Hostilities in the Gaza Strip and Israel | Flash Update #57

Key points

• Heavy Israeli bombardments from air, land and sea across Gaza, as well as ground operations and fighting and rocket fire from Palestinian armed groups to Israel continued for the second consecutive day. Between 1 December at 21:00 and 2 December at 15:30, at least 193 Palestinians have been killed and 652 injured, according to the Ministry of Health in Gaza (MoH); no Israeli fatalities have been reported in this context. 
• At least 160 of the Palestinian fatalities were reported in two incidents on 2 December. These involved the bombing and destruction of a six-storey building in Jabalia refugee camp, and of an entire block in Ash Sheja’iyeh neighbourhood of Gaza city. Operations to save hundreds of people reported to be under the rubble were still ongoing on 2 December in the afternoon hours. Prior to the bombings, Israeli forces dropped leaflets ordering the evacuation of these areas (see below).  
• Aid trucks carrying food, medicines, medical supplies, bottled water, blankets, tents and hygiene products entered from Egypt into Gaza on 2 December, and additional trucks carrying 138,000 litres of fuel.  
• Additionally, the Egyptian border was opened for the evacuation of 880 foreign nationals and dual citizens, as well as for 13 injured people and 10 of their companions. This follows a total halt in the movement of goods and people across the border on 1 December. 
• Since the resumption of hostilities on 1 December, only limited humanitarian operations have taken place within Gaza, primarily the provision of services in shelters and the distribution of flour in areas south of Wadi Gaza (hereafter: the south). 
• On 1 December, the Israeli military published online a detailed map, where the Gaza Strip is divided into hundreds of small areas. Reportedly, the map is intended to facilitate orders to evacuate specific areas ahead of their targeting. On 2 December, areas encompassing about 25 per cent of the Gaza Strip were designated for evacuation.  
• One of the areas designated for evacuation includes localities in the south, namely east of Khan Younis – Al Qarara, Khuza’a, Abasan and Bani Suheila – whose residents were ordered to move further south to Rafah. These areas encompass 19 per cent of the Gaza Strip (69 square kilometres) were home to about 352,000 people prior to the onset of hostilities.  The Israeli military had given orders to evacuate this area in previous weeks. On 2 December, thousands of internally displaced persons (IDPs) arrived at Rafah governorate, increasing the strain on already overcrowded shelters. 
• Also on 2 December, the Israeli military again ordered the evacuation of the eastern parts of Gaza city (Ash Shuja’iyeh, Az Zaytoun and the Old City) and of Jabalia, both in the north, and instructed residents to move towards the western areas of Gaza city. The designated areas cover about six per cent of the Gaza Strip and, prior to the hostilities, were home to about 415,000 people, many of whom have already evacuated. The scale and scope of population movements following these orders remains unclear.  
• Under international humanitarian law, parties to a conflict must take all feasible precautions to avoid, and in any event to minimize, civilian harm. This can entail evacuating civilians or giving effective advance warning of attacks, which provides civilians enough time to leave, as well as a safe route and place to go. All possible measures must be adopted to ensure that those civilians displaced can afford satisfactory conditions of safety, shelter, nutrition, and hygiene and ensure that family members are not separated. Civilians choosing to stay in areas designated for evacuation do not lose their protection. 

Hostilities and casualties (Gaza Strip)

• On 2 December at about 12:30, a six-storey building in Jabalia refugee camp, in the north, was hit and destroyed. Initial reports by local and international media indicate that more than 100 people, including many IDPs, were killed and many others are believed to be buried under the rubble. The building was hit one and half hours after Israeli forces dropped leaflets ordering residents of this area to evacuate.  
• On 2 December, at about 14:20, an entire block in Ash Shujaiyeh neighbourhood of Gaza city was heavily bombarded and about fifty residential buildings destroyed. The Palestinian Civil Defense Office reportedly announced that more than 60 people were killed, saying that its crews were working to rescue or retrieve more than 300 others from under the rubble. Video footage from the area showed people searching for survivors, using their hands and hammers to remove the rubble.  
• On 1 December, at about 10:00, Israeli forces in the vicinity of Shifa Hospital, in Gaza city, reportedly hit an ambulance evacuating wounded people; two paramedics were reportedly killed and several others injured.    
• Between 7 October and 19 November, over 12,700 fatalities were reported by the Gaza MoH, which then stopped reporting directly due to the collapse of many hospitals. Since then, the Gaza Government Media Office (GMO) reported more than 2,300 additional fatalities, bringing the cumulative toll to over 15,000 by 2 December, including 6,150 children and more than 4,000 women. The GMO’s methodology is not known. 
• The fatality toll since 7 October and until the resumption of hostilities includes at least 198 Palestinian medics, according to the Gaza MoH; 112 UN staff; 73 journalists and media workers, according to the Palestinian Journalist Syndicate; and at least 15 Civil Defense staff, according to the Palestinian Civil Defense. 
• Overall, 75 Israeli soldiers have been killed in Gaza since the start of the Israeli ground operations, according to official Israeli sources. 

