KHAN YOUNIS, Gaza Strip (AP) 鈥 For nearly 60 days, no food, fuel, medicine or other item has entered the Gaza Strip, blocked by Israel. Aid groups are running out of food to distribute. Markets are nearly bare. Palestinian families are left struggling to feed their children.

In the sprawling tent camp outside the southern city of Khan Younis, Mariam al-Najjar and her mother-in-law emptied four cans of peas and carrots into a pot and boiled it over a wood fire. They added a little bouillon and spices.

That, with a plate of rice, was the sole meal on Friday for the 11 members of their family, including six children.

Among Palestinians, 鈥淔ridays are sacred,鈥 a day for large family meals of meat, stuffed vegetables or other rich traditional dishes, al-Najjar said.

鈥淣ow we eat peas and rice,鈥 she said. 鈥淲e never ate canned peas before the war. Only in this war that has destroyed our lives.鈥

The around 2.3 million Palestinians in Gaza are now mainly living off canned vegetables, rice, pasta and lentils. Meat, milk, cheese and fruit have disappeared. Bread and eggs are scarce. The few vegetables or other items in the market have skyrocketed in price, unaffordable for most.

鈥淲e can鈥檛 get anything that provides any protein or nutrients,鈥 al-Najjar said.

Beans, peas and bread dunked in tea

Israel on March 2, then by resuming military operations March 18. It said both steps aim to pressure Hamas into . Rights groups call the blockade a 鈥渟tarvation tactic鈥 endangering the entire population and a potential war crime.

Item by item, foods have disappeared, al-Najjar said.

When meat became unavailable, she got canned sardines. Those are gone. They used to receive cartons of milk from the U.N. That ended weeks ago. Once a week, she used to buy tomatoes to give her children a salad. Now she can鈥檛 afford tomatoes.

Now, they are on a routine of cans of beans or peas and carrots, she said. When they can't find that, they get lentils or pasta from a charity kitchen. If she finds bread or sugar, she gives her kids bread dunked in tea to stave off their hunger, she said.

鈥淚鈥檓 afraid my son鈥檚 children will die of hunger,鈥 said Mariam鈥檚 mother-in-law Sumaya al-Najjar. The 61-year-old said she and her husband have cancer; she has stopped taking her medication because its unobtainable, and her husband is being treated in a hospital.

Mariam worries how she鈥檒l feed her children when what鈥檚 left in Gaza runs out.

鈥淢aybe we鈥檒l eat sand,鈥 she said.

Malnutrition hitting children at a key time in their development

Doctors warn that the lack of variety, protein and other nutrients in children's diet will cause long-term damage to their health.

Dr. Ayman Abu Teir, head of the Therapeutic Feeding department at Khan Younis鈥 Nasser Hospital, said the number of malnutrition cases has 鈥渋ncreased in a very substantial way.鈥 Specialized milk for them has run out, he said. The U.N. said it identified 3,700 children suffering from acute malnutrition in March, up 80% from February.

鈥淐hildren need the food pyramid for their development,鈥 Abu Teir said: meat, eggs, fish and dairy for their growth, fruits and vegetables to build their immune systems. 鈥淭hese do not exist in Gaza,鈥 he said.

He said a 1-year-old child weighing 10 kilos (22 pounds) needs about 700 calories a day.

The four cans of peas and carrots in the al-Najjars' Friday meal totaled about 1,000 calories, according to label information 鈥 not counting the rice they also ate 鈥 split among 11 people, including six children between the ages of 6 and 14.

Israel has previously said Gaza had enough aid after a surge in distribution during the ceasefire., and it accuses Hamas of diverting aid for its purposes. Humanitarian workers deny there is significant diversion, saying the U.N. strictly monitors distribution.

In the market, goods are few and prices spiral

On a recent day in a Khan Younis street market, most stalls were empty. Those open displayed small piles of tomatoes, cucumbers, shriveled eggplants and onions. One had a few dented cans of beans and peas. At one of the few working grocery stores, the shelves were bare except for one with bags of pasta.

Tomatoes sell for 50 shekels a kilo, almost $14, compared to less than a dollar before the war.

鈥淚 dream of eating a tomato,鈥 said Khalil al-Faqawi, standing in front of the empty stalls.

He said he has nine people to feed. 鈥淭he children ask for meat, for chicken, for a cookie. We can鈥檛 provide it,鈥 he said. 鈥淔orget about meat. We鈥檝e got lentils. Great. Thank you very much. What happens when the lentils run out?鈥

The only vegetables are those grown in Gaza. Israeli troops have destroyed the vast majority of the territory鈥檚 farmland and greenhouses or closed them off within military zones where anyone approaching risks being shot.

The remaining farms' production has fallen for lack of water and supplies.

Mahmoud al-Shaer said his greenhouses yield at most 150 kilos (330 pounds) of tomatoes a week compared to 600 kilos (1,300 pounds) before the war.

Even that can鈥檛 be sustained, he said. 鈥淚n two weeks or a month, you won鈥檛 find any at all.鈥

Israel has leveled much of Gaza with its air and ground campaign, vowing to destroy Hamas after its Oct. 7, 2023, attack on southern Israel. It has killed over 51,000 Palestinians, mostly women and children, according to Gaza鈥檚 Health Ministry, whose count does not distinguish between civilians and combatants. Almost the entire population has been . Hundreds of thousands live in tent camps.

In the Oct. 7 attack, militants killed about 1,200 people, mostly civilians, and abducted 251. They still hold 59 hostages after most were released in ceasefire deals.

Charity kitchens are running out of food

In Khan Younis, children mobbed the Rafah Charity Kitchen, holding out metal pots. Workers ladled boiled lentils into each one.

Such kitchens are the only alternative to the market. Other food programs shut down under the blockade.

The kitchens also face closure. The World Food Program said Friday it delivered its last food stocks to the 47 kitchens it supports 鈥 the biggest in Gaza 鈥 which it said will run out of meals to serve within days.

Kitchens can provide only lentils or plain pasta and rice. Hani Abu Qasim, at the Rafah Charity Kitchen, said they have reduced portion size as well.

鈥淭hese people who depend on us are threatened with starvation if this kitchen closes,鈥 Abu Qasim said.

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Keath reported from Cairo.

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