The ground shook as another airstrike slammed down nearby, a thunderclap ripping through the makeshift field clinic. Inside, panic surged. A baby wailed from one corner; a mother screamed for help in another. Amid toppled boxes of therapeutic food, I held a skeletal boy no older than 4 — limbs limp, eyes sunken. Just moments before, I had managed to feed him a spoonful of nutritional, peanut-rich paste. As I was readying another, an explosion knocked the food from my hands and scattered dust into the boy’s open mouth. He didn’t flinch; he was too weak even to cry.

It was the end of June. I cradled the boy in silence, surrounded by war.

I am a senior nutrition manager with the International Rescue Committee, one of the few organizations that is still able to deliver aid in Gaza. On a typical day, my colleagues and I screen hundreds of children for malnutrition at mobile clinics across the territory. We provide therapeutic food for kids who are at risk of starvation and counsel parents who are doing their best to care for their daughters and sons under unimaginable conditions.

Nearly half a million Gazans now face catastrophic levels of food insecurity, one of the worst hunger crises in the world today. They are on the brink of starvation; roughly 100,000 children and women are facing severe acute malnutrition, the harshest diagnosis. After the Israeli government imposed a blockade on humanitarian aid entering Gaza in March, I saw a sharp rise in hunger, especially among infants and toddlers, that has not abated. More and more mothers sit beside their sick children, clinging to hope. More and more fathers come to me with empty hands and tired eyes, asking if there’s anything — anything — we can give.

Gaza’s entire humanitarian infrastructure is under siege. Officially, Israel’s aid blockade ended in May. But the new system of food distribution that Israel has set up isn’t working and is making it harder for us to do our work. Increasing hostilities, Palestinians who are waiting for aid being killed in hundreds, blocked crossings, delays in permissions and critical shortages of fuel, medical supplies, water and food are making it nearly impossible to reach families in need.

Mothers arrive at our clinics exhausted, often after walking for hours carrying malnourished babies in their arms. They ask, “Will my child survive?” or “Do you have any milk or food?”

These are questions we can’t always answer. Today, many children in Gaza are so hungry they may never recover, and our supplies are critically low. Therapeutic food, high-energy biscuits and basic medicine arrive sporadically and must be rationed. Sometimes we are forced to turn families away or ask them to return later, knowing later may be too late. I often think of a 2-year-old boy whom we tried to help this month. He was severely malnourished, his condition deteriorated quickly, and he passed away because we didn’t have enough to give. We had so little then. We have less now.