Hostilities in the Gaza Strip and Israel | Flash Update #29

Hostilities and casualties (Gaza Strip)

• Israeli ground operations in northern Gaza have continued, with troops and tanks reportedly surrounding Gaza city from multiple directions. Further clashes with Palestinian armed groups have been reported, alongside intense bombardments across the Gaza Strip, including in the Middle and southern areas.  
• Between 3 November (noon) and 4 November (14:00), 231 Palestinians were killed in Gaza, bringing the reported fatality toll since the start of the hostilities to 9,488, including 3,900 children, according to the Ministry of Health (MoH) in Gaza. About 2,000 others are reported missing in Gaza, including 1,250 children. Most are presumed to be trapped under the rubble. 
• At least 70 Palestinians were killed and another 60 injured, according to the MoH, during two separate airstrikes in the past 24 hours, hitting two schools sheltering IDPs in the Jabalia Refugee Camp, north of Gaza city. Most of the fatalities are said to be women and children. Since the start of hostilities, 258 school buildings have sustained damage, representing more than 51 per cent of all schools in Gaza.
• On 4 November, four Israeli soldiers were reportedly killed in Gaza, bringing the total number of soldiers killed since the start of ground operations to 28, according to Israeli sources.  
• See the latest snapshot for more breakdowns

Access and movement (Gaza Strip)

• No movement of dual nationals, internationals, or patients from Gaza to Egypt was reported on 4 November. Media reports indicated that Hamas, demanding guarantees of safe passage, had prevented people from reaching the crossing, following an Israeli attack on the ambulance convoy leaving Shifa hospital to Rafah on 3 November. More than 1,100 people reportedly crossed from Gaza to Egypt on 2 and 3 November. 
• On 4 November, the Israeli military continued calling on residents of Gaza city and northern Gaza to move southwards and announced that people would be allowed to do so safely between 13:00 and 16:00. According to Israeli sources, Palestinian armed groups attacked Israeli forces as that were attempting to enable the access of people southwards.  
• On 4 November, 30 trucks carrying humanitarian supplies crossed from Egypt into Gaza through Rafah crossing. Since 21 October, 451 trucks have entered Gaza. Of these, at least 158 trucks carried food, 102 carried health supplies, 44 carried water or hygiene products, 32 carried non-food items, and eight carried nutrition supplies, with the remaining trucks carrying mixed cargo.  
• The Kerem Shalom crossing with Israel, which prior to hostilities was the main entry point for goods, remains closed. The Erez pedestrian crossing with Israel also remains closed. 

Displacement (Gaza Strip)

• Nearly 1.5 million people in Gaza are internally displaced (IDPs). Of them, 710,275 are sheltering in 149 UNRWA facilities, 122,000 people are in hospitals, churches, and public buildings, 109,755 people are in 89 non-UNRWA schools (previously 82), and the remainder are residing with host families. 
• Overcrowding conditions continue to create severe health and protection risks for IDPs and are taking a heavy toll on their mental health. Damage to water and sanitation infrastructure and the limited availability of fuel to pump water creates additional public health risks. Several cases of acute respiratory infections, diarrhea and chicken pox have already been reported among people taking refuge at UNRWA shelters. 
• Over 530,000 people are sheltering in 92 UNRWA facilities in the southern governorates of Deir Al Balah, Khan Younis and Rafah areas. Shelters have exceeded their capacity and are unable to accommodate new arrivals. Many IDPs are seeking safety by sleeping in the streets, near to UNRWA premises 
• An estimated 160,000 IDPs are housed in 57 UNRWA facilities in the north and in Gaza city. UNRWA, however, is no longer able to provide services in those areas and does not have accurate information on people’s needs and conditions since the Israeli evacuation order on 13 October. 
• See the latest snapshot for more breakdowns

Electricity 

• Gaza remains under a full electricity blackout since 11 October, following Israel’s halt of its electricity and fuel supply, which triggered the shutdown of Gaza’s sole power plant.  
• The entry of fuel, which is desperately needed to operate electricity generators to run life-saving equipment, remains banned by the Israeli authorities. 
• Multiple solar panels on the roofs of standing buildings, particularly in Gaza city, have reportedly been destroyed in the past few days during Israeli bombardments. Affected facilities include Shifa and Nasser hospitals, several water wells, and bakeries. This has eliminated one of the remaining sources of energy, which is not dependent on fuel. 

