Gaza Humanitarian Response Update | 5-18 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, 239,580 children aged 6-59 months have been screened for malnutrition. Of all screened children, 14,750 were diagnosed with acute malnutrition, of whom 11,462 with Moderate Acute Malnutrition (MAM) and 3,288 with Severe Acute Malnutrition (SAM), including 138 suffering from SAM with medical complications. Cases identified have been receiving treatment in four Stabilization Centres and 102 Outpatient Programme sites supported by WHO, UNICEF and their partners.   
• Partners have endeavored to expand the screening of pregnant and breastfeeding women (PBW). Some 27,617 PBW have been screened since January, and 1,801 PBW have been enrolled for treatment. Between 9 and 10 per cent of PBW screened in the months of June and July were found to be acutely malnourished (MUAC below 23 centimeters).
• Between 3 and 16 August, 26,825 children under the age of five and 12,728 PBW received a 30 day-allocation of Lipid-based Nutrient Supplements (LNS-MQ) in Khan Younis, Deir al Balah and Rafah, under the WFP Supplementary Feeding Programme. Along with LNS-MQ distribution, 19,045 mothers and caregivers were sensitized on Infant and Young Child Feeding (IYCF) practices.

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. While tents have been set up to conduct malnutrition screenings and provide services, 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-MQ, Ready-to-Use Therapeutic Food (RUTF), and Ready-to-Use Infant Formula (RUIF).

Response

• As of 19 August, 12 out of 18 bakeries supported by humanitarian partners were operational in the Gaza Strip - six in Deir al Balah, four in Gaza city and two in Jabalya. One bakery in Deir al Balah ceased operations on 10 August due to shortages of cooking gas, while the five bakeries in Rafah remain closed due to ongoing hostilities. One more bakery in Khan Younis is expected to commence operations soon to respond to the increasing needs in the governorate. 
• In response to repeated forced displacement caused by evacuation orders issued by the Israeli forces, a one-time distribution of ready-to-eat food parcels was made available to newly displaced people. Following the attack on the Al- Tabi’een school in Gaza city on 10 August, partners immediately mobilized, providing pastries, cooked meals and food parcels to affected populations. 
• To improve people’s access to bread, 50 per cent of bread production at all 12 active bakeries is currently being 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 kilograms of bread. 
• As of mid-August, about 500,000 cooked meals prepared in 160 kitchens were provided daily to families across the Strip. This represents a 30 per cent decrease compared with up to 700,000 meals provided at 200 kitchens in early July. This is attributed to the present scale of hostilities, lack of food supplies and cooking fuel due to the limited entry of humanitarian aid.
• During the reporting period, more than 2,400 veterinary kits were distributed to livestock-keeping households in southern and central Gaza to improve animal health and preserve herding livelihoods. This was the first time such kits entered the Strip since October 2023.
• Since early August, Food Security Sector partners and the Education Cluster have started providing school snacks, such as high-energy biscuits or date bars, in various learning spaces. This aims to support the resumption of education activities across the Strip and encourage children’s active participation. 

Challenges

• As of mid-August, more than 30 kitchens were forced to suspend their work or relocate due to the multiple evacuation orders issued in Khan Younis and Deir al Balah. FSS partners’ personnel have also been displaced, further contributing to the disruption in food delivery. 
• Partners lack sufficient food stocks to meet requirements for August. Insecurity, damaged roads, the breakdown of law and order, and access limitations have worsened along the main humanitarian route between the Kerem Shalom Crossing and Khan Younis and Deir al Balah. This has resulted in critical shortages of aid commodities to sustain operations, increasing the risk of spoilage and infestation of stranded food supplies due to high temperatures.
• The passage of fuel and other humanitarian supplies between southern/central Gaza and the north and via all crossings remains impeded. Ensuring continuous fuel supply to all bakeries and other essential services remains the utmost priority for FSS partners. 
• It is anticipated that the energy crisis will further worsen in upcoming months as winter and the rainy season approach. Protracted shortages of cooking energy continue to force displaced families to cook by burning wood from waste, which hinders proper food preparation and nutrition intake, exacerbates health and protection risks, and causes environmental hazards.
• The lack of entry of commercial supplies into northern Gaza for more than three months has resulted in a near total absence of protein sources such as meat and poultry, with only a few types of locally produced vegetables available at unaffordable prices. Although humanitarian partners were able to transport a few trucks of fresh produce to the north, commodities were subject to high rates of spoilage and were insufficient to meet the vast scale of needs.
• As most of the food rations provided contain gluten, there is a significant gap in supporting hundreds of people with Celiac Disease, Phenylketonuria and other medical conditions requiring special diets, with appropriate food rations.
• The shortage of animal feed and essential veterinary materials in the Strip impacts animal health and welfare and prevents livestock holders from providing decent care to them. It hinders local production of fresh nutritious food like meat and dairy products, which are key to a healthy and nutritious diet, especially for children.
• The lack of entry of seeds, fertilizers and other livestock 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 emergency 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. 
• A multi-sectoral integrated response is essential to address food insecurity, particularly during the upcoming winter season. The winterization needs of other clusters, including Shelter, WASH, Health and Logistics, must be urgently addressed to improve the food security response. If physical road access, healthcare provision, as well as energy, water, sanitation, hygiene and shelter conditions are further compromised, there is a high risk that the food insecurity and malnutrition situation will worsen beyond the already alarming rates observed across the Strip.

