Gaza Humanitarian Response Update | 22 July-4 August 2024

Response

• Partners continue to conduct Mid-Upper Arm Circumference (MUAC) screenings in shelters and healthcare facilities across the Gaza Strip. Since mid-January, 214,409 children aged 6-59 months, and 9,451 pregnant and breastfeeding women (PBW) have been screened for malnutrition. Of those screened, 13,837 were diagnosed with acute malnutrition and have been receiving treatment: 10,798 children diagnosed with Moderate Acute Malnutrition (MAM), and 3,039 with Severe Acute Malnutrition (SAM). Additionally, 724 PBW have been enrolled for treatment.
• Partners have maintained service delivery despite the repeated evacuation orders by the Israeli military and recurrent displacement. As of 4 August, four stabilisation centres, 100 outpatient treatment sites and 307 blanket supplementary feeding sites are providing nutrition services. Two SAM stabilization centres in North Gaza and Gaza governorates received two nutrition kits equipment and five kits for the case management of children who require inpatient care for SAM.
• Between 20 July and 2 August, 55,082 children under the age of five (CU5) and 23,297 PBW received 30 days needs of Lipid-based Nutrient Supplements (LNS-MQ) across Khan Younis, Dier al Balah, and Rafah, under the Blanket Supplementary Feeding Programme. Along with LNS-MQ distribution, 38,611 mothers and caregivers received key Infant and Young Child Feeding (IYCF) E-messages. 
• Preliminary results of a soft survey on breast feeding and use of breastmilk substitutes in Gaza show that only two out of every five infants under six months of age are exclusively breastfed. Additionally, caregivers are feeding their children formula milk, either purchased or received as a donation. These feeding practices are concerning given the associated risks of increased infant morbidity and mortality in emergencies, especially as the water and sanitation situation continues to deteriorate.

Challenges

• Repeated displacement, insecurity and access constraints continue to hamper the early detection of children and women requiring nutrition services and the scale-up of operational presence to provide needed support. Tents have been set up to conduct malnutrition screenings and provide services, but the lack of privacy renders breastfeeding counselling challenging. 
• Repeated displacement, including among children diagnosed with malnutrition, has made it difficult for partners to monitor and follow up on malnutrition cases and for families to carry supplies for malnutrition prevention and treatment. 
• Insecurity, access constraints, and limited infrastructure hinder the delivery and storage of nutrition supplies like LNS-SQ, Ready-to-Use Therapeutic Food (RUTF), and Ready-to-Use Infant Formula (RUIF).

Response

• As of 4 August, 13 out of 18 bakeries supported by humanitarian partners were operational in the Gaza Strip – four in Gaza city, two in North Gaza and seven in Deir al Balah. One bakery in Deir al Balah temporarily closed between 28 July and 4 August due to its location in a high-risk area that was placed under an evacuation order by the Israeli military on 28 July. The five bakeries in Rafah remain closed due to the ongoing hostilities. 
• As of 1 August, and to improve people’s access to bread, 50 per cent of bread production at all 13 active bakeries is purchased by partners to be distributed for free along with cooked meals, while the other 50 per cent is sold at a reduced NIS 3 (US$0.8) per two kg of bread.
• Partners provided cooked meals to 148 people (patients and their companions) who were medically evacuated from Gaza at the end of July. Overall, as of the end of July, around 500,000 cooked meals prepared in 150 kitchens were provided daily to families across the Strip. This is a 30 per cent decrease, compared with up to 700,000 meals provided at 200 kitchens in early July, attributed to the lack of food supplies and cooking fuel associated with the limited flow of humanitarian cargo into central and south Gaza. 
• A one-time distribution of ready-to-eat food parcels has targeted newly displaced people in western Khan Younis based on close monitoring of displacement and return movements. In late July, partners distributed food parcels to around 2,000 households in Al Mawasi area, with support from community representatives. This was the first large-scale food distribution since the Israeli military operation in Rafah began in early May. 
• Around 80 metric tons of animal feed were distributed by partners in southern and central Gaza throughout July, thereby contributing to the local production of meat and dairy products, which are key to ensure a nutritious diet, especially for children.

