Palestinians continue fleeing Rafah Governorate. Photo by WHO

Hostilities in the Gaza Strip and Israel | Flash Update #165

13 May 2024

The OCHA oPt Flash Update is published every Monday, Wednesday, and Friday, with a comprehensive update on the West Bank included every Wednesday. The next update will be issued on 15 May.

Key Highlights

About 20 per cent of Gaza’s population have been displaced again in the past week, including from Rafah in the south and northern Gaza.
Fuel shortages are threatening the continuity of health services and limited access to WASH facilities continues to drive a rise in infectious diseases, the World Health Organization reports.
Recent evacuation orders and intensified military activity in Rafah have forced a reversal in the scale-up of nutrition services while the number of children suffering from acute malnutrition continues to increase, the Nutrition Cluster warns.

Gaza Strip Updates

Israeli bombardment from the air, land, and sea continues to be reported across much of the Gaza Strip, resulting in further civilian casualties, displacement, and destruction of houses and other civilian infrastructure. Ground incursions and heavy fighting also continue to be reported in Jabaliya Refugee Camp, Gaza city, and eastern Rafah. As of 13 May, Rafah Crossing remains closed and there is a continued lack of safe and logistically viable access to Kerem Shalom crossing. According to Israeli authorities, aid supplies have entered northern Gaza via Erez Crossing on 9 May and via Zikim (Al Siafa) access point on 12 May, and 266,000 litres of fuel have also entered Gaza via Kerem Shalom crossing in the south on 12 May.
“The war in Gaza has become a moral stain on the conscience of our collective humanity” and has entered “yet another horrifying phase,” stated Assistant Secretary-General for Humanitarian Affairs and Deputy Emergency Relief Coordinator Joyce Msuya on 12 May. Describing Gaza as a “hellscape for millions trapped under incessant bombardment,” Msuya indicated that those who have escaped death and injury “now risk losing their lives because of a lack of food, safe water, medicine and healthcare.” Stressing that Rafah and Kerem Shalom crossings are a “lifeline” for the delivery of humanitarian aid into Gaza, the UN Deputy Relief Chief reiterated the Secretary-General’s “longstanding call for an immediate humanitarian ceasefire in Gaza, and the immediate and unconditional release of hostages” and added: “We also need Israeli authorities to abide by their obligations to facilitate safe, rapid and unimpeded access for humanitarian aid and humanitarian workers. This includes for UNRWA, which has been the backbone of the humanitarian response in Gaza.”
Between the afternoons of 9 and 13 May, according to the Ministry of Health (MoH) in Gaza, 187 Palestinians were killed and 323 were injured. Between 7 October 2023 and 12 May 2024, at least 35,091 Palestinians were killed and 78,827 were injured in Gaza, according to MoH in Gaza. Moreover, according to the Gaza Government Media Office (GMO) and Palestinian Civil Defense, there are some 10,000 people reportedly missing or under rubble in Gaza. GMO also reports that overall fatality figures purportedly include more than 14,000 children and 9,000 women. The MoH documents the full identification details of casualties and has recently published the breakdown of 24,686 out of 34,622 fatalities for whom full details have been collected by MoH as of 30 April 2024; according to MoH, these reportedly include 7,797 children, 4,959 women, 1,924 elderly, and 10,006 men. The documentation process is ongoing by the MoH.*
The following are among the deadly incidents on 10 and 11 May:
- On 10 May, four Palestinians, including three children, were reportedly killed, when the vicinity of Tawbah Mosque in Jabaliya Refugee Camp was hit.
- On 10 May, at about 16:30, at least eight Palestinians were reportedly killed and others injured when a house was hit in An Nuseirat Refugee Camp.
- On 11 May, at about 1:00, three Palestinians, including a journalist, his wife and child, were reportedly killed when a house was hit in Jabaliya Refugee Camp.
- On 11 May, at about 1:25, at least nine Palestinians, including five children, were reportedly killed and others injured when a house was hit in Az Zawayda area, in Deir al Balah.
- On 11 May, at about 4:40, seven Palestinians, including at least four women, were reportedly killed and others injured when a house was hit in Al Maghazi Refugee Camp, in Deir al Balah.
- On 11 May, at about 6:10, at least five Palestinians, including two women, were reportedly killed and others injured when a house was hit in northeastern Deir al Balah.
- On 11 May, at about 12:00, ten Palestinians were reportedly killed and others injured when a house was hit in As Sabra neighborhood in Gaza city.
- On 11 May, at about 19:15, six Palestinians, including a woman and an older man, were reportedly killed when a group of people were hit on Abu Husni Street in Deir al Balah.
- On 11 May, at about 15:50, nine Palestinians, including at least three children and three women, were reportedly killed and others injured when a house was hit in northwestern Rafah.
Between the afternoons of 10 May and 13 May, five Israeli soldiers were reported killed in Gaza. As of 13 May, 272 soldiers have been killed and 1,674 soldiers have been injured in Gaza or along the border in Israel since the beginning of the ground operation, according to the Israeli military. In addition, according to the Israeli media citing official Israeli sources, over 1,200 Israelis and foreign nationals, including 33 children, have been killed in Israel, the vast majority on 7 October. As of 13 May, it is estimated that that 132 Israelis and foreign nationals remain captive in Gaza, including fatalities whose bodies are withheld.
