Hostilities in the Gaza Strip and Israel | Flash Update #130

Key Highlights

• The Ministry of Health in Gaza reports that the casualty toll from the incident on Rashid Street on 29 February morning has increased to 112 killed and 760 injured. 
• The MoH in Gaza has reported that another four children have died of malnutrition and dehydration, bringing to 10 such child fatalities so far.    
• On 29 February, two Israeli settlers, including a 16-year-old child, were killed near Eli settlement in Nablus governorate in the occupied West Bank. 
• On 29 February, Israeli forces shot and killed two Palestinian brothers near Beit ‘Awwa village in Hebron. 

Gaza Strip Updates 

• 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. 
• Between the afternoon of 29 February and 12:30 on 1 March, according to the Ministry of Health (MoH) in Gaza, 193 Palestinians were killed, and 920 Palestinians were injured. Between 7 October 2023 and 12:30 on 1 March 2024, at least 30,228 Palestinians were killed in Gaza and 71,377 Palestinians were injured, according to MoH in Gaza. On 1 March, UN Secretary-General António Guterres stated: “I am appalled by the tragic human toll of the conflict in Gaza - more than 30,000 people reportedly killed and over 70,000 injured. I reiterate my call for an immediate humanitarian ceasefire and the unconditional release of all hostages.” 
• According to the MoH in Gaza, the casualty toll from the incident on Rashid Street south of Gaza city on 29 February has risen to 112 fatalities and 760 injuries. A number of countries have called for an independent investigation into the circumstances surrounding the incident. Condemning the deaths, the UN Secretary-General stated that “the desperate civilians in Gaza need urgent help, including those in the besieged north where the United Nations has not been able to deliver aid in more than a week.”   
• The following are among other deadly incidents reported on 28 February:  
  • On 28 February, at about 16:45, 14 Palestinians were reportedly killed, and tens of others injured, when four buildings in An Nuseirat Refugee Camp, in Deir al Balah, were struck. 
  • On 28 February, at about 19:00, nine Palestinians were reportedly killed, and tens of others injured, when a house in An Nuseirat, in Deir al Balah, was struck. 
  • By midnight on 28 February, 18 bodies were reportedly recovered from under the rubble in An Nuseirat, in Deir al Balah.  
  • By midnight on 28 February, 14 bodies were reportedly recovered from under the rubble in Khan Younis.  
  • On 28 February, at about 18:00, four Palestinians were reportedly killed, and others were injured, when a house in Al Bureij, in Deir al Balah, was struck. 
• Between the afternoons of 29 February and 1 March, there were no Israeli soldiers reported killed in Gaza. As of 1 March, 240 soldiers have been killed and 1,432 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, the vast majority on 7 October. As of 1 March, the Israeli authorities estimate that 134 Israelis and foreign nationals remain captive in Gaza, including fatalities whose bodies remain withheld in Gaza. 
• The MoH in Gaza reported that 10 children have died so far as a result of malnutrition and dehydration, including four at Kamal Adwan Hospital in northern Gaza on 29 February. On 27 February, Save the Children warned that Gaza is witnessing “a mass killing of children in slow motion because there is no food left and nothing getting to them,” echoing earlier warnings of the threat of malnutrition among children by UNICEF and the World Health Organization (WHO). On 29 February, the Secretary General of the Norwegian Refugee Council (NRC), Jan Egeland, reported witnessing “the children of Gaza visibly malnourished, reduced to searching the streets for food and assistance. … It is unimaginable that an entire population is left to starve while vast amounts of supplies sit waiting just a few miles away across the border." The NRC Secretary General called on all states supporting the parties to the conflict to “insist on a ceasefire and full humanitarian access and aid supplies. The human suffering in Gaza is already beyond belief, and this war on civilians must end immediately.” 
• On 29 February, the Union of Gaza Strip Municipalities appealed for the prompt entry of fuel to the Gaza city and northern Gaza governorates, to enable the municipalities to provide basic services including water, wastewater treatment and solid waste collection and transfer. Neither governorate has received fuel since the end of October 2023, compounded by the electricity cut, leading to a significant gap in service provision and a lack of water, and to the accumulation of waste and overflow of sewage. The union also appealed for the provision of heavy and medium machinery and back-up generators to replace destroyed equipment. According to Care, an analysis of satellite images reveals that cities in the Gaza Strip have experienced an enormous decrease in electricity, with nighttime light reduced by 84 per cent, and Gaza city witnessing the largest reduction at 91 per cent. The analysis found that 70 per cent of hospitals had little or no nighttime light, with power outages being particularly severe in Gaza city and North Gaza.  “Power means life or death in hospitals. We hear of newborns dying because there is no electricity for the incubators; children ceasing to breathe and mothers dying on the operation table simply because lifesaving machinery switched off,” the Care Country Director stated.  

