Hostilities in the Gaza Strip and Israel | Flash Update #161

The OCHA oPt Flash Update is published every Monday, Wednesday, and Friday, with an update on the West Bank included every Wednesday. The next update will be issued on 6 May. 

Key Highlights

• A ground operation in Rafah would bring “catastrophe on top of catastrophe,” UNICEF warns, highlighting the unimaginable toll the war is having on children.  
• On 29 April, the Palestinian Water Authority (PWA) announced the resumption of water pumping through Al Muntar water line after 200 days of complete shutdown, potentially serving approximately 300,000 people in Gaza city.  
• There are continued constraints on the entry of medical supplies into Gaza, reports Médecins Sans Frontières.   
• A joint ESCWA-UNDP assessment points to a setback of more than 20 years in human development in Gaza. 

Gaza Strip Updates 

• Israeli bombardment from the air, land, and sea continues to be reported across much of the Gaza Strip, resulting in further civilian casualties, displacement, and destruction of houses and other civilian infrastructure.  
• In a press encounter on 30 April, UN Secretary-General António Guterres warned of “devastating” and “serious” consequences of a potential military assault on Rafah. Guterres also expressed alarm at reports of mass graves discovered in Gaza, including at Al Shifa and Nasser hospitals, urging immediate access for independent, international investigators with forensic expertise “to establish the precise circumstances under which hundreds of Palestinians lost their lives and were buried, or reburied.” The UN chief stressed that the situation is “worsening by the day,” notwithstanding recent progress in bringing more aid into Gaza; to stave off “an entirely preventable, human-made famine,” he reiterated his “call on the Israeli authorities to allow and facilitate safe, rapid and unimpeded access for humanitarian aid and humanitarian workers, including UNRWA, throughout Gaza.” 
• Between the afternoons of 1 and 3 May, according to the Ministry of Health (MoH) in Gaza, 54 Palestinians were killed and 102 injured, including 26 killed and 51 injured in the last 24 hours. Between 7 October 2023 and 3 May 2024, at least 34,622 Palestinians were killed in Gaza and 77,867 Palestinians were injured, according to MoH in Gaza. 
• The following are among the deadly incidents on 30 April and 1 May:  
  • On 30 April, at about 21:00, three Palestinians, including a child, were reportedly killed when an apartment was hit in An-Nuseirat Refugee Camp.  
  • On 30 April, at about 22:25, two Palestinian children were reportedly killed when a house was hit in Ash Shaboura Refugee Camp in southern Rafah. 
  • On 1 May, at about 21:40, six Palestinians were reportedly killed and others injured when a house was hit in Az Zahraa area, south of Gaza city. 
• Between the afternoons of 1 May and 3 May, no Israeli soldiers were reported killed in Gaza. As of 3 May, 262 soldiers have been killed and 1,605 soldiers have been injured in Gaza since the beginning of the ground operation, according to the Israeli military. In addition, over 1,200 Israelis and foreign nationals, including 33 children, have been killed in Israel, the vast majority on 7 October. As of 3 May, Israeli authorities estimate that 133 Israelis and foreign nationals remain captive in Gaza, including fatalities whose bodies are withheld. 
• On 1 May, the Committee to Protect Journalists (CPJ) reported that it has documented 25 cases of detention of journalists in the occupied Palestinian territory. In addition to reports of injured or missing journalists, CPJ is investigating the killing of 97 journalists and media workers in Gaza since 7 October, calling it “the deadliest period for journalists” since they began collecting data in 1992. According to the Government Media Office (GMO) in Gaza, 141 Palestinian journalists and media workers have been killed in Gaza, 70 injured, and at least 20 detained since the onset of hostilities.  
• On 2 May, 64 people who had been detained from Gaza were released by Israeli authorities at Kerem Shalom crossing, reported the Palestinian Border and Crossing Authority. One was dead and another was critically injured, according to the same source. On 1 May, on the occasion of International Labor Day, three Palestinian institutions covering prisoner affairs reported in a joint press release that, based on Palestinian Ministry of Labour data, out of 10,300 workers from Gaza who were present in Israel to work on 7 October, 3,200 were released at Kerem Shalom Crossing in November 2023, 6,441 have been deported to the West Bank, and 1,000 remain missing. They noted that Israeli authorities refused to disclose information about the missing workers apart from announcing the presence of two military detention camps near Beersheba and Jerusalem. On 2 May, MoH in Gaza announced that the head of the Orthopaedic Department at Shifa Medical Complex, Dr. Adnan Al Bursh, who had been detained by Israeli forces since December 2023 died in an Israel prison.  
