International outcry over images of emaciated children and increasing reports of hunger-related deaths have pressured Israel to let more aid into the Gaza Strip. This week, Israel paused fighting in parts of Gaza and airdropped food.

But aid groups and Palestinians say the changes have only been incremental and are not enough to reverse what food experts say is a ” worst-case scenario of famine” unfolding in the war-ravaged territory.

The new measures have brought an uptick in the number of aid trucks entering Gaza. But almost none of it reaches UN warehouses for distribution.

Instead, nearly all the trucks are stripped of their cargo by crowds that overwhelm them on the roads as they drive from the borders. The crowds are a mix of Palestinians desperate for food and gangs armed with knives, axes or pistols who loot the goods to then hoard or sell.

Many have also been killed trying to grab the aid. Witnesses say Israeli troops often open fire on crowds around the aid trucks, and hospitals have reported hundreds killed or wounded. The Israeli military says it has only fired warning shots to control crowds or at people who approach its forces. The alternative food distribution system run by the Israeli-backed Gaza Humanitarian Foundation has also been marred by violence.