West Bank Updates 

• On 29 February, two Israeli settlers, including a 16-year-old child, were killed when a Palestinian man from Qalandiya Refugee Camp opened fire at a gas station on Road 60 near Eli settlement in Nablus. The man was subsequently shot and killed by an Israeli settler at the scene. Following the incident, Israeli forces closed most of the checkpoints and roads that connect the northern West Bank to the central and southern governorates. Settlers also gathered in multiple areas, preventing Palestinian vehicles from using Road 60.  
• On 29 February, Israeli forces shot at three Palestinian brothers near Beit ‘Awwa village in Hebron, reportedly for attempting to enter Israel through informal openings in the Barrier, killing two of them, aged 26 and 34 years, and injuring the third. Also on 29 February, a 22-year-old Palestinian prisoner with cancer died at an Israeli hospital; the man is from Kafr Ein village in Ramallah and had been in prison since September 2022. According to the Palestinian Prisoners Club, 11 Palestinians have died in Israeli prisons since 7 October 2023, mainly due to reported medical negligence or abuse. Since 7 October 2023, 409 Palestinians have been killed, including 103 children, and 4,611 Palestinians have been injured, including 709 children, in conflict-related incidents across the West Bank, including East Jerusalem, and Israel. Since the beginning of the year, 96 Palestinians have been killed, including 26 in refugee camps. During the same period, 15 Israelis, including four members of Israeli forces, were killed and 86 injured in conflict-related incidents in the West Bank, including East Jerusalem, and Israel.  
• Since 7 October 2023, 592 people, including 282 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.  
• Since 7 October 2023, OCHA has recorded 603 Israeli settler attacks against Palestinians that resulted in Palestinian casualties (54 incidents), damage to Palestinian-owned property (482 incidents), or both casualties and damage to property (67 incidents). 

Humanitarian Needs and Response Updates | 20–26 February

Health

Needs

• There is a crucial need to expand primary healthcare services within informal shelters; enhance routine immunization coverage; deliver medication for non-communicable diseases; extend sexual and reproductive health services; establish additional field hospitals in various locations across the Gaza Strip; ensure the availability of laboratory equipment, reagents and blood products.
• Following two reported cases of death among children due to Severe Acute Malnutrition (SAM) stemming from inadequate food supplies, there is an urgent need to access northern Gaza to deliver food and establish SAM stabilization centres along with outpatient therapeutic feeding programmes.

Response

• Between 12 and 18 February, 45 health cluster partners delivered primary and secondary healthcare services across Gaza, reaching 124,800 people.
• WHO, in collaboration with OCHA and PRCS, led missions to Nasser Medical Complex, Al-Amal, and European Gaza hospitals to evacuate critical patients to the International Medical Corps (IMC), United Arab Emirates, and Indonesian field hospitals as well as Al Aqsa Hospital. The team also prepositioned medicines, medical supplies, and fuel and provided hot meals and water.
• With the support of WHO, the IMC field hospital increased its bed capacity from 98 to 150.
• UNFPA and WHO have successfully identified and deployed 72 midwives across various shelters and at designated medical points to provide services for spontaneous vaginal deliveries, antenatal care and family planning.
• Medical Global, with WHO’s support, established a SAM stabilization centre in Tell As Sultan primary healthcare centre in Rafah with a capacity of five beds. Additionally, preparation for a training session for 32 healthcare workers on the management of SAM cases with medical complications is underway.
• For more information on the healthcare situation and response, as of 20 February, visit: Sitrep - issue 23 (who.int)

