Hostilities in the Gaza Strip and Israel | Flash Update #32

KEY POINTS

• The situation of hundreds of thousands of Palestinians in Gaza city and other areas north of Wadi Gaza (hereafter: the north) is increasingly dire. Armed clashes and intense bombardment continue as people struggle to secure the minimum amounts of water and food to survive.
• As of 7 November, no bakeries were active in the north, due to the lack of fuel, water and wheat flour, as well as the damage sustained by many. Food security partners have been unable to deliver assistance in the north for the past seven days.
• Attacks continue in close proximity to hospitals in the north that are sheltering tens of thousands of internally displaced persons (IDPs), who are provided with only the most essential services. According to the World Health Organization, hospitals in the north are conducting complex surgeries, including amputations, without anesthesia, due to the lack of medical supplies.
• Shelters south of Wadi Gaza (hereafter: the south) are unable to accommodate new arrivals as they face severe overcrowding; in one shelter, over 600 IDPs are forced to share one toilet.
• The daily volume of humanitarian assistance entering from Egypt meets a fraction of people’s needs. Drinking water brought in serves just 4 per cent of Gaza’s residents, while desperately needed fuel remains banned.

Hostilities and casualties (Gaza Strip)

• On 7 November, armed clashes between Israeli forces and Palestinian armed groups continued in and outside of Gaza city, as well as in the North Gaza governorate. Meanwhile, intense Israeli bombardments from the air, sea, and land continued across the Gaza Strip, while Palestinian armed groups continued launching projectiles toward Israel.
• Between 6 November (noon) and 7 November (14:00), 306 Palestinians were killed in Gaza, according to the Ministry of Health (MoH) in Gaza. Among the deadliest incidents reported overnight were three simultaneous strikes on residential buildings across east of Rafah, where more than 25 Palestinians were reportedly killed. Another airstrike hit a neighborhood in central Khan Yunis, reportedly resulting in 16 Palestinian fatalities.
• This brings the reported fatality toll since the start of the hostilities to 10,328, of whom 67 per cent are said to be children and women, according to MoH Gaza. About 2,450 others, including 1,350 children, have been reported missing and may be trapped or dead under the rubble, awaiting rescue or recovery.
• These reported fatalities include at least 192 medical staff, according to the MoH Gaza. Of them, at least 16 were on duty when killed, according to the World Health Organization (WHO). The fatalities further include 89 UNRWA staff, and 18 Palestinian Civil Defense personnel.
• The death toll among Israeli soldiers in Gaza remains 30, according to official Israeli sources.
• See the latest snapshot for more breakdowns.
• UN Secretary-General António Guterres stated that Israeli ground operations and continued bombardment are hitting civilians, hospitals, refugee camps, mosques, churches and UN facilities, while Hamas and other militants use civilians as human shields and continue to launch rockets indiscriminately towards Israel.

Access and movement (Gaza Strip)

• On 7 November, the Israeli military continued calling on residents of the north to move southwards. For the fourth consecutive day, it opened a “corridor” along the main traffic artery, Salah Ad Deen Road, for residents to leave the north between 10:00 and 14:00. UN monitors estimate that up to 15,000 people may have passed, three times the figure estimated on 6 November. The majority, including children, elderly people and people with disabilities, arrived on foot with minimal belongings. Some IDPs reported that they had had to cross Israeli checkpoints to reach the area and had witnessed arrests by Israeli forces.
• The Egyptian border was opened on 7 November for the evacuation of about 600 foreign and dual nationals, and 17 injured people. Some of the latter were transported from northern Gaza in an ambulance convoy led by the International Committee of the Red Cross (ICRC).
• Additionally, 81 trucks, primarily carrying food, 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 650. 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. Of them, nearly 725,000 are sheltering in 149 UNRWA facilities, 122,000 in hospitals, churches, and public buildings, 131,134 in 94 non-UNRWA schools, and the remainder with host families.
• Overcrowding remains a major concern. More than 557,000 people are sheltering in 92 UNRWA facilities in the south, where shelters are unable to accommodate new arrivals. The Khan Younis Training Centre, the most overcrowded UNRWA facility, hosts more than 22,000 IDPs: the space per person is less than two square metres, while each toilet is shared by at least 600 people.
• 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.
• On 7 November, an UNRWA school in Khan Younis was struck, killing one IDP and injuring nine others. This brings the total number of IDPs killed since 7 October to 67, while 549 others have been injured.
• 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 7 November, an ICRC convoy on its way to deliver lifesaving medical supplies to the Shifa and Al Quds hospitals in Gaza city, came under fire.* Two trucks were damaged, and one of the drivers was injured. The convoy ultimately reached Shifa hospital, where it delivered the medical supplies. The head of the ICRC delegation in Gaza stated that “ensuring that vital assistance can reach medical facilities is a legal obligation under international humanitarian law.”
• On 7 November, areas in close proximity to the Indonesian and Kamal Odwan hospitals (both in North Gaza governorate) were struck, killing people and damaging buildings and equipment.
• For the second consecutive day, on 7 November, the Israeli military ordered the evacuation of the Rantisi hospital in Gaza city, claiming that armed groups were using its premises and surroundings. This hospital is the only pediatric facility in northern Gaza, and it also accommodates about 6,000 IDPs. According to the MoH in Gaza, its evacuation would jeopardize the lives of 15 children on life support, 38 children undergoing kidney dialysis, 10 children relying on artificial respiratory devices, and others who are injured.
• According to WHO, due to the lack of medical supplies, hospitals in the north are conducting complex surgeries, including amputations, without anesthesia.
• Since 3 November, the main electricity generators at Shifa and the Indonesian Hospital have reportedly not operated due to the lack of fuel. Both facilities operate secondary, smaller generators, which provide electricity primarily to the Intensive Care Units, emergency rooms, and operating theatres.
• Since the start of hostilities, 14 out of 35 hospitals with inpatient capacities have stopped functioning and 46 (64 per cent) of all primary care facilities across Gaza have shut down due to damage or lack of fuel. Overall, WHO recorded 110 attacks on health affecting 39 health care facilities (including 22 hospitals damaged) and 36 ambulances.

