Offloading aid in Jabalya, northern Gaza. Photo by UNRWA/Mohammed Hinnawi, 19 March 2024

Hostilities in the Gaza Strip and Israel | Flash Update #145

22 Mar 2024

Key Highlights

As the military operation in Al Shifa Hospital continues, the World Health Organization expresses concern about the impact on the facility’s ability to function and save lives.
On World Water Day, UN Women highlights the impact severe water shortages in Gaza have had on women.
Some 13 per cent of displaced women in Rafah lack civil documentation for both them and their family members, hindering their access to aid and essential services, according to a recent UN rapid assessment.

Gaza Strip Updates

Intense Israeli bombardment and ground operations as well as heavy fighting between Israeli forces and Palestinian armed groups continue to be reported across much of the Gaza Strip, particularly in Al Rimal area near Al Shifa Hospital in Gaza city. This has resulted in further civilian casualties, displacement, and destruction of houses and other civilian infrastructure.
Between 7 October 2023 and 10:30 on 21 March 2024, at least 31,988 Palestinians have been killed in Gaza and 74,188 Palestinians have been injured, according to MoH in Gaza. As of the time of writing, there were no updated casualty figures covering the period until the afternoon of 22 March available from the MoH in Gaza.
The following are among the deadly incidents reported on 20 and 21 March:
- On 20 March, at about 13:20, one Palestinian police officer was reportedly killed, and at least three others were injured, when a Palestinian police checkpoint near As Sekka area in Jabalya Refugee Camp was hit.
- On 20 March, at about 13:35, three Palestinians were reportedly killed, and 10 others were injured, when a group of people at Hamouda junction in eastern Jabalya Refugee Camp were hit. Unconfirmed reports indicate that this group comprised police officers involved in securing the delivery of aid.
- On 20 March, at about 19:40, nine Palestinians were reportedly killed, all said to be women and children, when a house opposite Al Madin police station, in central Gaza city, was hit.
- On 20 March, at about 19:40, nine Palestinians were reportedly killed, including three women, and others were injured, when a house in western An Nuseirat Refugee Camp, in Deir al Balah, was hit.
- On 20 March, at about 20:40, one Palestinian man succumbed to wounds sustained when the yard of the UNRWA Rafah East Distribution Centre was hit on 13 March, bringing to seven the total number of reported fatalities in this incident.
- On 21 March, at about 5:00, nine Palestinians were reportedly killed, and others injured, when a house in Al Isra area, in northern An Nuseirat Refugee Camp, in Deir al Balah, was hit.
- On 21 March, at about 10:00, nine Palestinians were reportedly killed, and others injured, when a vehicle was hit in Bani Suheila area, in eastern Khan Younis.
Between the afternoons of 21 and 22 March, no Israeli soldiers were reported killed in Gaza. As of 22 March, 250 soldiers have been killed and 1,489 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 22 March, the Israeli authorities estimate that 134 Israelis and foreign nationals remain captive in Gaza, including fatalities whose bodies are withheld.
The Israeli military operation inside and around Al Shifa hospital in Gaza city has continued for the fifth consecutive day amid intensive exchanges of fire with Palestinian armed groups. According to WHO Director-General, Tedros Adhanom Ghebreyesus, access to the hospital is now impossible and a WHO mission on 21 March had to be cancelled due to insecurity. WHO and partners have also lost contact with health personnel at Al Shifa Hospital, where health workers have been among those reported arrested and detained. Calling for the protection of hospitals in line with international humanitarian law, the WHO Director-General stated: “The ongoing situation could impact the hospital’s ability to function, even minimally, and deprive people of critical, lifesaving care.” Since the first Israeli military raid into Al Shifa Hospital in November 2023, the hospital has been operating either partially or minimally, with the most recent delivery of essential supplies facilitated by WHO on 11 March. The Gaza Government Media Office has stated that at least three patients have died at Al Shifa Hospital due to a shortage of critical medications and limited power supply. Since the start of the military operation in the area of Al Shifa Hospital, the Israeli military stated that it has killed about 150 armed Palestinians and detained hundreds of suspects.