Challenges

• Shortages of fuel, food, medicine, and medical supplies at hospitals in northern Gaza and lack of access to the area.
• Continued hostilities in Khan Younis pose significant barriers to accessing healthcare.
• Following the strike on MSF’s guest house on 20 February, intensified efforts to ensure the safety of humanitarian guest houses throughout Gaza are urgently needed.
• The increase of bloody and watery diarrhea can be directly attributed to the lack of safe drinking water, posing a significant public health challenge.
• The absence of segregated sanitation facilities and electricity within shelters presents a considerable safety risk, depriving women and girls of secure environments and thereby increasing their vulnerability to sexual violence.

Nutrition

Needs

• A new report by the Global Nutrition Cluster highlights a steep rise in malnutrition among children and pregnant and breastfeeding women in the Gaza strip.
• Sustained collaboration with partners is needed to enhance their capacity in various nutrition response areas, including Mid-Upper Arm Circumference (MUAC) screening capacity, identifying cases of Severe Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM), and facilitating treatment using simplified protocols.
• There is a crucial need to expand MUAC screening into northern Gaza, where the situation is deteriorating rapidly and there is limited capacity.
• Continued distributions of supplementary nutrition food and blanket supplementary food to those in need to prevent malnutrition.

Response

• Five implementing partners continue conducting screenings for malnutrition among children aged 6 to 59 months, using MUAC measurements in shelters and health facilities. In total, 10,963 children aged 6-59 months underwent MUAC screening. Children with SAM and MAM are receiving treatment through the simplified treatment protocol.

Challenges

• Restricted access to northern Gaza significantly contributes to insufficient humanitarian aid delivery, leading to concerns about food insecurity and the possibility of widespread starvation and fatalities due to hunger.

Food Security

Needs

• The food security situation continues to be extremely critical across Gaza, particularly in northern Gaza, with people reportedly feeding their children animal fodder. Vulnerable segments of the population, including children, the elderly and people with underlying health conditions, are particularly exposed to the risk of malnutrition and famine.
• The food security situation in the Middle Area and southern governorates is also critical, with most of the population queuing for hours to receive food when trucks manage to enter. In Rafah, the situation is increasingly concerning, with growing reports of people stopping aid trucks to take food and eat it immediately.
• There is an urgent need to increase the fleet of delivery trucks.
• There is an urgent need to import the agricultural inputs necessary for reactivating domestic production of essential fresh foods like eggs, vegetables, meat, fish and milk to ensure the availability of a balanced nutrition.
• There is a need to establish secure and uninterrupted humanitarian corridors, with the support of the private sector and a focus on critical resources like fuel and cooking gas.

Response

• Between 19 and 25 February, a total of 18 partners engaged in providing food assistance across the Gaza Strip, reaching around 1.7 million people with food assistance at least once. Rafah Governorate received about 45 per cent of the total food assistance, followed by Deir al Balah (24 per cent), Khan Younis (15 per cent), and northern Gaza Strip (15 per cent).

Challenges

• Operating partners are reporting a lack of food to distribute, and some are reporting that existing stocks will last for only two days.
• The large number of people reached with hot meals is still insufficient to meet daily nutritional requirements.
• Ongoing airstrikes and heavy fighting in Gaza continue to affect the flow of food, posing challenges for the conduct of safe and efficient humanitarian operations. Frequent border closures, restrictions, and security concerns hinder the delivery of a consistent and dependable food supply.
• Rafah crossing is now working at a reduced rate and Karem Shalom is encountering closure due to Israeli demonstrators preventing trucks from entering. The humanitarian community is engaging with all relevant stakeholders to address this issue.

