Why is hypothermia killing Gaza’s children? 

In just a week of cold weather enveloping Gaza, six babies across the enclave have died from hypothermia.

As Israel continues its attacks on Gaza and its hospitals, its restrictions on what can enter the Palestinian territory mean that access to winter aid and medical intervention also remain limited. Israel’s war on Gaza has killed more than 45,500 people, most of them children and women.

Here’s what you need to know about the condition that has killed several infants, and that threatens a population of 2.3 million people, most of whom are displaced from their homes, and are surviving in the bitter cold with inadequate food and drinking water.

What is hypothermia?

Hypothermia, which literally means below normal heat, is a condition that occurs when the body loses heat faster than it can produce it.

The body typically maintains a fixed, warm core temperature of about 37 degrees Celsius (98.6 degrees Fahrenheit) using various mechanisms, such as metabolic heat production, which includes digesting food or moving muscles.

The core temperature must be maintained at about this level, between a narrow range of 36.1C (97F) and 37.2C (99F), depending on the individual, time of day, and activity level. This allows vital organs, such as the brain and heart, to continue functioning properly.

However, when the body can no longer compensate for the heat loss and internal temperatures drop dangerously low, the body enters a state of hypothermia.

At what temperature do you get hypothermia?

Hypothermia depends on the body’s core temperature rather than the outside temperature as one can develop it even in milder cold, not just freezing conditions.

A person can develop hypothermia even at temperatures above 4C (40F) if they become cold from rain, wind or submersion in cold water.

Medically, hypothermia begins when the body’s core temperature drops below 35C (95F), roughly two degrees lower than its average.

The severity of the condition depends on how low the internal temperature drops:

• Mild Hypothermia: 32–35C (89.6–95F)
• Moderate Hypothermia: 28–32C (82.4–89.6F)
• Severe Hypothermia: Below 28C (82.4F)

What happens to the body depends on the severity and stage of hypothermia.

During initial cold exposure, the body begins to lose heat through the skin. Wind or water accelerates this process by removing the thin layer of warmth around the body.

To conserve heat, blood vessels in the skin constrict, reducing blood flow to the surface. This keeps more heat near vital organs but causes fingers, toes and other extremities to feel cold and numb.

To generate more heat, the body begins to shiver, and breathing and the heart rate increase to pump warm blood to the vital organs and support metabolism.

However, mild confusion, clumsiness and fatigue may kick in as the cold begins to affect the brain and muscles.

As exposure to cold continues, heat loss outpaces the body’s internal attempts at heat generation and moderate hypothermia sets in. Shivering stops as muscles run out of energy, and a feedback loop worsens the situation: as metabolism slows, the body produces even less heat.

Heart rate, breathing and metabolic processes slow further as the body attempts to conserve energy. As this vicious cycle continues, the gap between heat lost and heat produced grows.

Eventually, the internal temperature drop becomes severe.

The brain’s ability to function deteriorates, leading to unconsciousness. The cold disrupts the heart’s electrical system, causing irregular rhythms that can lead to cardiac arrest.

Without rapid medical intervention, vital functions may fail entirely, resulting in death.

Can hypothermia be stopped?

Yes, hypothermia can be stopped if timely steps are taken.

Recovering from moderate to mild hypothermia includes moving the person to a warm, dry environment, removing any wet clothing, and covering them with blankets to warm the body.

Warm, non-alcoholic beverages can help if the person is conscious.

Severe hypothermia, however, often requires medical intervention. This includes passive rewarming with heated blankets, or active rewarming techniques such as administering warm intravenous fluids or blood rewarming.

Blood rewarming involves drawing blood from the body, typically through a large catheter, warming it with a specialised machine, and reinfusing it in the body.

Are babies more at risk of hypothermia?

Infants face a higher risk as their bodies lose heat more rapidly than adults.

This is because their bodies are shaped differently. Compared with adults, they have more skin (surface area) for their size (body mass). This means they lose heat faster through their skin, especially in cold environments. Since their small bodies can’t produce heat as efficiently as adults, they are at a higher risk of getting too cold.

They also may not exhibit obvious signs of cold stress, making it harder to recognise hypothermia.

Severe malnutrition also compounds the risks of hypothermia. Restrictions on the entry of food and medicine into Gaza, from the start of the war on October 7, 2023, mean that the enclave has been witnessing famine-like conditions for a year.

What are the current temperatures in Gaza?

In the last week of December 2024, temperatures ranged between approximately 19C to 20C (66F to 68F) and nighttime lows between 11C and 12C (52F and 54F)

However, the current winter in Gaza is harsh for those living in tents or without proper shelter, as heavy rains and strong winds have destroyed temporary coverings, soaking clothing and blankets.

With limited access to fuel, electricity or gas heaters because of severe restrictions imposed by Israel, many residents resort to cutting down trees for firewood to stay warm and cook.

How cold does it get in Gaza and does it snow?

During winter months, particularly in January, average low temperatures can drop to about 9C (45F), with daytime highs near 18C (65F).

Although winters in the enclave are not extremely harsh, heavy downpours and its coastal location can make it feel cooler. December and January are also the wettest months in Gaza.

It does not typically snow in Gaza, but rare instances of it have been reported in the past, such as in December 2013.