Gaza Humanitarian Response Update | 10- 23 November 2024

Response

• During the reporting period, WHO and Relief International established a new Stabilization Center (SC) for the treatment of acute malnutrition in Deir al Balah, bringing the total number of SCs presently operational throughout the Strip to four. Meanwhile, the SC in the Kamal Adwan Hospital in North Gaza remains closed. 
• Between 1 and 23 November, 3,410 children were admitted for outpatient treatment of acute malnutrition. An average of 4,700 children were admitted for outpatient treatment of acute malnutrition each month between July and October 2024, reflecting a marked increase in cases of acute malnutrition in recent months, compared to a monthly average of about 1,770 cases between January and June. Cumulatively, 32,817 children have been admitted for treatment since the beginning of 2024. 
• Between 10 and 31 October, the Nutrition Cluster has observed a significant increase in the admission of children suffering from Severe Acute Malnutrition (SAM) with nutritional edema – a life-threatening condition – where patients show swelling caused by fluid retention in the tissues which is an indicator of lack of protein in diets. Cases have surged from 10 per cent before October 2024 to 74 per cent of all children with SAM admitted for in-patient treatment at the two SCs in the Deir al Balah governorate, highlighting a worsening in the nutritional situation and the urgent need to scale up interventions. 
• WFP and its partners are scaling up the Blanket Supplementary Feeding Programme (BSFP), with 71,000 children and pregnant and breastfeeding women (PBW) reached between 1 and 23 November in Rafah, Khan Younis, Deir al Balah and Gaza city, despite delays faced in the first half of the month due to logistical challenges.  

Challenges

• In North Gaza, due to the escalation of hostilities, evacuation orders and tightened siege, all Nutrition Cluster partner activities continue to remain suspended, including the treatment of acutely malnourished children and supplementary feeding for children and PBW. The massive displacement of people from North Gaza to Gaza city has caused delays in detecting and initiating treatment for malnutrition cases and compromised required follow ups for children already under treatment.  
• The near halt to commercial trucks entering the Gaza Strip has not only driven commodity prices up and threatened market stability but also worsened the nutritional status of vulnerable children and women, who for months have faced severely limited access to adequate food, water and hygiene products.  
• Shrinking humanitarian space and continued supply chain complications, including the inability to reliably pick up supplies from the Kerem Shalom Crossing due to insecurity and the risk of looting, have prevented full coverage of the needs, despite the prepositioning of adequate quantities of supplies outside the Gaza Strip.  

Response

• As of mid-November, approximately 440,000 cooked meals prepared in 140 kitchens were distributed daily to families across the Strip. This represents a 25 per cent decrease in meal production compared to late September. As supply shortages continue, more kitchens will be forced to close, and for those that remain operational, partners have been adjusting the meal content or reducing the number of meals prepared to cope with the challenges.  
• As of 25 November, only four out of 19 bakeries supported by WFP remained operational across the Strip, all of them in the Gaza governorate. These bakeries resumed production at 50 per cent capacity after receiving a limited amount of fuel delivered from southern Gaza. More fuel delivery is urgently required to avert any further disruption and increase the production level. In Deir al Balah and Khan Younis, all eight bakeries are closed due to lack of flour while partners are prioritizing household-level distribution with the limited amount of flour received. Meanwhile, in North Gaza and Rafah, seven bakeries remain closed due to the ongoing hostilities.   
• In central and southern Gaza, about 700,000 people - 41 per cent of the estimated 1.7 million people in Deir al Balah, Khan Younis and Rafah - had received their reduced monthly food rations as of the third week of November.    
• Some parts of the North Gaza governorate have been under tightened siege for 50 days. Access remains extremely challenging, and partners’ ongoing attempts to deliver aid into these besieged areas continues to be largely prevented. On 11 November, after multiple attempts, a WFP convoy comprising three trucks of food and water supplies managed to reached Beit Hanoun, delivering essential aid for the first time in over a month. Following the delivery of aid, however, there have been reports of intense shelling and Israeli forces surrounding the area where WFP distributed the aid, ordering families to leave.  

