Hostilities in the Gaza Strip and Israel | Flash Update #118 | United Nations Office for the Coordination of Humanitarian Affairs

14 Feb 2024

Key points

Intense Israeli bombardment from air, land and sea continues to be reported across much of the Gaza Strip, resulting in further civilian casualties, displacement, and destruction of civilian infrastructure. Ground operations and heavy fighting between Israeli forces and Palestinian armed groups also continue to be reported, especially in Gaza’s southern city of Khan Younis.
Between the afternoon of 13 February and 12:00 on 14 February, according to the Ministry of Health (MoH) in Gaza, 103 Palestinians were killed, and 145 Palestinians were injured. Between 7 October 2023 and 12:00 on 14 February 2024, at least 28,576 Palestinians were killed in Gaza and 68,291 Palestinians were injured, according to MoH in Gaza.
Between the afternoons of 13 and 14 February, there were no Israeli soldiers reported killed in Gaza. As of 14 February, 230 soldiers have been killed and 1,352 soldiers injured in Gaza since the beginning of the ground operation, according to the Israeli military. In addition, over 1,200 Israelis and foreign nationals have been killed in Israel, according to the Israeli authorities, the vast majority on 7 October. As of 14 February, the Israeli authorities estimate that about 134 Israelis and foreign nationals remain captive in Gaza and reportedly include fatalities whose bodies are being withheld.
Airstrikes on Gaza’s southernmost city of Rafah and statements by Israeli officials have heightened concerns about a possible ground invasion in Rafah where well over one million people are crammed amid insecurity and acute shortages of shelter, food, clean water, and medical care. On 13 February, Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, Martin Griffiths, warned that a military operation in Rafah “could lead to a slaughter in Gaza” and “leave an already fragile humanitarian operation at death’s door,” noting that the “Government of Israel cannot continue to ignore these calls” by the international community.
Population movements out of Rafah toward Deir al Balah and An Nuseirat Refugee Camp have been reported, following intensified airstrikes on Rafah. This is occurring within the context of rising food insecurity, limitations on the entry of aid, the erosion of coping mechanisms, and the prospects of a ground operation in the area. On 13 February, the World Food Programme (WFP) expressed concern that displacement from Rafah would further decrease the resilience of people who have been previously displaced to Rafah in search of safety, and Action Against Hunger warned that it will be forced to suspend its activities if military operations expand to Rafah. On 12 February, the Food and Agriculture Organization (FAO) reported “unprecedented levels of acute food insecurity, hunger, and near famine-like conditions in Gaza,” warning that with every passing day “more and more people are simply going hungry and having less accessibility to food, nutrition, water, and medical services.”
Humanitarian and health workers continue to face enormous challenges and risks to serve people in need of urgent assistance and save lives, particularly given the insufficient materials and supplies that aid organizations are able to bring in, according to the Humanitarian Coordinator ad interim for the occupied Palestinian territory, Jamie McGoldrick. On 8 February, Project HOPE’s medical coordinator described the “inhumane conditions” she witnessed while working at Al Aqsa Hospital in Deir al Balah between 17 and 31 January, noting that “there were not enough health workers, medicine, or supplies to treat everybody.” On 10 February, the United Nations Population Fund (UNFPA), the World Health Organization (WHO) and OCHA delivered medicine, trauma supplies, and maternal health kits to Al Aqsa Hospital, following coordination with the Israeli authorities. The hospital is one of six hospitals that remain only partially functional south of Wadi Gaza, according to WHO. Like other partially functional hospitals across Gaza where average bed occupancy is 388 per cent, Al Aqsa Hospital is overwhelmed by the constant flow of patients and wounded persons, amid critical shortages of medical supplies, pharmaceuticals, fuel and health personnel, and has expanded services for less critical cases to two adjacent schools to cope with the rising caseload.
Nasser Hospital in Khan Younis continues to be besieged by Israeli tanks and there are continued allegations of sniper shooting toward the hospital and its vicinity, endangering the lives of 300 medical personnel, 450 wounded, and some 10,000 displaced people who are reportedly sheltering in the hospital’s compound. On 13 and 14 February, the Israeli military called for the evacuation of civilians seeking shelter at Nasser Hospital, claiming that military activities are being carried out from within the hospital’s compound. According to MoH in Gaza, three people were killed, and 10 others injured, inside Nasser medical complex by Israeli sniper fire in the afternoon of 13 February. Also on 13 February, the diesel generators of Nasser hospital reportedly ceased working, which reportedly led to the death of a 10-year-old child. As of 13:00 on 14 February, IDPs, including pregnant women and the elderly, were reportedly forced to begin to evacuate the hospital amid heavy gunfire in the area.
Damage to civilian infrastructure continues to be reported across Gaza, including residential buildings, schools, hospitals, roads, cemeteries, as well as water and sanitation facilities. In December 2023, UNICEF reported that at least half of water, sanitation and hygiene facilities have been damaged or destroyed in Gaza. UNRWA also reports that 152 UNRWA installations have sustained damage across Gaza since 7 October, including premises providing shelter to IDPs. According to UNOSAT data published on 1 February, 30 per cent of structures in the Gaza Strip have been destroyed or sustained severe to moderate damage, with the governorates of Gaza and Khan Younis experiencing the highest rise in damage in January 2024 compared to November 2023. On 10 February, the Education Cluster published a Satellite-derived Damage Assessment, which found that at least 55 per cent of 563 school buildings have been either directly hit or confirmed as damaged. On 8 February 2024, UN High Commissioner for Human Rights Volker Türk stated: “Such destruction of homes and other essential civilian infrastructure also entrenches the displacement of communities that were living in these areas prior to the escalation in hostilities.”