Water and sanitation (Gaza Strip)

• On 6 November, UNRWA and UNICEF distributed limited amounts of fuel to 120 municipal water wells across the Gaza Strip, including in the north, enough for the wells to operate for about two days. 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 the north, neither the water desalination plant nor the Israeli pipeline is operational. Municipal staff are struggling to access some of the water wells producing brackish water. For the past week, partners specializing in water, sanitation and hygiene (WASH) have been unable to distribute bottled water among IDPs accommodated in shelters in the north.
• In the south, one of the two desalination plants is operational, alongside two pipelines supplying water from Israel, providing a limited number households connected to the network with driking water for a few hours per day.
• The current water aid entering from Egypt in bottles and jerry cans is addressing only 4 per cent of the residents’ water needs per day, based on an allocation of three litres per person per day for all purposes, including cooking and hygiene. Water assistance is being primarily distributed in the south, where over 700,000 people have sought refuge in shelters.

Food security

• As of 7 November, no bakeries were active in the north, due to the lack of fuel, water and wheat flour, as well as the damage sustained by many. During the day, many people desperately looking for food broke into the last three bakeries with remaining stocks of wheat flour and took about 38 metric tons. Currently, wheat flour is reportedly no longer available in the market throughout the north.
• Food security partners have been unable to deliver assistance in the north during the past seven days. Reports by IDPs indicate that no food is provided in the shelters and people are merely surviving with limited assistance by local NGOs and community-based organizations, alongside reliance on negative coping mechanisms, such as eating food with limited nutritional value or unfit for human consumption.
• 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.
• WFP and its partners report that some essential food items such as rice, pulses, and vegetable oil are nearly depleted in the market. Other items, including wheat flour, dairy products, eggs, and mineral water, have disappeared from the shelves in shops across Gaza over the past two days. Despite limited stock at the wholesale level, these items cannot reach retailers due to extensive damage, security issues, and the lack of fuel.
• While about 9,000 tons of wheat grain are stored in mills in Gaza, a significant portion of it cannot be used, due to massive destruction, security concerns, and shortages of fuel and electricity.
• 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 the south, with only flour being provided to bakeries.

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 three Palestinians, between the afternoon of 6 November and noontime on 7 November in three incidents involving confrontations with Palestinians: during a search-and-arrest operation in Sa’ir (Hebron), and during protests in solidarity with Gaza in Beit ‘Anan (Jerusalem) and Beit Fajjar (Bethlehem).
• Since 7 October, 150 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 attacks 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 (397). 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 2,375 Palestinians, including at least 251 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.
• Between 5 and 7 November, OCHA verified five settler attacks. In three of these incidents, armed assailants known by Palestinian residents to be settlers, but who were wearing Israeli forces’ uniforms, raided the communities of Ar Rakeez and Umm Fagarah (both in Hebron), and Hizma (Jerusalem) where they vandalized a residential structure and water tanks and punctured the tires of vehicles. In two other incidents, in Burqa (Ramallah) and Kafr ad Dik (Salfit), at least 70 Palestinian-owned trees, in restricted areas near settlements, were vandalized.
• Since 7 October, OCHA has recorded 218 settler attacks against Palestinians, resulting in Palestinian casualties (28 incidents), damage to Palestinian-owned property (157 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 27,634 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.

* This sentence has been rectified following the publication of this update.