Hostilities in the Gaza Strip and Israel | Flash Update #49

KEY POINTS

• A humanitarian pause agreed by Israel and Hamas entered into force on 24 November at 7:00, with no major incident recorded as of 22:00. Emergency Relief Coordinator, Martin Griffiths, has expressed hope that “this first day of the humanitarian pause is followed by many others and that it leads to a longer-term humanitarian ceasefire – for the benefit of the people of Gaza, Israel and beyond.” 
• The 24 hours prior to the pause witnessed an intensification of Israeli strikes from air, land and sea in multiple areas throughout Gaza, alongside ground battles with Palestinian armed groups to the north of Wadi Gaza (hereafter: the north) and in the Middle Area. In one of the deadliest incidents, at about 20:00 on 23 November, a school in Jabalia was hit in an airstrike, reportedly killing 27 people and injuring another 93. 
• The pause has allowed the UN to scale up the delivery of assistance into and across Gaza. On 24 November, 200 trucks were dispatched from Nitzana to the Rafah crossing, and 137 trucks of goods were offloaded by the UNRWA reception point in Gaza, making it the largest volume of aid since the resumption of humanitarian deliveries on 21 October. Additionally, 129,000 litres of fuel and, for the first time since 7 October, four trucks carrying cooking gas, crossed into Gaza.  
• The agreement reportedly  involves the gradual release of hostages and detainees. On 24 November, 24 hostages held in Gaza and 39 Palestinians held in Israeli prisons were released. The hostages released included 13 Israelis – nine women and four children – and 11 foreign nationals. Among the Palestinians detainees were 24 women and 15 boys.  
• It is estimated that several thousands of Palestinians attempted to move from the area south of Wadi Gaza (hereafter: the south) to the north on 24 November, despite an Israeli military warning that returning to the north is prohibited. In several reported incidents in the morning and the afternoon, Israeli forces opened fire and threw teargas canisters at people heading northwards; at least one person was reportedly killed, and dozens injured.  
• On 24 November, the Palestine Red Crescent Society (PRCS) and a UN team evacuated at least 21 patients and wounded people, and 19 of their companions, from Al Ahli Baptist Hospital in Gaza city (in the north), to a hospital in Khan Younis (in the south). Despite the lack of electricity, supplies and food, Al Ahli resumed admitting patients and providing limited medical services, after being inaccessible for several days. 
• Also on 24 November, an UN convoy was able to reach two UNRWA facilities sheltering internally displaced persons (IDPs) in the north, where it delivered flour and conducted an initial assessment. This is the first aid delivery to a shelter in the north in over one month. 

Hostilities and casualties (Gaza Strip)

• Airstrikes, shelling and ground clashes intensified overnight and until the humanitarian pause entered into force at 7:00 on 24 November. The Jabaliya refugee camp, in the north, reportedly came under one of the heaviest artillery bombardments so far. Intense tank fire and ground operations by Israeli forces, as well as clashes with armed groups, were reported in areas to the east of A Bureij, Deir Al Balah, Al Mughraqa, An Nuseirat camp and Al Maghazi camp. Tank shelling was also reported east of Rafah and Khan Yunis.  
• Several of the Israeli airstrikes carried out on 23 November resulted in many casualties. In addition to the incident in the Jabalia school (see above), the following incidents have been reported: Shortly after midday, two residential buildings in different parts of Rafah city were hit, reportedly killing a total of 14 people, including six children; at 13:00, a house in central Khan Yunis was hit, reportedly killing five people, including a pregnant woman; at about 15:00, a house in the Sheikh Radwan area of Gaza city was hit, reportedly killing ten people; at about 20:40, two cars in An Nuseirat camp were hit, reportedly resulting in 11 fatalities, most of them children.  
• No new fatality figures have been issued in the past 24 hours. According to the Government Media Office (GMO), as of 18:00 on 23 November, more than 14,800 people have been killed in Gaza, including about 6,000 children and 4,000 women. This office, which is under the de facto authorities in Gaza, has been reporting casualties since the Ministry of Health in Gaza stopped doing so on 11 November, following the collapse of services and communications at hospitals in the north. 
• As of 18:00 on 24 November, the number of Israeli soldiers killed since the start of ground operations has remained 75, according to official Israeli sources. 

