Gaza Humanitarian Response Update | 6-12 May 2024

Response

• Although heightened insecurity and the issuance of evacuation orders by Israeli authorities have already negatively affected the operations of some health facilities, Health Cluster partners continue to provide healthcare services across the Gaza Strip. 
• The remaining functional hospitals currently have a 2,730-bed capacity in total, including 526 beds at nine field hospitals and the rest at 12 partially functional hospitals.
• Twenty Emergency Medical Teams (EMTs) are currently deployed across Gaza, including two in the northern areas.
• Efforts continue to restore health services at Nasser Medical Complex in Khan Younis, which is expected to formally reopen next week. Between 6 and 12 May, the hospital already started providing hemodialysis treatment to patients who can no longer access services at An Najjar Hospital in Rafah.

Challenges

• Four hospitals, eight primary healthcare centers and 35 medical points are located within areas subject to the evacuation orders issued by Israeli authorities. The An Najjar Hospital in Rafah has ceased providing services, resulting in the loss of 220 beds. If Kamal Adwan and Al Awda hospitals in North Gaza are also forced to stop functioning due to fuel shortages and hostilities, an additional 260 beds will be lost.
• The continued closure of Rafah Crossing and the lack of safe and logistically viable access to the Kerem Shalom Crossing are increasing the risk of shortages in medical and other supplies necessary for the continuity of health services across Gaza. The current situation is also preventing the rotation of EMT personnel and the entry of additional EMTs into Gaza.
• Limited fuel availability continues to hamper health interventions at hospitals and primary healthcare facilities.

Response

• Partners have expanded their interventions at existing centers in Khan Younis, Deir al Balah, and in all schools sheltering internally displaced persons (IDPs). 
• Since mid-January, at least 70,583 children aged 6-59 months have undergone Mid-Upper Arm Circumference (MUAC) screenings, of whom 5,169 have been diagnosed with acute malnutrition, including 3,986 with Moderate Acute Malnutrition (MAM) and 1,183 with Severe Acute Malnutrition (SAM). 
• A total of 38 mother-to-mother support groups have been established. In April, more than 78,000 caregivers of children under the age of two were reached with messages on Infant and Young Child Feeding Practices in Emergencies (IYCF-E).

Challenges

• Cases of acute malnourishment among children continue to rise due to the unprecedented food crisis, deteriorating health, water and sanitation services, and widespread fear and stress undermining the ability of mothers to breastfeed their babies.  
• The scale-up of nutrition interventions has been reversed in Rafah, where at least three out of 22 health facilities and 25 out of 35 medical points providing nutrition services were closed, due to the latest evacuation orders and military escalation. In addition, new services due to open last week in northern Gaza were put on hold due to the escalating situation.  
• Access constraints across Gaza continue to hamper the early detection of children and women in need of nutrition services and the safe scale-up of operational presence and needed support.

Response

• Mapping shelter stocks and response activities to identify gaps and sharing with partners an updated guidance on prioritization.

Challenges

• No remaining stocks of shelter materials inside Gaza. The shelter cluster partners continue to advocate for greater access to Gaza for trucks carrying shelter items. 
• Very low remaining stocks of fuel, for distribution of shelter and non-food items by cluster partners. 
• The rapid, large-scale population movement out of Rafah and the fluidity of the situation more generally. 
• Households’ own lack of access to transport for carrying shelter items. 
• Lack of safe identified locations for shelters. 

Response

• Efforts continue to enhance protection monitoring, assessments, coordination, and mainstreaming, including the integration of GBV prevention and risk mitigation and mine action in the activities and plans of other clusters and working groups. 
• Child Protection: Child Protection actors are scaling up activities to prevent and respond to family separations and enhance the identification and registration of unaccompanied and separated children. In the month of April, Child Protection partners reached 65,217 children and 13,641 caregivers with a range of services, including identification, registration and alternative care provision for unaccompanied and separated children, mental health and psycho-social support (MHPSS), distribution of clothes and shoes and awareness raising on Explosive Ordinance Risk Education and Child Rights (See here for data on the response.)  
• Gender-Based Violence (GBV): During the reporting period, 990 boxes of sanitary pads were distributed to GBV Sub-Custer partners across the Gaza Strip to support women and girls. The mapping of available GBV services in Khan Younis and Deir al Balah is being updated, and efforts are ongoing to ensure that all implementing partners on the ground are familiar with safe referral pathways and the updated service map.  
• Mine Action: Between October 2023 and the end of April 2024, Mine Action partners conducted over 50 Explosive Hazard Assessments (EHAs) and supported more than 95 inter-agency convoys. Moreover, partners repeatedly reached around 1.5 million people through digital EORE campaigns, while 206,219 people were reached through in-person EORE activities, and 47,500 informational materials were distributed.

Challenges

• Evacuation orders, displacement, and concurrent increases in rent and transportation costs are hindering service delivery and access to aid. Protection Cluster actors have been forced to relocate their services, with many providers and their families displaced themselves. There is a limited presence of frontline staff in Al Mawasi, where there is a high population density. This has also negatively impacted the re-establishment of GBV referrals and services, with partners reporting a lack of tents in Khan Younis and Deir al Balah and exorbitant rent costs. Transportation costs have similarly increased, heightening the cost for accessing services, including for women and girls.   
• Cash shortages are hindering the encashment of Cash and Voucher Assistance (CVA) by some recipients; this is negatively affecting 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 abrupt interruption in the entry of fuel has nearly halted activity implementation. Monitoring and coordinating activities are not possible unless more fuel is immediately allocated to partners.  
• Frequent interruptions of internet and communications services as well as damage to key infrastructure continue to curtail mobility and operations.  
• Logistic and security constraints continue to hamper the creation of safe spaces for confidential GBV case management activities, such as safe houses/shelters for high-risk cases, the Clinical Management of Rape (CRM), and the implementation of alternative care options for unaccompanied children.    
• Denial of entry of critical items, such as mine action supplies, sanitary pads, dignity and menstrual health management kits for women and girls, as well as recreational materials for children. These supplies are absent or extremely limited on the local market and, when available, are very expensive.     
• Administrative hurdles, such as registration of organizational entities and delayed provision of visas. 

