Hostilities in the Gaza Strip and Israel | Flash Update #168

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 22 May.

Key Highlights

• Nearly 40 per cent of Gaza’s population have been displaced over the past two weeks, many of whom have already been displaced multiple times. 
• The Health Cluster warns of a further surge in malnutrition and communicable diseases due to large scale displacement towards areas that lack food, water and other basic necessities. 
• The Ministry of Health appeals for support to address acute shortages of medications.

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, especially in Jabalya and eastern Rafah. 
• Between the afternoons of 17 and 20 May, according to the Ministry of Health (MoH) in Gaza, 259 Palestinians were killed and 391 were injured, including 106 killed and 176 injured in the last 24 hours. Between 7 October 2023 and 20 May 2024, at least 35,562 Palestinians were killed and 79,562 were injured in Gaza, according to MoH in Gaza.
• The following are among the deadliest incidents reported between 16 and 19 May:  
  • On 16 May, at about 14:50, four Palestinians, including a pregnant woman and her unborn baby, were reportedly killed when a house was hit in Jabalya Refugee Camp. 
  • On 17 May, at about 0:55, six Palestinians were reportedly killed when a house was hit on Al Falouja Street in Jabalya. 
  • On 18 May, at about 10:00, 15 Palestinians were reportedly killed and others injured while trying to return to their homes in areas of Jabaliya Refugee Camp from which Israeli forces withdrew.  
  • On 18 May, at about 12:30, 28 Palestinians, including ten women and ten children, were reportedly killed and others injured when a residential square was hit in Mashrou’ Beit Lahiya near Kamal Adwan Hospital, in North Gaza. 
  • On 18 May, at about 11:00, 12 Palestinians were reportedly killed and others injured when Iqra’ Library was hit in central Jabalya Refugee Camp. 
  • On 18 May, at about 14:00, four Palestinian men were reportedly killed and others injured when a house was hit in Khuza'a area, in Khan Younis. 
  • On 19 May, at about 1:00, 31 Palestinians were reportedly killed and others injured when a house was hit in the New Camp of An Nuseirat, in Deir al Balah.
• Between the afternoons of 17 and 20 May, three Israeli soldiers were reported killed in Gaza and one died of injuries sustained on 15 May. As of 20 May, 282 soldiers have been killed and 1,745 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. Between the afternoons of 17 and 20 May, the Israeli military announced that it has recovered the bodies of four Israelis from Gaza; as of 20 May, it is estimated that 128 Israelis and foreign nationals remain captive in Gaza, including fatalities whose bodies are withheld.
• On 18 May, the Israeli military issued a new evacuation order for all or parts of 10 neighbourhoods in the western part of North Gaza governorate covering 7.7 square kilometres. Since 6 May, six evacuation orders have been issued encompassing 61 square kilometres; these include two orders for 37.1 square kilometres in Rafah and four orders for 24.4 square kilometres in northern Gaza. To date, 285 square kilometres, or about 78 per cent of the Gaza Strip, have been placed under evacuation orders by the Israeli military; this encompasses all areas north of Wadi Gaza, whose residents were instructed to evacuate in late October, as well as specific areas south of Wadi Gaza designated for evacuation by the Israeli military since 1 December.
• The forced displacement of thousands of people from Rafah and in northern Gaza continues, many of whom have already been displaced multiple times. According to UN estimates, between 6 and 18 May, more than 900,000 people or nearly 40 per cent of Gaza’s population have been displaced; these include about 812,000 displaced from Rafah and more than 100,000 people displaced in northern Gaza. Displaced people from Rafah are currently seeking shelter in Khan Younis and Deir al Balah on any open land available, including access roads and agricultural land, as well as in damaged buildings that have not been structurally assessed. The Shelter Cluster has assessed that the majority of people who were forced to leave Rafah need shelter assistance, yet there are no tents and very few shelter and non-food items left for distribution in Gaza. On 18 May, UNRWA Commissioner General, Philippe Lazzarini, noted that people are moving without safe passage or protection and arrive in areas, such as Al Mawasi, which are already crammed and lack safe water supplies, sanitation facilities, and “minimal conditions to provide emergency humanitarian assistance in a safe and dignified matter.” Lazzarini further emphasized that no one and no place is safe in Gaza: “The claim that people in Gaza can move to ‘safe’ or ‘humanitarian’ zones is false. Each time, it puts the lives of civilians at serious risk.”   
• On 15 May, a rapid assessment carried out by humanitarian organizations in two IDP sites, which comprise 500-700 tent-size shelters each, pointed to makeshift dwellings being made of blankets, nylon, and foraged materials. Tents located directly on the beach slope were often unstable, and poorly protected from the elements, with solid waste from the nearby elevated areas rolling down at them and into the sea. The sites lacked water storage capacity, water distribution points and affordable drinking water. With no electricity, and cooking gas and wood being too expensive, families were resorting to burning trash and plastic to cook. Unsanitary pits and buckets were also used as informal latrines. Furthermore, health professionals at the assessed displacement sites needed support in establishing or improving local health points. Under international humanitarian law, civilians – whether they move or stay – must be protected. Wherever they are in Gaza, their essential needs, including food, shelter, water and health, must be met.
• The Health Cluster warns of a further surge in malnutrition and communicable diseases, including skin rashes, diarrheal illnesses and Hepatitis A, due to large scale displacement towards areas that continue to lack basic necessities such as water and food. Meanwhile, critical health facilities have become inaccessible due to their presence within or near areas affected by evacuation orders, disrupting people’s access to essential healthcare services including kidney dialysis, non-communicable disease management, maternal health, child health, and trauma care services. These include four hospitals, four primary health care centres, and 21 medical points, in Rafah and two hospitals, five primary health care centres, and 16 medical points in northern Gaza. WFP partners have also lost access to 101 distribution points for malnutrition prevention activities in Rafah and nine UNRWA nutrition sites have been similarly affected or closed, the Nutrition Cluster reports.
• As of 20 May, 15 of Gaza’s 36 hospitals are partially functioning and several of them are no longer providing inpatient services. The abrupt halt to all medical evacuations outside Gaza since 7 May, following the closure of Rafah Crossing, has further exacerbated bed shortages at hospitals. The Health Cluster estimates that since 7 May, some 700 critically ill and injured patients have been unable to leave Gaza to receive needed medical treatment elsewhere. Between 7 October and 18 May, 46 per cent (5,957 out of 12,761) of critical patients who submitted requests for medical evacuation were approved and 38 per cent (4,895) were medically evacuated abroad.  
• In North Gaza, both Al Awda and Kamal Adwan hospitals are in areas subject to evacuation orders. Al Awda Hospital has been besieged and is currently inaccessible, the Health Cluster reports. A number of patients and health workers remain inside the facility, with Médecins Sans Frontières warning that, “amid nearby fighting, the hospital has now run out of drinking water.” Meanwhile, access to Kamal Adwan Hospital is increasingly difficult; intense hostilities have reportedly occurred in the vicinity of the hospital and resulted in an increased influx of injured patients to the already overstretched facility. On 19 May, the MoH appealed for support from all humanitarian and international institutions to help address acute shortages of medications necessary for the provision of emergency and primary health care as well as other health services. MoH warned that hospitals and other service delivery points have zero stocks, which threatens the lives of patients.  

Funding 

• As of 20 May, Member States have disbursed about US$835 million out of $3.4 billion (24 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 $212 million out of $2.8 billion (7.5 per cent) requested for the 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 13 – 19 May, please visit: Gaza Humanitarian Response Update | 13–19 May 2024. It is updated throughout the week to reflect new content. 

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