somewhere they hoped would be safer. “Day after day, I saw my son getting weaker,” said his father, Shareef Kafarneh, a 31-year-old taxi driver from Beit Hanoun in northern Gaza.

Eventually, they ended up in Al-Awda, in Rafah, where Yazan died on Monday morning. He had suffered from both malnutrition and a respiratory infection, according to Dr Jabr al-Shaer, a pediatrician who treated him. Al-Shaer blamed the lack of food for weakening Yazan’s already frail immune system.

New York Times News Service