How will the UK’s recognition of Palestine help those starving in Gaza?

0:00This is The Guardian.

0:07Today, the reality of Gaza's unfolding famine.

0:17I think the first thing you notice when you go into Gaza is the sheer devastation of the land, the mass destruction of all the buildings, this sort of dystopian, completely destroyed land. The pictures you have all seen can't possibly do it justice. Nick Maynard is a surgeon who's just come back from a month working at the NASA Hospital in southern Gaza. The striking thing about going into any of these hospitals over the last 22 months is the overwhelming crowding of the hospitals. Of course, we know they're not safe places, but people assume they're going to be safe. So as you approach the hospital, The grounds are full of people living there.

0:57Patients and relatives lying on the floor on mattresses, sometimes no mattresses, on the stairwells. Sometimes people have created beds on the stairwells, in the lifts. There's mass overcrowding. It was Nick's third stint in Gaza since the war began. This time, he noticed a change. But I guess the thing that really struck me the most was how thin everyone was, how malnourished they were. Catching up with friends who I haven't seen for the best part of a year and barely recognising some of them because they had lost so much weight. There's a lot of tension, there's a lot of very precarious situations where people start fighting because they're starving, they're all looking for food.

1:42About a week into our trip, a gunfight broke out in the hospital between families who were fighting over food. The major cause of this was the severe hunger, the forced starvation they're having to endure.

2:00For months, Israel has imposed a near-total blockade of aid into Gaza, limiting supplies of medicine and food. Now, this week, UN-backed experts say a famine is unfolding. Images of starving and emaciated children have piled pressure on international governments to take action. On Tuesday, Keir Starmer said Britain is prepared to recognise Palestinian statehood on condition as European leaders scramble to find a new path to peace. From The Guardian, I'm Lucy Hoth. Today in Focus, as the population of Gaza starves, has international action come too little too late?

2:46Nick this is your third time volunteering as a surgeon in Gaza since October 2023 working with medical aid for Palestinians what was different this time around? So there are a lot of similarities between previous trips lots of mass casualties There's multiple major explosive injuries from bombs in children and in young adults and some older adults. And that's been similar to previous trips. But there were two big changes on this occasion. The first big change was the huge number of gunshot wounds we saw. Those were young teenage boys being shot by the Israeli military at the food distribution points.

3:28We saw some terrible injuries there. But the other major factor is the effect of the malnutrition. And that has a devastating impact on the patient's ability to heal from their major injuries and the major surgery we carry out. So they come in with these terrible injuries and the shrapnel damage that the fragmentation bombs Israelis use is just appalling to behold. These bombs consist of thousands upon thousands of very small metal fragments which just rip through the body and the internal organs, causing the most devastating injuries. and if they were otherwise fit and healthy well nourished even though they're devastating injuries which require major surgery they would be expected to survive the vast majority of them but because they're so malnourished the impact of that malnutrition it suppresses the immune system it impairs the ability of the body to heal so these terrible internal injuries that we repair surgically damage to the liver, the pancreas, the stomach, the duodenum, the intestine, you name it.

4:33The tissues don't heal because they're so malnourished. They get into this vicious cycle. The malnutrition gets worse. Their healing gets even worse. They then get more infections. That then makes the whole situation worse and they spiral and then many of them die. Which must just be devastating for you as a surgeon. Have you ever seen anything like that in all your years? Nothing, nothing like this and nothing. And I mean, nothing can prepare you for seeing these awful things and seeing these young people die. And, you know, I had a 12 year old boy die on the operating table from he'd been shot by the Israeli military at one of these food distribution points.

5:13I spent all night about three weeks ago operating on an 11 year old girl who had a severe explosive injury from a bomb and she had terrible injuries to her chest and in particular terrible injuries to her esophagus and that's my main specialty in the UK is operating on the esophagus so I spent all night one night operating reconstructing repairing her esophagus she was never going to be able to eat or drink for weeks on end we didn't have the adequate nutrition to give her but despite all the odds she was improving I feel very emotional talking about it now because I got to know her and her family very well.

5:50Her father, I got to know what I saw two or three times a day, would talk to him. And it was very emotional when I left. I was very emotional saying goodbye to her. But I left thinking she was going to survive. She was odds on going to survive. But I got a terribly distressing phone call two days ago that she'd died. And this is an entirely preventable death, entirely preventable death, as many of them were, were it not for the forced starvation, the deprivation of food, nutritional support, essential drugs and everything, which the Israelis are refusing to allow to get into Gaza. Well, I mean, much of the world has been horrified by these images of starving and emaciated babies and children coming out of Gaza, particularly in the last few days with new warnings about the scale of the hunger crisis.