On 11 May, the Israeli military issued a new round of evacuation orders affecting some 34 neighbourhoods in eastern Rafah and North Gaza. Recent evacuation orders cover a total area of 18.6 square kilometres, including 22 neighbourhoods in Jabaliya (12.6 square kilometres) and 12 neighbourhoods in Rafah (six square kilometres). UNRWA estimates that, as of 13 May, nearly 360,000 people have fled Rafah. Another 100,000 people in northern Gaza have so far been displaced, UN agencies estimate. In total, some 20 per cent of Gaza’s population have been displaced again over the past week.
On 12 May, the Palestinian Red Crescent Society (PRCS) announced that operations had been restored at the ophthalmology, surgery and orthopedics departments of the Al Amal Hospital in Khan Younis. Two new field hospitals have also been established in Rafah, the World Health Organization (WHO) reports, one operated by the International Committee of the Red Cross (ICRC) and the second by MoH in Gaza. This brings to nine the number of field hospitals in Gaza, of which six are in Rafah, two in Khan Younis and one in Deir al Balah. Yet, fuel shortages, insecurity and access constraints are threatening the continuity of health services across Gaza, including, according to WHO, the potential need to expand emergency surgical procedures and referrals in the event of an expanded military operation in Rafah. Médecins Sans Frontières (MSF) reported on 11 May that, due to the new evacuation orders issued by Israeli authorities, it had begun referring “the remaining 22 patients at the Rafah Indonesian Field Hospital to other facilities” as it could “no longer guarantee their safety.” Ambulances are also reportedly struggling to reach the European Gaza Hospital in Khan Younis because the main road connecting it to Rafah is blocked due to military activity in eastern Rafah. According to WHO, only two out of 36 hospitals (Nasser and Al Aqsa hospitals), five out of nine field hospitals, 17 out of 89 primary healthcare centres, 23 out of 188 medical points, and 10 mobile clinics are located within the so-called “Humanitarian Area” map shared by Israeli authorities. On 10 May, UNICEF’s Senior Emergency Coordinator in the Gaza Strip, Hamish Young, warned that, if hospitals run out of fuel, all life-saving equipment, such as ventilators and incubators, will stop working. Echoing the same message, UNFPA underscored that life support services for premature babies will lose power, and pregnant women and new mothers will be left without options to deliver their babies safely.
Fuel shortages threaten the continued operations of the already degraded water desalination plants, water wells and sewage system as well as truck deliveries of life-saving aid to people in need, added Hamish Young of UNICEF. This would result in deaths among children that “can and must be prevented.” “Exhausted and terrified” people, Young stressed, have been resorting to creating improvised toilets by digging holes in the ground around groups of tents, exacerbating the risk of infections. Among all communicable diseases spreading in Gaza, cases of acute watery diarrhea and jaundice syndrome have been rising at a sustained pace, increasing by 22 and 26 per cent, respectively, in the second part of April compared with the preceding 14 days. According to WHO, as of 1 May, over 415,700 diarrheal illnesses and 61,099 cases of acute jaundice syndrome have been documented and limited access to proper WASH facilities continues to contribute to the rise in infectious diseases, including diarrhoea illness and hepatitis A.
On 11 May, the Coastal Municipalities Water Utility appealed to all international and humanitarian organizations to urgently provide the necessary fuel to operate the electrical generators of WASH facilities. On 12 May, the mayor of Nuseirat also issued a statement warning that basic municipal services, including water wells, sewage pumps, and solid waste collection and transfer mechanisms, would cease functioning in 48 hours due to the depletion of fuel supplies.
Although some fuel and food supplies have entered Gaza over the past two days, aid supplies remain largely insufficient. Prevailing conditions could aggravate the already catastrophic levels of hunger faced by the population. As of 8 May, WHO reports that 58 children suffering from Severe Acute Malnutrition (SAM) with complications have so far been admitted to three SAM Stabilization Centers operational in Gaza. According to the Nutrition Cluster, at least 70,583 children aged 6-59 months have undergone Mid-Upper Arm Circumference (MUAC) screenings since mid-January, 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). While a new nutrition stabilization centre and outpatient therapeutic programme have been established at the new International Medical Corps (IMC) field hospital in Deir al Balah, the Nutrition Cluster cautions that the scale-up of nutrition interventions has been reversed in Rafah; due to the latest evacuation orders and military escalation, three out of 22 health facilities and 25 out of 35 medical points providing nutrition services have closed and new services due to open in northern Gaza were put on hold.
In April, severe access restrictions, coupled with relentless hostilities, air strikes and the general breakdown of law and order, continued to hinder the scaling up of vital humanitarian assistance across Gaza. Throughout April, 10 per cent of missions requiring coordination with the Israeli authorities were denied, preventing the delivery of live-saving food, health and water and sanitation assistance, as well as the medical evacuations of critical patients. A total of 41 missions from southern to northern Gaza also faced protracted delays of over four hours on average, with humanitarian convoys having to wait for extended periods at checkpoints amid high security risks and at times even being forced to abort their missions. The closure of crossings also represented another frequent challenge, with humanitarian organizations being unable to fully utilize the Erez Crossing and the Ashdod port to bring in supplies into northern Gaza. Infrastructural damage, the ubiquitous presence of debris and the threat of unexploded ordnance have further exacerbated access constraints, increasing travel time for humanitarian movements, and often resulting in delays, mission postponements, and cancellations.

