Caroline Willemen, a project coordinator at the Doctors Without Borders (Medecins Sans Frontieres, or MSF) clinic in Gaza City, painted a grim picture of what she’s witnessed in the Palestinian territory since arriving roughly six weeks ago.

The humanitarian situation in Gaza has been dire throughout Israel’s 22-month war against Hamas, but the crisis has reached new heights in recent months amid ongoing Israeli restrictions on aid. The world’s leading global hunger monitor warned last week that the “worst-case scenario of famine” is playing out in Gaza, and the World Food Program (WFP) recently said that 1 in 3 people in the enclave are going multiple days in a row without anything to eat.

The humanitarian situation in Gaza has been dire throughout Israel’s 22-month war against Hamas, but the crisis has reached new heights in recent months amid ongoing Israeli restrictions on aid. The world’s leading global hunger monitor warned last week that the “worst-case scenario of famine” is playing out in Gaza, and the World Food Program (WFP) recently said that 1 in 3 people in the enclave are going multiple days in a row without anything to eat.

Caroline Willemen, a project coordinator at the Doctors Without Borders (Medecins Sans Frontieres, or MSF) clinic in Gaza City, painted a grim picture of what she’s witnessed in the Palestinian territory since arriving roughly six weeks ago.

“It’s completely dystopian,” Willemen told Foreign Policy. “I’ve been doing this work for nine years. I’ve never in my life seen a scale of destruction and desperation like what I’ve seen here.”

Israel has faced rising global condemnation as Gazans, including children, die from malnutrition amid near-daily reports of fatal incidents involving Israeli forces opening fire on desperate Palestinians seeking aid. These deadly shootings have been linked to a controversial aid system run by the Gaza Humanitarian Foundation (GHF), a recently formed organization backed by the United States and Israel.

“What we are witnessing is a genocide. Hunger is part of that,” Willemen said, describing the situation as “apocalyptic” and “engineered chaos.”

“We don’t use the word ‘genocide’ lightly at all, but here we use it because of what we see—people being starved on purpose, people being shot at when they look for food, people being deprived of sufficient water,” she added. Israel maintains that there’s no policy of starvation in Gaza, though the hunger crisis comes at a time when far-right Israeli cabinet ministers are openly calling for depopulating and resettling the Palestinian territory.

Amid the mounting international criticism over the crisis, including from some of its closest allies, Israel recently said it would take steps to allow more aid into Gaza.