Hostilities and casualties (Gaza Strip)

Reports of attacks on police members and premises in Rafah continue. On 13 February, the police station in Zalata area, east of Rafah, was reportedly hit; no casualties were reported. Previously, on 6 and 10 February, nine police officers were reportedly killed in Rafah: six while guarding an aid truck, and three as a police vehicle was struck, respectively.
The following are among the deadliest incidents reported on 12 and 13 February:
- On 12 February, at about 13:00, two Palestinians, including a boy and his 21-year-old sister, were reportedly killed, when a group of people in Bader Refugee Camp in northwestern Rafah was struck.
- On 13 February, at about 1:00, five Palestinians, including a journalist and his son and daughter, were reportedly killed, when a residential building, near Ash Shuhada mosque in Deir al Balah was struck.
- On 13 February, at about 2:45, at least three Palestinians, including a young girl and two women, were reportedly killed, when a residential building in southern An Nuseirat Refugee Camp in Deir al Balah was struck.

West Bank Updates

Since 7 October 2023, 388 Palestinians have been killed, including 99 children, and 4,475 Palestinians, including 686 children, injured in conflict-related incidents across the West Bank, including East Jerusalem, and Israel. During the same period, 10 Israelis, including four members of security forces, were killed and 75 injured in conflict-related incidents in the West Bank, including East Jerusalem, and Israel.
On 12 February, Israeli settlers, accompanied by Israeli forces, raided Jinba community in the Masafer Yatta area in southern Hebron, searched Palestinian houses, and destroyed belongings inside some 18 houses. Israeli settlers also stole electric tools, water pumps and generators, as well as destroyed the main door of the community’s health clinic and speakers of the local mosque. Furthermore, settlers raided two animal pens, which caused panic among sheep and the death of two lambs while trying to run away. Since 7 October 2023, OCHA has recorded 532 Israeli settler attacks against Palestinians that resulted in Palestinian casualties (50 incidents), damage to Palestinian-owned property (423 incidents), or both casualties and damage to property (59 incidents).
On 13 February, a Palestinian residence was rendered uninhabitable after being targeted by two off-shoulder missiles during an operation by Israeli forces in Sir village in Jenin, displacing a family of six. Moreover, initial information indicates that the destruction of homes and roads, during the Israeli military operation in Jenin Refugee Camp on 13 February, has hindered the access of residents to Jenin city. Since 7 October 2023, 814 Palestinians, including 332 children, have been displaced, following the destruction of 127 homes during operations carried out by Israeli forces across the West Bank. About 94 per cent of the displacement was reported in the refugee camps of Jenin, Nur Shams and Tulkarm.
Since 7 October 2023, 513 people, including 251 children, have been displaced in Area C and East Jerusalem after their homes were demolished due to the lack of Israeli-issued building permits, which are almost impossible to obtain.