Hospitals and health centres that remain functional in the Gaza Strip continue to suffer severe shortages of fuel, medical equipment and medications. During a visit to Kamal Adwan Hospital on 21 March, jointly with WHO, UNICEF and OCHA, Humanitarian Coordinator ad interim, Jamie McGoldrick, described how overwhelmed the hospital currently is with trauma patients from incidents of food distributions and patients who were able to leave Al Shifa Hospital where there is an ongoing military operation. Kamal Adwan is the only paediatrics hospital in northern Gaza. It is also struggling to provide a wide range of medical services in the areas of neurology, urology, ophthalmology, and haemodialysis, receiving about 1,000 patients per day. As malnutrition levels among children in northern Gaza have doubled in February compared with January, WHO has established a nutrition stabilization centre at the hospital; this centre is now a lifeline for children suffering from severe acute malnutrition with medical complications. Moreover, on 19 March, OCHA, UNRWA and WHO carried out a joint mission to deliver fuel and medical supplies to UNRWA’s health centre in Jabalya and Kamal Adwan Hospital in Beit Lahiya. During the mission, the team also assessed critical medical needs at the Palestine Red Crescent Society (PRCS) medical point in Jabalya, the only one run by PRCS in northern Gaza and one of eight PRCS medical points in the Gaza Strip. On the visit to Kamal Adwan Hospital, the Humanitarian Coordinator emphasized the need to provide more support, supplies and fuel “to make sure the hospital keeps running.”
On World Water Day, 22 March, UN Women highlighted the impact severe water shortages in Gaza have had on women who are struggling to survive “with no food, no water, [and] no tents.” According to the Water, Hygiene, and Sanitation (WASH) Cluster, water production from all the water sources in Gaza has dropped to only 5.7 per cent of pre-October production levels as of February 2024, with very limited supplies available for drinking and domestic use, including for personal hygiene. In a joint press release on 22 March, the Palestinian Central Bureau of Statistics and the Palestinian Water Authority reported that the average per capita water consumption in the Gaza Strip has dropped from 84.6 litres per day prior to 7 October to 3-15 litres per day. In December 2023, UNICEF had warned that children in southern Gaza were accessing only 1.5 to 2 litres of water per day, well below the recommended requirements for survival. According to humanitarian standards, the minimum amount of water needed in an emergency is 15 litres, which includes water for drinking, washing, and cooking. For survival alone, the estimated minimum is three litres per day.
A recent rapid assessment carried out by the Women’s Affairs Center, UNDP’s Programme of Assistance to the Palestinian People (PAPP), and UN Women between the end of December 2023 and the end of January 2024, sheds light on the immediate impact of hostilities on women. According to the assessment findings, the vast majority (91 per cent) of displaced women surveyed in Rafah reported that their homes had been damaged or destroyed and over half had lost at least one family member since 7 October. In addition, the assessment finds that some 94 per cent of women feel unsafe and lack privacy and a similar percentage have been struggling to afford necessities such as food, water and hygiene supplies. To cope, women have resorted to extreme measures such as fasting and selling part of the aid they receive to purchase needed clothing and hygiene supplies. The assessment also finds that overcrowding at displacement sites raises concerns about gender-related protection risks, especially gender-based violence (GBV). Moreover, nearly half of surveyed women reported lacking civil documentation for them and/or their family members, including 13 per cent who lack civil documentation for both them and their family members, hindering their access to aid and essential services. According to the Protection Cluster, an estimated 30 to 40 per cent of people in Gaza have lost their identification documents during displacement. Although in-kind assistance does not require people to produce identification, the lack of such documents presents a significant obstacle to obtaining Multi-purpose Cash Assistance (MPCA).