Health care, including attacks (Gaza Strip)

• On 4 November, the entrances of both Nasser Children's Hospital in Gaza city and Al Quds Hospital in Gaza city were reportedly hit during Israeli airstrikes. Two people were reportedly killed, dozens were injured, and damage was caused to the entrances of these health facilities. Al Quds Hospital is currently a refuge for about 14,000 IDPs.  
• Since the start of hostilities, 14 out of 35 hospitals with inpatient capacities have stopped functioning and 51 (71 per cent) of all primary care facilities across Gaza (72) have shut down due to damage or lack of fuel.  

Water and sanitation (Gaza Strip)

• Hundreds of thousands of residents in Gaza city and the northern areas face a severe water shortage, raising concerns of dehydration and waterborne diseases due to consuming water from unsafe sources. However, a precise assessment is uncertain due to the hostilities and access restrictions. 
• Over the past few days, most water facilities in the abovementioned areas, including some 60 municipal water wells, have shut down due to the lack of fuel and the inability of staff to reach them. This compounds the situation generated by the shutdown of the single seawater desalination plant in the north, and Israel’s halt in the water supply during the first week of hostilities. Consequently, nearly all water supplies through the network, as well as trucking activities, have reportedly ceased. Residents rely on the minimal volume from private wells and purification plants and consume unsafe water from agricultural wells.  
• At least 25 sewage pumping stations in Gaza city and the northern areas have also ceased operating. The municipality of Gaza city has warned about the imminent risk of sewage flooding in large areas of the city, including Az Zaytoun and Ad Daraj neighbourhoods. 

Food security

• Food supplies entering from Egypt are primarily distributed to IDPs and host families in southern Gaza, with only flour being provided to bakeries. At the shop level, the World Food Programme (WFP) estimates that current stocks of essential food commodities will be sufficient for about five more days, with retailers facing significant challenges when restocking from wholesalers due to widespread destruction, insecurity, and lack of fuel.  
• Access to bread is increasingly challenging. The only operative mill in Gaza remains unable to grind wheat due to lack of electricity and fuel. Eleven bakeries have been struck and destroyed since 7 October. Only one of the bakeries contracted by WFP, and eight other bakeries in the southern and Middle areas have been intermittently providing bread to shelters, depending on the availability of flour and fuel. People queue for long hours in bakeries, where they are exposed to airstrikes. 
• Distribution of food assistance to IDPs in northern Gaza was almost completely halted for the past few days, following the intensification of ground operations. Anecdotal information suggests that limited food assistance by local NGOs and community-based organizations continues. 

Hostilities and casualties (Israel)

• The indiscriminate firing of rockets by Palestinian armed groups towards Israeli population centres has continued over the past 24 hours, resulting in no reported fatalities. Overall, about 1,400 Israelis and foreign nationals have been killed in Israel, according to the Israeli authorities, the vast majority on 7 October. As of 3 November, the names of 1,159 of these fatalities have been released, including 828 civilians. Of those whose ages have been provided, 31 are children. 
• According to the Israeli authorities, 242 people are held captive in Gaza, including Israelis and foreign nationals. Media reports indicate that about 30 of the hostages are children. So far, four civilian hostages have been released by Hamas, and one female Israeli soldier was rescued by Israeli forces. Hamas has claimed that 57 of the hostages were killed by Israeli airstrikes. 

Violence and casualties (West Bank)

• Israeli forces shot and killed a 17-year-old Palestinian child on 3 November during confrontations that erupted over the course of a protest in solidarity with Gaza in the Israeli-controlled area of Hebron city (H2).  
• Since 7 October, 136 Palestinians, including 43 children, have been killed by Israeli forces; and eight, including one child, by Israeli settlers. Two Israelis have been killed by Palestinians. 
• The number of Palestinians killed in the West Bank since 7 October accounts for more than one-third of all Palestinian fatalities in the West Bank in 2023 (383). Nearly 50 per cent of these fatalities occurred during confrontations that followed Israeli search-and-arrest operations, primarily in Jenin and Tulkarm governorates. Some 35 per cent were in the context of demonstrations in solidarity with Gaza; and most of the remaining 10 per cent were killed while attacking or allegedly attacking Israeli forces or settlers, and in settler attacks against Palestinians.  
• Since 7 October, Israeli forces have injured 2,300 Palestinians, including at least 241 children, over half of them in the context of demonstrations. Sixty-two Palestinians have been injured by settlers. Some 27 per cent of those injuries have been caused by live ammunition. 
• In three incidents recorded in the past 24 hours, Israeli settlers raided the villages of Ein Shibli (Nablus) and Ramin (Tulkarm), where they set fire to and vandalized uninhabited residential structures, an animal shelter, several vehicles, and crops.  
• Since 7 October, OCHA has recorded 198 settler attacks against Palestinians, resulting in Palestinian casualties (27 incidents), damage to Palestinian-owned property (138 incidents), or both casualties and damage to property (33 incidents). This reflects a daily average of seven incidents, compared with three since the beginning of the year. Over one-third of these incidents included threats with firearms, including shootings. In nearly half of all incidents, Israeli forces were either accompanying, or actively supporting, the attackers. 