Displacement (Gaza Strip)

• On 24 November, the Israeli military continued calling and exerting pressure on residents of the north to leave southwards through a “corridor” along the main traffic artery, Salah Ad Deen Road, between 9:00 and 16:00. OCHA’s monitoring estimated that less than 400 people moved south.  
• A man interviewed by OCHA at the crossing point indicated that the main reason forcing him and his family to leave the north was hunger. He further said that his family had received no food assistance for weeks and forcing them to break into groceries to find food to survive. 
• In previous days, Israeli forces had been arresting some people moving through the “corridor.” IDPs interviewed by OCHA reported that Israeli forces had established an unstaffed checkpoint where people are directed from a distance to pass through two structures, where a surveillance system is thought to be installed. IDPs are ordered to show their IDs and undergo what appears to be a facial recognition scan.  
• The movement of unaccompanied children and separated families has also been observed in recent days. Humanitarian actors are assisting these children, including through registration of cases.  
• Over 1.7 million people in Gaza, or nearly 80 per cent of the population, are estimated to be internally displaced. Of them, nearly 896,000 IDPs are sheltering in 99 facilities in the south. 
• Due to the overcrowding and poor sanitary conditions at UNRWA shelters, there have been significant increases in some communicable diseases and conditions such as diarrhoea, acute respiratory infections, skin infections and hygiene-related conditions like lice.  
• Due to the lack of space in shelters in the south, most displaced men and older boys are sleeping in the open, in school yards or in the streets, next to the external walls of the shelters. At least in one UNRWA shelter in Khan Younis, a few hundred of IDP families have been accommodated in tents outside the shelter premises. 

Humanitarian Access (Gaza Strip)

• On 24 November, 129,000 litres of fuel and, for the first time since 7 October, four trucks of cooking gas, entered Gaza from Egypt. Fuel is being distributed by UNRWA to support food distribution, and the operation of generators at hospitals, water and sanitation facilities, shelters, and other critical services. 
• A total of 137 trucks of goods were offloaded on 24 November, as of 18:00, by the UNRWA reception point in Gaza. Overall, between 21 October and 23 November at 18:00, at least 1,860 truckloads of humanitarian supplies (excluding fuel) have entered Gaza through the Egyptian border, compared with a monthly average of nearly 10,000 truckloads of commercial and humanitarian commodities (excluding fuel) entering Gaza before 7 October. 
• On 24 November, an unconfirmed number of Palestinians stranded in Egypt, were allowed to return to Gaza, for first time since the outset of hostilities.  
• The same day, 23 wounded and sick people, along with 21 companions, left Gaza via the Rafah crossings. No dual and foreign nationals exited Gaza to Egypt on 24 November. These figures exclude released hostages. 
• The Kerem Shalom crossing with Israel, which prior to the hostilities was the main entry point for goods, has remained closed. 

Electricity

• Since 11 October, the Gaza Strip has been under an electricity blackout, after the Israeli authorities cut off the electricity supply, and fuel reserves for Gaza’s sole power plant depleted.  

