Hostilities in the Gaza Strip and Israel | Flash Update #34

KEY POINTS

• On 9 November, over 50,000 people fled areas to the north of Wadi Gaza (hereafter: the north) southwards through a “corridor” opened by the Israeli military.
• The Emergency Relief Coordinator, Martin Griffiths, stressed that “the UN cannot be part of a unilateral proposal to push hundreds of thousands of desperate civilians in Gaza into so-called safe zones.”
• Hundreds of thousands of people remaining in the north are struggling to secure the minimum amounts of water and food to survive.
• All municipal water wells shut down again due to the lack of fuel, halting the supply of water for domestic non-drinking uses.
• UNRWA opened two additional shelters and is now hosting 582,000 IDPs in 92 facilities south of Wadi Gaza (hereafter: the south) in increasingly overcrowded conditions: on average, every toilet is shared by 160 people, and every shower unit by 700 people.
• An Naser Children’s Hospital in Gaza city was hit during an airstrike, reportedly killing three people and injuring dozens more. The vicinity of Shifa hospital was also reportedly hit and Gaza's only psychiatric hospital stopped functioning.
• With only 65 trucks entering from Egypt on 9 November, the volume of aid entering from Egypt is “wholly inadequate,” as Griffiths put it in remarks made today, stressing that hundreds of trucks are needed every day, including fuel, and that more than one entry point should be operated.
• In the West Bank, 18 Palestinians were killed by Israeli forces in less than 24 hours, since the afternoon of 8 November, bringing the Palestinian fatality toll since 7 October to 175, including 46 children.

Hostilities and casualties (Gaza Strip)

• Clashes between Israeli forces and Palestinian armed groups were reported in and outside of Gaza city, in several areas in the North Gaza governorate and to a lesser extent in the Middle area. Meanwhile, intense Israeli bombardments from the air, sea, and land continued across the Gaza Strip, while Palestinian armed groups continued launching projectiles toward Israel. Israeli ground troops have effectively divided the Gaza Strip into northern and southern sections.
• Between 8 November (14:00) and 9 November (14:00), 243 Palestinians were killed in Gaza, according to the Ministry of Health (MoH) in Gaza. According to initial information, on 8 November at about 15:30, an airstrike hit a residential building in Gaza city, killing 19 people and injuring 45; another strike at 18:00 hit a house in Jabalia Refugee Camp, reportedly killing 15 Palestinians; on 9 November after midnight, a building in eastern of Khan Yunis was hit, reportedly killing six and injuring several others.
• The fatality toll reported by MoH in Gaza since the start of the hostilities stands at 10,818, of whom 68 per cent are said to be children and women. About 2,650 others, including some 1,400 children, have been reported missing and may be trapped or dead under the rubble, awaiting rescue or recovery.
• The reported fatalities since 7 October include at least 192 medical staff, according to the MoH Gaza. Of them, at least 16 were on duty when killed, according to WHO. The fatalities further include 99 UNRWA staff, and 18 Palestinian Civil Defense personnel.
• In the past 24 hours, at least two Israeli soldiers were reportedly killed in Gaza, bringing the total number of soldiers killed since the start of ground operations to at least 35, according to Israeli sources.
• See the latest snapshot for more breakdowns.

Displacement (Gaza Strip)

• On 9 November, for the sixth consecutive day, the Israeli military – which has called upon residents of the north to leave southwards – opened a “corridor” along the main traffic artery, Salah Ad Deen Road between 9:00 and 16:00. It is estimated that, over the course of these seven hours, more than 50,000 people fled.
• Internally Displaced Persons (IDPs) reached the main junction next to Wadi Gaza on foot or donkey carts, as vehicles were reportedly stopped by the Israel military at about 4-5 kilometres away from that point. Most were able to carry only few personal belongings. UN monitors and NGOs distributed water and biscuits next to the junction. IDPs interviewed by OCHA monitors indicated that they did not know where they would stay overnight.
• Over 1.5 million people in Gaza are estimated to be internally displaced. To cope with the increased flow of IDPs, UNRWA opened two additional shelters in the Middle area, bringing the agency’s total number of shelters in the south to 92, sheltering 582,000 IDPs.
• Overcrowding remains a major concern. On average, 160 people sheltering in UNRWA schools facilities share a single toilet and there is one shower unit for every 700 people. The worsening sanitary conditions, along with the lack of privacy and space, generate health and safety hazards.
• See the live IDP dashboard for the latest figures and more breakdowns.