Challenges

• Fourteen months into the crisis, as humanitarian food assistance continues to dwindle, people have run out of ways to cope, food systems have collapsed, and the likelihood of famine occurring is imminent and substantial.  Overall, more than one million people have not received their monthly food rations since July or earlier. 
• In central and southern Gaza, food security conditions are alarmingly deteriorating, with insecurity and looting, fueled by the breakdown in public order and safety, in the area around the Kerem Shalom Crossing continuing to hamper partners’ efforts to bring in assistance and distribute onward. On 16 November, for instance, a UN convoy comprising more than 100 trucks of food supplies was looted, resulting in loss of cargo and severe damage to most of the trucks. 
• The ongoing insecurity, combined with access impediments within the Strip, continues to significantly disrupt the supply chain, causing reverberating impacts:  
  • More than 100 kitchens producing about 330,000 meals per day in central and southern Gaza are at constant risk of shutdown. Many families, left with no alternatives, rely on community kitchens as a primary food source.   
  • All eight bakeries supported by WFP in Deir al Balah and Khan Younis have been closed due to lack of flour. 
  • A remote monitoring exercise conducted by FSS partners in central and southern Gaza in October revealed a stark increase in the number of households experiencing severe hunger, with people increasingly relying on the most severe coping strategies to survive, such as reducing adults’ food intake in favour of children.   
  • Wheat flour is also extremely scarce south of Wadi Gaza, with the price of a 25-kilogramme bag of flour reaching 800 NIS (over US$200), compared with 40 NIS (about $10) prior to October 2023.    
• Hunger and malnutrition continue to weaken people’s immune system, contributing to the increasing spread of diseases, with women, children, the elderly and people with disabilities or chronic medical conditions being particularly vulnerable.  
• To scale up the humanitarian response and keep bakeries functional in the Gaza governorate, the unimpeded passage of both fuel and humanitarian supplies between areas south and north of Wadi Gaza must be allowed and facilitated.   
• Local markets across the Gaza Strip are facing a severe crisis as many goods are on the brink of running out. Nearly all the trucks that entered Gaza in October were humanitarian, with extremely few commercial trucks crossing into the Strip. It is vital to urgently resume commercial deliveries at scale to complement humanitarian efforts, enhance dietary diversity, stimulate the local economy by increasing the affordability and availability of goods, and improve cash liquidity. 
• The energy crisis is further worsening as the winter begins, with a growing reliance on burning waste for cooking fuel in northern Gaza, where cooking gas has not been entering for more than 13 consecutive months. This continues to hinder proper food preparation and the intake of nutritious food, exacerbates health and protection risks, and causes environmental hazards. In central and southern Gaza, firewood is increasingly scarce in highly congested areas along the coast, so women and children venture into the eastern parts in search for firewood, exposing themselves to a wide range of risks, including to explosive ordnance. 

Response

• Between 10 and 23 November, five convoys comprising 106 trucks were dispatched from Amman to Gaza via the Erez West entry point. Of the total, 52 inter-agency trucks carrying 388 metric tonnes (MT) of food, water, sanitation and hygiene (WASH), shelter and mixed cargo items were facilitated by the Logistics Cluster on behalf of seven partners. To date, the Logistics Cluster has facilitated 86 humanitarian inter-agency convoys through the Jordan corridor, dispatching 1,108 trucks comprising 11,218 MT of aid into Gaza on behalf of 25 partners. Detailed convoy information is accessible via the interactive dashboard. 
• Following the opening of the Kissufim land entry point on 12 November, two cargo collection test runs took place on 12 and 13 November. The convoys, however, faced severe security incidents transporting cargo from Kissufim to Deir al Balah, resulting in violence by armed looters against truck drivers and commodity losses. On 20 November, the Logistics Cluster received 15 pallets of humanitarian supplies in its common warehouse in Deir al Balah from an airlift operation conducted by the Government of Jordan, with no looting occurring. 
• On 18 November, the Logistics Cluster conducted a general assessment of the Karem Abu Salem/Kerem Shalom platform. Preliminary findings indicate that the platform holds approximately 12,000 pallets, including about 1,000 pallets of damaged and/or expired goods. Clearing the platform would require an estimated 550 trucks.   
• At the Erez West entry point, the Logistics Cluster has continued its daily operations to collect aid supplies and there has been a slight improvement in security conditions for cargo transport. 
• Since December 2023 and as of 23 November 2024, the Logistics Cluster has consolidated 21,379 cubic metres of humanitarian cargo at the consolidation warehouse in Amman, and 50,753 cubic metres at the common storage warehouse in Gaza. 
• As of 21 November, 933 UN and International NGO trucks (60 per cent of which loaded with food supplies) were on standby in Al Arish, ready to be dispatched into Gaza. 

Challenges

• Severe access and security constraints across the Gaza Strip continue to hamper the Logistics Cluster’s ability to safely and consistently collect and transport humanitarian aid on behalf of partners.  
• Most transport operations attempted in the area of Karem Abu Salem/Kerem Shalom crossing face severe looting incidents, resulting in truck damage and substantial cargo losses. 