Protection

Needs

• Identification, tracing and reunification as well as interim and alternative care arrangements are critically needed for unaccompanied, previously detained and separated children. UNICEF estimates that some 17,000 children are unaccompanied or separated.
• Provision of MHPSS, including psychological first aid (PFA) and specialized counselling, and winter clothing and blankets are urgently needed for children and newborn babies.   
• Re-establishment of emergency Gender-Based Violence (GBV) services and referral pathways, including health services for GBV survivors, Clinical Management of Rape (CMR), MHPSS, as well as safe spaces and shelters are needed.
• There is a need for a continuous pipeline to distribute dignity kits and Menstrual Hygiene Management (MHM) supplies for over 690,000 menstruating women and girls.
• A comprehensive Humanitarian Mine Action (HMA) response is needed given the likely scale of Explosive Ordnance (EO) contamination despite the absence of formal large-scale assessments of contamination levels.
• There is a need for deployment of Explosive Ordnance Disposal (EOD) operators to conduct explosive hazard assessments of safe sites for humanitarian response, in addition to training for humanitarian workers and messaging tailored to different groups on Explosive Ordnance Risk Education (EORE) and Conflict Preparedness and Protection (CPP). 
• Victim Assistance (VA) services for survivors of shelling and explosive ordnance-related accidents are also needed.

Response

• Child Protection partners have reached 267,511 boys and girls and 27,307 women and men through awareness-raising interventions, MHPSS, identification and registration of unaccompanied and separated children, and distribution of clothing kits.
• GBV sub-cluster partners have provided 26,800* women and girls with 104,320 packs of sanitary napkins, which is sufficient to cover needs for the next 3 months, as well as a total of 3,500 Dignity Kits and 8,926 MHM kits.
• GBV responders are conducting procurement and distribution of CMR kits, and identification of health service points to provide CMR.
• Partners are exploring ways to establish emergency safe spaces, to provide PFA and recreational activities for vulnerable women and girls. Partners continue to expand PFA services for vulnerable groups, including GBV survivors, through frontline responders.
• Mine Action (MA) partners are actively engaged in carrying out Explosive Threat Assessments to the prioritized humanitarian sectors, delivering EORE and CPP sessions, producing educational materials, conducting digital campaigns, Radio and SMS campaigns, tailoring them to people with disability needs, and exploring partnerships with local organizations to enhance their reach and impact.
• To ensure a well-coordinated effort, the MA sub-cluster has now established active bi-weekly technical working groups on EORE-CPP, GIS, and will soon initiate an explosive ordnance disposal forum for Gaza.*

Challenges

• Difficulties in providing sufficient urgent and safe alternative temporary care arrangements for unaccompanied children, especially adolescents, due to physically and resource-exhausted families and communities, extreme overcrowding and continuous insecurity.
• Limited access prevents the provision of critical protection services to thousands of affected people.
• Obtaining authorization to deploy MA personnel, especially EOD operators for EO contamination assessments; restrictions on importing essential humanitarian mine action supplies; and unreliable communication systems that interfere with EORE, messaging, and coordination activities.

Logistics

Response

• Storage and transport capacity inside Gaza remains challenging with ongoing assessments for identification of additional storage options. The Cluster continues to facilitate access to temporary storage, transport, and cargo notification transshipment services.   
• The Logistics Cluster delivered an online training on the Service Request Forms (SRF), for storage and transport bringing together 79 participants.  
• IMPACCT Working Group and the Logistics Cluster organized an information session with UN agencies on customs clearance challenges in Jordan. A second session with International NGOs is already planned for the following week.   
• The Logistics Cluster common service provision in Port Said, Egypt will be discontinued at the end of February as storage is not identified as current gap. Assessment of logistics gaps and needs remains ongoing.  
• As of 25 February 2024, the Logistics Cluster received for storage 6,251 m3 of cargo on behalf of 17 organisations in Gaza in total, and so far supported 21 organisations with cargo notification services in Rafah.   
• The last convoy of 23 trucks from Amman – King Hussein Bridge - Gaza departed on 14 February, and it took nine days to reach Rafah due to protests in Nitzana—upcoming convoy date to be shared. So far, through Jordan corridor, the Logistics Cluster facilitated partners` access to the inter-agency convoy, transporting a total of 3,596 mt of relief items on 267 trucks on behalf of six partners, taking the King Hussein Bridge route. 

