Hostilities in the Gaza Strip and Israel | Flash Update #170

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 27 May.

Key Highlights

• No hospitals are currently accessible in North Gaza governorate; and communicable diseases are on the rise, with children under five particularly affected, the World Health Organization reports.
• Some displaced people in central Gaza are now surviving on three per cent of the minimum standard for daily water needs, warn international NGOs.
• Network outages, insecurity, and access challenges continue to disrupt aid operations in Gaza, reports the Emergency Telecommunications Cluster.

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 as well as eastern and central Rafah.
• Between the afternoons of 22 and 23 May, according to the Ministry of Health (MoH) in Gaza, 91 Palestinians were killed and 210 were injured. Between 7 October 2023 and 23 May 2024, at least 35,800 Palestinians were killed and 80,200 were injured in Gaza, according to MoH in Gaza. Casualty numbers covering the period until the afternoon of 24 May are not available as of the time of reporting.
• The following are among the deadly incidents reported between 21 and 23 May:
  • On 21 May, at about 15:00, six Palestinians, including an infant, were reportedly killed and others injured when a house was struck in As Sahaba neighbourhood, in Gaza city.
  • On 22 May, at about 0:35, six Palestinians were reportedly killed when a residential building was hit in Beer An Na’aja area of Jabalya Refugee Camp.
  • On 22 May, at 0:50, 12 Palestinians, including at least four children and a pregnant woman, were reportedly killed and others injured when a location near Al Quds factory and a house were hit in Az Zawayda area in Deir al Balah.
  • On 22 May, at about 19:55, four Palestinians were reportedly killed and others injured when internally displaced persons (IDPs) were hit while evacuating a shelter in Jabalya Refugee Camp, in North Gaza.
  • On 22 May, at about 13:05, six Palestinians were reportedly killed and others injured when a residential building was hit in Jabalya Refugee Camp.
  • On 22 May, at about 17:00, six Palestinians were reportedly killed when a residential building was hit near Al Jurn roundabout in Jabalya city.
  • On 22 May, at about 18:00, ten Palestinians were reportedly killed and 20 injured when a group of people were hit in Az Zaytoun area in Gaza city.
  • On 22 May, at about 22:45, eight Palestinians were reportedly killed and others injured when a house was hit behind Al Ouruba school, in the New Camp of An Nuseirat, in Deir al Balah.
  • On 23 May, at about 0:30, at least ten Palestinians, including children and women, were reportedly killed when the fourth floor of Fatima Az Zahra Mosque was hit in Ad Daraj neighbourhood, in Gaza city.
  • On 23 May, at about 1:30, 16 Palestinians, including 10 children, were reportedly killed when a four-story building was hit in Gaza city.
• Between the afternoons of 22 and 23 May, three Israeli soldiers were reported killed in Gaza. As of 24 May, 285 soldiers have been killed in Gaza or along the border in Israel since the beginning of the ground operation and 1,781 soldiers have been injured, 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. On 24 May, the Israeli military announced that the bodies of three Israelis, thus far listed as hostages, were recovered from Gaza; as of 24 May, it is estimated that 125 Israelis and foreign nationals remain captive in Gaza, including fatalities whose bodies are withheld.
• On 22 May, at about 7:50, Israeli forces reportedly released an unconfirmed number of Palestinian detainees at Kissufim Crossing in Al Qarara, east of Khan Younis. According to Palestinian media reports, 30 detainees were released, of whom three, including a woman, were transported to Al Aqsa Hospital in Deir al Balah.
• Entry of aid supplies into Gaza continues to be limited. Between the start of the military operation in Rafah on 7 May and 23 May, only 906 truckloads carrying humanitarian assistance entered Gaza through all operating entry points, including 143 through Kerem Shalom Crossing, 62 through Erez, 604 through Erez West, and 97 through the floating dock.  These figures do not include commercial trucks, as the UN has been unable to observe the arrival of private sector cargo through Kerem Shalom crossing due to insecurity. Supplies that are dropped off at the crossing without safety or logistical viability for humanitarian organizations to pick them up are also not included in these statistics. Additionally, just over 1 million litres of fuel have entered the Gaza Strip since the beginning of the military operation in Rafah. This represents an average of 29 per cent of fuel allocations that would have been received under arrangements in place prior to 6 May, further affecting the functioning of bakeries, hospitals, water wells, and other critical infrastructure. On 22 May, the World Food Programme (WFP) warned that “humanitarian operations in Gaza are near collapse” and “if food and humanitarian supplies do not begin to enter Gaza in massive quantities, desperation and hunger will spread.” As of 24 May, only 11 out of 16 bakeries supported by humanitarian partners are operational, including one in Jabalya, six in Deir Al Balah, and four in Gaza city.
• The World Health Organization (WHO) warns that “access to health care in Gaza is further shrinking.” According to WHO, on 22 May, the Israeli military reportedly raided Al Awda Hospital, which had been under siege since 19 May. The majority of the 140 hospital staff, patients and their companions who were present at the hospital were allowed to evacuate, while 12 staff, including the director, as well as 14 patients and eight companions remained, the WHO Director-General reported. At Kamal Adwan Hospital, all health workers and patients have been evacuated, the majority of whom are now at Al Helou Hospital in Gaza city and four critical cases are at Al Ahli Hospital, WHO informs. As of 24 May, there is only one hospital considered partially functional in North Gaza (Al Awda) but it remains inaccessible.
