FAMINE is “absolutely ravaging” Gaza City, the UN agency for children warned today as Israel ended a humanitarian pause that allowed limited aid into the city.

The Israeli military declared Gaza City a “dangerous combat zone” as it began what it called “initial stages” of a fresh assault on the remains of the shattered city.

The agency wrote on X: “In accordance with the situational assessment and directives of the political echelon, starting today at 10am, the local tactical pause in military activity will not apply to the area of Gaza City, which constitutes a dangerous combat zone.

“The IDF continues supporting humanitarian efforts while conducting operations to protect Israel.”

Gaza City has been pounded by Israeli tanks and strikes over the past week, with resident Mohamed Aboul Hadi saying: “The massacres never stopped, even during the humanitarian pauses.”

About one million Palestinian people were expected to be forcibly displaced by Israel’s expanded assault in the area.

UNRWA, the UN agency for Palestinian refugees, said that with famine confirmed in the city, “any further escalation would deepen suffering and push more people toward catastrophe.”

Staff at a nutrition centre in Gaza City supported by Unicef were already facing an overwhelming demand on their services, the body warned.

“It’s clear on the ground that famine is absolutely ravaging Gaza City,” Unicef spokeswoman Tess Ingram told Al Jazeera.

She said she had met “so many” parents who were “in complete despair because they have run out of options.”

Children at the centre are screened for malnutrition, with those on the edge given fortified biscuits as a preventive treatment, and those already suffering given ready-to-use therapeutic food.

“It’s basically a medicine that’s administered to children like a paste. They take it over a series of weeks to get better,” said Ms Ingram.

“But we just don’t have enough. The demand is really high and supplies are low.”

UN bodies have vowed to remain in the area.

It comes one week after the world’s leading food security authority confirmed famine in Gaza City following months of warnings.

The Integrated Food Security Phase Classification said hunger had been driven by fighting and Israel’s blockade on aid and worsened by mass displacement and the collapse of food production.

Gaza’s Health Ministry said today that five people, including two children, had died “due to famine and malnutrition” in the past 24 hours, bringing the total number of hunger-related deaths to 322, including 121 children.

It reported that at least 59 Palestinians, including children and aid-seekers, were killed since dawn in Israeli attacks across Gaza, among them several in al-Mawasi, a so-called “humanitarian zone” designated by Israel.

The ministry said Israel’s war on Gaza has killed 63,025 Palestinians and injured 159,490 since October 7 2023.

The Norwegian Refugee Council, which co-ordinates a coalition of aid groups in Gaza, said it had not been informed that Israel’s “tactical pauses” were being suspended.

“We have faced unprecedented access and movement restrictions,” spokeswoman Shaina Low said.

“Intensified military operations are going to further hinder our ability to respond.”

The UN warned on Thursday that Gaza could lose half its hospital bed capacity during the expanded assault on Gaza City.

“We cannot provide health services to two million people besieged in the south,” said Health Ministry spokesman Zaher al-Wahidi, warning that the forcible evacuation of the strip’s largest city would be an environmental and health catastrophe.

Far-right Israeli Finance Minister Bezalel Smotrich meanwhile called for Israel to annex the Gaza Strip if Hamas refuses to disarm, in the latest of calls by ministers to take full control of the region.

United Nations secretary-general Antonio Guterres said that the expanded military operation in Gaza City “signals a new and dangerous phase.”

The foreign ministers of Spain, Norway, Ireland, Slovenia, Iceland and Luxembourg issued a joint statement condemning the offensive, warning that the intensification of military operations would “lead to the intolerable deaths of innocent Palestinian civilians, including women, children and elderly people,” as well as endangering the lives of Israeli captives held by Hamas.

They said they were “horrified” by the confirmation of famine in Gaza and denounced the forced displacement of Palestinians as “a flagrant violation of international law.”

“We urge the Israeli government to immediately reconsider its decision and cease operations. This spiral of violence must end,” they said.

Israel also announced today that its military had recovered the remains of two hostages, Ilan Weiss and another not publicly named.

Prime Minister Benjamin Netanyahu said: “We will not rest or be silent until we return all of our hostages home — both the living and the dead.”

The Hostages and Missing Families Forum, which has led large-scale protests demanding a ceasefire to secure the release of captives, mourned the losses and said Israeli leaders must prioritise a deal.

“We call on the Israeli government to enter negotiations and stay at the table until every last hostage comes home. Time is running out for the hostages,” it said in a statement.