Health care, including attacks (Gaza Strip)

• On 23 November, at about 22:00, an Israeli airstrike reportedly hit the Indonesian hospital in Beit Lahia (North Gaza) destroying its generator. Subsequently, Israeli troops raided the hospital. At least one woman was reportedly killed and three patients were detained. The troops left the facilities at dawn. The hospital is not operational.  
• On 24 November, Israeli forces also withdrew from the Shifa hospital compound in Gaza city, where they had been carrying out operations for nine days. Before leaving, the Israeli forces reportedly destroyed tunnel they had found underneath the compound; oxygen pipes and generators were also reportedly destroyed. Some 250 patients and staff members are estimated to remain at Shifa, which is currently non-operational.  
• Out of 24 hospitals operating in the north prior to the war, only four small ones are estimated to be operational and admitting new patients. Of the 11 medical facilities in the south, eight are currently functional. The bed capacity across Gaza has declined from 3,500 prior to the war to 1,400 presently, amid a surge in those seeking treatment. Only one of the currently functional hospitals in the south has the capacity to treat critical trauma cases or perform complex surgery, according to the WHO. 
• Hospitals and medical personnel are specifically protected under international humanitarian law (IHL) and all parties to the conflict must ensure their protection. Hospitals must not be used to shield military objectives from attack. Any military operation around or within hospitals must take steps to spare and protect the patients, medical staff, and other civilians. All feasible precautions must be taken, including effective warnings, which consider the ability of patients, medical staff, and other civilians to evacuate safely.  

Water and sanitation (Gaza Strip)

• Sewage flowing in the streets has been reported in several areas across Rafah, over the past few days. This is attributed to a combination of the limited operation of only one wastewater treatment plant due to fuel shortage and damage sustained by the sewage infrastructure. 
• UNRWA continues delivering fuel to the Gaza’s main water utility, which in turn distributed it to water and sanitation facilities in the south: two seawater desalination plants, 79 water wells, 15 water pumping stations, 18 sewage pumping stations, and one wastewater treatment plant. Supply of potable water in the south via two pipelines coming from Israel has continued. 
• In the north, grave concerns of dehydration and waterborne diseases due to water consumption from unsafe sources continue. The water desalination plant and the Israeli pipeline supplying water to the north are not functioning. There has been no distribution of bottled water among IDPs accommodated in shelters for about two weeks due to partners’ inability to access the north. 

Food security

• On 24 November, UNRWA managed to distribute flour to two IDP shelters in the north. Other than that, no food distribution has been carried out in the north for several weeks. Due to the lack of cooking facilities and fuel, people have been resorting to consuming the few raw vegetables or unripe fruits that remain available to them. No bakeries are operational, due to the lack of fuel, water, and wheat flour, and structural damage. Wheat flour is reportedly no longer available in the market. Food Security Cluster members have raised serious concerns about the nutritional status of people, especially lactating women, and children. 
• Also in the north, livestock is facing starvation and the risk of death due to shortage of fodder and water. Crops are being increasingly abandoned and damaged due to lack of fuel required to pump irrigation water. 
• Across Gaza, farmers have been slaughtering their animals due to the immediate need for food and the lack of fodder to keep them alive. This practice poses an additional threat to food security as it leads to the depletion of productive assets. 
• Food prices in the market have experienced an unprecedented surge. According to the Palestinian Central Bureau of Statistics, during October, food and beverages prices increased by 10 per cent; with vegetables increasing by 32 per cent, wheat flour by 65 per cent, and mineral water by 100 per cent.  

Hostilities and casualties (Israel)

• The indiscriminate firing of rockets by Palestinian armed groups towards Israeli population centres continued prior to the entry into force of the pause on 24 November, with no reported fatalities. In total, over 1,200 Israelis and foreign nationals have been killed in Israel, according to the Israeli authorities , the vast majority on 7 October. As of 20 November, the names of most fatalities in Israel have been released, including 859 civilians and police officers. Of those whose ages have been provided, 33 are children. 
• Following the release of hostages on 24 November, 211 people remain captive in Gaza, including Israelis and foreign nationals, according to the Israeli authorities. Before the pause, four civilian hostages had been released by Hamas, one Israeli soldier had been rescued by Israeli forces, and three bodies of hostages had reportedly been retrieved by Israeli forces. On 22 November, the Emergency Relief Coordinator, Martin Griffiths, reiterated his call for the immediate and unconditional release of all hostages. 

