GAZA CITY, Gaza Strip — You likely have seen the images: an emaciated Palestinian baby boy, lying limp in his mother's arms.
The pictures are of 18-month-old Mohammad Al-Motawaq and his widowed mother, Hidayat Al-Motawaq, in Gaza City.
The images are among those published by major media organizations, including NPR, which depict the extreme hunger that has gripped most of Gaza.
NPR first met the family and photographed them in late July, in their tent by the Mediterranean Sea in north Gaza, where they had been displaced.
Since then, the images of Mohammad have been widely circulated within Israel and around the world for a very different reason: Many of Israel's supporters believe the images show how international media are falsifying reporting about mass starvation in Gaza.
The furor began after an Israeli blogger falsely claimed the boy had cerebral palsy, and therefore, the blogger alleged, due to a genetic condition, Mohammad only appeared to be starving when he was not.
In fact, Mohammad's family says the baby had been going without food for up to four days at a time.
"We first received the child [Mohammed Al-Motawaq] in January. He was suffering severe malnutrition. We treated with supplements, and his health developed well," says Dr. Suzan Mohammed Marouf, a nutrition specialist at the Patient's Friends Benevolent Society Hospital in Gaza.
She has been Mohammad's primary doctor, treating him for malnutrition since January and checking up on the child almost daily.
She says the hospital gave him vitamins and milk. His mother showed NPR photos from February. Mohammad is rotund and smiling, almost a different child from the one he is now.
Since images of Mohammad captured the world's attention, his mother has still not been able to get substantially more food for herself, Mohammad or his sibling. Mohammad's weight has improved from its lowest point but currently hovers around seven kilograms, or around 15 1/2 pounds, say Marouf and his mother. Marouf says his weight should be around 10 to 12 kilograms, or 22 to 26.4 pounds.
"Mohammed's health has not developed enough yet and we cannot stop treating him," says Marouf.
"He used to laugh"
His doctors say Mohammad has muscular dystrophy. It is a genetic condition that, in Mohammad, causes lack of coordination. He has a slightly larger than average head as a result of his condition as well, Marouf says, and he is extra vulnerable to malnutrition.
But with good food and physical therapy, his mother says Mohammad learned to stand earlier this year. He used to laugh, play, and say "mom" and "dad," she says.
Then in mid-March, Israel ended a temporary ceasefire. It tightened restrictions on what could get into Gaza. Food dried up. The United Nations says over 20,000 children have had to be treated for acute malnutrition since April.
In February, Marouf says, Mohammad weighed 10 kilograms, 22 pounds. As he lost weight starting in March, he also lost his newly acquired abilities to stand and to speak.
Among some types of muscular dystrophy, the muscles of the patient can atrophy. Patients with muscular dystrophy can also be at risk of seizures, cognitive disabilities and even lung and heart failure if the condition is not regularly treated.
This makes Mohammad's case of malnutrition even more urgent, says Dr. Saeed Salah, a nutritionist who directs the hospital where Mohammad has been treated.
With care and food, Mohammad can develop just as any other child would, he adds.
"If we give him good nutrient[s] and other criteria for care of the baby, of the child, he will be dealing with a good life than what we are suffering now," he tells NPR.
A public diplomacy war
The public furor over Mohammad's case continues to reverberate in Israel, where allegations that his appearance in the photo is due to his existing medical condition and not lack of food have been used to discredit other images of hungry people in Gaza.
"It's worse that you're starving a sick kid, and there are so many other kids that are starving," says Dahlia Scheindlin, a public opinion researcher in Tel Aviv.
The theme, she explains, of many Israeli media outlets remains "the more you give the Gazans humanitarian aid, the more it will be spun into funds for Hamas, which will then regroup and kill more Israelis."
Israel's military, which controls all supplies going in and out of Gaza, has repeatedly denied there is mass hunger in the Palestinian enclave. Israel also denies accusations of deliberate starvation.
"We see the claims of starvation are fake and it's an organized campaign by Hamas in order to fight us," Brig. Gen. Effie Defrin, a spokesperson for Israel's military, told reporters in late July during an organized tour of a land crossing into Gaza. "We are feeding them, and Hamas and the U.N. refuse to feed them."
Yet even with Israel's new daily pauses in military operations, nearly every major humanitarian organization in Gaza says Israel is allowing only a dribble of aid to be delivered. In July, a U.N.-backed panel of experts said the hunger conditions in Gaza had crossed two out of three thresholds for famine.
Throughout July, Gaza health authorities recorded dozens of children's deaths due to malnutrition — figures some Israeli outlets dispute, saying they are manipulated by Hamas.
This week, COGAT, Israel's defense body which coordinates food and aid into Gaza, said it would allow vetted "local merchants" to distribute food that enters Gaza.
In Gaza, Mohammad's doctors argue his case of malnutrition is the rule, not the exception, despite his muscular dystrophy.
"He is not the only child with malnutrition. The hospital is overwhelmed with cases of malnutrition and sometimes we put two children in one bed," says Marouf. "I consider malnutrition a monster that hunts children during times of food scarcity."
Salah, the hospital's director, says people don't have to take him at his word, especially if they believe reports of mass hunger are Hamas propaganda.
"Let the other side, which is the international media, to come here," he says, to Gaza. Israel has banned international press access, except for limited trips accompanied by Israel's own forces.
Salah argues, if the international press could go into Gaza, they could see for themselves what is happening.
Anas Baba reported from Gaza City. Emily Feng reported from Tel Aviv. Abu Bakr Bashir contributed to this story from Sheffield, England. Ahmed Abuhamda contributed from Cairo. Eleanor Beardsley contributed from Tel Aviv.
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