Even before the escalation of conflict in October 2023, International Medical Corps had a strong presence in Gaza, going back to 2008. At that time, our Nutrition team focused on integrating nutrition into services for outpatients who suffered from non-communicable diseases (NCDs), including hypertension, diabetes, kidney disease and heart disease.
Since 2023, ongoing conflict, mass displacement and widespread infrastructure damage have created severe barriers to safe infant-feeding practices, while access to essential health and nutrition services have been drastically limited, and maternal malnutrition and psychosocial stress have severely undermined breastfeeding success. Infants and children from birth to 59 months of age, as well as pregnant and lactating women (PLWs), face heightened vulnerabilities—requiring interventions to prevent malnutrition and reduce mortality risk. In response to these challenges, we have expanded our nutritional offerings.
With the launch of our first field hospital, in Rafah in southern Gaza in January 2024, our team of three nutrition counselors and two nutrition supervisors began providing community management of acute malnutrition (CMAM) and infant and young-child feeding in emergencies (IYCF-E) activities, including screening for malnutrition. Our focus was on children under 5 and PLWs, using mid-upper arm circumference (MUAC) measurements to determine levels of malnutrition. We enrolled all children with a normal MUAC into our blanket supplementary feeding program, and children with malnutrition into our outpatient therapeutic program. We enrolled malnourished PLWs in our targeted supplementary feeding program.
We integrated IYCF activities into CMAM services, as well as into maternal health services and at maternity wards, via individual and group counseling sessions focused on delivering key IYCF-E messages to caregivers. We also enrolled infants experiencing breastfeeding difficulties in individualized assessment sessions involving both the mother and the infant to identify the specific type of support required, which included targeted breastfeeding counseling, referral to health or protection services, or the need to provide ready-to-use infant formula in cases where establishment of breastfeeding was unsuccessful.
Moving into the Community
From March to May 2024, we began moving our nutrition programming into the community by training 21 of our community volunteers on CMAM and IYCF protocols. During this time, we opened our first stabilization center to manage cases of severe acute malnutrition, including those with medical complications. That summer, we launched the “Find and Treat” campaign, during which we dispatched 1,200 volunteers across Gaza to conduct mass screening and give us a holistic overview of the nutrition situation.
What our team has seen during the past two-and-a-half years of response is alarming. Gaza Nutrition Manager Raghda Ibrahim Qashta says that volunteers and staff have encountered young children presenting with severe forms of acute malnutrition. However, this hasn’t been limited to young children, who are traditionally the focus of humanitarian nutrition interventions. Children over the age of 5, people with NCDs and people who have been injured in the war are also being profoundly affected by the lack of food in Gaza.
“Currently, we are observing an increasing trend in stunting among young children, as well as children over the age of 5,” Raghda says. “This is largely attributed to prolonged food insecurity and persistent gaps in access to adequate nutrition within the community.”
Now, with three field hospitals in Gaza and plans to establish three community-based multipurpose health centers, we are expanding our services to alleviate malnutrition even more—further improving access to lifesaving nutrition interventions, promoting safe infant-feeding practices and supporting successful breastfeeding.
We are now offering nutrition screening for children over 5 and a therapeutic nutritional program for people with NCDs. Through our clinical nutrition services, we have fully integrated therapeutic nutrition into the management of both adult and pediatric cases across inpatient departments—including surgical wards, intensive-care units and internal medicine. Our clinical nutritionists conduct systematic screening and assessments to determine inpatients’ nutritional needs, and provide individual, specialized nutrition support. The nine cooks in our central kitchen in Deir Al Balah produce as many as 12,000 meals per week for everyone being treated in our hospitals—including 500 special meals for patients with dietary restrictions—as well as for International Medical Corps staff members. The kitchen works closely with Logistics team members, who deliver the packaged food to all of our field hospitals, where cooks on staff distribute it to patients and other staff members.
Powerful Results
The Nutrition team’s hard work is having powerful results. Since January 2024, they have screened more than 111,000 children under 5 and 58,000 PLWs, while admitting more than 8,000 to malnutrition management programs—including treating 221 children in the stabilization center who suffered from malnutrition and medical complications. They’ve also trained more than 800 healthcare workers and volunteers on CMAM and IYCF—workers and volunteers who have reached more than 66,000 caregivers and PLWs with behavioral change intervention, individual counseling and group counseling on key messages, including the importance of breastfeeding. We have also supplied more than 80,000 children and PLWs with micronutrient supplementation, high-energy biscuits and lipid-based nutrient supplements.
“Our Nutrition team has now grown to 57 staff members—with plans to expand to nearly 100—delivering holistic and integrated nutrition services,” Raghda says. “I am incredibly proud of our team and the work they are doing under such challenging conditions. Their teamwork and commitment to serving the community make a huge difference every day.”