The UN warned Friday that all of Gaza's approximately one million children were facing "massive trauma" as fighting in the war-ravaged territory resumed, and amid dire aid shortages.
Humanitarians described an alarming situation in Gaza, amid a growing civilian death toll since Israel resumed aerial bombardment and ground operations this week after a six-week ceasefire.
Sam Rose, the senior deputy field director in Gaza for the UN agency for Palestinian refugees UNRWA, highlighted the psychological shock for already traumatized children to once again find themselves beneath the bombs.
This is a "massive, massive trauma for the one million children" living in the Palestinian territory, he told reporters in Geneva, speaking from Gaza.
The breakdown of the ceasefire that took effect on January 19 comes as the population is already dramatically weakened from 15 months of brutal war sparked by Hamas's deadly October 7, 2023 attack on Israel.
"It's worse this time," Rose warned, "because people are already exhausted, they're already degraded, their immune systems, their mental health, (and) populations on the verge of famine.
"Children who had come back to school after 18 months out of school, now back in tents,... hearing the bombardment around them constantly.
"It's fear on top of fear, cruelty on top of cruelty, and tragedy on top of tragedy."
James Elder, a spokesman for the UN children's agency UNICEF, said traumatized children usually only start to process their trauma when they begin returning to normalcy.
"Psychologists would say our absolute nightmare is that they return home and then it starts again," he told reporters.
"That's the terrain that we've now entered," he said, warning that Gaza was the only "example in modern history in terms of an entire child population needing mental health support".
"That's no exaggeration."
Gaza's civil defense agency said 504 people had been killed since Tuesday, including more than 190 under the age of 18.
The toll is among the highest since the war started more than 17 months ago with Hamas's attack on Israel.
It has also been a deadly period for humanitarians, with seven UNRWA staff killed just since the ceasefire broke down, bring the total number killed from that agency alone to 284 since the Gaza war began.
A Bulgarian worker with another UN agency was also killed this week, as was a local staff member of Doctors Without Borders, the medical charity said Friday.
Humanitarians warned the situation on the ground has been made worse by Israel's decision earlier this month to cut off aid and electricity to Gaza over the deadlock in negotiations to prolong the ceasefire.
"We were able to bring in more supplies in during the six weeks of the ceasefire than ... in the previous six months," Rose said, warning though that that progress was "being reversed".
Currently, he said, there is only enough flour supply in Gaza for another six days.
Asked about Israel's charge that Hamas has diverted the more than sufficient aid inside Gaza, Rose said he had "not seen any evidence" of that.
"There is no aid being distributed right now, so there is nothing to steal."
He warned though that if aid is not restored, "we will see a gradual slide back into what we saw in the worst days of the conflict in terms of looting ... and desperate conditions among the population".
Elder meanwhile described the vital aid items that aid agencies were unable to bring into Gaza.
"We've got 180,000 doses of vaccines a few kilometers away that are life-saving and are blocked," he said.
He also pointed to a "massive shortage" of incubators in Gaza even as pre-term births were surging.
"We have dozens of them, again sitting across the border," he said. "Blocked ventilators for babies."
