United Nations official says Palestinians in Gaza are experiencing ‘hell in all shapes’ as Israel steps up its Gaza City assault.

Bones and skin are all that is left of seven-year-old Mai Abu Arar.

The Palestinian girl is one of tens of thousands of children facing malnutrition in Gaza as Israel’s man-made famine deepens with the Israeli military stepping up its assault on Gaza City.

Mai’s mother, Nadia Abu Arar, says her child was once lively and joyous, but she is now fighting for her life after drastically losing weight.

“The doctors told me that she isn’t suffering from any disease or from any past condition. They’re saying it’s all due to malnutrition and I haven’t seen any improvement in her situation at all,” Nadia told Al Jazeera.

Hunger has weakened Mai to the point that she can now only consume liquid food through a syringe.

Hisham Abu Al Oun, paediatric director at the Patient’s Friends Hospital in Gaza City, said Israel has been preventing the delivery of medicines to the enclave, which has made it challenging to treat patients suffering from malnutrition.

“Potassium chloride is the easiest medication that any doctor can prescribe. We don’t even have that. We have babies dying because we don’t have it. Sometimes supplies come in, but unfortunately, very little,” he said.

On Friday, a United Nations-backed hunger monitor, the Integrated Food Security Phase Classification (IPC), confirmed for the first time that more than half a million people are experiencing famine in northern Gaza.

At least 289 people, including 115 childre,n have died due to starvation in the enclave so far.

Israel has been imposing a suffocating blockade on Gaza, allowing only a small amount of food through airdrops and the United States-backed group GHF, forcing Palestinians to risk their lives to reach aid sites deep inside areas under control of the Israeli military.

On Sunday, Philippe Lazzarini, head of the UN  Relief and Works Agency for Palestine Refugees (UNRWA), said Palestinians in Gaza are experiencing “hell in all shapes”.

“This will haunt us. Denial is the most obscene expression of dehumanisation,” Lazzarini said in a statement.

“It’s time for the Government of Israel to stop promoting a different narrative + to let humanitarian organisations provide assistance without restrictions & allow international journalists to report independently from Gaza.”

In its report, the IPC said Israel’s ongoing war has led to at least 1.9 million people being displaced twice as the Israeli siege resulted in a man-made famine.

Liz Allcock, a rights advocate with Medical Aid for Palestinians (MAP), told Al Jazeera that hunger is affecting everyone in Gaza.

“It plays out in the entirety of the [Gaza] Strip and on a daily basis. It’s not only children, small children … It is also elderly people who are unable to get access to any kind of food. It is also healthcare staff, aid workers who are fainting on the job because they don’t have enough sustenance to keep them going,” she said.

Israeli Prime Minister Benjamin Netanyahu has repeatedly denied that people in Gaza are experiencing starvation, blaming aid agencies and Hamas for not delivering supplies to people in the territory.

The UN has said that despite the growing amounts of aid ready for delivery at crossings near Gaza, Israel has not granted aid agencies the necessary authorisation to deliver and distribute the assistance.