Violence and casualties (West Bank)

• Over the past 24 hours, Israeli forces killed two Palestinians, including a 14-yearold child, during two search-and-arrest operations in Aqbat Jaber Refugee Camp (Jericho) and in Beita village (Nablus). No Israeli casualties were reported. 
• Since 7 October, 213 Palestinians, including 55 children, have been killed by Israeli forces; and an additional eight, including one child, have been killed by Israeli settlers in the West Bank, including East Jerusalem. Four Israelis have been killed in attacks by Palestinians. 
• The number of Palestinians killed in the West Bank since 7 October accounts for 48 per cent of all Palestinian fatalities in the West Bank in 2023 (454). About 66 per cent of the fatalities since 7 October have occurred during confrontations that followed Israeli search-and-arrest operations, primarily in Jenin and Tulkarm governorates; 24 per cent have been in the context of demonstrations concerning  Gaza; seven per cent have been killed while attacking or allegedly attacking Israeli forces or settlers; two per cent have been killed in settler attacks against Palestinians; and one per cent during punitive demolitions. 
• Since 7 October, Israeli forces have injured 2,877 Palestinians, including at least 364 children, over half of them in the context of demonstrations. An additional 78 Palestinians have been injured by settlers. Some 33 per cent of those injuries have been caused by live ammunition. 
• No new settler attacks were reported in the past 24 hours. Since 7 October, OCHA has recorded 281 settler attacks against Palestinians, resulting in Palestinian casualties (33 incidents), damage to Palestinian-owned property (210 incidents), or both casualties and damage to property (38 incidents). This reflects a daily average of almost six 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 143 Palestinian households comprising 1,014 people, including 388 children, have been displaced amid settler violence and access restrictions. The displaced households are from 15 herding/Bedouin communities.  
• On 24 November, in Rummana village (Jenin), Israeli forces demolished on punitive grounds the home of a family whose member was accused of killing an Israeli in August 2023. As a result, six people, including one child, were displaced. Punitive demolitions are a form of collective punishment and are prohibited under international law.    
• Additionally, 162 Palestinians, including 82 children, have been displaced since 7 October following demolitions in Area C and East Jerusalem, due to lack of permits; and 48 Palestinians, including 24 children, have been displaced following punitive demolitions. 

Funding

• As of 24 November, Member States have disbursed US$238.6 million against the updated Flash Appeal launched by the UN and its partners to implement its response plan in support of 2.2 million people in the Gaza Strip and 500,000 in the West Bank. This constitutes about 20 per cent of the $1.2 billion requested. An additional $250 million has been pledged by 23 November. Private donations are collected through the Humanitarian Fund.

HUMANITARIAN NEEDS AND RESPONSES: 13-19 November

Health

On 18 November, the World Health Organization led a joint UN team that visited Shifa Hospital, in Gaza city to conduct a rapid situational analysis, assess medical priorities, and establish logistics options for the evacuation of patients. 

Since 1 November, Cluster partners have delivered the following items across Gaza:

• various medical supplies to ten hospitals and the ambulances; 
• assistive and mobility devices, wound dressing kits and first aid kits to 805 people;  
• 87 reproductive health kits to hospitals to enable safe deliveries;  
• cash transfers to 724 vulnerable women in Gaza, including pregnant and lactating women, breast cancer patients, and survivors of gender-based violence (GBV);  
• 600 postpartum kits;  
• 900 family hygiene kits distributed in one IDP shelter in An-Nusseirat and 120 host community shelters;  
• 1,070 dignity kits to women staying in IDP shelters. 

During the same period, there have been an average of 10,000 consultations a day at mobile primary healthcare providers in shelters; 2,925 children were vaccinated after this service resumed in November; 132 wound dressing and 60 physiotherapy sessions were provided. Limited mental health and psychosocial services are being provided by partners, mainly in shelters. Cluster partners are also working to strengthen disease surveillance and early warning systems. 