• Shortages in fuel, medical supplies and equipment are threatening the ability of the remaining health facilities to operate. In Deir al Balah, the situation remains critical at Al Aqsa Hospital, where on the night of 23 May, the electricity was largely cut off, due to the depletion of fuel to operate generators. Humanitarian organizations were able to deliver 15,000 litres of fuel to the hospital on 24 May. In a press briefing on 23 May, the administration of Al Aqsa Hospital had appealed for an urgent intervention by international organizations to provide 50,000 litres of fuel to avert “an imminent crisis” if the electricity stops, which would threaten the lives of more than 1,200 wounded and sick patients, particularly those in the Intensive Care Unit, newborns in incubators, and some 600 patients with kidney failure requiring dialysis treatment.
• Between 15 and 21 May, WHO documented eight new attacks on healthcare facilities, for a total of 458 attacks on health care since the escalation of hostilities on 7 October, affecting 102 healthcare facilities, including 32 of Gaza’s 36 hospitals, and 109 ambulances. As of 24 May, 15 out of 36 hospitals in Gaza are only partially functional, 21 hospitals are out of service, and there are six* functional field hospitals, according to WHO. Partially functional hospitals include facilities that are unable to provide inpatient care, with available bed capacity at existing hospitals reaching 439 per cent as of 13 May, or more than four times the case load that their maximum capacity allows for, according to MoH. The Health Cluster estimates that hospital bed capacity in the Gaza Strip currently stands at 2,368 beds, compared with about 3,500 beds before the war.
• Access to sexual, reproductive, and maternal health (SRMH) services across the Gaza Strip is becoming increasingly limited. Only five hospitals continue to offer such services, including As Sahaba and Al Helou hospitals in Gaza city, Al Awda Hospital in Deir al Balah, Al Amal Hospital in Khan Younis, and Al Emirati Hospital in Rafah, in addition to two field hospitals, 15 primary healthcare centres and 17 medical points. The Health Cluster reports that, with 170-180 deliveries taking place daily in Gaza and 27 per cent of them requiring caesarean sections, there is a critical need to establish additional containerized clinics across Gaza to scale up SRMH services, particularly in Al Mawasi and Deir al Balah to address the urgent needs of displaced people. The lack of adequate SRMH services exposes mothers and newborns to severe and life-threatening health risks, and if women survive pregnancy and childbirth, the risk of disease, infections and critical nutrition deficits hampers postpartum recovery, reports CARE.
• On 22 May, the International Rescue Committee (IRC) and Medical Aid for Palestinians (MAP) reported that some displaced people in central Gaza are surviving on just three per cent of the internationally recognized minimum requirements. 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. This is the case, for instance, at a shelter visited by the IRC that houses 10,000 people and receives just 4,000 litres of water per day, translating to about 0.4 litres per person, for drinking, washing, cooking and cleaning. The IRC stressed that this situation is forcing people to rely on unsafe water sources like seawater and agricultural wells, and the lack of adequate water quantities is contributing to dehydration. In the absence of sanitation facilities, displaced people are also building their own makeshift latrines, with up to 600 individuals sharing a single latrine, a situation exacerbated by the scarcity or unaffordability of hygiene supplies. Within this context, communicable diseases, including diarrhoea and suspected Hepatitis A, continue to increase, with children under the age of five being particularly affected. The Health Cluster reports that, among cases for which age-disaggregated data exist, children under five make up 29 per cent of acute respiratory infections, 33 per cent of bloody diarrhoea cases, and 28 per cent of acute watery diarrhoea illnesses.
• Aid operations in Gaza continue to be disrupted by network outages and difficulties facing local Mobile Network Operators (MNOs) and Internet Service Providers (ISPs) in carrying out needed maintenance and repair works. This is due to damaged infrastructure, limited access to fuel and prevailing insecurity. The ability of the Emergency Telecommunications Cluster (ETC) to provide services is also severely limited due to import challenges; since 7 October, the ETC only had 20 satellite phones, four Very High Frequency (VHF) repeaters, four solar power solutions, and 30 VHF handheld radios approved for import into Gaza by Israeli authorities. Coordination is also under way to secure the clearances and licenses required to program the 30 imported VHF radios, transport them from Jerusalem to Gaza, and enable the re-activation of the Gaza Security Communications System (SCS). Recently, intensified hostilities and limited staff rotations through border crossings have hampered the transport of received ICT equipment to Gaza, the deployment of shared ETC communications services, and the provision of face-to-face technical support to humanitarian responders. Funding challenges are an additional concern, as the ETC has so far only received about 23 per cent of required funds under the Flash Appeal and continues to appeal for additional funding to address life-saving communication needs of humanitarian actors in Gaza.

Funding

• As of 23 May, Member States have disbursed about US$885 million out of $3.4 billion (26 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 $262 million out of $2.8 billion (9 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). The HF has allocated an additional $22 million to bolster prioritized HF-funded projects in Gaza. Recently, 14 projects for a total of $5 million have been approved under the Third Reserve Allocation titled "Critical Humanitarian Aid for Gaza Amidst Escalating Conflict and Displacement (Phase 3)." Following a steep rise in displacement from Rafah to Khan Younis and Deir al Balah and to capitalize on the operational presence of national partners, these projects will be implemented by national NGOs (12 projects) or through a partnership between international and national NGOs (2 projects). Since 7 October, the oPt HF has mobilized over $100 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.