• UNICEF Executive Director Catherine Russell warned on 1 May that a ground operation in Rafah “would bring catastrophe on top of catastrophe,” highlighting the “unimaginable toll” the war is having on children, who comprise 47 per cent of Gaza’s population. Some 600,000 children are now crammed into Rafah, according to UNICEF, with nearly all being “either injured, sick, malnourished, traumatized or living with disabilities.” Reporting on his three visits to the Intensive Care Unit at the European Hospital in Rafah, UNICEF spokesperson James Elder described seeing multiple children occupying the same bed, “each one arriving after a bomb had ripped through their homes, each one dying despite doctors’ immense efforts.” In Al Mawasi, paediatric nurse Becky Platt also highlighted the physical pain and psychological distress affecting injured children at the Emergency Health Unit set up by Save the Children (SCI); according to Platt, the recovery path is long and difficult amid a shortage of effective pain relief, rehabilitation treatment, and devices like wheelchairs or prostheses.  
• Only 12 out of Gaza’s 36 hospitals are now partially functioning; these include two in North Gaza, three in Gaza, two in Deir al Balah, two in Khan Younis, and three in Rafah. Functioning facilities are operating with limited capacities, overwhelmed with patients and coping with critical shortages of fuel, medicines, supplies and staff, according to the latest analysis by WHO and the Health Cluster. Six field hospitals are also fully operational, all located south of Wadi Gaza, and 70 per cent of primary healthcare centres throughout Gaza remain unserviceable. Despite access constraints that prevent the scaling up of assistance in northern Gaza, Health Cluster partners are doing everything possible to deliver critical health services and restore minimum services at damaged facilities, including Nasser Hospital. On 2 May, the International Medical Corps (IMC) announced plans to establish a second field hospital, with a 42-bed capacity, near Deir al Balah, to scale up primary as well as specialized sexual, reproductive, maternal and child health services. IMC’s existing field hospital in Al Mawasi, in western Rafah, has been supporting 53,502 people since its establishment in January, with 1,400 surgeries conducted as of 24 April. On 2 May, the Palestinian Red Crescent Society (PRCS) also reported that the first baby was born at the newly reopened maternity ward of Al Amal Hospital in Khan Younis. 
• Incremental progress in access to food, water, and sanitation facilities, has been recently observed in Gaza, with reports of continued constraints on the entry of medical supplies.   
  • On 29 April, the Palestinian Water Authority (PWA) announced the resumption of water pumping through Al Muntar "Mekorot" water line after 200 days of complete shutdown and substantive repairs. Potentially serving approximately 300,000 people in Gaza city, this is the third Israeli water line to resume operations after their shutdown in October 2023. Renewed water pumping has so far benefited four neighbourhoods in Gaza city, including Az Zaitoun, Ad Draraj, As Sabra and At Tuffah, the Municipality of Gaza informed OCHA on 2 May. According to the WASH Cluster, as of 30 April, water production across Gaza stands at approximately 77,000 cubic meters per day, representing about 20 per cent of Gaza's total water production prior to the recent hostilities.   
  • On 1 May, the World Food Programme (WFP) reported that after months of restricted access, it is building a storage capacity in Beit Hanoun. On the same day, a convoy carrying humanitarian supplies from Jordan, including food parcels, sugar, rice, supplementary food and milk powder, entered Gaza via back-to-back transfer at Erez crossing, following inspection by Israeli authorities only at Allenby Bridge. Once inside Gaza, local trucks carrying the assistance were rerouted by armed men toward UN premises undesignated for offloading the aid. All trucks reached the two designated UN premises as of 3 May and distribution is ongoing. Expressing readiness to scale up food assistance to northern Gaza, WFP emphasized that “rolling back six months of starvation requires steady flows of food supplies [with] safe, lasting access…sustained over time.” 
  • On 2 May, the Coastal Municipalities Water Utility (CMWU) reported that it has successfully connected a 250-Kilovolt power generator, supplied by the Egyptian authorities, at the wastewater treatment plant in Rafah. This has enabled the reactivation of plant’s pumping system, preventing sewage overflow towards the Egyptian border and averting potential health hazards in areas populated by hundreds of internally displaced persons (IDPs) living near the border with Egypt. In a related development, the Municipality of Gaza warned on 2 May of the potential danger of the accumulation of sewage in the rainwater collection lagoon in Ash Sheikh Radwan neighbourhood, in northern Gaza city, due to the lack of electricity, limited fuel supplies, and damage to three main sewage pumping facilities. 