Challenges and Gaps

• The storage and transport capacity inside Gaza remains challenging with ongoing assessments for identification of additional storage options. The Logistics Cluster continues facilitating access to temporary storage, transport, and cargo notification transshipment services.  
• The Logistics Cluster is collecting the pipeline for incoming cargo through the Egypt and Jordan corridors for the coming three months. This is a vital exercise for operational planning, understanding the resources available and allocating based on the prioritization list. Partners have received a dedicated form for their organisation via email and are requested to update it every Sunday. Partners who have not received the form can reach out to [email protected].

Emergency Telecommunications

Needs

• There is an urgent need for independent communication platforms for responders in Gaza to coordinate emergency response and deliver aid, amid ongoing communication blackouts and unreliable/intermittent access to telecommunication services.
• There is a crucial need to import all essential satellite-based communications equipment (sat phones, data solutions), Security Communications Systems (VHF Radios and networks), and power solutions (solar power solutions, generators).

Response

• Since its establishment, the ETC has been engaging with the Israeli authorities to obtain authorization to import all essential telecommunications equipment into Gaza and provide independent access to communications for humanitarian responders.
• The ETC has been supporting humanitarian agencies in Gaza with Information and Communication Technology (ICT) assessments, technical advice and information, repairs, and guidance on the use of ICT equipment. Since 9 January, the ETC has conducted 16 ICT assessments in 13 locations in Rafah, and supported 17 humanitarian agencies with ICT repairs, technical advice, and guidance on the use of ICT equipment to maximize the available telecommunications resources on the ground.
• For more information on ETC activities, please visit: Palestine: Conflict | Emergency Telecommunications Cluster (ETC) (etcluster.org).

Challenges

• Limited access to electricity, fuel, and telecommunications services continues to impede the humanitarian response in Gaza.
• The process of importing telecommunications equipment into Gaza remains lengthy and extremely challenging.

Multi-Purpose Cash Assistance (MPCA)

Response

• Between 19 and 25 February, 27,028 households received one round of emergency MPCA. Cash out operations are concentrated in the governorates south of Wadi Gaza, with the majority being reported in Rafah. As of 25 January, one round of emergency MPCA was delivered to some 160,000 households, a top-up was delivered to 35,000 people (including people with disabilities and nursing mothers), and over 16,000 households have received a second round.
• Since 7 October, some 116,000 households have cashed out their assistance, and about 5,400 payments have been cancelled after not being cashed out for months mainly due to the lack of connectivity and available agents (especially north of Wadi Gaza). Provided assistance falls well short of need given market collapse and price volatility.
• Based on the last post-distribution monitoring data (PDM) collected between mid-January and mid-February, food remains the most purchased item with humanitarian cash (80 per cent), followed by medicines (39 per cent), water (23 per cent), hygiene bedding (10 per cent), and transportation. PDM data show that cash remains a relevant modality of assistance which can be used by recipients to access goods and services that remain available.

Challenges

• Poor electricity supply and connectivity is affecting the ability of financial service providers to make cash accessible, compromising the encashment of the MPCA package.
• Since late December, commercial trucks have sporadically entered Gaza, with 830 trucks recorded as of 26 February. Informal markets are the primary source of accessible goods, which complicates efforts to track distributions and gather market data.

Funding

• The Flash Appeal for the occupied Palestinian territory (oPt), which 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), was extended through the end of March 2024. As of 1 March, member states disbursed nearly $940 million against the updated Flash Appeal (76 per cent); this includes about $616 million out of $629 million (98 per cent) requested for October-December 2023 and $324 million out of $600 million (54 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 Central Emergency Relief Fund (CERF) are currently funding more than 94 ongoing projects in the Gaza Strip to meet urgent humanitarian needs, notwithstanding constraints on the entry and delivery of aid into and within the Gaza Strip. These interventions, totalling about $88 million, address needs in the areas of food security, shelter, water, sanitation and hygiene (WASH), health and protection. Since October 7, the oPt HF has received a total of $88 million in contributions from member states and private donors. Private donations are collected directly through the Humanitarian Fund.

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. 

* Asterisks indicate that a figure, sentence, or section has been rectified, added, or retracted after the initial publication of this update.