Response

• Between 5 and 18 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 95,000 cubic metres per day across the Gaza Strip, or just about a quarter of water supply provided prior to October 2023. This includes 42,500 cubic metres of water produced by water wells (municipal, UNRWA, private).
• During the reporting period, WASH Cluster partners received about 20,000 litres of fuel per day, which represents only 28 per cent of the minimum daily threshold of 70,000 litres required to meet critical needs and ensure the public health objectives of the WASH sector.
• A total of 20 Cluster partners implemented a WASH assessment entailing both household-level evaluations and Key Informant Interviews across IDP sites, including UNRWA shelters, non-UNRWA collective centers and informal settlements. The assessment is expected to be completed by early September. 
• Water trucking operations are now a significant means of distributing water across the Gaza Strip, with many people relying on direct collection from trucks or from communal distribution points. Twenty-two partners are distributing over 7,000 cubic metres of water daily to 775 registered locations.
• The Cluster is finalizing a WASH Winterization Preparedness and Response Plan to mitigate risks of stormwater flooding. In 2023, the Cluster identified about 180 high-risk locations prone to flooding in Gaza, but this number is expected to be significantly higher due to the extensive destruction. Partners have prioritized a list of supplies, materials and equipment needed to prepare for an effective flood response, including mobile pumps, jetting and vacuum trucks, personal protective equipment (PPE) and hoses. 

Challenges

• The evacuation orders issued during the reporting period have significantly hindered the ability of Cluster partners to provide services. The order on 16 August alone disrupted operational access to 12 groundwater wells, three reservoirs, one sewage pumping station and one temporary solid waste dump site. In Deir al Balah, the loss of water production is estimated at 70 per cent (9,000 cubic metres a day). While the water procured through the Mekerot Bani Suhaila pipeline might still be available, partners have lost access to the control valves for the network and are thus unable to manage the flow of water, with further assessments currently underway.
• Since January, no chlorine has entered Gaza to treat drinking water with the current reserves projected to last one month. This is deeply alarming given the reported outbreaks of hepatitis A and polio. The need for chlorine is even more urgent in the winter, as waterborne diseases are likely to increase, placing the lives of thousands at risk, especially children. The situation is further complicated by the need to double the chlorine dosing (12 per cent presently, compared to 6 per cent before October). This is due to the degradation of chlorine solution concentration caused by prolonged storage and rising temperatures. 
• The stormwater drainage network in Gaza is combined with the sewage network in a number of areas. In heavily destroyed areas, where an estimated 68 per cent of the infrastructure is damaged, there is already clogging and flooding, with raw sewage pooling in streets and IDP sites. This situation poses a dual risk during the rainy season: potential flooding and the contamination of water sources and contact with the population. 
• Acute shortage of critical hygiene products, including handwashing soap, laundry powder/liquid, shampoo, and disinfection solutions continue to exacerbate the spread of diseases. Even when these products are available in the market, people cannot afford them.

Response

• Between 5 and 18 August, despite the Israeli-issued evacuation orders and minimal resources, Shelter Cluster partners provided family tents to 499 families who were displaced within Khan Younis or from parts of Deir al Balah to other locations.
• In northern Gaza, partners provided 600 tents to IDP families attempting to return to their damaged homes. 
• The Shelter Cluster continues to track the needs of new IDPs in the Deir al Balah and Khan Younis governorates and provide shelter support, including tents, Non-food items (NFI)s and sealing off kits.

Challenges

• The severe lack of shelter materials and NFIs, which is particularly acute in central and southern Gaza, continues to hamper the Cluster’s ability to implement a meaningful response, mainly due to movement and logistical impediments, the breakdown of law and order, and the risk of looting. The inability to use the Kerem Shalom Crossing to bring humanitarian items into Gaza is a key obstacle.
• Restrictions imposed by the Israeli authorities on the transport of shelter materials between northern and southern Gaza means that partners cannot cover needs as they develop. 
• Recurrent displacement and access impediments continue to hinder the ability of Cluster partners to carry out assessments and acquire a comprehensive understanding of needs.