6:42I'm wondering about the condition of babies and children you had in your care dealing with the effects of that malnutrition. Many of the pictures we've seen on the news in the last week have been children I've known and I've met their families, their mothers. And some of them have died. I mean, there were four premature newborn babies who all died in the early days of my visit. There was not enough formula feed for them. Their mothers were malnourished, so couldn't breastfeed. and four of them died. There were other children on the intensive care unit who were being fed at one point with only with 10 % dextrose.

7:20That's effectively sugar water, water with a bit of sugar added to it, which provides no nutritional value whatsoever. On several occasions, there were some American doctors, for example, who were there, who had all heard there was a huge shortage of formula feed to give newborns and infants. So they all brought formula feed in with their luggage and every single carton of it was confiscated, was taken away by the Israeli border guards. Every single carton. Barbaric. And what kind of conversations were you having with Palestinian patients and colleagues about access to aid? I mean, it seems that there is this terrible choice, as you say, between going to one of these Gaza Humanitarian Foundation sites where you risk being shot or hit with shrapnel versus you and your family potentially starving to death.

8:15I mean, what did you understand from conversations with people about that terrible binary? They feel they have no choice. I mean, one of the anaesthetists I work with went out between operations to the food distribution point to get food for his starving family. We forgot sometimes out there, we're working with these local guards and doctors and nurses. They're living in tents. They're living with their families in tents without any food at all, without any food. So one doctor I was with would get phone calls from his wife saying, I can't get up. I'm too weak to get up. You've got to bring us some food.

8:48So they go out to the food distribution points in between operations sometimes to try and get food. One of them came back once covered in cuts and bruises and grazes. And he'd been involved in a fight. Tell me about the kind of psychological impact of hunger, starvation that you were seeing in the hospital. I mean, how they put up with this is quite beyond me. And they always try and put on a brave face and everything. But you catch them in moments when they are just staring vacantly into space. And they've all had their relatives or close friends killed. You know, one anaesthetist I worked with, his wife, all his children had been killed.

9:29They've all had horrible casualties like that. One surgeon who's a close friend of mine was operating. We were doing a big major trauma case together and halfway through the operation, someone came in and told him his sister had just been killed. Yeah. So he had to unscribe. He couldn't carry on. another operating theatre nurse a lovely young man who I'd worked with he went off for two days break to his tent in Al Mawasi and he was killed with his three small children the following day so they're all witnessing this the whole time they still work heroically but it has a profound effect on them psychologically and the the amount of psychological support they will need is unfathomable

10:21Emma Graham Harrison, you're The Guardian's chief Middle East correspondent. And you were with us on Today in Focus last week talking about international efforts to secure a ceasefire. But I think in many ways we've never felt further from that goal. There have long been warnings about the impact of Israel's blockade on aid. Those warnings have been mounting for months and now it seems that the worst case scenario is unfolding. What's happened this week? Well, perhaps we could just start with a very stark statistic from Gaza, which is that in the last week starvation has killed more Palestinians than in the 21 previous months of war combined.

11:01mind. What's happening in Gaza is that months of total siege followed by very limited food shipments far below what people need to eat at a basic survival level is killing people at a faster and faster rate. What happened internationally is that food security experts who've been monitoring the situation in Gaza throughout the war, who've repeatedly warned that Gaza is approaching famine, put out an alert on Monday saying that a worst case scenario famine was unfolding in Gaza. Now, a UN-backed monitor has in the last hour said that the worst case scenario of famine is playing out in the Gaza Strip.

11:49Whilst not being an official declaration of famine, the Integrated Food Security Phase Classification says there is mounting evidence of widespread starvation, malnutrition and disease, and it's driving a rise in hunger-related deaths. And we had the Emergency Director of the World Food Programme, who obviously is someone who spends his life thinking about starvation, saying that this is the worst famine the world has seen in decades. There's not been anything like it this century, despite multiple severe crises, and that you have to go back to the famine in Ethiopia in the 1980s or in Biafra in Nigeria during the Civil War to find a comparable scale of suffering and death.

12:37You've spoken to us before about the new aid distribution system in Gaza, the Gaza Humanitarian Foundation that started operations in May. Of course, at those sites, we've now had over a thousand people killed and many, many more wounded attempting to access food. Tell me more broadly how much aid is getting into Gaza and being distributed and how far that falls short of what is needed. So Israel has simply not allowed enough food into Gaza for months now. So, you know, this IPC report said that the population in Gaza needs around 62 ,000 tonnes of food staples each month for sort of basic survival.

