Gaza is on the verge of a “humanitarian catastrophe” and 1 million Palestinians could soon go hungry, the United Nations has warned.

The budget of the UN’s Palestinian refugee agency (UNRWA) is expected to dry up “in a month” and is in desperate need of additional funds, UN officials told The Independent.

Nearly 2,000 Gazans shot by the Israeli army may also lose their limbs due to the funding crisis.

In total, UNRWA needs $1.2bn (£922m) a year to maintain its schools, medical and food programmes and financial support for 5 million Palestinian refugees in Gaza, the West Bank, Syria, Lebanon and Jordan.

Last summer it was forced to beg for additional donations from Europe and the Gulf after the US, its single largest financier, decided to slash all funding, leaving a budget deficit of more than $440m.

Without fresh donations, the hardest hit will be in Gaza, a 25-mile enclave that is home to nearly 2 million people and subject to a 12-year-long Israeli and Egyptian imposed siege.

Gaza protests: Wounded patients being treated at MSF clinic Show all 9 1 /9 Gaza protests: Wounded patients being treated at MSF clinic Gaza protests: Wounded patients being treated at MSF clinic Palestinian patients wounded during Gaza-Israel border protests at a clinic run by medical charity Doctors Without Borders (MSF) in Gaza City Bel Trew Bel Trew/The Independent Gaza protests: Wounded patients being treated at MSF clinic 'I was a fisherman before, but I now can’t do anything, I have no work. I can’t walk. I’m struggling,' says Rami Hessi Bel Trew/The Independent Gaza protests: Wounded patients being treated at MSF clinic According to Gaza’s ministry of health, more than 5,800 Palestinians have been injured by live fire shot by Israeli soldiers during regular rallies held at the border fences since March 2018 Bel Trew/The Independent Gaza protests: Wounded patients being treated at MSF clinic Sabreen al-Najjar, left, the mother of Razan, a 20-year-old medic who was shot dead on the Gaza border last year Bel Trew/The Independent Gaza protests: Wounded patients being treated at MSF clinic Palestinian patients wounded during Gaza-Israel border protests at a clinic run by medical charity Doctors Without Borders (MSF) in Gaza City Bel Trew Bel Trew/The Independent Gaza protests: Wounded patients being treated at MSF clinic Palestinian patients wounded during Gaza-Israel border protests at a clinic run by medical charity Doctors Without Borders (MSF) in Gaza City Bel Trew Bel Trew/The Independent Gaza protests: Wounded patients being treated at MSF clinic Palestinian patients wounded during Gaza-Israel border protests at a clinic run by medical charity Doctors Without Borders (MSF) in Gaza City Bel Trew Bel Trew/The Independent Gaza protests: Wounded patients being treated at MSF clinic Palestinian patients wounded during Gaza-Israel border protests at a clinic run by medical charity Doctors Without Borders (MSF) in Gaza City Bel Trew Bel Trew/The Independent Gaza protests: Wounded patients being treated at MSF clinic Palestinian patients wounded during Gaza-Israel border protests at a clinic run by medical charity Doctors Without Borders (MSF) in Gaza City Bel Trew Bel Trew/The Independent

The UN estimates that an extra $20m is needed to plug an otherwise imminent health crisis.

“The worst-case scenario is we would not able to continue to feed half the population of Gaza,” Elizabeth Campbell, director of UNRWA’s Washington DC office told The Independent.

“We will have to close schools, people would have no access to our health care systems. We will have to cut jobs.”

After the Palestinian Authority (PA), UNRWA is the largest employer of people in Gaza.

Ms Campbell warned that a destabilised Gaza would also pose a direct threat to Israel.

“You will have a major humanitarian catastrophe which would easily spread across territories,” she said.

“We are deeply concerned about the security implications.”

Her warnings were echoed by Jamie McGoldrick, the UN humanitarian coordinator for occupied Palestinian territory, who said on Wednesday that without immediate funding as many as 1,700 people in Gaza could lose their limbs over the next two years.

Some 29,000 people in the enclave have been wounded by Israeli fire at protests and clashes near to the border fences over the past year.

At least 7,000 have suffered gunshot wounds, mostly to their lower limbs. Hundreds of those are in need of urgent limb-saving treatment provided by the UN.

“These are people who have been shot during the demonstrations and who are in need of rehabilitation, and very, very serious and complex bone reconstruction surgery over a two-year period before they start to rehabilitate themselves,” Mr McGoldrick said.

Without such procedures, these people risk being in need of an amputation, he warned.

There are additional health fears if the UN’s vaccination programme in Gaza is forced to stop.

Meanwhile, the UN’s World Food Programme has already had to cut aid for 193,000 people this year in the West Bank and Gaza. This will have to be slashed further if the agency faces a cash flow crisis in June, which is likely.

The warnings came as Israel and Gaza teeter on the cusp of another war amid the deadliest flare-up of violence since the 2014 conflict.

Fighting erupted on Saturday morning when armed factions within the militant-run strip fired nearly 700 rockets at southern Israel, prompting Israeli forces to pound nearly 350 targets in the enclave.

The violence had been triggered by the killing of four Palestinians, including two militants, along the border by Israeli fire the day before, after a shooting incident had left two Israeli soldiers wounded.

By the end of the weekend, the airstrikes and rockets had killed 25 people, including two women and two children in Gaza. Four civilians were killed in Israel.

Egypt and the UN struggled to broker a fragile ceasefire which still holds.

But many fear it will only be temporary as the United States is due to deliver its long-awaited and controversial peace plan next month.

The “deal of the century” has already been rejected by the Palestinians on the grounds it is likely to be pro-Israeli.

A Palestinian stands amid the rubble of a community centre in Rafah that was destroyed in a recent confrontation between Hamas and Israel (AFP/Getty) (SAID KHATIB/AFP/Getty Images)

The Palestinians cut diplomatic ties with Washington, a historic mediator in the region, last year after Donald Trump’s decision to recognise the contested city of Jerusalem as Israel’s capital.

Trump’s peace plan, if it is deemed to favour one side, may be the touchpaper to ignite fresh fighting in the same month UNRWA will hold a pledging conference to plug its massive funding shortfall.

Piling pressure on the volatile situation is the financial crisis of the PA. In February, the US Agency for International Development announced it had ceased all assistance to the West Bank and Gaza.

The PA has also refused to take tax remittances from Israel after it deducted 5 per cent of the taxes it collects on behalf of Palestinians because it is given to families of those connected and jailed by Israel for security offences.

Unless the issue is resolved, the World Bank predicts, the Palestinians’ financing gap could exceed $1bn in 2019, putting further strain on an economy, battered by a 50 per cent unemployment rate.

You will have a major humanitarian catastrophe which would easy spread across Elizabeth Campbell, UNRWA Washington director

Ms Campbell said UNRWA will likely have to cut more jobs from its 18,000 workforce in Gaza and the West Bank, who are mainly teachers.

Last year they cut 250 jobs, sparking unrest and protest.

“It had a destabilising effect. We lost control of our compound in Gaza for three weeks,” she added, warning it could happen again.

She said now was “not the time to walk out” on UNRWA, without a viable alternative to their services.

Dissolving their institutions will mean Palestinians “have poverty, vulnerability, hunger, no nationality and no political horizon”, she concluded.