Along with the constant threats of bombings, famine has loomed over Gaza and the West Bank for months.

Now, the Associated Press has reported that acute hunger in northern Gaza has caused the deaths of at least 20 people due to malnutrition at Kamal Adwan and Shifa hospitals, according to the Health Ministry.

Most of the dead are children, as well as a 15-year-old boy and a man in his 70s. Children are particularly vulnerable to malnourishment for several reasons, but their still-developing brains and bodies are primary among them.

These deaths took place in the north, which was the first portion of Gaza to suffer bombardment and bore the brunt of the early Israeli invasion. However, the effects are starting to be felt in the South as well.

16 premature babies have died of malnourishment at Emirati Hospital in Rafah over the past five weeks, according to senior doctors on the scene.

"The child deaths we feared are here," Adele Khodr, UNICEF's Middle East chief, lamented in statement earlier this week. It is difficult to fathom the agony of slow death due to malnourishment, which strikes children and the elderly first and hardest.

Additionally, underfed mothers have difficulty breastfeeding due to a lack of proteins. Also, the destroyed sanitation and water infrastructure has become a catalyst for diarrheal diseases which leave victims unable to retain the nourishment they are able to ingest, according to UNICEF.

The Israeli offensive has largely slowed the delivery of food, water, medicine, and supplies to a virtual trickle. In signature fashion, Israel has blamed the looming famine and dearth of supplies on UN agencies' failure to distribute supplies.

UNRWA, the largest U.N. agency in Gaza, says Israel restricts some goods and imposes cumbersome inspections that slow entry. Additionally, the UN says convoys are regularly turned back by Israeli forces and the military often refuses passage during combat.

This week Israel has said it will open crossings for aid into northern Gaza and allow sea shipments.Dr. Husam Abu Safiya, the acting head of Kamal Adwan Hospital, told the AP his staff currently treats 300 to 400 children a day, and that 75% of them are suffering from malnutrition.

The United States and other countries have employed airdrops into Gaza but the amounts are nothing compared to the volume of truck deliveries. UNRWA says Israel has not allowed deliveries in northern Gaza for months.

Last week, the Israeli military organized a food delivery in Gaza City that resulted in the deaths of 120 people as troops guarding the convoy opened fire on what they say was a perceived threat, with some being trampled in the ensuing chaos as well.

At Emirati Hospital, Dr. Ahmed al-Shair, deputy head of the nursery unit, said the recent deaths of premature babies were rooted in malnutrition among mothers.

Malnourishment and extreme stress are both factors causing premature, underweight births, and doctors say anecdotally cases have risen during the war, though the U.N. does not have statistics.

Last week HNGN reported that the United States military has been ordered by the Biden administration to build a temporary port for the delivery of supplies to the stricken Palestinian population.

This will allow for the delivery of aid capacity that is far greater than can be done by airdrops and convoys.