The Palestinian Centre for Human Rights (PCHR) issues an urgent appeal to protect the lives of patients suffering from celiac disease in the Gaza Strip, whose lives are now at risk due to the complete denial of access to their essential therapeutic foods—primarily gluten-free flour and other critical dietary items.
This denial comes within the context of the tightened siege imposed on the Gaza Strip and the ongoing genocidal campaign perpetrated by Israeli occupation forces against the civilian population. Since 2 March 2025, Israel has completely halted the entry of humanitarian aid and food supplies, including the essential items required for the survival of this vulnerable group. This has resulted in a total disruption of gluten-free food supply chains, with no safe dietary alternatives available. As a result, 42 patients have developed severe malnutrition and life-threatening complications, while 72 others are suffering from moderate malnutrition. Throughout Israel’s genocidal campaign, these patients have experienced acute health deterioration, exhibiting symptoms such as diarrhoea, severe abdominal pain, migraines, dizziness, signs of poisoning, fainting, and anaemia.
There are approximately 1,288 diagnosed celiac patients in the Gaza Strip. Celiac disease is a chronic autoimmune disorder affecting the digestive system, triggered by the consumption of gluten, a protein found in staple grains such as wheat, barley, and oats, which are widely used in most food products. Ingesting gluten causes an immune response that damages the lining of the small intestine, inhibiting the absorption of vital nutrients. The only known treatment for celiac disease is a strict, lifelong gluten-free diet. Even minimal or unintentional exposure to gluten can lead to severe and potentially life-threatening health episodes for those affected.1
Haitham Mohammed Abu Shaaban, 34, a resident of Al-Rimal neighbourhood in Gaza City, told PCHR’s field researcher:2
“Since the beginning of the current war, my suffering has intensified drastically—especially when it comes to accessing gluten-free flour, which is essential for my survival. Before the humanitarian truce in January 2025, I used to receive limited quantities of flour every three months, barely enough to last a single week. Once I exhausted all options, I was sometimes forced to break my strict dietary regimen—resulting in immediate health complications such as diarrhoea and severe abdominal pain. When the condition persisted, the symptoms escalated to something far more dangerous: intense headaches, dizziness, a sense of poisoning, and even fainting. At the beginning of 2024, I was left with no choice but to completely abandon my gluten-free diet for a month and a half due to the total absence of gluten-free flour. That was one of the most difficult periods of my life. I had no alternatives—not even temporary food substitutes to mitigate the harm. It felt like living through a real famine. Even standing for prayer became physically exhausting. I couldn’t bear the situation any longer. The price of gluten-free flour, when it was available, was exorbitant and completely out of reach. We were just beginning to feel some relief after a shipment of gluten-free flour entered Gaza in February 2025—it truly saved me and allowed me to return to my dietary treatment. But now the fear is creeping back, especially as the Israeli authorities have intensified the blockade since early March 2025. Options and alternatives are running out, and all patients are at serious risk—many have already been forced to break their diets.”
Before the Israeli military genocidal campaign in October 2023, patients with celiac disease in Gaza received approximately 25 kilograms of gluten-free flour per month. However, following the escalation, the supply was completely cut off for hundreds of patients who remained in Gaza City and the northern areas, while the forcibly displaced patients who fled to central and southern Gaza could only access extremely limited quantities—no more than 4 kilograms every three months, depending on distributions by local health institutions. These institutions are currently unable to provide any supply due to the intensified siege imposed on Gaza since 2 March 2025.
