Displaced children staying at the Khan Younis Training Centre, the most overcrowded UN shelter in Gaza. With less than two square metres per person, many of the 22,000 displaced people at this facility stay outdoors. Photo by UNRWA

Hostilities in the Gaza Strip and Israel | Flash Update #31

06 Nov 2023

Hostilities and casualties (Gaza Strip)

Clashes between Israeli forces and Palestinian armed groups in northern Gaza reportedly intensified on 6 November. The Israeli military claimed it has fully encircled Gaza city and has been reportedly advancing into the city from the south. Intense bombardments from the air, sea and land continued across the Gaza Strip.
Between 5 November (noon) and 6 November (14:00), 252 Palestinians were killed in Gaza, according to the Ministry of Health (MoH) in Gaza. Among the deadliest incidents were two airstrikes at about 1:30 a.m., hitting residential buildings in Az Zawaidah (Middle area), killing 10 people, and in Tal As Sultan area (Rafah) killing 15 others.
On the 31st day of hostilities, the cumulative reported Palestinian fatality toll in Gaza surpassed 10,000, including 4,008 children and 2,550 women, according to the MoH in Gaza. About 2,260 others are reported missing in Gaza, including 1,270 children. Most are presumed to be trapped under rubble.
An additional telecommunication cut off was noticed across the Gaza Strip overnight (5 to 6 November), severely impeding the ability of ambulances and rescuers to reach those injured or trapped under collapsed buildings.
On 6 November, one Israeli soldier was reportedly killed in Gaza, bringing the total number of soldiers killed since the start of ground operations to 30, according to Israeli sources.
See the latest snapshot for more breakdowns.
On 5 November, the leaders of 18 UN agencies and humanitarian NGOs issued a joint statement expressing “shock and horror” at the mounting death toll from the conflict and calling for an immediate humanitarian ceasefire.

Access and movement (Gaza Strip)

On 6 November, the Egyptian border reopened for the evacuation of an unconfirmed number of foreign nationals and dual citizens, and a handful of injured people. This followed no such exits during the previous two days. On 2 and 3 November, 84 injured people were taken for medical care in Egypt, along with 66 relatives who accompanied them.
On 6 November, for the third consecutive day, the Israeli military called on residents of Gaza and the North Gaza governorates (hereafter: the north) to move southwards, opening a corridor between 10:00 and 14:00. UN monitors estimate that some 5,000 people passed. As roads leading to the main crossing junction had been heavily damaged, it was only reachable by foot. Entire families, including children, elderly people and persons with disabilities reported walking long distances, carrying their personal belongings by hand. The Israeli military has claimed that Hamas has been physically hindering people’s movement to the south.
On 6 November, 98 trucks primarily carrying food items, medicines, health supplies, bottled water and hygiene products crossed from Egypt into Gaza, bringing the number of trucks that have entered Gaza since 21 October to 574.* Prior to the start of hostilities, an average of 500 truckloads entered Gaza every working day.
The Kerem Shalom crossing with Israel, which prior to the hostilities was the main entry point for goods, remains closed, as does the Israeli pedestrian crossing of Erez.

Displacement (Gaza Strip)

About 1.5 million people in Gaza are internally displaced (IDPs). Of them, some 717,000 are sheltering in 149 UNRWA facilities, 122,000 in hospitals, churches, and public buildings, 110,000 people in 89 non-UNRWA schools, and the remainder are residing with host families.
Overcrowding remains a major concern. More than 557,000 people are sheltering in 92 UNRWA facilities in the south and shelters are unable to accommodate new arrivals. The Khan Younis Training Centre, the most overcrowded UNRWA shelter, hosts more than 22,000 IDPs: the space per person is less than two square metres, while at least 600 people are sharing one toilet.
The worsening sanitary conditions, along with the lack of privacy and space, generate health and safety hazards. Thousands of cases of acute respiratory infections, diarrhea and chicken pox have been reported among people taking refuge at UNRWA shelters.
An estimated 160,000 IDPs are housed in 57 UNRWA facilities in the north. 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 12 October.
A total of 50 IDPs sheltering in UNRWA premises have been killed and 461 injured since 7 October, in the context of hostilities.
See the live IDP dashboard for the latest figures and more breakdowns.

Electricity

Gaza remains under a full electricity blackout since 11 October, following Israel’s halt of its power 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.

Health care, including attacks (Gaza Strip)

On 5 November, the close vicinities of four hospitals in Gaza city have been struck; these strikes killed eight people and damaged buildings and some equipment, according to the WHO monitoring. The affected facilities, which include the Psychiatric Hospital, the Ophthalmic Hospital, Al Quds Hospital and Rantisi Pediatric Hospital, have remained operational.
On 6 November, the Israeli military called for the evacuation of the Rantisi hospital claiming that armed groups were using its premises and surroundings. Similar evacuation calls had been made to all hospitals in the north, in some cases including allegations about the use of their premises by armed groups.
At around midnight between 5 and 6 November, the Jordanian air force reportedly air-dropped urgent medical aid to the Jordanian field hospital in Gaza city, in coordination with the Israeli military.
Since 3 November, the main electricity generators at Shifa Hospital in Gaza city and the Indonesian Hospital in North Gaza have reportedly stopped operating due to the lack of fuel. Both hospitals operate secondary, smaller generators, which provide electricity primarily to the Intensive Care Units, emergency rooms, and operating rooms.
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. Out of the 102 attacks on health recorded by the World Health Organization (WHO), 83 were in the Gaza and North Gaza governates.

