An American paediatric doctor volunteering with the Heroic Hearts charity in Gaza's Al Shifa Hospital said he can "see every rib" on starving children and that the "entire medical infrastructure" in Gaza is gone.
Dr Ahmed Yousaf said signs of starvation and malnutrition are visible on every child he interacts with in Gaza.
Speaking on RTÉ's Morning Ireland, he said there is a perception in the west about what starvation and famine looks like but it is a "long, drawn out process" of deprivation.
"The odds that they are going to grow into normal, healthy adults is close to zero in this environment," he said.
"The chance that they may die acutely as a consequence of not receiving basic nutritional aid and medications is extremely high.
"They are now dealing with the complications of medical illness they would never otherwise have to deal with outside of the reality of being deprived of nutrition and being so malnourished."
Dr Yousaf said Al Shifa used to be the largest hospital in Gaza but has now been "reduced to rubble" and the vast majority of the hospital is not functional.
He said they have no access to medical supplies and most days they are "scavenging for enough supplies to do the bare minimum" for patients.
All of this is now against the backdrop of hunger, he added.
"The starvation process of this place, of this strip of two million people, it didn't just happen in the last month or two. It's been gradually choked over the last 22 months, with a little spritz of allowance of the distribution of aid in randomly in these last three or four months," he said.
"Every healthcare worker here and patient and family tells us it's the worst it's ever been in finding food anywhere for anybody."
Dr Yousaf said he regularly treats patients with gunshot wounds "that are clearly military rounds".
He said these patients are usually young boys and men, who are more likely to risk their safety to retrieve aid for their families.
"I've held the hands of dying teenage boys who, when I ask why they would risk their lives, tell me they 'don't have a choice'," he said.
"And when I say 'who did this to you' they say 'the military, the IDF shot us'. And that's all I can convey.
"All I can convey are what people tell me and what I see, and what I see are the consequences of military ballistics on human flesh and the bodies of children and young men."
Dr Yousaf's current stint in Gaza is his second time there, having already travelled to the enclave a year ago.
"A year ago I thought I would never see a sign of the loss of humanity as bad as I did last year and unfortunately I was proven wrong," he said.
"This year we're seeing a level of brutality and inhumanity I didn't think we were capable of in 2025."
Live updates: Israel must 'immediately halt' Gaza City plan, says UN
More: Middle East stories
