Hunger, sickness and crime stalk Gaza under Israel’s blockade

Months later, he can’t believe how much things have fallen apart.

In Gaza City, where he lives, community kitchens are closing because they have nothing left to cook. Each day, clinics run by his organization, MedGlobal, are visited by more malnourished children he described as “skin and bones."

At night, a mix of hungry men and opportunistic gangsters roam the streets looking for places to loot. In the absence of authorities, armed vigilantes chase down and beat up suspected thieves. He worries about break-ins, because he has a bag of flour in his home.

“Things can’t continue like this," Abed said. “We just won’t survive."

Since Israel imposed the blockade—now the longest of the war set off by Hamas’s deadly Oct. 7, 2023, attacks on southern Israel—the territory is descending into a state of chaos. Residents and aid workers say they have seen a breakdown of law and order amid the perfect storm of hunger, collapsed governance and intensifying conflict since March, when a two-month cease-fire fell apart.

“I’ve been doing this kind of work for two decades and I’ve never seen anything like it," said Claire Manera, an emergency coordinator for the nonprofit Doctors Without Borders, speaking from Deir al-Balah in central Gaza. At night, she hears the sounds of gunshots and men shouting outside her compound.

Israel has defended the blockade, saying Hamas reroutes aid to support its operations and that the pressure is needed to convince the militant group to release the roughly two dozen hostages it still holds. It says supplies built up in Gaza during the cease-fire and it is working on a plan to distribute aid with the help of American contractors that it says would circumvent Hamas.

The toll of the war in Gaza has been immense, with most of the population of more than two million displaced at least once, vast swaths of the enclave reduced to rubble, persistent shortages of medicine and daily necessities, and more than 52,000 killed, according to Palestinian authorities, who don’t say how many were combatants.

The return to fighting has been especially hard to bear for a population that got a brief taste of relative normalcy during the cease-fire. With no clear progress in negotiations, the fighting is set to get worse.

On May 5, Israel approved plans to increase its military campaign in Gaza, piling pressure on Hamas to free the remaining hostages. Israeli officials said they plan to seize parts of the territory and stay there, laying the groundwork for a potentially long occupation that could saddle it with the responsibility for administering Gaza and providing for its population.

Israel also plans to move the population south and set up hubs where private contractors will oversee aid distribution with help from the U.S. The United Nations and some 200 aid groups said they won’t take part in the humanitarian plan in its current form because it violates their principle of remaining neutral.

Meanwhile, conditions on the ground are worsening by the day. Residents said they are more hopeless than at any point in 19 months of war.

Photos and videos shared by Gaza residents showed makeshift markets with shrinking stocks of canned food, bags of pasta and root vegetables. Flour is scarce, and what’s left of it is often infested with insects, said Sally Kali, a displaced woman who lives in Gaza City.

“Many people grind up pasta and bake it into bread," she said, “and it’s delicious, given the current options."

As the blockade grinds on, some restaurants and shops that had reopened during the cease-fire are shutting back down. World Central Kitchen, a charity, said Wednesday it had stopped serving meals and baking bread for Gazans after running out of supplies. Many households started cutting down on portions and eventually skipping meals altogether, with many eating just once a day.

Fights over food and water are on the rise. Three aid workers said they have seen chaotic clashes at distribution points, particularly around trucks that bring clean water to population centers. Fuel shortages are worsening the water crisis, as trucks carrying water now have to limit their trips. That, in turn, is worsening a sanitation crisis that is making people sick.

“We have to make a choice," said Manera, of Doctors Without Borders. “We can keep delivering water and reduce our medical activities, or we can keep a hospital open and stop supplying water."

Gaza’s medical facilities were already overwhelmed. After two months under siege, front-line medics say more children, pregnant women and lactating mothers are showing signs of malnutrition. At the same time, clinics are flooded with new casualties of the conflict, as Israeli airstrikes continue almost daily. Patients keep coming, but supplies can’t be restocked.

Palestinian children among destroyed buildings in Gaza City.

On Wednesday, a strike near a busy restaurant in Gaza City killed more than 30 people and injured dozens more, according to Palestinian health authorities. Israel’s military said it was aware of the claim of casualties during what it said was a strike against two militants. It said it used intelligence findings and precise munitions to mitigate the risk to civilians.

Video footage verified by Storyful showed pools of blood next to tables and chairs knocked over by the blast.

One of the most visible signs of desperation has been a surge in crime. A man in the coastal city of Al Shati said he looked on as children joined a group of looters who ransacked a local market earlier this week.

“For them, this isn’t theft," he said. “If they can provide something for their family, that’s an accomplishment."

During the cease-fire, Hamas-controlled police maintained a degree of order, residents and aid workers said. Israel has since broken the group’s grip on public order, but hasn’t replaced it, rejecting alternatives such as allowing the West Bank-based Palestinian Authority to oversee Gaza.

Hamas continues to try to assert its authority, including killing alleged criminals. Ismail Al-Thawabta, the director of Gaza’s government media office, confirmed that Hamas has recently executed what it said were gang leaders after examining evidence against them.

Gazans are angry with Israel, but a number of them have also vented frustration in rare protests against Hamas for continuing to fight from their midst and drawing fire toward them.

The nighttime lawlessness is enough to keep many Gazans inside their homes after sunset, afraid of getting caught in clashes between rival gangs or accused of thievery themselves.

Ahmad Masri, a resident and activist who lives in a tent in the northern Gaza city of Beit Lahia, said conditions are worse than they have ever been.

“There’s no food, no clean water, not even a decent bathroom," he said. “People are begging for flour. We’ve forgotten what meat tastes like."

Write to Feliz Solomon at feliz.solomon@wsj.com