Response

• The Logistics Cluster-operated cargo notification system has so far been utilized by 32 organizations, informing them once their cargo arrives at the Rafah transshipment point and is ready for pick up. 
• To date, the Cluster has facilitated storage services (with pick-up at Rafah transshipment point) for 31,335 cubic metres of humanitarian supplies on behalf of 32 partners at four warehouses in Rafah.   
• On 7 May, the sixth direct convoy, comprising 24 trucks of food assistance provided by two partners, was dispatched from Amman via the Jordan Corridor and entered northern Gaza through Erez Crossing. On 9 May, a seventh direct convoy comprising 25 trucks of food departed from Amman and entered Gaza through Kerem Shalom Crossing. 
• The Logistics Cluster is in the process of setting up a new warehouse (1,700 square metres) in Deir al Balah for common storage by humanitarian actors. 
• On 7 May 2024, a security incident occurred at the Logistics Cluster common storage facility in eastern Rafah due to active hostilities, likely resulting in damage or loss of aid commodities. The warehouse remains inaccessible due to the volatile security situation and will be assessed as soon as security conditions allow.  
• As of 5 May, the pipeline forecast for the next three months stood at 285,741 metric tons of humanitarian aid, including 180,801 metric tons through the Egypt corridor, 36,367 metric tons through the Jordan corridor, 26,090 metric tons exclusively of flour from the Ashdod port, and an additional 42,483 metric tons of cargo which are yet to be allocated to a specific corridor.
• A convoy of five trucks transporting key equipment - such as mobile storage units and prefabs – that was dispatched from Jordan through the Amman-Aqaba-Nuweiba-Al Arish-Kerem Shalom-Rafah route on 30 April, is still awaiting entry into Gaza in Al Arish.

Challenges

• The overall deterioration in the security situation severely hampers the movement of aid workers and humanitarian relief items across the Gaza Strip.  
• Infrastructural damage, access challenges, lengthy checkpoint clearance procedures, lack of logistical supplies, assets and spare parts, as well as extreme fuel shortages continue to limit storage and transport capacity within Gaza.  
• The absence of a regular schedule for convoys travelling directly from Amman to Gaza prevents effective planning and a timely and reliable flow of aid via the Jordan Corridor. Other convoys carrying assistance via the King Hussein/Allenby Bridge have been paused as humanitarian cargo will now require Israeli customs clearance; the resumption date remains unknown pending clarification on custom clearance requirements. 
• The Logistics Cluster has no presence at crossings or cross-loading points, preventing real-time visibility on cargo approved or rejected by Israeli authorities. 
• Access to northern Gaza remains extremely limited. 
• Uncertainty around the opening of additional entry points continues to undermine effective planning and international procurement of cargo.

Response

• On 6 May, the ETC Cluster relocated, installed, and tested the complete Very High Frequency [VHF] radio repeater system and a dedicated 24/7 solar power solution from Al Shaboura Clinic in Rafah to the WFP guesthouse in Deir al Balah to ensure there is a reliable and secure communications platform for humanitarian responders. 
• The ETC Cluster is assessing with UNDSS and OCHA a plan for internet connectivity at the newly proposed Joint Humanitarian Operations Centre [JHOC] in Deir al Balah, including preparations for addressing data connectivity gaps and carrying out needed ICT assessments. 
• For more information on ETC activities, please visit: Palestine: Conflict | Emergency Telecommunications Cluster (ETC) (etcluster.org). 

Challenges

• The ETC Cluster urgently needs US$1.8 million requested in the revised oPt Flash Appeal launched on 17 April to address critical life-saving communication efforts in Gaza until 31 December 2024. Due to protracted funding challenges, the Cluster is currently unable to purchase the complete Security Communications System [SCS] kits which were pre-approved by Israeli authorities. Once acquired, the Cluster plans to install a kit at each site in Deir al Balah, Gaza city and Jabaliya.
• Limited access to electricity, fuel and telecommunications services continue to hamper effective coordination of the emergency response and delivery of life-saving aid. Due to shortages of fuel, Mobile Network Operators [MNOs]―Jawwal and Ooredoo―are only able to operate at 40-50 per cent of their capacity.
• The import of telecommunications equipment into Gaza remains lengthy and extremely challenging. Only 20 satellite phones, four VHF repeaters and 50 VHF handheld radios have been approved by Israeli authorities since 7 October 2023.

Response

• Between 6 and 12 May, the SAWA helpline answered 1,629 calls, delivered 830 psychosocial counseling sessions, and referred 265 cases through official protection referral mechanisms. 
• In-person training and consultation sessions on PSEA continue to be regularly conducted for humanitarian responders and service providers.  
• UNICEF and its partners started the implementation of a community-led Initiative project in Gaza, which aims to assist volunteer community groups and PSEA focal points on the ground in Gaza to address immediate humanitarian and protection needs within 75 communities in Gaza. 
• As of 12 May, Sanad's Facebook, Instagram and Telegram accounts had around 8,000 followers in total, 70 per cent of whom were women.

Challenges

• Safely reaching people in need of assistance across Gaza remains a major challenge. 
• Internet and telecommunication blackouts continue to hinder remote mental health and counseling support to victims and contribute to underreporting of potential SEA cases through the helplines. 
• Two in-person PSEA sessions had to be cancelled during the reporting period due to the developments in Rafah.