Funding

The Flash Appeal for the occupied Palestinian territory (oPt) was extended through the end of March 2024 on a “no cost” basis given that enabling operational conditions for the implementation of planned activities did not materialize, and requirements were split between the last quarter of 2023 and the first quarter of 2024. The Flash Appeal, which was launched in October 2023 and updated in November 2023, requests US$1.2 billion to meet critical needs of 2.7 million people across the oPt (2.2 million in the Gaza Strip and 500,000 in the West Bank, including East Jerusalem). As of 13 February, member states disbursed a total of $887.1 million against the updated Flash Appeal (72.2 per cent); this includes $608.7 million out of $629.1 million (96.8 per cent) requested for October-December 2023 and $278.4 million out of $600 million (46.4 per cent) requested for January-March 2024. For funding analysis, please see the Flash Appeal Financial Tracking dashboard.
The occupied Palestinian territory Humanitarian Fund (oPt HF) and the CERF are currently funding more than 94 ongoing projects in the Gaza Strip to address urgent humanitarian needs. These interventions, totalling approximately $77 million, cover needs in the areas of food security, shelter, water, sanitation and hygiene (WASH), health and protection. Since October 7, the oPt the HF has received a total of $86 million in contributions from member states and private donors. Private donations are collected directly through the Humanitarian Fund. Recently approved projects include $3.5 million for the Emergency Fleet Augmentation project that aims to enhance aid delivery to Gaza under the oPt HF, and $700,000 for “Strengthening Collective Gender Responsive and Inclusive Accountability to Affected People in OPT” under the CERF.

HUMANITARIAN NEEDS AND RESPONSE UPDATES | 5–12 February

Health

Needs

High need for primary health services in informal shelters hosting IDPs.
The high number of surgeries and procedures has led to increased demand for anaesthetic and analgesic medications which are in short supply.
There is a need to increase routine immunization coverage and conduct a catch-up campaign.
Provision of medication for non-communicable diseases and psychotropics is needed.
There is a need to reduce overcrowding in maternity hospitals.
The continued siege around some hospitals is significantly affecting their case management capacity.
Laboratory equipment and reagents are needed to support diagnostics.
Blood and blood products in hospitals are needed for emergencies and medical procedures to ensure that patients receive timely transfusions.

Response

Cluster partners are reaching a weekly average of about 450,000 people in need of various health services and supplies.
Ongoing disease surveillance at all health facilities is underway to ensure early diagnosis and treatment of cases as well as early detection of potential outbreaks.
Planning to open stabilization centres for acute malnutrition cases with medical complications. One will be at Tal as Sultan and another in one of the field hospitals.
12 Emergency Medical Teams (EMTs) were deployed, assisting more than 16,000 patients.
A weekly average of nearly 300,000 primary health care consultations was reported by partners.

Challenges and Gaps

There is a need to strengthen referral mechanisms between hospitals.
The influx of IDPs migrating to Rafah has overwhelmed the available bed availability in hospitals, leading to insufficient capacity to meet the healthcare needs of the population. Heigtened insecurity in Rafah is also greatly affecting response activities.
Heightened insecurity and limited access to health facilities in the northern and middle governorates continue to present major challenges for partners to respond.
Persisting siege of hospitals remains a major challenge.
Referring patients outside of Gaza remains a challenge, as the waiting list continues to grow.
Partner operations continue to be negatively affected by the displacement of staff, social stresses and telecommunication challenges.
Limited access to proper WASH facilities is hindering prevention of diseases.

Nutrition

Needs

There is a need for continued prepositioning of essential nutrition supplies to ensure timely access to life-saving supplies in areas facing significant challenges.
Ongoing collaboration with partners is still needed to enhance capacity in Mid-Upper Arm Circumference (MUAC) screening, identify cases of Severe Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM), and the delivery of effective treatment.
There is an urgent need to establish a stabilization centre in Rafah for treating children suffering from severe malnutrition and suffering from complications.

Response

Thirty-six staff members (17 Female, 19 male) received training on MUAC screening to enhance early case identification and treatment. The training is crucial for enhancing the capacity of our partners and expanding MUAC screening across affected areas.
Five implementing partners continue conducting screenings for malnutrition in 4,466 children aged 6 to 59 months, using MUAC measurements in shelters and health facilities. Children who are detected with MAM and SAM are referred for treatment using simplified treatment protocol.
The Nutrition Cluster continues to conduct MUAC training sessions every week.
UNICEF and WFP continue to collaboratively stock up nutritional supplies in the Gaza Strip and the West Bank.
The Nutrition Cluster is partnering with WHO to set up a stabilization centre in Rafah with five beds to treat children with SAM and suffering from medical complications.

Challenges and Gaps

Ongoing hostilities in Gaza have caused significant food shortages, poor access to clean water and sanitation facilities, and disruptions to healthcare services. This situation is putting children under five and pregnant or lactating women (PLW) at a relatively higher risk of malnutrition.
Without private areas for breastfeeding women, it is challenging to encourage and sustain breastfeeding practices. This lack of privacy could have lasting negative effects, particularly on children under two years of age and new-born babies.