Displacement (West Bank)

• Since 7 October, at least 111 Palestinian households comprising 905 people, including 356 children, have been displaced amid settler violence and access restrictions. The displaced households are from more than 15 herding/Bedouin communities.  
• An additional 120 Palestinians, including 55 children, have been displaced since 7 October following demolitions in Area C and East Jerusalem, due to lack of permits, and another 23, including 13 children, following punitive demolitions. 

Funding

• The Humanitarian Country Team estimates it will cost US$1.2 billion to meet critical needs for 2.7 million people across the Occupied Palestinian Territory between 1 October and 31 December 2023. For humanitarian actors to implement this plan, they must have safe and sustained access to all people in need, across the Gaza Strip and the West Bank; sufficient fuel must be made available; and the flow of humanitarian assistance into Gaza must increase. 
• The magnitude and scope of the response, and lag time between funding pledges and the receipt of these funds, mean that the full implementation of the plan is not expected by the end of 2023. Outstanding response priorities will be rolled into the 2024 Humanitarian Response Plan or appeal extension. 
• These requirements will be reflected in an updated Flash Appeal to be issued on 6 November. The original appeal, launched on 12 October, requested  US$294 million to support nearly 1.3 million people. 
• Private donations are collected through the occupied Palestinian territory Humanitarian Fund.

HUMANITARIAN NEEDS AND RESPONSES

Multi-Purpose Cash Assistance (MPCA)

Priority needs

• Access to basic needs and services is severely halted by the lack of resources and the security situation. IDPs outside formal shelters have extremely limited access to assistance. Those are prioritized for Emergency MPCA. 
• Banks are temporarily closed, limiting access to cash. The capacities of financial service providers are severely limited and change by the hour (partners currently using PalPay). 
• Depletion of stocked items to be purchased is worsening. 

Response to date

• Some 17,874 households started receiving Emergency MPCA (NIS754 or $187 per household) as of 26 October. Redemption rates were reported as up to 86 per cent. 

Protection

Priority needs

• An estimated 20,000 people in need of specialized mental health services, including mental health drugs, who are in precarious situations with the disruption to mental health services. 
• Documentation of violations of international human rights law and humanitarian law. 
• Opening roads, safe access to basic needs, medicines, mental health support, and ambulance services in the West Bank. 

Response to date

• Some 3,000 IDPs have received psychosocial support and social work intervention services from UNRWA social workers and counsellors since the crisis began. 
• In the West Bank, UNRWA provided psychosocial support services to 155 Palestinian workers from Gaza, in Hebron, Ramallah, and Tulkarm, and to 240 students at Nur Shams Boys’ schools. 
• One partner reached at least 4,000 IDPs in shelters in Gaza and provided psychological first aid (PFA) and needs assessment for non-food items (NFIs) and assistive devices. 
• Partners provided about 700 psychological, social, and legal consultations for gender-based violence (GBV) incidents. Furthermore, 1,144 first psychiatric medical services were provided for GBV cases. 
• UNICEF is leading the mapping of orphanages and shelters which host children with a view to support Unaccompanied and Separated Children (UASC) registration, to facilitate identification, reunification, and alternative care options at national level (both Gaza and the West Bank). 

Shelter

Priority needs

• Urgent need to provide services and basic shelter and NFI to IDPs.  
• Provision of NFIs and house maintenance for people displaced in urban centres and with host families. 
• Provision of shelter cash assistance for IDPs (reintegration package and belongings loss compensation) for at least 25,000 families. 