Humanitarian Access (Gaza Strip)

• On 9 November, the Egyptian border reopened for the evacuation of an unconfirmed number of foreign nationals and dual citizens, and a handful of injured people. Between 2 and 7 November, 119 injured people were taken for medical care in Egypt.
• A total of 65 trucks, carrying food, medicines, health supplies, bottled water, blankets, and hygiene products, as well as seven ambulances, crossed from Egypt into Gaza on 9 November. This brings the number of trucks that have entered Gaza since 21 October to 821. 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.
• In the International Humanitarian Conference held on 9 November in Paris, the UN Emergency Relief Coordinator, Martin Griffiths stated that “the modest number of trucks we have so far managed to get in via the Rafah border crossing is wholly inadequate compared to the vast sea of needs […] We need to get hundreds of trucks per day into Gaza, not dozens, and be allowed to reach every place people are sheltering.”

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 9 November, at about 5:00 a.m., the An Naser Children’s Hospital in Gaza city was hit during an airstrike, reportedly killing three people and injuring dozens more. The vicinity of Shifa hospital was also reportedly hit. Gaza's only psychiatric hospital stopped functioning after sustaining damage due to an attack on 5 November. Health workers were forced to discharge inpatients and halt other services.
• On 8 November, Al Quds Hospital in Gaza city announced that its main generator had been shut down, and a smaller generator is being used instead to reduce fuel consumption. As a result, the surgical ward, oxygen generation plant and MRI ward, have had to shut down. The hospital will provide two hours of electricity a day for IDPs taking shelter in its facilities. The hospital has been isolated from neighbouring areas and is facing a severe shortage of food, baby formula, medicine and disposables.
• According to the Director of Surgery at Shifa Hospital in Gaza city, patients who have undergone surgery are at a high risk of infection due to the unhygienic conditions and lack of equipment. In some cases, wounds have been covered by white flies and their larva, risking tissue damage, bacterial infection, and septicemia.
• WHO warned on 8 November of the risk of the rapid spread of infectious diseases and bacterial infections due to the water shortage and related consumption of contaminated water. Since mid-October, over 33,500 cases of diarrhea have been reported, mostly among children under five; by contrast, the monthly average of diarrhea cases in the latter group in 2021 and 2022 stood at 2,000.
• Nine (out of 22) UNRWA health centres are still operational in the south, recording 6,530 patient visits on 8 November. These centres also provide medical care for post-natal and high-risk pregnant women. There are an estimated 50,000 pregnant women in Gaza, with more than 180 giving birth every day. A total of 718 post-natal mothers have been attended in UNRWA shelters since the beginning of October.

Water and sanitation (Gaza Strip)