13:22That's not including meat, vegetables, fresh fruit, which people haven't seen there for months. That's just things like, you know, pasta and lentils. In March and April, Israel did not allow any food to enter Gaza at all. in May less than 20 ,000 tons or less than a third of what Gaza needs was allowed in and in June less than 40 ,000 tons so less than two-thirds of what Gaza would need just for that month was allowed in. Israel is very aware of what Palestinians need to eat and it chose to only allow in a quarter of what they needed to survive between March and the end of June. And meanwhile, we have this very stark image of trucks at the border packed with tons of food and aid ready to go into Gaza, but being blocked from doing so.

14:14Emma, with the situation now tipped into full blown famine, as you say, according to food experts, we've had these horrifying images of starving and emaciated babies and children that have caused horror around the world and led to mounting pressure on international governments to do more. What impact has that had on the Israeli government and what has been the response from Netanyahu? So Israel has said that there's going to be humanitarian pauses in fighting, which was one of the problems in getting aid in. They said that they're going to let in more aid and we have seen an increase. But it's simply not enough.

14:53I mean, Netanyahu himself described the amount being let in as minimal. We will need to continue allowing minimal humanitarian supplies. We have done this until now, but the UN is creating an excuse and a lie about Israel. You know, you have within the Israeli government far-right ministers who are absolutely opposed to any aid entering Gaza. The last couple of days, Israel has let in 200 trucks one day, 260 trucks the next day. You know, before this war began, 500 trucks a day were going into Gaza. And that was when the population were well fed or at least decently fed. Most people had shelter.

15:30There was a functioning health system. there was clean water. That was 500 trucks a day. So it's just impossible that 200 trucks a day or even 260 trucks a day, which is I think what went in yesterday, can feed a starving population. And of course, on Monday, Netanyahu claimed there isn't any starvation in Gaza at all. What a bold-faced lie. There is no policy of starvation in Gaza, and there is no starvation in Gaza. At other times, the Israeli government say that if there is starvation, it's because of looting by Hamas. How is this all playing out in Israel? Are there any signs of criticism or opposition to the government?

16:14So, you know, mainstream public opinion in Israel is still very much in support of the war, but there is growing opposition within Israel to the war. A lot of it is political. It's about both the toll on Israeli society in terms of soldiers who've been fighting now for nearly two years, and then also people concerned about the hostages. There's a very small but increasingly vocal and expanding minority of Israelis who are opposing the war because of Palestinian suffering in Gaza. To the Middle East now, where for the first time two major Israeli human rights groups have accused Israel's government of committing genocide in Gaza.

16:55So, for instance, we had this week for the first time two Israel-based human rights organisations came out and said that Israel is committing genocide in Gaza. They're very powerful reports. These are very respected groups, B'Tselem and Physicians for Human Rights, who have a long track record of documenting abuses by Israeli authorities in the region. ...of Israel's conduct in this conflict. Now, Israel's government, of course, in the past has rejected these claims of committing genocide in Gaza. We also had 31 prominent public figures published a letter in The Guardian this week calling for sanctions on Israel, severe sanctions to stop what's happening in Gaza.

17:37Our former prime minister, Ehud Olmert, in an interview with me, called for international intervention to stop Israel continuing down a road that was very dangerous, not just for Palestinians, but for itself. So there's a vocal, a small minority, but an increasingly vocal minority inside Israel speaking out not just against the war, but against Palestinian suffering.

18:14This is the moment to act. Emma, amid mounting outcry over what's happening in Gaza, Keir Starmer's government in the UK has announced a change in the government's position on Palestinian statehood. I can confirm the UK will recognise the state of Palestine by the United Nations General Assembly in September. Tell me more about what's been announced. So Starmer has said that he will recognise a Palestinian state in September if there is not a ceasefire deal and a commitment from the Israeli government to a two -state solution, a process that will lead to the creation of a Palestinian state. Unless the Israeli government takes substantive steps to end the appalling situation in Gaza, agree to a ceasefire and commit to a long term sustainable peace, reviving the prospect of a two state solution.

19:17Although it's couched as a conditional thing, which is sort of very diplomatically clever, you know, it's not, Starmer hasn't presented it as a ultimatum or a unilateral British move. He's saying, look, you show you're committed to peace. We'll hold off as you want us to. But the reality is that even if Netanyahu agrees a ceasefire, which is really unclear at this point, I think it's sort of categorically impossible that he's sort of going to commit to a process that leads to the creation of a Palestinian state. Given that his coalition is made up of people who want to annex Gaza and the occupied West Bank, it would be sort of political suicide, you know, his government would fall.

20:02This means that the UK is now in step with France, who has also called for the recognition of Palestinian statehood.