Displacement (Gaza Strip)

• About 1.8 million people in Gaza, or nearly 80 per cent of the population, are estimated to be internally displaced. However, obtaining an accurate count is challenging , especially given difficulties in tracking IDPs staying with host families and accounting for those who returned to their homes during the pause but remain registered in UNRWA and other shelters.    
• Nearly 1.1 million IDPs are registered in 156 UNRWA facilities across Gaza, of whom about 86 per cent (958,000) are registered in 99 UNRWA shelters in the south. Another 191,000 IDPs are estimated to be staying in 124 public schools and hospitals, as well as in other venues such as wedding halls, offices, and community centres. The rest are hosted by families. 
• Due to the overcrowding and poor sanitary conditions at UNRWA shelters in the south, there have been significant increases in some communicable diseases and conditions such as diarrhea, acute respiratory infections, skin infections and hygiene-related conditions like lice. There are also initial reports of disease outbreaks, including hepatitis.  
• Concerns have been raised about vulnerable groups of people who are struggling with difficult shelter conditions. This includes people with disabilities; women who are pregnant, have recently given birth, or are breastfeeding; people who are recovering from injuries or surgeries; and those with compromised immune systems. 

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. Depending on the availability of fuel, electricity is produced by generators, as well as by solar panels. 

For more information on electricity supply to the Gaza strip, please see this dashboard.

Health care, including attacks (Gaza Strip)

• On 1 December, the Palestine Red Crescent society (PRCS) established a stabilization medical point in Jabalia, in the north, to provide first aid medical services to the wounded and serve as a referral point to the nearest hospitals.  
• On 2 December, the MoH in Gaza stated that the bed occupancy rate at operational hospitals stands well over capacity, at 171 per cent, while at the intensive care units the occupancy rate is up to 221 per cent. The establishment of triage extensions at several hospitals, to support the admission and referral of patients is in progress. 
• On 1 December, UNRWA reported a Hepatitis A outbreak in one of its shelters.  
• UNRWA further reported that there are around 50,000 pregnant women across Gaza, with over 180 giving birth daily. UNRWA midwives have been providing care for post-natal and high-risk pregnant woman at the nine operational primary health centres. Post-natal care continues in shelters, but conditions are not suitable for newborns in shelters. 
• Four hospitals in the north are partially operating and admitting patients, with only limited services. Two other hospitals are providing dialysis services for kidney patients only. None of the hospitals in the north has surgery capacity. 
• The remaining 12 hospitals in the south are  partially 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 has the capacity to treat critical trauma cases or perform complex surgery, according to the WHO. 

Water and sanitation (Gaza Strip)

• Grave concerns of waterborne diseases due to water consumption from unsafe sources persist, particularly in the north where the water desalination plant and the Israeli pipeline are not functioning.  There has been almost no improvement in the access of residents in the north to water for drinking and domestic purposes for weeks. 
• In the south, UNRWA continues to operate eight water wells that provide potable and domestic water to IDP shelters, alongside water trucking operations. Over the past few weeks, solid waste collection from the camps, and emergency shelters and transfer to landfills also continues, to reduce the level of health and environmental risks.  

Food security

• On 28 November, the Palestinian Central Bureau of Statistics (PCBS) stated that Gaza –loses US$1.6 million daily in farm production losses. These   losses are likely higher considering the destruction of farm equipment and farmland, and damage caused to thousands of trees, especially olive trees. The economic impact is significant, considering that 55 per cent of Gaza’s agricultural products used to be sold outside Gaza. 
• The entry of cooking gas to Gaza stopped following the resumption of hostilities. The amount that entered during the pause (about 85 tons per day) is a third of the equivalent daily average that entered between January and August 2023.  