Challenges

• As of early August, and due to multiple evacuation orders in Khan Younis and Deir al Balah since 22 July, at least 20 food distribution points, 18 cooked meal provision points and two warehouses located in/near areas placed under evacuation orders were affected; most of their activities remain suspended. Thirteen were closed and five were forced to relocate. Staff of food partners have also been displaced, further contributing to the disruption.
• Food supply stocks are currently insufficient to meet food parcel requirements and their timely distribution in August. Insecurity, damaged roads, the breakdown of law and order, and access limitations have worsened along the main humanitarian cargo route between Kerem Shalom Crossing and Khan Younis and Deir al Balah. This has resulted in critical shortages of aid commodities to sustain humanitarian operations, increasing the risk of spoilage and infestation of stranded food supplies due to high temperatures.    
• The passage of fuel and humanitarian supplies between southern/central Gaza and the north and via all crossings remains impeded. Ensuring there is a continuous fuel supply to all the bakeries and other essential services remains partners’ top priority.
• Most distributed food rations contain gluten, negatively affecting hundreds of people with celiac disease and other medical conditions associated with gluten. FSS partners are currently seeking to bring in gluten-free flour. 
• The lack of a constant flow of seeds, fertilizers and other animal and crop production inputs is a key obstacle hampering the restoration of local food production in Gaza. There is an urgent need to strengthen advocacy for, and implementation of, a dual-track approach to food assistance and livelihood interventions. Agricultural activities, including small-scale gardening that is critical to enhance dietary diversity, remain largely suspended. The implications of missing the upcoming agricultural season will likely devastate people’s livelihoods.
• The lack of entry of commercial supplies into northern Gaza for nearly three months has resulted in a near total absence  of protein sources such as meat and poultry on the local market, with only a few types of locally produced vegetables available at unaffordable prices. Moreover, markets in central and southern Gaza are affected by ongoing hostilities, the reduced entry of commercial truckloads and the high risk of looting. Fewer varieties, less quantities and higher prices are observed. Fresh produce is available but at inflated prices compared with the first half of July. For example, the price of eggs has increased by more than 60 per cent - while personal hygiene items are barely seen in the market.

Response

• Between 29 July and 4 August, the Coastal Municipal Water Utility/Palestinian Water Authority (CMWU/PWA) reported that the average water supply for safe drinking and domestic purposes was approximately 93,000 cubic metres across the Gaza Strip, or just about a quarter of water supply prior to the escalation of hostilities.  This includes 49,500 m3 of water produced by water wells (municipal, UNRWA, private). 
• In July, 75,460 litres of fuel were received by WASH partners, a 29 per cent increase compared with June, although it only addresses 70 per cent of the minimum operation threshold and 35 per cent of the essential critical needs to ensure the public health objectives of the WASH sector. 
• In northern Gaza, the lack of fuel deliveries for 10 days in late July meant the population was reliant on the North Mekerot supply line and private vendors. Repair works on UNRWA groundwater wells are ongoing and only four out of seven are operational. 
• The Israeli military’s evacuation orders in Khan Younis have stopped the access of WASH partners to two reservoirs, ten groundwater wells and four brackish water desalination plants, with serious concern that these facilities will be damaged or destroyed.  Therefore, groundwater wells in western Khan Younis have increased water production hours to compensate and water trucking has scaled up from 400 to 600 cubic metres a day.
• Ten UNRWA health facilities/medical points were assessed with the WASH Fit tool, which ensures that different partners cover the specific criteria of health facilities and assess the capacity to respond in the event of an infectious outbreak. Plans are ongoing to expand the work of Infection Prevention Control technical teams to other facilities.

Challenges

• The lack of generators and alternative energy sources, combined with the shortage of fuel and spare parts to operate existing generators, continue to severely hamper water production and sewage pumping, exposing the population to major health risks across the Gaza Strip. For example, there is currently a lack of fuel and spare parts to address reported sewage flooding between Az Zawaida and An Nuseirat Refugee Camp, particularly around As Sawalha pumping station.
• The Middle Area Short Term Low volume (STLV) and South Gaza STLV desalination plants were closed on 27 July due to nearby bombardments that risked damaging the operational plants.
• Israeli forces have reportedly damaged the Canada reservoir water facility in Rafah. Footage shows soldiers detonating explosives on the pump machinery. The site remains unassessed. The Canada reservoir is a critical blending and distribution point for central and western Rafah, serving 150,000 people prior to the escalation of hostilities.
• WASH response actors cannot keep up with the high number of requests to remove sludge from septic tanks and cesspools and flooded sewage from streets due to a lack of vacuum trucks. The private sector is also struggling to meet demand.
• The depletion of chlorine reserves, consumed at double the rate before the war, requires the urgent import of new chlorine supplies to facilitate water purification.