20:14Given the extremely dire humanitarian situation on the ground, what difference will this make to the Palestinian people at this stage in the conflict? I mean, that's a really good question. And there's an argument for saying that in concrete terms, probably not very much. But I think it is significant. It's sort of politically and diplomatically meaningful. And despite Israeli officials dismissing it, despite the fact that, recognition of a Palestinian state still leaves an extremely long path to reach the reality of a Palestinian state. The Israeli Prime Minister has put this on social media.

20:58Starmer rewards Hamas's monstrous terrorism and punishes its victims. You can see that it's something Israel's very worried about because of the response. And I think you can see, you know, just from that, really, that obviously, even if you can't track what it might mean in immediate concrete terms, and particularly really for people in Gaza, it is still a very significant step. And it will leave America and Israel even more isolated than they already are. We had Trump in Scotland earlier this week saying that he did believe that there were starving children in Gaza, that he'd seen the images and that he wanted to, in fairly general terms, create food centres in Gaza.

21:43Well, I want them to make sure they get the food. I want to make sure they get the food, every ounce of food. I think you want the same thing? Are there signs that there will be any concrete action from the White House? You know, Trump is the one person that is very difficult for someone like Netanyahu to dismiss. You know, if he says he thinks starvation is real, it's really hard for Netanyahu to ignore that. And he was fairly explicit when he lifted the total siege in May that he was doing it because of pressure from America. So, you know, I think the fact that we're seeing more food going into Gaza, even if it's still not enough, is probably because of America, really, mostly.

22:21The question is, firstly, how long is Trump's interest going to be sustained? And then the Americans have said that they want that aid distributed by Israel, which is extremely problematic on many levels. You know, whether that's trying to expand the GHF, you know, a model that we've seen is very deadly, inefficient, basically unable to feed Gaza, or he's thinking of some kind of militarised aid handout, which will also be extremely problematic. You know, after nearly two years in which Israeli forces have killed at least 60 ,000 Palestinians, the majority of them civilians. The idea that the Israeli military, the same Israeli military, could turn around and organise food distribution on a scale to end starvation is just absolutely not credible.

23:10So, I mean, I think, yes, American pressure is critical to more food going in now, but will it be sustained enough to end the famine? And that's far from clear, I think.

23:28Coming up, Surgeon Nick Maynard on what more he wants the British government to do in Gaza.

23:47Israel's Prime Minister Benjamin Netanyahu said on Monday that there is no starvation in Gaza. how does that stand up to what you've just witnessed? It disgusts me. It makes me very angry. Maybe I shouldn't be shocked by what the Israeli government come out with, but I've seen with my own eyes people dying of malnutrition. I've seen with my own eyes the devastating impact of the forced starvation. So that is an out-and-out lie, and the world needs to wake up, and our governments need to wake up. And yet Netanyahu does seem to have been forced to make some, albeit very limited, concessions, saying Israel will ease the aid blockade to allow minimal aid into Gaza over borders and via airdrop and also to impose daily humanitarian pauses in three densely populated areas of Gaza.

24:42Nick, will this make any material difference to the humanitarian crisis on the ground and perhaps offer your medical colleagues some reprieve? None at all. Listen, don't get me wrong, any aid going in, any food going in, of course we welcome. But I do not believe for a second it'll make any material difference. It'll have no material impact whatsoever unless it's a permanent ceasefire. So what Netanyahu has come out with, even the words that some of our Western governments have come out with, to me are worthless unless they're accompanied by proper actions to get unlimited aid in there. And we have not seen that yet.

25:23What do you make of the announcement from Keir Starmer this week about a recognition of Palestinian statehood on condition? And what more would you like to see from the British government in terms of action? Utterly meaningless gestures and posturing by Keir Starmer. Of course, we need to have Palestine recognised, But that's not going to make any difference now. They need to get in there and get aid in there. The airdrops, we know from before, every bit of aid is welcome. But to believe that's going to make any material difference is very naive. And I think it is just political gesturing by him and nothing more than that.

26:03I'd like some actions, but I'd like them today to come out and say, we recognise there is a genocide being carried out there. We recognise there are multiple war crimes being carried out every single day. And they need to put huge pressure on the US government to then put pressure on Israel to stop this genocide, to stop these war crimes, to allow unlimited aid to go into Gaza and for there to be a permanent ceasefire. The world is sitting back and watching a genocide being carried out. they're sitting back and watching ethnic cleansing being carried out and I have witnessed this with my own eyes but our governments are allowing this to happen they are complicit in this so my message to all the people is listen to what people like me and many other health care workers can tell you about what's going on out there go marching go protesting go to your MPs put pressure on our government because they have to act and they have to act now well Nick thank you thank you very much for asking me.