Shelter and Non-Food Items (NFI)

Needs

Some 1.7 million people are need of shelter and NFI assistance, including 900,000 people reached with partial shelter and NFI assistance. Partial assistance means that although a household has received some shelter and NFI items, not all their needs have been met.
Urgent needs are tents, sealing-off kits (SOKs) and NFIs, including bedding, kitchen sets, and winter clothing. SOKs can be used to consolidate makeshift shelters or to protect damaged housing to facilitate return where possible.
Technical assistance is required to improve self-built shelters and spontaneous/informal sites. Also see Shelter Cluster snapshot, as of 7 February.

Response

A total of 26 partners are providing assistance. Some 28,000 tents, 7,600 SOKs, and 35,000 NFI kits are currently in the pipeline.
The vast majority of assistance is currently provided in-kind; cash will be pursued further when market conditions allow.
Further details in the Cluster response strategy and website dashboard.

Challenges and Gaps

Slow entry of items into Gaza due to limited aid trucks and bureaucratic processes are complicating procurement.
Rising prices of shelter materials in neighbouring markets, including high freight rates and shipping costs.
Need to restore commercial imports and re-establish local markets to relieve pressure on in-kind provision.
Restrictions on or denial of the entry of key shelter items including timber, hand tools, and cooking stoves.
Lack of security and access to IDP locations, including logistical challenges such as lack of fuel and rising social tensions because of the limited quantity of aid available in comparison to outstanding needs.
Unplanned sites and lack of adequate tools is leading to water damage to makeshift shelters and tents, and recurrent displacement resulting in loss and need for re-distribution of assistance.

Water, Sanitation and Hygiene (WASH)

Needs

Some 2.25 million people need WASH Assistance. Two-thirds of IDPs are concentrated in the Rafah area and urgently need WASH support.
Access to safe drinking water for the entire population of Gaza is needed, especially for IDPs and in the northern areas of Gaza.
Currently only 5.7 per cent of water is being produced from all the water sources in Gaza, compared to pre-war production levels. Safe drinking water and water for domestic use, including personal hygiene, remains very limited.
Only 17 per cent of the 284 groundwater wells are operating with limited hours; some 39 wells were destroyed and 93 were moderately to severely damaged.
None of the wastewater treatment systems are working due to damage, lack of fuel/power supply, and maintenance. Municipalities have limited water treatment, no water quality testing capacity, and no fuel for solid waste management, and operations have been suspended since 19 November 2023.
Mekorot Connections: Two of the three water pipelines are not functioning (the Mentar pipeline since the beginning of the conflict, and the Bani Suhaila pipeline since 18 December. The Bani Saeed pipeline is functioning, but is currently producing 6,000 cubic metres per day, which is only 42 per cent of its full capacity. Plans are in place to repair the Bani Suheila pipeline, but there are challenges for safe access, communication, and coordination of repair activities.
Two out of out of three desalination plans are partially operating: the Middle Area plant produces an average of 750 cubic metres per day and is distributed via water trucking and the South Gaza desalination plant produces 1,700 cubic metres per day; around 600 cubic metres are distributed via water trucking and 1,100 cubic metres via the water network.
The UAE's small desalination plant located on the Egyptian side of Rafah, operates at full capacity, providing 2,400 cubic metres per day, following the construction of a 3-kilometre transmission line.

Challenges and Gaps

The risk to public health is intensified due to an acute scarcity of hygiene materials and adequate sanitation infrastructure. Persistent anecdotal reports of Hepatitis A cases in Gaza, as recorded by UNRWA and the Health Cluster, highlight ongoing concerns.
The constraints of the clearance and transport of items considered to be dual-use into Gaza remain a limiting factor of the overall WASH response.
Sanitation remains a major issue and the situation continues to deteriorate. Despite significant efforts by UNICEF through its partners to construct 80 family latrines this week, the sanitation coverage remains very low. WASH partners continue to construct family latrines, but the lack of cement, wood and other construction materials slows down the progress.
The crisis is exacerbated by a fuel shortage, hindering sewage station operation and leading to environmental and public health concerns. The situation is worsened by continuous restricted access to essential sanitation supplies and services in Gaza.