Main factors that have been impeding operations include limited access to the north; shortage of fuel, medical supplies, water, food, and other essential supplies; displacement of partners, their staff and families; and overcrowding in IDP shelters. NGO partners have experienced difficulties with their logistics capacity in Egypt. So far, only 19 per cent of funding required to respond has been committed. 

Protection

Mine contamination is already widespread and poses devastating risks for people in Gaza. Despite challenges, during the reporting period, 18 Explosive Ordnance Risk Education (EORE) focal points were deployed in UNRWA shelters in the south and will begin awareness raising. The UN Mine Action Service is developing a training course for 20 UNRWA staff in Khan Younis and Rafah. Planning for the expansion of risk education outreach in non-UNRWA shelters is underway. One NGO also reached 4,900 people with risk education about unexploded ordnances and sent 500,000 SMS related messages.  

A mapping of GBV-related service providers and responders has been completed. The main priority in this context is to reduce overcrowding in shelters, which increase stressors, reduce privacy, and exacerbate risks of violence towards women and girls. Of concern is the significant gap in dignity kits supplies and access for women of the reproductive age. There are 3,000 kits in Egypt ready to move into Gaza once approved, and a further 6,000 in the pipeline. Funding is urgently needed to meet the soaring needs of women and girls in Gaza. 

Cluster partners are assessing needs and available supply of assistive devices and kits in UNRWA southern governorate shelters. While demand for assistive devices continues to increase, the remaining stockpiles in northern Gaza are inaccessible. Further supplies are being procured and in the pipeline via Egypt. Significant damage to rehabilitation facilities has cut critical services.  

Mental health care needs are skyrocketing, especially for persons with disabilities, children, and those with pre-existing complex conditions. However, many services have been destroyed and many staff are unable to work. Only limited psychosocial support (PSS) services and psychological first aid is being provided in some shelters across Gaza where protection actors are sheltering and have capacity to respond. 

Despite extreme overcrowding at shelters, UNRWA has been able to provide some recreational activities, PSS support, and mine risk awareness sessions. They have also conducted child protection assessments and been assessing how to implement activities with children and young adults and scale up these activities across all their shelters.  

Food security

Since 7 October, the World Food Programme (WFP) has reached an estimate of 550,300 IDPs in UN shelters with daily fresh bread, canned food, or date bars. Additionally, food parcels were distributed to 38,659 displaced people in host communities to support their food needs over a 15-day period. In addition, WFP has provided cash-based transfers. In November, redemption rates decreased compared with October, due to the closure of the majority of WFP-contracted shops, stock depletion, or connectivity disturbances preventing assistance activities across Gaza. WFP is piloting a programme relying on the existing electronic voucher platform to distribute food parcels at shops and partner distribution points. Overall, 73.5 WPF truckloads entered Gaza carrying 1,296 metric tons of food assistance. This falls short of meeting the necessary needs of food in the Strip.  

In addition to in-kind food distribution, UNRWA has been distributing flour to bakeries for producing bread for distribution. To date, 88 UNRWA trucks containing food entered Gaza, carrying 1,760 metric tons of food assistance.  

Twenty international and local NGOs have jointly reached 1,9 million people since the beginning of the war (cumulative). Partners have used different modalities, including food parcels, hot meals and e-vouchers 

Water, Sanitation and Hygiene (WASH)

During the reporting period, WASH Cluster partners delivered the following items. In the absence of safe access to the north, distribution has been made possible in areas south of Wadi Gaza only. 

• Some 165 cubic metres of bottled water at IDP centres, addressing drinkable water needs of about 100,000 people. 
• Some 1,733 cubic metres of water through water trucking for hosting communities and IDP centres from the municipal and private desalination plants in the south, addressing the drinking and domestic water needs of 300,000 people (less than 5 litres a day per person).  
• Four cleaning kits for four IDP centres in Rafah, hosting about 10,000 people. 
• Some 6,500 family hygiene kits for IDPs (3,800 in the north and 2,700 in the south), serving about 40,000 people. 
• Additional sanitary units for UNRWA IDPs. 