Hostilities and casualties (Israel)

• On 1 December, the indiscriminate rocket fire by Palestinian armed groups from Gaza towards Israel resumed. 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.  
• On 1 December, Israeli forces reportedly brought the body of one Israeli man who had been taken hostage, to burial in Israel. During the humanitarian pause, 86 Israeli and 24 foreign national hostages had been released. It is estimated that about 133 people remain captive in Gaza, including Israelis and foreign nationals, according to Israeli sources. 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. 

Violence and casualties (in and around the West Bank)

• On 2 December, Israeli forces shot and killed a 14-year-old Palestinian child at a checkpoint near Tell village (Nablus), reportedly after he attempted to stab a soldier; no injuries among Israeli forces were reported. According to Palestinian medical sources, Israeli forces prevented the evacuation of the boy’s body. Another 16-year-old Palestinian child died of wounds sustained after being shot by Israeli forces during an operation in Jenin Refugee Camp on 9 November, bringing the death toll during that operation to 16 fatalities, including five children. 
• Since 7 October, 243 Palestinians, including 65 children, were killed in the West Bank, including East Jerusalem. Additionally, two Palestinians from the West Bank were killed while carrying out an attack in Israel on 30 November. Of those killed in the West Bank, 231 were killed by Israeli forces, eight by Israeli settlers and two either by forces or settlers. The eight-week toll represents more than half of all Palestinians killed in the West Bank this year. Already, 2023 is the deadliest year for Palestinians in the West Bank since OCHA began recording casualties in 2005. 
• Since 7 October, four Israelis, including three members of Israeli forces, have been killed in attacks by Palestinians in the West Bank, including East Jerusalem. An additional four were killed in West Jerusalem in a Palestinian attack (one of whom appears to have been killed by Israeli forces who misidentified him).  
• Two-thirds of the Palestinian fatalities in the West Bank since 7 October have occurred during search-and-arrest and other operations carried out by Israeli forces, including some – mainly in Jenin and Tulkarm governorates – involving exchange of fire with Palestinians. More than half of the fatalities were reported in operations that did not involve armed clashes. 
• Since 7 October, Israeli forces have injured 3,270 Palestinians, including at least 516 children; 45 per cent of them in the context of demonstrations and 46 per cent in the context of search-and-arrest and other operations. An additional 80 Palestinians have been injured by settlers and 18 others either by Israeli forces or settlers. Some 33 per cent of those injuries have been caused with live ammunition, compared with 9 per cent in the first nine months of 2023. 
• Two settler attacks took place on 1 December, resulting in damage to Palestinian-owned property. In one of the incidents, Israeli settlers raided the village of Qarawat Bani Hassan (Salfit) where they open fire and threw stones at Palestinian-plated vehicles and vandalized four vehicles. In another incident, according to Palestinian eyewitnesses, Israeli settlers vandalized 50 olive trees in the outskirts of Qusra (Nablus) village.  
• Since 7 October, OCHA has recorded 305 settler attacks against Palestinians, resulting in Palestinian casualties (33 incidents), damage to Palestinian-owned property (231 incidents), or both casualties and damage to property (40 incidents). This reflects a daily average of five incidents, compared with three since the beginning of the year. One-third of these incidents included threats with firearms, including shootings. In nearly half of all recorded 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.  
• Additionally, 220 Palestinians, including 114 children, have been displaced since 7 October following demolitions in Area C and East Jerusalem, due to lack of Israeli issued building-permits; and 63 Palestinians, including 31 children, have been displaced following punitive demolitions.  

Funding

• As of 2 December, Member States have disbursed USD$352.6 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 29 per cent of the $1.2 billion requested. Private donations are collected through the Humanitarian Fund.

HUMANITARIAN NEEDS AND RESPONSES: 20-26 November

Health

During the reporting period, Cluster partners have delivered the following items across Gaza:

• Various medical supplies to six hospitals and the ambulances;
• 300 Interagency Emergency Health Kits (IEHK);
• 15 Acute Watery Diarrhea (AWD) community kit and 50 midwifery kit and 15 obstetric surgical kit; 16 Inter-Agency Emergency Health Kits (IARH)
• 72 rehabilitation and nursing sessions, and 3,177 post-natal care consultations.
• 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 30,000 primary healthcare consultations per day through fixed and mobile clinic services; 10,156 children were vaccinated after this service resumed in November. Mental health and psychosocial services are being provided by partners, mainly in shelters, to 20,000.