Response

• Between 22 July and 6 August, following the issuance of several evacuation orders by the Israeli military and notwithstanding minimal resources, Shelter Cluster partners provided family tents to 327 families who were displaced from east to west Khan Younis or from parts of Deir al Balah to other locations. 
• In northern Gaza, partners provided 245 tents to a new IDP site in Jabalya, and 250 tents to IDP families returning to their damaged buildings, while preparations are ongoing to dispatch additional tents and NFIs. In Deir al Balah, NGO partners provided shelter materials and NFIs to about 115 families who were recently displaced from northern Gaza. 
• The Shelter Cluster continues to track destinations and needs of new IDPs in Deir al Balah and Khan Younis governorates and provide, where possible, shelter support (e.g. tents, NFIs, sealing off kits).

Challenges

• Partners remain unable to implement a meaningful Shelter response due to the severe lack of shelter materials and NFIs in Gaza mainly due to access and logistical impediments, the breakdown of law and order, and the risk of looting. There is no clear data on shelter and NFI materials already at Kerem Shalom Crossing and could not be picked up by partners due to lack of access. 
• Restrictions by the Israeli authorities on the transport of shelter materials between northern and southern Gaza means that partners cannot cover needs as they arise.  
• Recurrent displacement and limited access to many locations continue to hinder the ability of Shelter and NFI actors to carry out assessments and develop a comprehensive understanding of needs.  

Response

• Between January and June 2024, Child Protection partners in Gaza provided critical case management services to highly vulnerable children, with over 12,000 cases recorded by partners. Most are children with disabilities, many of whom have been injured in hostilities and others who have pre-existing disabilities and have lost their support network and/or assistive devices (e.g. wheelchairs and hearing aids) during multiple rounds of forced displacement. Cases of neglect, post-traumatic stress disorder or psychological distress among children are among the most critical concerns that necessitate the scale up of mental health and trauma support. (see the Child Protection online dashboard). 
• UNRWA Protection teams continue to identify and respond to the exponentially increasing protection risks and needs of displaced people in Khan Younis and Deir al Balah, by conducting visits to shelters and IDP sites, undertaking focus group discussions and key informant interviews with IDPs, monitoring aid distribution, and ensuring follow up on previously identified vulnerable cases. They also continue to provide Explosive Ordinance Risk Education (EORE) and Prevention of Sexual Exploitation and Abuse (PSEA) awareness sessions.
• The Protection Cluster and partners kicked off the Emergency Protection Responder (EPR) training, targeting 100 responders, to build a workforce of frontline protection actors to support humanitarian response across Gaza.   More than 250 people have registered for the training, with several other community groups and NGOs expressing interest. 
• GBV messages and tips on safe identification and referral were further disseminated during the reporting period. GBV sub-cluster has also updated the content of the Dignity Kits to include winter-specific items.
• Following the opening of sheltering services in cooperation with the Center for Women Legal Research and Consulting, efforts continue to introduce GBV, child protection (CP) and other related service providers with the safe shelter's operating procedures, criteria and legal framework for protecting and empowering women and families.
• Ten explosive hazard assessments (EHA) at humanitarian sites and 13 route assessments in support of inter-agency convoys were conducted during the reporting period. In-person EORE sessions continue to be delivered, with a focus on displacement areas in Nuseirat, Deir al Balah, Khan Younis and Gaza; digital campaigns using SMS, radio and social media; awareness-raising sessions for humanitarians; distribution of materials, and Training of Trainers (ToT) sessions for local partners.

Challenges

• Insecurity, the disruption of aid flows, the breakdown of law and order, and the denial of entry of critical items continue to hinder the Protection Response. Denied items include mine action supplies, sanitary pads, dignity and Menstrual Hygiene Management Kits (MHM) for women and girls, recreational materials for children, as well as assistive devices for persons with disabilities. 
• Shortage of tents affects the ability to expand group-based psycho-social support and support safe space or temporary accommodation for unaccompanied children. The limited availability of supplies, including menstrual hygiene management kits and dignity kits, on the local market in southern Gaza has disproportionate impact on women and girls at risk of GBV and increasing their vulnerability to disease and violence.  
• Widespread blackout, poor access and connectivity to communications services, fuel shortages and damage to key infrastructure continue to curtail mobility, and implementation of activities. Repeated evacuations, ensuing displacements and limited access to areas affected by hostilities, including in northern Gaza, continue to constrain community outreach, referral pathways, and protection activities. 
• Following the evacuation orders in Khan Younis, findings of a recent assessment by GBV sub-cluster partners showed that 44 per cent of service providers who responded were forced to close service delivery points and could not relocate, with a disproportionate impact on women, girls under 17 years of age, the elderly, and PBW. Repeated displacement denies women and girls access to any safety, shelter, food and safe drinking water. The findings point to the increasing difficulty to trace the beneficiaries and resume service provision amid frequent evacuations. 
• The indirect impact of the evacuations is the increasing cost of service delivery as transportation is becoming more costly and   communicating with the beneficiaries is becoming more limited. Frontline workers, who are also displaced, are working in a space that is rapidly shrinking, threatening their ability to ensure continued support and cope with the increasing demand for their services. 
• Cash shortages are hindering the use of Cash and Voucher Assistance (CVA) by some recipients, negatively impacting living conditions, increasing the risk of exposure to violence or exploitation for women and girls, and hindering the ability of partners to pay local service providers and staff salaries.  
• The closure of the Rafah Crossing continues to impede the entry/exit of international aid workers. 
• Lack of funding continues to limit the deployment of additional EOD experts and Explosive Ordnance Risk Education and Conflict Preparedness and Protection (EORE-CPP) teams to meet the soaring needs. Administrative hurdles, such as registration of organizational entities and delayed provision of visas, continue to prevent the scale up of mine action work. 