Water and sanitation (Gaza Strip)

On 6 November, UNRWA and UNICEF distributed limited amounts of fuel to 120 municipal water wells across the entire Gaza Strip, including in the north, enabling the wells to resume operations. The water extracted is brackish and therefore meant only for non-drinking domestic uses. The fuel had been stored in Gaza since before the start of hostilities.
In northern Gaza, the two main sources of drinking water, a desalination plant and a water connection from Israel, have been shut down for several weeks. In the south, one of the two desalination plants is operational, alongside two pipelines supplying water from Israel.
On 4 and 5 November, seven water facilities across the Gaza Strip were directly hit and sustained major damage, including three sewage pipelines in Gaza city, two water reservoirs (in Rafah and Jabalia refugee camp) and two water wells in Rafah. The Gaza municipality warned about the imminent risk of sewage flooding.

Food security

As of 6 November, only one bakery has reportedly remained operational in Gaza city and another in northern Gaza, which are unable to meet people’s needs. Therefore, those who can afford buying wheat flour and have the means to build cooking fires are preparing flatbread at home.
Access to bread in the south is also challenging. The only operative mill in Gaza remains unable to grind wheat due to a lack of electricity and fuel. Eleven bakeries have been hit and destroyed since 7 October. Only one of the bakeries contracted by the World Food Programme (WFP), along with eight other bakeries in the south, intermittently provides bread to shelters, depending on the availability of flour and fuel. People queue for long hours in bakeries, where they are exposed to airstrikes.
Food supplies entering from Egypt include mainly ready-to-eat food (canned tuna and date bars) and are primarily distributed to IDPs and host families in southern Gaza, with only flour being provided to bakeries.
Distribution of food assistance to IDPs in the north 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. Some reports indicate that no bakery is currently operational in these areas.

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, 240 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 six Palestinians, including one child, between the afternoon of 5 November and noontime on 6 November. During a military operation in Tulkarm, an undercover Israeli unit shot and killed four men, who according to the Israeli military, were members of armed groups. Another Palestinian man was shot and killed by Israeli forces in Halhul (Hebron) in confrontations during a search-and-arrest operation. In East Jerusalem, a 16-year-old Palestinian boy stabbed and injured a female Israeli police officer and was subsequently shot and killed; the police officer, who was reportedly injured also by Israeli gunfire or shrapnel, later died of her wounds.
Since 7 October, 147 Palestinians, including 44 children, have been killed by Israeli forces; and an additional eight, including one child, have been killed by Israeli settlers. Three Israelis have been killed in Palestinians attacks.
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 (394). About 55 per cent of the fatalities since 7 October occurred during confrontations that followed Israeli search-and-arrest operations, primarily in Jenin and Tulkarm governorates. Some 30 per cent were in the context of demonstrations in solidarity with Gaza; eight per cent were killed in settler attacks against Palestinians, and the remaining seven where while attacking or allegedly attacking Israeli forces or settlers.
Since 7 October, Israeli forces have injured 2,340 Palestinians, including at least 248 children, over half of them in the context of demonstrations. Sixty-four Palestinians have been injured by settlers. Some 27 per cent of those injuries have been caused by live ammunition.
In the past 24 hours, Israeli settlers entered the communities of Qawawis (Hebron), Al Mazra'a al Qibliya (Ramallah), and As Sawiya (Nablus), damaging trees, water pumps and a vehicle.
Since 7 October, OCHA has recorded 208 settler attacks against Palestinians, resulting in Palestinian casualties (28 incidents), damage to Palestinian-owned property (147 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 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 27, including 13 children, following punitive demolitions.

Funding

On 7 November, the UN and its partners issued a plan that outlines the minimum necessary to scale up humanitarian operations in support of 2.2 million people in the Gaza Strip and 500,000 of the most vulnerable in the West Bank. An estimated US$1.2 billion is required to deliver existing humanitarian services amid ongoing hostilities. The UN has shared its response plan with potential donors and partners as part of an updated Flash Appeal.
Private donations are collected through the 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 25,359 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 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 the registration of unaccompanied and separated children, 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 716,881 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 and 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 health-care services in the shelters, through 95 mobile medical units and medical teams.
PMRS has eight mobile health teams also providing primary health-care 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 designated emergency shelters in the Gaza governorate.
Islamic Relief Palestine provided food assistance to 10,000 IDPs in non-UNRWA 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 needs

Safe access to schools and communities.

Response to date

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.