Education

Needs

More than 625,000 students and nearly 23,000 teachers in the Gaza Strip have been affected by school closures and attacks on education, leaving them with no access to education or a safe place.
According to the Ministry of Education, as of 6 February, more than 4,851 students and 239 educational staff have been killed and more than 8,227 students and 836 teachers have been injured in the Gaza Strip since 7 October.
Some 92 per cent of all school buildings in Gaza are being used as shelters for IDPs and/or have sustained varying levels of damage. Some 392 schools (79 per cent of the total school buildings in Gaza) have sustained damage, including 141 schools that sustained major damage or were destroyed. Combined, these schools previously served some 457,019 children and more than 17,043 teachers. The North, Gaza, and Khan Younis governorates have been especially impacted, accounting for 76 per cent of all damaged schools (source: Education Cluster Damaged School Dashboard.)
The Education Cluster conducted a Satellite-derived Damage Assessment of all Gaza schools to verify damage to schools based on proximity to damaged sites. Key findings include:
- Satellite-derived Damage verification exercise confirmed the large level of damage to schools previously reported by the cluster in Gaza.
- Actual damages to school infrastructure might be 15 to 20 per cent higher than what has been previously reported by the Education Cluster.
- At least 55 per cent of schools in Gaza will either need full reconstruction or major rehabilitation work to be functional again.
- One quarter of directly hit and damaged schools are UNRWA-run schools
- Forty-five per cent of school buildings that have been used by IDPs as shelters, have been either directly hit or damaged.
- The satellite-derived images provide evidence for military use of schools.
Education partners are concerned about reports, videos and pictures depicting schools being used for military operations by Israeli forces, including their use as detention and interrogation centres, or as military bases.
Key priorities include the provision of Education in Emergencies (EiE) recreational activities and psychological support, including Social Emotional Learning (SEL) activities to children in shelters and designated emergency shelters (DESs); establishing Temporary Learning Spaces (TLS) in shelters/DESs to start non-formal learning for children; and provision of emergency supplies and learning kits. In addition, a key need is to identify and support of children with disabilities and other needs, with assistive devices for learning.

Response

Since October 2023, eleven partners have reached more than 135,126 students and teachers with psychosocial support, emergency learning, recreational supplies and activities, and awareness sessions in the Deir al Balah, Khan Younis, and Rafah governorates. Most of the cluster responses are delivered by local partners (source: Education Cluster 5W dashboard).
UNICEF, with three of its partners and Teacher Creativity Centre, is working on establishing TLS to start non-formal education activities with displaced children in shelters/DESs.
The Education and the Shelter Clusters are jointly carrying out advocacy activities to highlight the devastating impacts of the current situation in Gaza on children and the inextricable links between shelter and schooling.

Challenges and Gaps

No activities have been undertaken in the North Gaza and Gaza governorates due to ongoing hostilities and access challenges.
As of 11 February, the education response remains significantly underfunded, receiving less than 10 per cent of its requirements. Urgent funding is required to meet immediate response requirements.

Logistics

Response

The Logistics Cluster has conducted the Gaps and Needs Analysis Survey to identify needs and gaps, and to adapt the Cluster`s strategy and services accordingly. Findings will be made available by mid-February.
The Logistics Cluster has made available to partners an additional common warehouse in the North Camp of Rafah, bringing up the total storage capacity to 2,470 m2. The Logistics Cluster has secured storage space at the WFP warehouse in Amman with a capacity of 1,300 m2 for consolidation and pre-positioning of cargo.
As of 11 February, the Logistics Cluster in Rafah has stored 6,696 cubic metres of cargo for of 16 organisations and supported 21 organizations with cargo notification service.
On 6 February, the Logistics Cluster facilitated access for an inter-agency convoy (five partners), which transported a total of 335 metric tons of relief items on 24 WFP trucks from Jordan to Gaza, via the King Hussein Bridge.

Challenges and Gaps

The storage and transport capacity inside Gaza remains limited. The Logistics Cluster continues to facilitate access to temporary storage, transport from handover points to common warehouses, and cargo notification trans-shipment services.
The Logistics Cluster is coordinating the pipeline for incoming cargo through the Egyptian and Jordanian corridors for the coming three months. This is a vital exercise for operational planning, in terms of understanding the resources available and making allocations based on the prioritization list. Partners have received a dedicated form and are requested to update it weekly. Partners who have not received the form can reach out to [email protected].

Protection against sexual abuse and exploitation (PSEA) remains a cross-cutting priority for all clusters. The SAWA helpline, reachable at 121 and through WhatsApp at +972 59-4040121 (East Jerusalem at 1-800-500-121), operates 24/7. This toll-free number is widely disseminated across all areas of intervention to report cases of SEA and to facilitate emergency counselling and referrals for affected communities to access life-saving services. The PSEA Network monitors calls daily and will increase the number of counsellors if necessary.