An Emergency Medical Team (EMT) Coordination Cell is now operational in Cairo and will soon be active in Gaza. The strategy involves providing a surge in supplies, infrastructure, and staffing to support existing health facilities. Médecins Sans Frontières (MSF) and The International Committee of the Red Cross (ICRC) surge teams are already on the ground, offering healthcare services. The Jordanian field hospital is being set up, and 31 teams are ready to deploy with support from WHO.

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 the funding required to respond has been committed.

Protection

Mine risk education remains a top priority right now in protection for people in Gaza. Despite challenges, during the reporting period, 21 Explosive Ordnance Risk Education (EORE) focal points were deployed in 11 UNRWA shelters in the south benefiting 4,768 people. The UN Mine Action Service is planning to send 1 million people EORE messages. Planning for the expansion of risk education outreach in non-UNRWA shelters is underway. One of the biggest challenges is reaching everyone in Gaza, both physically reaching them particularly in the north, in non UNRWA locations as well as challenges with patchy communication and electricity shortages.

A registration tool for unaccompanied and separated children is ongoing. Temporary care arrangements are being confirmed as well as coordination with Ministry of Social Development (MOSD) and WHO on children who are evacuated for medical reasons. Child protection actors in Gaza are being identified and mapping of available services is ongoing. Access challenges, including fuel shortages, and limited children related supplies in Gaza such as suitable winter clothes, recreational kits and activities continue to affect the scale of immediate child protection responses. Important also is identifying/mapping available child protection actors and services

Providing crucial support for women and girls involves addressing the depletion of local hygiene supplies, particularly dignity and menstrual hygiene kits. Despite efforts to procure these supplies, the demand exceeds the available resources, necessitating increased supplies, improved access, and additional funding. Ensuring the safety of women in shelters is paramount, prompting the GBV sub-cluster to develop an observation tool. A team of volunteers will collect observations in nearby sites, contributing valuable information on gender-related issues and needs. Challenges include reaching GBV partners, comprehensive mapping of services, and the significant impact on GBV services. Out of over 20 partners, only nine were reached, and six can assist with voluntary observational work. Re-establishing referral pathways for survivors, crucial in GBV response, requires rebuilding and coordination with UNRWA is deemed essential.

Beyond mine risk efforts, disability and inclusion initiatives concentrate on psychosocial support (PSS) recreational activities in UNRWA southern shelters. In the past week, 46 sessions were conducted across 46 shelters, benefitting 10,649 children and 316 adults (parents and caregivers participating in the activities with their children). Additionally, 108 assistive devices were distributed. More supplies, including assistive devices, hygiene kits, and wound dressing kits, are expected to arrive in Gaza in the coming days. Ongoing challenges and constraints hampering the much-needed scale-up of response efforts include insufficient fuel for movements and communication issues.

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 November 24th, WFP has supported 121,161 people in shelters and host communities by distributing bread, food parcels, and e-vouchers. Additionally, one WFP bakery operates ad-hoc, reaching approximately 90,000 people in shelters with bread on Fridays.

On November 26, UNRWA extended its flour distribution to areas outside shelters in the southern governorates, reaching 20,720 families thus far.

During the current humanitarian pause, the prioritised flour distribution continued in the North and Gaza City as part of ongoing humanitarian convoys in the North of Wadi Gaza.

On November 26, at UNRWA shelters in Jabalia in the north, approximately 7.6 metric tons of high-energy biscuits provided by the World Food Programme (WFP), were distributed as ready-to-eat food. This allocation is sufficient to meet the minimal daily food intake for 23,616 people for one day.

Partners are encountering difficulties in operating, given the situation on the ground. Despite the 4-day truce, they reported difficulties in fuelling their vehicles to implement/monitor the food assistance.

• Anera, PARC, together with United Palestinian Appeal, Taawon, and Middle East Children Alliance, covered around 55,000 people with food parcels in host communities this week.
• ACF targeted host families by giving fresh vegetable parcels to 3,200 people to host families.
• OXFAM distributed 1000 Food parcels to IDPs in non-UN shelters in Rafah and Khan Younis and reached 1133 families in Rafah and Khan Younis with food vouchers.
• Beit Lahia Development Association distributed bread for host families, targeting around 6,000 beneficiaries.
• Other partners are mobilizing resources in the coming days, targeting the three governorates of the Middle Area, Khan Younis and Rafah.