  • The ability to bring into Gaza biomedical equipment, such as oxygen concentrators, continues to be very constrained, reported Médecins Sans Frontiers (MSF) on 1 May. Oxygen concentrators filter surrounding air to deliver purified oxygen for patients, and are vital for malnourished children suffering from anaemia, newborn babies with breathing difficulties and injured patients with severe blood loss. Pending approval are also the MSF requests to bring in a range of medical supplies, from ultrasound scanners to external defibrillators, generators, and intravenous sodium chloride solutions that are essential for rehydrating patients and diluting drugs. According to MSF, such requests have been repeatedly rejected by Israeli authorities and, when approved, it has taken an average of one month from the moment humanitarian cargo arrives in Egypt to the time it enters Gaza, with supplies undergoing multiple inspection processes. If a single item is rejected at Nitzana crossing, “the entire shipment is rejected and returned to Rafah, where the lengthy process begins again,” added MSF. Stressing the lack of clarity and consistency in what is being allowed to enter, MSF noted that the same items are sometimes approved and at other times rejected. In April, Israeli authorities approved the entry of fridges and freezers to store temperature-sensitive medicines, which MSF had requested in November and are now expected to reach Gaza in May.
• Between 27 April and 2 May, 35 per cent (8 out of 23) of humanitarian aid missions to northern Gaza were facilitated by Israeli authorities, 52 per cent (12) were impeded, two missions were denied, and one mission was cancelled. During the same period, out of 21 humanitarian aid missions to areas in southern Gaza that require coordination, 66 per cent (14) were facilitated by Israeli authorities, three missions were impeded, and four missions were denied. Impediments primarily entail prolonged waiting time prior to departure and delays at Israeli checkpoints on Salah Addin and Al Rasheed roads en route to northern Gaza and back to the south. On 29 April, one aid mission experienced a total of over nine hours of waiting time on its way to the north and back to Rafah due to heightened security procedures at the checkpoint, and ongoing fighting between Palestinian armed groups and Israeli forces near the checkpoint.
• On 2 May,  the United Nations Development Programme (UNDP) and the Economic and Social Commission for Western Asia (ESCWA) published the findings of their second initial rapid assessment of the macroeconomic and social consequences of the war in Gaza at six months, with projections for seven-, eight- and nine-months scenarios. Using various analytical tools such as satellite images, the assessment forecasts that Gross Domestic Product (GDP) loss could reach 29 per cent in 2024 if the war extends to nine months, with total losses of US$7.6 billion, up from the 25.8 per cent currently estimated by the Palestinian Central Bureau of Statistics (PCBS). Moreover, the poverty rate across the State of Palestine is projected to more than double, reaching 60.7 per cent by the ninth month and plunging an additional 1.86 million people into poverty. All four scenarios indicate a setback of more than 20 years in human development in Gaza and from 13 to 16 years in the West Bank, the assessment finds. Commenting on the findings, ESCWA Executive Secretary Rola Dashti stated: “This assessment projects that Gaza will be rendered fully dependent on external assistance on a scale not seen since 1948, as it will be left without a functional economy, or any means of production, self-sustainment, employment, or capacity for trade.” According to UNDP Administrator, Achim Steiner, these unprecedented losses “will precipitate a serious development crisis that jeopardizes the future of generations to come.”  

Funding 

• On 17 April, the Humanitarian Country Team released a new Flash Appeal for the occupied Palestinian territory (oPt), which requests $2.8 billion to meet the most critical needs of 2.3 million people in Gaza and 800,000 people in the West Bank, including East Jerusalem, between April and December 2024.  
• The oPt HF has 118 ongoing projects, for a total of $72.5 million, addressing urgent needs in the Gaza Strip (85 per cent) and West Bank (15 per cent). In light of the updated Flash Appeal, the HF has allocated an additional $22 million to bolster prioritized HF-funded projects in Gaza. Since 7 October, the oPt HF has mobilized $90 million from Member States and private donors, designated for programmes throughout Gaza. A summary of the oPt HF activities and challenges in March 2024 is available through this link and the 2023 Annual report of the oPt HF can be accessed here. Private donations are collected directly through the Humanitarian Fund. 

For the Gaza Humanitarian Response Update for the period between 22 and 28 April, please visit: Gaza Humanitarian Response Update | 22–28 April 2024. It is updated throughout the week to reflect new content.

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