The northern Gaza Strip has become an epicenter of a devastating humanitarian crisis, particularly in the towns of Beit Lahia and Jabalia, according to the United Nations Office for the Coordination of Humanitarian Affairs (OCHA).
Despite the evacuation orders from the Israel Defense Forces, tens of thousands of residents -- between 50,000 and 75,000, according to OCHA -- have refused to evacuate. These residents are now trapped under unimaginable conditions.
Most United Nations efforts to deliver aid to the area in November were obstructed by Israeli forces, except for a single World Food Program mission on Nov. 11, according to an OCHA report.
With a lack of humanitarian aid, water, health services and safety, the region is facing a catastrophic collapse on all levels. The horrors of the ongoing conflict have left deep scars on the civilian population. Mass casualty incidents have become disturbingly frequent, according to OCHA.
"My house in Beit Hanoun was destroyed on the 7th of October. In a day when I was in Jabalia the raids were intense. I thought they would storm Beit Lahia, but in the morning, they stormed Jabalia camp. We found tanks behind the school we were in, so we fled to Gaza City and stayed there for about 25 days," Ahmed Ashour, a displaced resident from Beit Hanoun, a neighborhood in northern Gaza's Jabalia, told ABC News in an interview.
Ashour added, "We have taken children out from under the rubble, and they were torn in pieces. I feel great sorrow. What can I tell you? While I was in Gaza, a raid bombed a school. We found children, women, and men in pieces, and the largest piece did not exceed the size of a small hand."
Sarah Hamidi, an International Committee of the Red Cross delegate, further described the conditions faced by civilians in northern Gaza.
"Survival, protecting loved ones, and finding shelter - this is life for civilians in northern Gaza," Hamidi said. "They face constant fear, ongoing explosions, and severe shortages of food, water, and medical care. People live among rubble and dirt, and children wake to the sound of gunfire. Supplies are almost gone, leaving hospitals and families on the brink."
The collapse of ambulance and civil defense services in northern Gaza has left injured people with little hope of rescue, according to Mahmoud Basal, the spokesperson of the Civil Defence in Gaza. In many cases, those trapped under the rubble have no means of survival, he said.
"For over a year, first responders have risked their lives amid ongoing attacks and violence, while hospitals face crippling shortages of fuel, food, water, and staff," Hamidi said. "Damaged roads and a lack of ambulances force families to carry the injured for kilometers or use donkey carts. Civil Defense lacks the machinery to rescue people from rubble, leaving families to dig with their hands. Even reaching a hospital offers no certainty of care."
Due to hospitals in northern Gaza barely functioning due to a lack of fuel, medical supplies and staff, some international organizations are trying to transfer the wounded and sick to hospitals located in less dangerous conflict areas, according to OCHA.
The institutions face a new set of challenges during the transfer process.
The International Committee of the Red Cross (ICRC) transferred 15 patients from Al-Awda Hospital located in the north of Gaza City to Al-Arabi Al-Ahli and Al-Shifa hospitals earlier this week, the ICRC and Palestinian Red Crescent said in a joint statement.
"Operating in a conflict zone brings immense logistical challenges-damaged roads, slow movement, and coordinating with hospitals and local support like the PRCS. Convoys need ambulances, medical supplies, and safe passage, but hostilities, explosive remnants, and checkpoints make every step unpredictable," Hamidi said.
Without aid, families in northern Gaza are left without basic necessities, OCHA says. The scarcity of water and sanitation has further exacerbated the public health crisis, according to OCHA.
The economic collapse in Gaza has been devastating. The Consumer Price Index has surged by 283% since October 2023, pushing families into extreme poverty, according to OCHA.
Ahmed paints a bleak picture of life under these conditions: "We were eating lentils and pasta - that's what was there. There was a famine, and everything was expensive," he said.
Food shortages and skyrocketing prices have forced families into starvation, with children being the most vulnerable.
The Israeli government denies that conditions causing malnutrition exist inside Gaza and says it works with international organizations to ensure necessary aid crosses the border into Gaza from Israel.
The situation in northern Gaza is a stark reminder of the human cost of conflict.
"The current situation in the north of Gaza is unsustainable - on top of a year of displacement, struggling to find the basics, watching loved ones get killed or wounded, and trying to keep your family safe, civilians are now facing a situation where they do not know what the next hour or day will bring," Adrian Zimmerman, the head of the International Committee of the Red Cross's Gaza delegation, told ABC News. "Not enough of anything is entering Gaza and reaching civilians. People call us, telling us they are terrified, and asking how they can feed their hungry children."