The disruption in the supply of gluten-free flour has forced patients to consume unsafe alternatives such as regular starches and rice, which expose them to serious and life-threatening complications, including intestinal inflammation, mucosal atrophy, anaemia, osteoporosis, and nutrient malabsorption disorders. These conditions gradually lead to severe deterioration of the digestive system and may result in death if the deprivation continues—with increased risk of developing intestinal cancer.3
Nabeela Jameel Al-Habbash, 54, a resident of Al-Nasr neighbourhood in Gaza City, told a PCHR field researcher:4
“Since I was diagnosed with celiac disease in 2008, I have lived on a strict gluten-free diet and carefully monitored my health with the support of local health institutions that provided us with gluten-free flour and other products suitable for our diet. But today, after months of war since October 2023, I am going through the worst health deterioration I’ve ever experienced. I was forcibly displaced from my home and, for over a year, I was unable to access sufficient quantities of gluten-free flour. I stopped medical follow-ups and had to resort to homemade, insufficient substitutes, which led to serious health complications. I developed severe symptoms that left me unable to stand on my own. I needed my family’s help even for the simplest daily tasks. My haemoglobin dropped to 7.6, and I suffered acute deficiencies in calcium, iron, and essential vitamins. My face lost its colour from extreme pallor, and I lost over 20 kilograms. I experienced chronic diarrhoea and developed severe skin rashes that resembled burns—all because I could not access gluten-free flour.Local institutions now try to distribute whatever small amount they receive to all patients. Instead of the 25 kilograms we used to receive monthly before the war, we now get just 3 kilograms every few months. With supplies completely cut off, I was forced to break my diet, which caused a sharp deterioration in my health. I fear this situation will persist. This is not just war. This is daily suffering with every meal. All I ask for is access to safe, life-sustaining food to protect me from life-threatening complications.”
According to specialist physicians, the number of people with celiac disease in Gaza has increased from approximately 1,000 before the Israeli military offensive in October 2023 to 1,288 by May 2025. This includes 510 women, 248 men, and 530 children (306 girls and 224 boys). Among them, 36 patients are persons with disabilities (22 female and 14 male). This sharp rise is attributed to heightened stress, food insecurity, and dependence on unhealthy, canned, and processed foods, which are known triggers for immune system deterioration in individuals with a genetic predisposition to autoimmune disorders such as celiac disease.5
Children under the age of 10, over 200 of whom are living with celiac disease, are among the most vulnerable. They are severely impacted—physically and psychologically—by being denied foods available to other children. Their families are unable to provide safe alternatives, exposing them to severe complications if they consume gluten-containing products.
The PCHR affirms that the deliberate deprivation of life-saving, therapeutic food for patients with celiac disease does not only constitute a grave violation of the right to health and food, but also amounts to a systematic crime against a protected civilian population under international humanitarian law.
Article 23 of the Fourth Geneva Convention strictly prohibits the denial of essential food and medical supplies to civilian populations. Moreover, Article II(c) of the Convention on the Prevention and Punishment of the Crime of Genocide defines genocide to include the deliberate imposition of living conditions aimed at destroying a group, in whole or in part.
Under Article 8 of the Rome Statute of the International Criminal Court, the intentional starvation of civilians through the denial of objects indispensable to survival constitutes a war crime.
Therefore, the Israeli authorities’ obstruction of the entry of essential gluten-free therapeutic food for celiac patients in Gaza amounts to both a war crime and a crime against humanity, necessitating urgent international accountability and immediate humanitarian intervention.
The PCHR reiterates that the continuation of these conditions poses an imminent threat to the lives of patients and calls upon the international community—particularly the High Contracting Parties to the Geneva Conventions—to take immediate and urgent action to halt this crime.
PCHR demands the immediate reopening of all border crossings to allow the unrestricted entry of food supplies into the Gaza Strip, with particular emphasis on therapeutic food essential for individuals with celiac disease. This includes the regular and sustained delivery of gluten-free flour, with monthly needs estimated at approximately 33 metric tonnes to meet the basic dietary requirements of patients.
Furthermore, PCHR calls for the urgent facilitation of access for medical and humanitarian organisations to deliver adequate healthcare and nutritional support to these patients. It also stresses the need to hold accountable those responsible for these punitive policies before international courts, in line with international humanitarian and human rights law.
