E. Mark Windle 6 June 2025
“The paradox is that the tale of Palestine from the beginning until today is a simple story of colonialism and dispossession, yet the world treats it as a multifaceted and complex story — hard to understand and even harder to solve.” (Ilan Pappé)
It is a tragic sign of the times when little introductory narrative is required for the near apocalyptic scenes in the Gaza Strip today. The world has watched from a distance, while Israel’s onslaught and the civilian death toll in the Israel-Hamas conflict progresses to a level that once seemed unimaginable. Each day, the nightmare that Palestinian civilians endure takes on a new dimension.
Since the beginning of the last century (and even before), Gaza’s history has been dominated by political decisions and conflicts relating to Arab and Jewish perceived ancestral rights. For decades now, historians, philosophers, and academics have argued the fine detail of Gaza’s politics and the feasibility of future coexistence. Claims and counterclaims have been made by prime ministers, government officials (de facto or otherwise), Zionists, radical Palestinian factions and ordinary civilians on both sides of the border. While “The Hundred Year Hunger” is not intended to be a political microanalysis, it would have been impossible to present its theme—Gaza’s nutritional welfare—without political context. The two are inseparable.
My motivation to investigate Gaza’s history of food insecurity and malnutrition stems from a former background as a specialist dietitian. The bulk of my 25 years in the NHS was spent working in critical care and burns nutrition at Pinderfields Hospital in the north of England. I witnessed at first-hand how much nutritional status can influence recovery and survival from major physiological trauma. From the relative comfort of my First World clinical setting, it was clear how timely surgical intervention, medicine, nutrition support and the efforts of a skilled multidisciplinary team can significantly optimise clinical outcome. The scenario created by Israel’s long- term offensive in Gaza struck me as a stark antithesis. Constant blockades, the widespread destruction of infrastructure, and people-herding have resulted in a chronic and severe lack of access to medical and nutritional care.
But while it seems like society has entered a new level of immorality, Gaza’s story of food insecurity and oppression started way before the events of 7th October 2023. Like other parts of the Middle East, the Levant has been shaped over several centuries by a range of ethnic cultures, trade activity, religion, and invasion. Numerous colonial nations have claimed some or all of the land now referred to as Palestine. From the Bronze Age to contemporary times, the region has been occupied by Canaanite, Israelite, Roman, Philistine, Assyrian, Babylonian, Persian, Greek, Ottoman, and British Empires. And of course, the State of Israel itself.
The decision to home in on the last hundred years for this project was not an arbitrary one. Prior to the 1900s, Arab, Jewish, Bedouin and other communities in the Levant led fragile, self-sufficient existences. The phenomenon of large-scale enforced food insecurity particularly came to the fore in the last century. To investigate it, we have to consider latter-day Ottoman rule over Palestine; the British mandate; Israel’s proclamation of independence and mass displacement of Palestinians at the start of the Nakba; the Egyptian / United Arab Republic and Israeli occupations; and a subsequent series of critical incidents that have perpetuated Jewish and Arab tensions. A perfect storm doesn’t quite describe the Palestinian struggle. Rather, a cumulative assault through political upheaval, war, and mass displacement followed by population containment.
In “The Hundred Year Hunger” the timeline is explored of chronic food deprivation and malnutrition among the most vulnerable in Gazan society. Drawing from Palestinian, Israeli and international sources, the efforts and challenges faced by humanitarian aid organisations through the decades and in the current conflict are also presented.
Regardless of how Israel chooses to justify the latest conflict, food and water have consistently been weaponised through blockade and deprivation, with the result of inflicting harm on the Gazan population. As is the trend in such crises, the most vulnerable in society— women and children—are most affected by malnutrition. Anaemia and other manifestations of nutrient deficiency have led to adverse effects on maternal, foetal and child health. Miscarriage and birth defect rates are high. Suboptimal nutritional status also impairs immune function and the ability of mother and child to recover from disease. This baseline amplifies the number of civilian losses already caused by bombings and ground attacks from the IDF. Malnutrition also affects the ability to recover from injuries, limb loss, and surgery, thereby increasing mortality rates through wound infection and sepsis.
The unrelenting violence and destruction of the Gaza Strip, aided by arms funding from the US, the UK, Germany, Italy and others, paints a bleak picture for any survivors of the current war. There are a number of unknowns regarding Gaza’s eventual reconstruction. But even for that to begin, Gaza needs a ceasefire, immediate healthcare intervention and a solid plan to sustain the long-term nutritional welfare of the Gazan people. Without that, starvation and malnutrition may well be the end game.
“The Hundred Year Hunger. A Timeline of Food Insecurity and Malnutrition in Gaza” by E. Mark Windle is available via A Nickel and a Nail.
(Copyright 2025) E. Mark Windle is a freelance writer and former clinical dietitian specialising in major burn injury and critical care nutrition. He has written for The Journal of Human Nutrition and Dietetics, The Journal of Burn Care and Research, Dietetics Today and Complete Nutrition. Mark was commissioned by the British Dietetic Association to contribute to The Manual of Dietetic Practice (Fifth Edition), the core reference book of the UK dietetic profession. He is also author of Food, Digestion and Nutrition, published by Worth Press.