Response to date

• Some 710,275 IDPs are hosted at 149 UNRWA schools across the Gaza Strip. 
• Distribution of 20,000 NFIs in Rafah and Khan Younis, including bedding sets and dignity kits. 
• Distribution of 820 hygiene kits to displaced families.  
• ICRC/PRCS distributed 15,500 NFIs for displaced families, mainly mattresses and blankets

Health

Priority needs

• Improve the nutritional status, particularly of about 283,000 children under five and pregnant or lactating women, in response to the concerning food security and water situation in Gaza. 
• Ensuring the provision of Infant and Young Child Feeding in Emergencies, including preventive nutrition interventions, cash voucher assistance, curative nutrition interventions, intact nutrition supplies pipeline, and a functional nutrition coordination mechanism. 
• Addressing shortages of medical supplies impacting case management. 
• Fuel supply for hospitals and ambulances. 
• Urgent need to restock medical supplies given depletion of stocks in the local market. 
• Need for short and long-term mental health and psychosocial support services for large numbers of psychologically traumatized people. 
• Access to mobile clinics for 29 communities in Area C locations in Hebron, Jenin and Qalqiliya who have not had access since escalations began. 

Response to date

• UNRWA continues to provide primary healthcare services in the shelters, through 95 mobile medical units and medical teams.  
• PMRS has eight mobile health teams also providing primary healthcare services to IDPs and expects to increase the number to twelve. 
• Partners are continuing to mobilize resources in Cairo; with support from WHO, the Health Cluster has deployed a logistics team based in Cairo to assist partners with health coordination.

Food Security

Priority needs

• Electricity, fuel, and water sources to maintain agriculture. 
• Many shops have food supplies to last less than a week. 
• Safe access to farms, livestock, fisheries, and other livelihoods. 
• Urgent import of fodder. 

Response to date

• On 2 November, WFP continued to assist UN shelters by distributing bread, tuna, date bars and food parcels for host communities.  
• Oxfam covered 189 households in the Gaza governorate.  
• Dan Church Aid (DCA) covered 18,000 households sheltering in UNRWA DES in the Gaza governorate.  
• Islamic Relief Palestine provided food assistance to 10,000 IDPS in non-URWA shelters or with host families.  
• Anera provides hot meals to a total of 120,000 people. Food parcels, 80 per cent to UNRWA DES shelters, 20 per cent to hosting communities and other smaller scale shelters. 2,000 households in North Gaza and 12,000 households in Khan Yunis have already been covered. Ten thousand households in the Middle Area are ongoing. Vegetable baskets to host families and small-scale shelters for 2,000 IDPs (UN shelter) in Khan Younis and 2,000 IDPs (UN shelter) in the Middle Area. Planning food parcels distributed covering 1,000 IDPs in collective shelters and host families.  
• Save the Children is providing food in-kind to 75,000 IDPs outside UNRWA shelters. 
• UPA in partnership with PARC is providing 617 food parcels in five different shelter schools. 

Education

Priority eeds

• Safe access to schools and communities.

Planned responses

• Provision of emergency education supplies and learning, recreational kits/stationery to 11,250 children. 
•  Provision of psychosocial support to 28,300 school-aged children 
•  Provision of recreational activities for school-aged children. 

WASH (Water, Sanitation and Hygiene)

Priority needs

• Provision of clean drinking water. 
• Provision of alternative power supply and 20,000 litres per day of emergency fuel to sustain the operation of WASH facilities, along with replenishing the chlorine supply for water treatment plants. 
• Support to restore disrupted municipal services, including solid waste management, water, and sanitation operations, as appealed by the Gaza Strip municipalities. 
• Delivery of essential WASH services and provisions to IDPs in collective centres, including drinking water and hygiene kits. 

Response to date

Since 7 October WASH partners have provided:

• Some 9,500 hygiene kits to families in the UNRWA IDP centres.  
• 1,950 cubic metres of drinking water trucked to IDP centres and host families.  
• 175 cubic metres of bottled water among IDPs in UNRWA shelters. 
• Four water storage tanks, with a capacity of 10 cubic metres, and twenty others, with a capacity of 1.5 cubic metres each, to be used by communities and shelters. 
• 8,000 units of ten litres of water capacity.  
• 4,000 water purification tools for the hosted families in vulnerable communities and IDP centres.  
• 211 cubic metres of fuel to WASH facilities. 
• 5 cubic metres of anti-scaling to desalination plants. 

Protection against sexual abuse and exploitation (PSEA) remains a cross-cutting priority for all clusters. The SAWA helpline, reachable at 121 and through WhatsApp at +972 59-4040121 (East Jerusalem at 1-800-500-121), operates 24/7. This toll-free number is widely disseminated across all areas of intervention to report cases of SEA and to facilitate emergency counseling and referrals for affected communities to access life-saving services. The PSEA Network monitors calls daily and will increase the number of counselors if necessary.