The situation in the north is of extreme concern and the highest priority for the WASH Cluster: the water desalination plant and the Israeli pipeline are not functioning, while there has been no distribution of bottled water among IDPs accommodated in shelters, raising grave concerns about dehydration and waterborne diseases due to water consumption from unsafe sources. 

The average water production from all Gaza water sources does not exceed 12 per cent of its usual capacity before the escalation. WASH Cluster issued a document outlines the Water Supply and Fuel Relationship.

WASH partners have secured US$6 million, representing some 15.6 per cent of the need for immediate response to the current situation. 

Shelter and Non-Food Items (NFI)

During the reporting period, Shelter Cluster partners delivered the following items. In the absence of safe access to the north, distribution has been made possible in areas south of Wadi Gaza only.  

• 7,600 bedding sets (blankets, mattresses, and mats),  
• 2,000 kitchen sets,  
• 2000 washing kits,  
• 370 tarps, 1000 dignity kits in public schools and buildings, including hospitals,  
• 350 tents donated to UNRWA to decongest overcrowded shelters. 

Due to limited supplies, cluster partners only covered less than 7 per cent of the estimated Shelter and NFIs needs.  

There is still a major gap in shelter winterization materials and essential NFIs, including sealing off kits for damaged houses and creating additional living spaces; a high shortage in bedding sets, including mattresses and blankets to cover the needs of the IDPs in different settings, including UNRWA shelters; and winterized tents to protect homeless IDPs from harsh weather conditions.  

Education

Since 7 October, eight Education Cluster partners have reached 45,867 students and teachers. The main deliverables included emergency learning and recreational supplies (42,533 people reached), psychosocial support (30,018 reached), and recreational activities (8,082 reached). The response has been focusing on Khan Younis, Rafah and Middle governorates, as North Gaza and Gaza governorates are inaccessible. 

Logistics

16 November marked one month since the activation of the Palestine Logistics Cluster. The Palestine – Gaza Response Operation Overview and One Month Infographic are available on the dedicated operation webpage.

During the reporting period, the entry of limited amounts of fuel for UNRWA has been coordinated, for the first time since the start of hostilities, with regular daily deliveries expected from 19 November. fewer trucks entered Gaza for several days during the week due to a backlog of aid from previous days, shortage of fuel and a communication shutdown leading to an inability to effectively manage or coordinate humanitarian aid convoys under these circumstances. 

Three staff members based in Gaza joined the Logistics Cluster to support UNRWA, the Palestine Red Crescent Society (PRCS) and a partner NGO in receiving shipments crossing from Rafah.  

The Logistics Cluster has also conducted a Storage Needs and Capacity Survey in Gaza and Egypt. Results show that about 165,000 cubic metres of storage space is available inside Gaza, the majority of which is in Gaza city and Rafah. Sixteen organizations require storage inside Gaza, while 14 organizations require storage in Egypt. The Logistics Cluster will continue following up with the organizations to ensure needs are met. 

Emergency Telecommunications

The Emergency Telecommunications Cluster (ETC) coordination team continues to engage all parties ― the Egyptian Red Crescent, OCHA, the International Telecommunications Union (ITU), and the Egyptian authorities ― to fast-track the importation process of telecommunications equipment through either Egypt or Israel into Gaza. Liaison with OCHA continues the importation of equipment into Gaza via Israel. To coordinate a collective approach among partners for the importation of equipment, a survey was launched on 16 November and is currently ongoing. A security communications services implementation plan is being developed. 

Reliable communications networks are needed to enable humanitarians to stay connected in high-risk situations, restore security communications networks for UN staff, and coordinate response activities. 

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.

* Asterisks indicate that a figure, sentence, or section has been rectified, added, or retracted after the initial publication of this update.