West Bank Updates

On 21 March 2024, a 24-year-old Palestinian man died of critical wounds sustained by an Israeli drone strike on a Palestinian vehicle in Jenin Refugee Camp the day before, bringing to four the death toll of that incident.
On 21 March, Israeli forces, including an undercover unit, shot and killed a 29-year-old Palestinian man in Aqbat Jaber Refugee Camp during a raid that involved an exchange of fire with Palestinians. Israeli forces also searched houses in the camp and injured three Palestinians, including a five-year-old girl who sustained injuries from shrapnel and two men who were injured with live ammunition and arrested.
On 22 March, a Palestinian man opened fire at an Israeli bus near Dolev Israeli settlement, in Ramallah governorate, causing damage to the bus, the Israeli military reported. Israeli forces then reportedly initiated a search operation lasting for about three hours, during which eight members of Israeli forces were injured in an exchange of fire with the man, according to Israeli media sources. An Israeli drone and helicopter were deployed and struck the Palestinian man with two missiles, killing him. During the incident, Israeli forces raided the nearby villages of Deir Ibzi and Kafr Ni'ma, closed the road gate at the only entrance to Ras Karkar village (with an estimated population of 2,200), and broke into the house of the killed Palestinian man, arresting his brother alongside two other Palestinians.
Since 7 October, 434 Palestinians have been killed, including 421 by Israeli forces, nine by settlers and three by either Israeli forces or settlers, across the West Bank, including East Jerusalem. These include 126 Palestinians killed since the start of 2024, the vast majority by Israeli forces. Some 5,000 Palestinians have been injured, including 725 children, since 7 October in the West Bank, including East Jerusalem.
Since 7 October, 15 Israelis, including four members of Israeli forces, have been killed and 109 injured in the West Bank, including East Jerusalem, and Israel.
According to the Islamic Waqf, some 120,000 worshippers performed Friday prayers in Al Aqsa Mosque on the second Friday of the month of Ramadan (22 March). Measures announced by the Israeli authorities last week limited the access of Palestinians holding West Bank IDs to Friday prayers at Al Aqsa Mosque in East Jerusalem to children under 10 years of age, women over 50, and men over 55, with a valid one-day permit and magnetic card. Eligible persons can cross the checkpoints starting at 4:00 and return before 17:00. In 2023, men over 55, women of all ages and children under 12 were allowed entry without a permit on Fridays during Ramadan.
On 20 March, a Palestinian man was displaced after he was forced to demolish his residence due to the lack of Israeli-issued building permit in Al ‘Isawiya in East Jerusalem. Since 7 October, over 1,600 Palestinians have been displaced due to home demolitions, more than half of whom were displaced in operations carried out by Israeli forces, 38 per cent by the demolition of homes that lacked Israeli-issued building permits, and 8 per cent due to demolitions on punitive grounds. Also since 7 October 2023, over 1,240 Palestinians, including about 600 children, from at least 20 herding communities have been displaced amid settler violence and access restrictions.

Funding

The Flash Appeal for the occupied Palestinian territory (oPt), which requests US$1.23 billion to meet the 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 21 March, member states disbursed nearly $1.05 billion for the updated Flash Appeal (85 per cent); this includes about $616 million out of $629 million (98 per cent) requested for October-December 2023 and about $434million out of $600 million (72 per cent) requested for January-March 2024. For funding analysis, please see the Flash Appeal Financial Tracking dashboard.
The oPt Humanitarian Fund (oPt HF) is currently supporting 122 projects, for a total of US$ 74.5 million, addressing urgent needs in the Gaza Strip (83 per cent) and West Bank (17 per cent). Despite logistical hurdles, safety and security concerns, and fuel scarcity that hinder the procurement and transport of supplies, implementation is led by 77 international NGOs, 20 national NGOs, and 16 UN agencies. Of the projects implemented by international NGOs or UN agencies, 56 per cent are in partnership with national NGOs. For a summary of the oPt HF activities and challenges in February 2024, please follow this link.
The oPt HF has recently finalized its First Reserve Allocation of US$ 3.5 million for 2024, which aims at boosting the aid transport capacity to enable humanitarian partners to increase the delivery of vital aid and services to people across the Gaza Strip. This is in addition to a total of $88 million received by the Fund since 7 October from Member States and private donors and allocated for programming across Gaza, including 43 per cent in Rafah, 21 per cent in Deir al Balah, 20 per cent in Khan Younis, and 16 per cent in Gaza and North Gaza governorates. Private donations are collected directly through the Humanitarian Fund. In addition, the Central Emergency Relief Fund (CERF) has recently allocated US$ 700,000 to a project led by UN Women that aims to strengthen gender-responsive and inclusive accountability to affected people, bringing to $18.7 million the total CERF allocation to oPt since 7 October.

For the Humanitarian Needs and Cluster Response Update for the period between 12 and 18 March, please visit: Humanitarian needs and response update | 12-18 March 2024. The update for a given week is initially published on Mondays and is updated throughout the week to reflect new content.