Response

• Between 10 and 22 November, the Palestinian Water Authority (PWA) and Coastal Municipalities Water Utility (CMWU) reported that, on average, a total of 88,761 cubic metres of water was produced daily across the Gaza Strip. Of this quantity, an average of 46,847 cubic metres of drinking water was produced from the two operational seawater desalination plants and the three Mekorot supply lines. Municipal ground water wells produced an average of 41,914 cubic metres. The total water production severely declined in the second part of the reporting period due to the drop in water production in the North Gaza governorate and variations in fuel availability.  
• During the reporting period, WASH Cluster partners received only 12 per cent of the daily minimum requirement of 70,000 litres of fuel to meet critical WASH and public health needs, including water production and distribution, sewage management, repair works and solid waste management. 
• Two shipments of chlorine of 20,000 litres to treat the wells in the southern and central areas were received while another shipment of 9,000 litres is expected by the end of the month. Critical supplies for the southern desalination plants, such as filters and lubricants, were provided by UNICEF to CMWU. 
• During the reporting period, 29 WASH Cluster partners reported the distribution, by trucking, of a total of 7,682 cubic metres of water per day to 760 water collection points. Persisting shortages of fuel supply, along with security concerns, continue affecting water distribution in Gaza city.  
• Water quality testing is ongoing in multiple facilities and test results are regularly shared with facility operators.  
• Partners are responding to the findings of a preliminary WASH Cluster assessment through water trucking, installation and rehabilitation of latrines to benefit about 100,000 IDPs, solid waste management and distribution of hygiene kits. A total of 10,000 hygiene kits are expected to be provided by UNICEF, with a gap of 10,000 kits persisting.  
• As part of winterization preparedness efforts, solid waste removal has been completed in the south-western part of the Strip, with waste to be transferred near the airport, and large earthworks to clear drainage channels have been completed in Maghazi, while they remain ongoing in An Nuseirat. The Hygiene Promotion Group has finalized a flood risk matrix and shared it with partners to help them prioritize activities with communities.  

Challenges

• Amid ongoing military operations in North Gaza, all regular requests to deliver fuel to water production points and conduct solid waste and sewage management have been consistently denied since the beginning of October 2024. This is having a catastrophic impact on basic WASH services to maintain public health.  
• Fuel provided to WASH facilities has decreased, substantially affected the production of water substantially.   
• Supply constraints continue to have an enormous impact on critical WASH service delivery; 10,000 hygiene kits and 10,000 jerry cans are still urgently needed as part of the WASH response to the large displacement influx into Gaza city.  
• The winterization response is severely constrained both by limited entry of required equipment and materials into Gaza and challenges in moving stocks from southern to northern Gaza. At the same time, the transfer of solid water to safe locations remains a challenge in the south-western part of the Strip. Critical supplies like cement must be urgently provided for the ongoing projects. 

Response

• Between 10 and 23 November, Cluster partners reported the distribution of about 126 family tents and a few sealing-off kits (SOKs) to households in need in the Gaza governorate.   
• In southern Gaza, during the reporting period, more than 1,100 families living along the beach were provided with tents, enabling them to relocate to less vulnerable areas. Additionally, 147 families in Khan Younis received Shelter NFI Kits, including sealing-off kits and bedding kits.  
• During the reporting period, 19 trucks entered southern Gaza through the Fence Road. These included seven trucks with sealing-off materials and 12 trucks with bedding materials. This is still an average of 11 trucks a week since the start of September 2024.  
• Updated figures show that around 154,000 people have received shelter items in Khan Younis, Rafah and Deir al Balah (excluding NFIs) since the start of September. This leaves a gap of 846,000 people still in need of shelter assistance in these governorates.  
• In North Gaza and Gaza, 66,300 people have been assisted with shelter items (excluding bedding sets).  
• The cluster has completed an Energy Assessment looking at both household energy and operational energy needs, to better understand, plan and support energy provision in the context.   
• The Transitional Shelter Working Group held a workshop outside Gaza to work on designing emergency shelters and identifying key materials that are vital for creating adequate shelter.   

Challenges

• Active hostilities, armed looting, access restrictions, damaged roads, lack of fuel, and unexploded ordnance all continue to hamper Shelter Cluster partners’ efforts to scale up shelter assistance into Gaza.  
• Weather conditions are deteriorating, and displaced people do not have adequate shelter. Partners continue mobilizing resources to address emerging needs.    
• There are around 58,000 sealing-off kits and over 36,000 tarpaulins that have been procured and are waiting to be brought into Gaza. These materials would serve over 76,000 families (~ 400,000 people). At a rate of 11 trucks a week, it would take at least another eight weeks to bring these items into the Strip. Shelter actors are currently in the process of procuring hundreds of thousands more kits and tarpaulins.  

