"Gaza City, the last refuge for families in the northern Gaza Strip, is fast becoming a place where childhood cannot survive. It is a city of fear, flight and funerals.
"The world is sounding the alarm about what an intensified military offensive in Gaza City could bring - a catastrophe for the almost 1 million people who remain there.
"It would be an unthinkable tragedy, and we must do everything in our power to prevent it. But we cannot wait until the unthinkable has happened to act.
"In Gaza City, over nine days, I met families who fled their homes in fear - already displaced, now displaced again - arriving with nothing but the clothes on their backs. I met children who were separated from their parents in that chaos. Mothers whose children have died of starvation. Mothers who fear their children will be next. I've spoken to kids in hospital beds, their small bodies shredded by shrapnel.
"This unthinkable is not looming - it is already here. The escalation is underway.
"The collapse of essential services is leaving the youngest and most vulnerable fighting for survival. Only 44 of the 92 UNICEF-supported outpatient nutrition treatment centers in Gaza City are still functioning, depleting thousands of malnourished children of more than half of the lifelines they depend on to fight famine.
"Malnutrition and famine are weakening children's bodies as displacement strips them of shelter and care, and bombardments threaten their every move. This is what famine in a war zone looks like and it was everywhere I looked in Gaza City.
"An hour in a nutrition clinic is enough to erase any questions of whether there is a famine - crowded waiting rooms, parents in tears, children fighting the double-punch of disease and malnutrition, mothers who cannot breastfeed, babies losing their vision, their hair and their strength to walk.
"The story is the same - a bowl a day from the community kitchen, almost always lentils or rice, shared amongst the family, parents skipping so children can eat. No nutrients. No other options - aid is scarce, and the market is far too expensive.
"Last week, in a stabilisation centre in a Gaza City hospital treating the most malnourished children I was shocked to find Nesma and her daughter Jana. I first met Nesma and Jana in April 2024 when Jana was malnourished, for the first time, and our mission evacuated Jana in an ambulance from north to south Gaza for treatment. You might recall that back then, the north was largely cut off from the south and children like Jana were suffering without sufficient food.
"Nesma told me the treatment in the south worked, Jana recovered and when the ceasefire earlier this year allowed families to return to North, they reunited with the rest of the family. Then, the blockade on aid, hunger returned and this time, both of Nesma's children deteriorated. Last month, 2-year-old Jouri died from malnutrition and Jana is barely hanging on.
"The horrors in Gaza have dragged so long that children like Jana are returning to emergency wards or relapsing just weeks after finishing treatment for malnutrition because of the ongoing lack of food, safe water and other essential supplies.
"Without immediate and increased access to food and nutrition treatments, this recurring nightmare will deepen, and more children will starve. A fate that is entirely preventable.
"Nesma said, 'I don't want to relive the pain of losing Jouri. This is an unbearable pain for any mother. I am crushed after raising my child only to lose her in my arms. I beg not to lose Jana too, that would be too much for me to bear.'
"UNICEF is here and responding - delivering aid and running services from north to south.
We are fighting the famine - in the past two weeks alone we provided enough Ready-to-Use Therapeutic Food (RUTF) - the main treatment for malnutrition in children - to our partners to administer to more than 3,000 acutely malnourished children over the six-week course of treatment.
"We also provided complementary food to support more than 1,400 infants and High-Energy Biscuits for 4,600 pregnant and breastfeeding women for the next two weeks.
"Add to this the provision of safe drinking water, the construction of temporary learning centres, child protection case management for vulnerable children - such as those without parental care, cash assistance for families, lifesaving equipment for babies in hospitals, mental health sessions, waste collection and more.
"Our team is doing everything in their power to help children. But we could do far more, reach every child here, if our operations on the ground were enabled at scale and we were well funded.
"Palestinian life is being dismantled here, steadily but surely. The suffering of children in the Gaza Strip is not accidental. It is the direct consequence of choices that have turned Gaza City and indeed the entire Strip into a place where people's lives are under attack, from every angle, every day.
"For example, hospitals in Gaza City are on their knees. Of the 11 hospitals partly functioning, only five still have neonatal intensive care units. The 40 incubators between them are running at up to 200 per cent capacity meaning as many as 80 babies are fighting for life in overcrowded machines, utterly dependent on generators and medical supplies that may run dry at any moment. How do they survive an evacuation order?
"This data is all new, but it feels like I am telling you something you already know. Because we have seen this before in Rafah, in Khan Younis, the North. We have known for a long time that the so-called safe zone, Al Mawasi, is not safe. That children are being killed or maimed in their sleep, almost every night.
"On Monday night, it was Muna. She survived a strike that killed her mum, her 2-year-old brother and her 8-year-old sister. I met her on Tuesday in a Gaza City hospital after abdominal surgery on an explosive injury, and the amputation of her left leg. She is 13. 'It hurt a lot,' she told me, 'But I'm not sad about my leg. I'm sad that I lost my mum.'
"UNICEF continues to call on Israel to review its rules of engagement to ensure children are protected, as is required under International Humanitarian Law (IHL). On Hamas and other armed groups to release all the remaining hostages. On Israel to allow sufficient aid to enter Gaza and safe and consistent access for humanitarian personnel to deliver lifesaving assistance to families, wherever they are.
"On both parties to protect civilians, including those under evacuation orders - people must be free to move to safety but never forced. To protect essential infrastructure, including hospitals, shelters, schools, and water systems from attack. And to reinstate the ceasefire.
"And, finally, on the international community, especially states and stakeholders with influence, to use their leverage to end this. If not now - when?
"Because the cost of inaction will be measured in the lives of children buried in rubble, wasted by hunger, and silenced before they ever had a chance to speak.
"The unthinkable in Gaza City has already begun."