Response

• Protection Cluster partners continue to identify and respond to the exponentially increasing protection risks and needs of displaced people across the Strip. For instance, in Khan Younis and Deir al Balah, UNRWA Protection teams have been 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 Ordnance Risk Education (EORE) and Prevention of Sexual Exploitation and Abuse (PSEA) awareness sessions. 
• The Gender-Based Violence (GBV) and Child Protection (CP) Sub-Clusters held a first workshop with national partners focused on child protection, GBV and prevention of sexual exploitation and abuse. The workshop resulted in the production of a draft Standard Operating Procedure (SOP) on Prevention and Protection of Child Survivors.
• The GBV Sub-Cluster has also updated the content of the Dignity Kits to include winter-specific items and messages and guidelines on the safe identification and referral of GBV cases were further disseminated to Protection and other humanitarian partners 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 also continue, as well as awareness-raising sessions for humanitarians and the distribution of materials, and Training of Trainer (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 provide safe spaces or temporary accommodation for unaccompanied children. The limited availability of supplies on the local market, including MHM and dignity kits has disproportionate impact on women and girls at risk of GBV and increases their vulnerability to diseases and violence.
• Widespread blackouts, poor connectivity and access to communications services, fuel shortages and damage to key infrastructure continue to curtail mobility. 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.
• About 44 per cent of service providers were forced to close service delivery points and could not relocate due to evacuation orders and continuous population displacement. These have heightened the risk of GBV and the need for gender-responsive interventions, as they disproportionately impact women, girls under the age of 17, the elderly, and PBW.
• The indirect impact of the evacuations is the increasing cost of service delivery as transportation is becoming more costly and communication with beneficiaries is increasingly challenging. Frontline workers, who are also being displaced, are working in an increasingly shrinking space, struggling to trace beneficiaries, ensure continued support, and cope with the rising demand for 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

• Education Cluster members provided at least 5,500 school-aged children (43 per cent boys and 57 per cent girls) with access to learning activities in at least five newly established Temporary Learning Spaces (TLSs) in Asdaa Refugee Camp, in Khan Younis, and Al-Mashallah neighbourhood, in Deir al Balah. These children also received some minimal learning materials salvaged from the remainder of supplies that partners could locally mobilize. In addition, 100 parents and caregivers participated in awareness-raising sessions on the main principles of social-emotional learning. These sessions aimed at helping parents develop skills to support their children with learning at home (source: Education Cluster 5W dashboard). 
• Following the launch of the UNRWA “Back to Leaning” programme on 1 August, 39 UNRWA schools serving as shelters for displaced populations are providing learning activities (23 in Deir al Balah and 16 in Khan Younis), reaching over 14,000 school-aged children and 464 teachers. Fifty-five more schools/shelters are scheduled to commence learning activities in Gaza city and North Gaza governorates. UNMAS is supporting UNRWA in ensuring safe access to schools in these governorates ahead of the activities.

Challenges

• Ongoing displacement due to continuous evacuation orders is severely impacting response efforts. Between 10 and 17 August, five UNRWA shelters and two non-UNRWA shelters have been forced to evacuate; disrupting several newly established TLSs. This ongoing crisis is exacerbating strained resources and impeding the expansion of educational activities. Safety concerns and the arrival of newly displaced people to shelter in classrooms designated for educational use are further complicating the situation. Additionally, since the resumption of learning activities in UNRWA shelters, there have been at least 13 recorded attacks on schools. Although these incidents have not directly affected UNRWA shelters, they are hindering the resumption of educational activities in schools. 
• Continued restrictions on the entry of education supplies, which are labelled as non-humanitarian items, have significantly limited the implementation of learning activities. Schools have lost their teaching and learning materials, and students have been unable to receive any supplies, making it difficult for teachers to effectively engage students. Additionally, there are no available supplies in the local market. The Cluster continues to urge all relevant stakeholders to intensify advocacy efforts to lift the restrictions on education supplies, both through humanitarian aid and the private sector.

Response

• During the reporting period, the ETC procured critical telecommunications and IT equipment, including Very High Frequency (VHF) radios and solar-powered solutions, from a local vendor in Ramallah and prepositioned them in Jerusalem. The equipment is intended to strengthen the Gaza Security Operations Centre (SOC) and will be used to set up new VHF repeaters in Gaza. The equipment will be transported into Gaza once approval from the Israeli authorities is obtained. 
• One of the four solar-powered solution kits delivered by the ETC to Gaza on 24 July is being delivered to UNRWA to facilitate humanitarian operations by UN agencies in Khan Younis. Recently, the ETC delivered a kit to the United Nations Department of Safety and Security (UNDSS) to provide uninterrupted power supply to the Gaza SOC, ensuring 24/7 operations. 
• The ETC Cluster continues to advocate for the need to import more 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

• 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 make 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 is 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 funding requested by the Cluster (US$1.8 million) under the updated OPT Flash Appeal has been received.