Response

• During the reporting period, SMWG partners started phase 1 of the baseline site assessment exercise, conducting 424 site assessments in Khan Younis and Deir al Balah governorates. This baseline assessment aims to ensure accurate data about site location, population estimates and needs. It is anticipated that this exercise will generate a smaller, more accurate site master-list, enabling the humanitarian community to more effectively provide services in these IDP sites. 
• SMWG partners are continuing winterization preparedness activities across 75 IDP sites in Khan Younis and Deir al Balah that host approximately 75,000 people, supporting site-level committees with financial, technical, and in-kind support for maintenance and repairs. 
• To support scaled-up service delivery in Gaza city, the SMWG produced static maps of IDP site locations, regular updates on displacement figures, as well as a live IDP site list to improve service delivery to the over 100,000 people displaced from North Gaza to Gaza city. 
• SMWG partners identified at least 301 households (747 people) that moved from North Gaza to southern Gaza via the checkpoint on the Al Rasheed road and referred them to partners for further support. 
• SMWG partners conducted various capacity strengthening activities including a 4-day capacity building workshop in training skills for 19 participants from nine organizations, as well as training sessions for site management committees from 16 IDP sites.  

Challenges

• The skyrocketing prices of common winterization items on the local market have made assistance to communities nearly impossible. The prices of shovels and plastic rope have increased by 300 and 345 per cent, respectively, while the price of a single bag of cement has risen by 1,900 per cent. 
• UNRWA collective shelters continue to be impacted by ongoing hostilities, resulting in deaths, injuries, destruction, and further displacement. Partners continue to call for the protection of civilian infrastructures, including IDP shelters. 

Response

• During the reporting period, UNRWA’s protection teams conducted seven observation missions in shelters and IDP sites across Khan Younis and Deir al Balah, including Al Mawasi, undertook seven focus group discussions, and seven key informant interviews. They also continued to monitor aid distribution and follow up on vulnerable cases.  The teams monitored learning activities in UNRWA shelters and delivered BBC Lifeline podcast activities to 1,233 children. They also followed up on urgent WASH interventions in UNRWA shelters and conducted awareness raising sessions on explosive ordnance, gender-based violence (GBV) and prevention of sexual exploitation and abuse (PSEA) reaching 42, 299 and 34 people, respectively in UNRWA shelters, and IDP sites. 
• On 19 November, UNRWA and OHCHR jointly visited two UNRWA shelters in Gaza city   recently impacted by the hostilities. IDPs living in the shelters expressed their fear and concern about the lack of safety even in UN buildings where they had sought refuge. 
• Between 9 and 14 November, 43 Palestinian detainees were released at the Kerem Shalom crossing. Despite being informed on the same day of the release, the ICRC was able to meet the released detainees at the crossing, and all were reunited with their families before being transferred to the European Gaza Hospital in Khan Younis. Subsequently, UNRWA’s protection teams provided them with accommodation in Khan Younis, providing them with food parcels, bedding and hygiene kits, UNRWA, in coordination with the ICRC, provided them with referrals for additional health, shelter, and psychosocial support. 
• During the reporting period, 26,000 children and 20,000 caregivers were provided with Mental Health and Psychosocial Support Services (MHPSS). A total of 4,409 children and 2,334 caregivers also received awareness raising sessions on child protection risks and explosive remnants of war. Child Protection partners also provided case management services for 582 cases, with nine instances in which unaccompanied and separated children were reunified with their families.   

Challenges

• The protection environment in northern Gaza remains dire, with vulnerable people often unable to evacuate due to health conditions and mobility challenges. Critical shortages of food, water and medications persist, compounded by the acute lack of essential NFIs, like tents, tarpaulins, mattresses and cleaning materials, across UNRWA shelters and IDP sites.  
• In southern Gaza, NFIs and food supplies, particularly flour, are also scarce. Limited access has made distribution points unsafe, especially for women and girls, and those with disabilities, female heads of households and elderly women. Women report being forced by men within their households to search for basic necessities. 
• Continued evacuation orders, the ongoing siege on parts of northern Gaza, as well as poor communication networks are exacerbating child protection risks, including family separation and direct conflict-related violence. The difficulty in bringing supplies into Gaza is a critical concern as winter approaches. 
• Most sites presently used for MHPSS activities in collective shelters are either tents or open spaces and will not be suitable during the winter. 