• On 9 November, following a few days of limited operation, all municipal water wells across the Gaza Strip shut down again due to the lack of fuel. As a result, the trucking and pumping of brackish water for non-drinking domestic uses came to a halt.
• Anecdotal reports indicate that people hosted or living near the sea, are reaching the beaches to bath and wash clothes in the sea, as well as carrying seawater to their homes and shelters for domestic consumption. This practice may carry various negative health ramifications due to the high pollution levels of seawater.
• In the north, neither the water desalination plant nor the Israeli pipeline is operational. Similarly, no distribution of bottled water among IDPs accommodated in shelters has taken place for over a week. There is serious concern about dehydration and waterborne diseases following water consumption from unsafe sources.
• In the south, one of the two desalination plants shut down on 9 November due to a lack of fuel, while the other operated at about five per cent of its capacity supplying drinking water to IDP shelters through trucking. Two pipelines from Israel connected to the Deir al Balah and Khan Younis are also providing households connected to the network with drinking water for a few hours per day.
• UNRWA has been providing about 1.5 litres of potable water and 3-4 litres of non-potable water per person per day in all shelters in the south. In the largest shelter located in Khan Younis (over 21,700 IDPs), UNRWA in partnership with UNICEF, installed a desalination plant, which turns brackish water extracted from wells, into potable water.
• Water entering from Egypt in bottles and jerry cans can only address the drinking needs (three litres per person per day) of about 4 per cent of the people.
• Transfer of solid waste to landfills has largely stopped across the Gaza Strip, due to lack of fuel and insecurity. Waste is accumulating in the streets and outside IDP shelters, creating a high risk of airborne diseases and infestation of insects and rats.

Food security

• Lack of food in the north is of increasing concern. As of 9 November, no bakeries were active, due to the lack of fuel, water, and wheat flour, as well as the damage sustained by many. Wheat flour is reportedly no longer available in the market. Food security partners have been unable to deliver assistance during the past eight days. There are indications of negative coping mechanisms due to food scarcity, including skipping or reducing meals and using unsafe and unhealthy methods for making fire. People are reportedly resorting to unconventional eating, such as combinations of raw onion and uncooked eggplant.
• 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 front of 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 the south.
• 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. The prices of available food items in the market have increased by 10 per cent since the start of hostilities, according to a WFP survey.
• 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.

Hostilities and casualties (Israel)

• The indiscriminate firing of rockets by Palestinian armed groups towards Israeli population centres has continued over the past 24 hours, with no reported fatalities. As of 9 November, the names of 1,162 of fatalities in Israel have been released, including 845 civilians and police officers. Of those whose ages have been provided, 31 are children.
• According to the Israeli authorities, 239 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 had been killed by Israeli airstrikes.

Violence and casualties (West Bank)

• Israeli forces shot and killed 18 Palestinians, including one child, between the afternoon of 8 November and noontime on 9 November. The deadliest incident, which lasted for over 12 hours, took place in Jenin Refugee Camp and resulted in 13 Palestinians, including one child, killed. The operation involved armed clashes with Palestinians, and airstrikes, resulting in extensive infrastructure damage. Another five fatalities were recorded during confrontations in the course of search-and-arrest operations in Anin (Jenin), Bethlehem city, Balata Refugee Camp (Nablus), Al Am’ari Refugee Camp (Ramallah), and At Tabaqa (Hebron)
• Since 7 October, 167 Palestinians, including 45 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 42 per cent of all Palestinian fatalities in the West Bank in 2023 (415). About 59 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 27 per cent were in the context of demonstrations in solidarity with Gaza; seven per cent were killed in settler attacks against Palestinians, and the remaining seven per cent were killed while attacking or allegedly attacking Israeli forces or settlers.
• Since 7 October, Israeli forces have injured 2,492 Palestinians, including at least 253 children, over half of them in the context of demonstrations. Sixty-six Palestinians have been injured by settlers. Some 32 per cent of those injuries have been caused by live ammunition.
• In the past 24 hours, six settler attacks resulting in damage or injuries were reported. These included raids in the villages of At Taybe (Hebron), Qusra (Nablus), Bruqin (Salfit), Khirbet Tana (Nablus), Al Mughayyir and Sinjil (the latter two in Ramallah) where settlers vandalized agricultural structures and crops. In two of these attacks, Israeli settlers physically assaulted and injured two Palestinians who were harvesting olives.
• Since 7 October, OCHA has recorded 230 settler attacks against Palestinians, resulting in Palestinian casualties (28 incidents), damage to Palestinian-owned property (167 incidents), or both casualties and damage to property (35 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 135 Palestinians, including 66 children, have been displaced since 7 October following demolitions in Area C and East Jerusalem, due to lack of permits, and another 27, including 15 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.