Response

• During the reporting period, Cluster members supported about 15,000 children (43 per cent boys and 57 per cent girls), by delivering psychosocial support, recreational activities, awareness sessions, and informal learning activities in North Gaza, Gaza, Deir al Balah and Khan Younis governorates. Cluster Members established more than ten new Temporary Learning Spaces (TLS) to enhance opportunities for a return to learning. Currently, there are 48 TLSs (28 in Deir al Balah, 19 in Khan Yunis, and one in north Gaza), providing improved access to learning for approximately 8,750 students.
• On 1 August, UNRWA launched a “Back to Learning” programme at UNRWA schools/shelters in Gaza city as well as Deir al Balah and Khan Younis governorates. The programme seeks to provide safe spaces for children to play, learn and cope with trauma. The first phase is focused on expanding psychosocial support activities, creating spaces for children to reunite with old friends and make new ones, and raising awareness on the risks of explosive ordnance, with plans to gradually expand to cover nearly 100 schools. The second phase will focus on reading, writing and math lessons, among other informal learning activities, until conditions allow for the resumption of formal education (source: Education Cluster 5W dashboard).

Challenges

• Education supplies, which are crucial for the return to learning, continue to be labelled as non-humanitarian items and are repeatedly denied entry into Gaza. On 28 July, three trucks carrying UNICEF education supplies, which were initially approved for entry, were denied entry and forced to turn back to Al Arish. This deprives children and teachers of the needed educational materials.
• Attacks on education continue. The Education Cluster released the findings of a new damage assessment that relies on satellite imagery collected on 6 July, showing an increase of 6.5 per cent in the number of damaged school buildings compared with the May analysis. Nearly 85 per cent of school buildings are currently estimated to require significant reconstruction before they can be used for education purposes, which means that at least 525,000 students will have no learning spaces to return to. According to the Ministry of Education, as of 6 August, 9,317 students and 397 educational staff have been killed, while more than 14,614 students and 2,246 teachers have been injured since 7 October.

Response

• On 27 July, the ETC shared the findings from the inter-agency security assessment conducted at three sites on 21 July to identify a joint operating base for humanitarians in Gaza city. The summary of the findings included the critical gaps, action points, and challenges in setting up a Security Communications Systems (SCS) repeater site in Gaza city.
• Four solar-powered solution kits were successfully delivered to Gaza city on 24 July. 
• The ETC Cluster also continues to advocate for the need to import more ICT and telecommunications equipment into Gaza to set up common communications services. For more information on ETC activities, please visit: Conflict | Emergency Telecommunications Cluster (ETC) (etcluster.org).

Challenges

• Due to escalating hostilities, increased restrictions on the movement of commodities, damaged infrastructure and lack of fuel and spare parts, local Mobile Network Operators and Internet Service Providers in the Gaza Strip are experiencing network outages and are unable to conduct the necessary repairs. Current conditions are also rendering it difficult to maintain the functionality of the remaining network and have resulted in the loss of connectivity in Rafah.  
• The availability of telecommunications equipment is severely limited, hampering the delivery of ETC services. A significant amount of equipment has been damaged or destroyed, and the import of new equipment has been lengthy and challenging. Only 20 satellite phones, 30 VHF digital radios, four VHF repeaters and four solar power solutions have been coordinated for importation into Gaza with Israeli authorities since 7 October 2023. 
• Increasing insecurity, displacement, and relocation of staff from Rafah to Deir al Balah have rendered it difficult to deploy shared ETC communications services or provide face-to-face technical support for humanitarian responders. 
• The lack of funding has limited the ETC Cluster’s capacity to address immediate communications needs for humanitarian responders in Gaza. Thus far, less than 32 per cent of requested funding (US$1.8 million) by the Cluster under the updated OPT Flash Appeal has been received.