Response

• During the reporting period, one Education Cluster partner successfully retrieved 64 pallets of recreational materials, enough to benefit 5,760 children, as well as 26 pallets of stationery kits for 1,872 learners, which are expected to significantly enhance the quality of services provided to children. The partner, however, was unable to collect tents, which continues to hamper the possibility to expand Temporary Learning Spaces (TLSs).  
• The Ministry of Education and Higher Education (MoEHE) is conducting a monitoring exercise across partner-supported TLSs to expand the accreditation of learning programs and facilitate the transition of students enrolled in the programs deemed eligible to e-school. While challenges such as limited internet connectivity and a lack of devices are hindering students’ ability to enroll and attend e-school, the initiative is expected to encourage many children to enroll in the established TLSs. Efforts are ongoing, jointly with the Emergency Telecommunications Cluster (ETC), to improve internet connectivity to make it easier for learners to enroll, attend lessons, and access content on digital platforms. 
• On 21 November, the Education Cluster in Gaza launched the Cluster Coordination Performance Monitoring exercise, which will conclude on 5 December. This initiative aims to assess the effectiveness of functional areas of cluster operations, identify areas for improvement, provide opportunities for self-reflection, and inform the development of the Cluster's work plan for 2025, among other objectives. 

Challenges

• On 17 November, a fire outbreak at Al Awda Camp 2 in An Nuseirat damaged a TLS, which was subsequently closed, affecting over 300 school-aged children who were previously accessing learning at the site.  
• Between 9 and 23 November, 13 new incidents impacting schools were reported, eight of them in Gaza city, with five incidents overall affecting UN-run schools. Eleven out of the 13 incidents involved airstrikes, resulting in significant damage to infrastructure and tragic losses of lives among those seeking shelter in these schools. These incidents continue to ignite fear among parents, children, and teachers, hampering the expansion of education-in-emergency interventions in school settings. 
• The ongoing restrictions on the entry of educational supplies into Gaza continue to significantly hinder Cluster partners’ efforts to scale up the educational response, with a substantial stock of essential materials procured by two Cluster partners, including tents to set up new TLS, presently stranded in Amman.  
• School-aged children are exposed to escalating protection risks while outside of learning environments. Recent reports from the Women’s Affairs Center in Gaza, a member of the Child Protection Area of Responsibility, highlight an alarming rise in child marriages, including among children under the age of 15. In the past five months alone, courts have recorded at least 404 cases of child marriage, representing 8.2 per cent of all marriage instances during this period. 

Response

• An additional 58 satellite-based tracking devices, intended for use by 10 UN agencies operating in Gaza, were delivered to the Strip on 20 November. The ETC team is configuring the devices before activating and handing them over to the requesting UN agencies.  
• In November, the ETC Cluster, jointly with the UN Department of Safety and Security (UNDSS), trained 105 UN personnel from 12 UN agencies operating in Gaza on Security Communications Systems (SCS) and the use of Very High Frequency (VHF) radios and satellite-based communication devices.  
• For more information on ETC activities, please visit: Palestine: Conflict | Emergency Telecommunications Cluster (ETC) (etcluster.org). 

Challenges

• The lack of fuel continues to severely compromise the operation of critical telecommunications infrastructure, causing Mobile Network Operators (MNOs) and Internet Service Providers (ISPs) to operate at a limited capacity. The situation has severely disrupted humanitarian aid operations and communication with humanitarian responders in Gaza. Due to the ongoing hostilities, damaged infrastructure, limited fuel supply, the unavailability of spare parts, and the lack of safe access, local MNOs and ISPs continue to experience network outages and are unable to conduct the necessary repairs. 
• The safety of humanitarian aid workers in Gaza is a primary concern. The lack of safe access, recurrent evacuation orders and the cancellation of scheduled missions continue to hinder the deployment of shared ETC services and technical support to humanitarian partners.  
• A significant amount of equipment has been damaged or destroyed, and the import of new equipment is lengthy and challenging. Only 20 satellite phones, 30 VHF digital radios, 83 satellite-based tracking devices, and four solar power solutions have been imported into Gaza since 7 October 2023, following coordination with the Israeli authorities. This is severely limiting the delivery of planned ETC services. 
• Insufficient funding has limited the ETC Cluster’s capacity to address immediate communications needs for humanitarian responders in Gaza. The Cluster continues to appeal for funding from varied potential donors. 

Protection against sexual abuse and exploitation (PSEA) remains a cross-cutting priority for all clusters. Aid distribution must be delivered with dignity and respect. Any wrongdoing can be reported through SAWA toll-free number 164. SAWA will assist and provide services free of charge and with the utmost confidentiality.