Shelter and Non-Food Items (NFI)

During the reporting period, including since the humanitarian pause, Shelter Cluster partners conducted field assessments at numerous collective centres and makeshift shelters in the south, revealing a shortage of basic bedding sets (mattresses and blankets) for the majority of IDPs. There is also an urgent need for firewood as an alternative fuel source for preparing food due to a lack of other options.

Due to limited supplies, cluster partners coverage of Shelter and NFIs needs not more than 3 per cent of needs, and not more than 17 per cent if the items in the pipeline that have not arrived are considered.

Severe shortages in shelter winterization materials and essential NFIs persist, including sealing off kits for damaged houses and creating additional living spaces; there is a significant lack of bedding sets, including mattresses and blankets, to meet the needs of IDPs in various settings.

Education

Since 7 October, nine Education Cluster partners have reached 50,726 students and teachers. The main deliverables included emergency learning and recreational supplies (26,833 people reached), psychosocial support (31,318 reached), and recreational activities (49,726 reached). The response has been focusing on Khan Younis, Rafah, and Middle governorates, as North Gaza and Gaza governorates are inaccessible.

Multi-Purpose Cash assistance (MPCA)

Since the beginning of the hostilities, 66,870 households (including roughly 449,000 people) were delivered Emergency MPCA. Cash out rates across the response stand at 70-75 per cent but have been declining slightly over the past few days. While distribution is delivered across the Gaza strip, the vast majority is now concentrated in the south.

Formal market actors, such as supermarkets and retailers are largely depleted and facing major challenges in re-stocking and operating; however, informal markets, such as vendors, minimarts, carts and stalls, reportedly turned into the main source for goods. Information is still unclear on whether shops and markets actors were able to restock during the pause.

Post distribution monitoring data from recipients of cash assistance point to food, water, medicines, hygiene products, and clothing as the top expenditures reported. About 81 per cent of respondents reported that unrestricted cash helped them accessing needed goods and services, either fully or partially. Over 95 per cent reported unrestricted cash as their preference for future assistance.

Logistics

The Logistics Cluster developed and disseminated a new online reporting form to collect information regarding incoming supplies as well as the current stock levels in Egypt and other countries. The form was shared with 34 organisations that are part of the Logistics Cluster and other Clusters and is an ongoing project to be updated on a weekly basis.

On 22 November, 21 mobile storage units (MSUs) arrived in Al Arish, Egypt. The MSUs will be installed, in Egypt to augment the Egyptian Red Crescent’s (ERC) warehousing capacity, and 11 will be delivered to Gaza to expand the storage capacity in key locations. An additional three MSUs were already delivered to Gaza and are in the process of being installed. The latter MSUs will provide an additional 960 m2 of storage capacity. To further support partners inside Gaza, an International NGO will support with providing access to their storage capacity through the Logistics Cluster to receive I/NGOs’ cargo on behalf of the wider humanitarian community.

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, 11 partners have submitted their ICT equipment needs through a survey which is currently ongoing. The ETC urgently requires an initial US$250,000 out of the total requested US$800,000 in the Flash Appeal to continue its ongoing activities and address the immediate needs in Gaza.

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.

Water, Sanitation and Hygiene (WASH)

The standards for emergency water supply include aspects for water quantity, water quality and access to water. The minimum daily water needs for the population of Gaza has been agreed at 15 liters/person/day (L/D/P), whereas the pre-crisis water use was approximately 100 L/P/D.

During the reporting period, the Coastal Municipalities Water Utility and WASH agencies have produced on average over 50,327 cubic meters of water, which is the equivalent of approximately 22.6 L/P/D. Water quality and access standards, however, remain unachieved. Access is a particular challenge as the water networks are fractured, production points are reduced, power for pumping and distribution restricted and storage and outlets minimized. Many communities are isolated across Gaza but particularly north of Wadi Gaza.

WASH partners' activities included the trucking of 316 cubic meters of water, the distribution of 522 cubic meters of bottled water, and 10,280 family hygiene kites, all in the south. In addition, 260 Solid Waste Containers were distributed in 13 shelters in the north.

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 counselling and referrals for affected communities to access life-saving services. The PSEA Network monitors calls daily and will increase the number of counsellors if necessary.

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