Funding

As of 10 May, Member States have disbursed about US$746 million out of $3.4 billion (22 per cent) requested to meet the most critical needs of 2.3 million people in Gaza and 800,000 people in the West Bank, including East Jerusalem, between January and December 2024. This includes about $623 million out of $600 million (104 per cent) requested for January-March 2024 and about $123 million out of $2.8 billion (4 percent) requested for the new Flash Appeal launched on 17 April to cover the period between April and December 2024. For funding analysis, please see the Flash Appeal Financial Tracking dashboard.
The oPt HF has 118 ongoing projects, for a total of $72.5 million, addressing urgent needs in the Gaza Strip (85 per cent) and West Bank (15 per cent). In light of the updated Flash Appeal, the HF has allocated an additional $22 million to bolster prioritized HF-funded projects in Gaza. Since 7 October, the oPt HF has mobilized $90 million from Member States and private donors, designated for programmes throughout Gaza. A summary of the oPt HF activities and challenges in April 2024 is available through this link and the 2023 Annual Report of the oPt HF can be accessed here. Private donations are collected directly through the Humanitarian Fund.

For the Gaza Humanitarian Response Update for the period between 6 – 12 May, please visit: Gaza Humanitarian Response Update | 6–12 May 2024. It is updated throughout the week to reflect new content.