Hostilities in the Gaza Strip and Israel | Flash Update #58

Key points

• Heavy Israeli bombardments from air, land and sea across Gaza, as well as ground operations and fighting and firing of rockets by Palestinian armed groups to Israel continue. From the afternoon of 2 December to the afternoon of 3 December, at least 316 people were killed and at least another 664 injured in Gaza, according to the Ministry of Health (MoH) in Gaza. On 3 December, one Israeli soldier was reportedly killed in Gaza and another succumbed to his wounds sustained in previous days.
• On 3 December, aid trucks carrying humanitarian supplies entered from Egypt into Gaza. However, their number and content were unclear as of 23:00. Additionally, the Egyptian border was open for the evacuation of 566 foreign nationals and dual citizens, 13 injured people and 11 companions, as well as for the entry of ten humanitarian staff.
• On 3 December, the Rafah governorate was the one in Gaza where limited aid distributions, primarily of flour and water, took place. In the adjacent Khan Younis governorate, aid distribution largely stopped due to the intensity of hostilities. The Middle Area was largely disconnected from the south, following Israeli forces’ prevention of movement, including of humanitarian supplies. Access to areas north of Wadi Gaza (hereafter: the north) from the south came to a halt following the resumption of hostilities on 1 December.
• On 3 December, the Israeli military designated an area covering about 20 per cent of Khan Younis city for immediate evacuation. The area was marked in an online map published on social media. Prior to the onset of hostilities, this area was home to nearly 117,000 people. The area also includes 21 shelters with about 50,000 internally displaced persons (IDPs), the vast majority of whom were previously displaced from the north. Instructions accompanying the map call residents to move to Al Fukhari town, east of Khan Younis, and Ash Shaboura and Tell As Sultan neighbourhoods in Rafah, which are already overcrowded. The scope of displacement as a result of the order to evacuate is 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)

• The following are among the deadliest incidents reported since 2 December afternoon:
  • On 2 December at about 14:00, a house in Al Qarara, east of Khan Yunis, was hit reportedly killing at least ten people and injuring others;
  • On 2 December, at about 21:00, several houses in Deir al Balah were hit, reportedly killing nine people and injuring 12 others;
  • On 2 December, at about 23:00, an apartment in a building in An Nuseirat, Middle Area, was hit, reportedly killing 13 people and injuring tens more;
  • On 2 December, at about 23:20, a house in Rafah was hit, reportedly killing seven people and injuring others;
  • On 3 December, at about 1:50, a house in Al Bureij camp was hit, reportedly killing seven people;
  • On 3 December, at about 10:00, six houses in Az Zaytoun neighbourhood of Gaza city were hit, reportedly resulting in dozens of casualties.
• According to the MoH in Gaza, between 7 October and 3 December afternoon, at least 15,523 Palestinians have been killed in Gaza, about 70 per cent of whom are said to be women and children. Many more are missing, presumably under the rubble, waiting rescue or recovery.
• The fatality toll since 7 October and until the resumption of hostilities on 1 December includes at least 198 Palestinian medics, according to the Gaza MoH; 112 UN staff; 77 journalists and media workers, according to the Palestinian Journalist Syndicate; and at least 26 Civil Defense staff, according to the Palestinian Civil Defense.
• Overall, 77 Israeli soldiers have been killed in Gaza since the start of the Israeli ground operations, according to official Israeli sources.

Displacement (Gaza Strip)

• On 1 December, the Israeli military issued on social media a detailed map, where the Gaza Strip is divided into hundreds of small areas. Reportedly, the map is intended to facilitate orders to evacuate people to specific areas ahead of their targeting. On the following two days, various areas, encompassing about 28 per cent of the Gaza Strip, were marked in the map for evacuation.
• In addition to the area within Khan Younis city (see above), the largest area designated for evacuation includes localities east of Khan Younis – Al Qarara, Khuza’a, Abasan and Bani Suheila – whose residents were ordered to move further south to Rafah. These areas, encompassing 19 per cent of the Gaza Strip (69 square kilometres), were home to about 352,000 people prior to the onset of hostilities. Subsequently, thousands of IDPs arrived at Rafah governorate, increasing the strain on the humanitarian response, including on already overcrowded shelters.
• On 2 December, the Israeli military 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 constitute about six per cent of the Gaza Strip and. Prior to the hostilities, they 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.
• 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 , movement of IDPs following evacuation orders since 1 December, and access restrictions.
• 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 A.
• 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 2 December, Al Awda Hospital in An Nuseirat (Middle Area) announced that it has exhausted its fuel stock to run generators and ambulances, risking its complete shut down if no additional fuel is provided. This hospital is the main provider of maternity services in the Middle Area.
• 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.
• Four hospitals in the north are partially operating and admitting patients, with only limited services. Another two are providing dialysis services for kidney patients only. None of these six hospitals have surgery capacity.
• The 12 hospitals in the south are partially functional. At present, the bed capacity across Gaza is 1,400, down from 3,500 prior to the hostilities. This decline comes 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 World Health Organization (WHO).

Water and sanitation (Gaza Strip)

• Grave concerns about waterborne diseases due to water consumption from unsafe sources persist, particularly in the north where the water desalination plant and the pipeline from Israel was shut down. 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 have also continued to reduce the level of health and environmental risks.

Hostilities and casualties (Israel)

• The indiscriminate rocket fire by Palestinian armed groups from Gaza towards Israel continued on 3 December; no casualties were reported. Over 1,200 Israelis and foreign nationals have been killed in Israel, according to the Israeli authorities, the vast majority on 7 October.
• During the humanitarian pause (24-30 November), 86 Israeli and 24 foreign national hostages had been released. It is estimated that about 137 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, a Palestinian man was shot and killed by either Israeli forces or settlers, and three others were injured during a settler attack in the town of Qarawat Bani Hassan (Salfit). Armed Israeli settlers, accompanied by Israeli soldiers, reached the outskirts of the village, where they threw stones, Molotov cocktails and opened fired at Palestinian homes, one of which was set on fire and others damaged.
• On 3 December, Israeli forces carried out an operation in Qalqiliya city, where exchange of fire took place between them and Palestinians: a Palestinian man, reportedly a bystander, was shot in the back by Israeli forces and killed.
• Since 7 October, 244 Palestinians, including 65 children, have been killed in the West Bank, including East Jerusalem. Additionally, two Palestinians from the West Bank have been killed while carrying out an attack in Israel on 30 November. Of those killed in the West Bank, 234 have been killed by Israeli forces, eight by Israeli settlers and another two have been killed 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 an attack perpetrated by Palestinians (one of whom was 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 exchanges 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 3,279 Palestinians, including at least 520 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 82 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.
• In addition to the settler attack in Qarawat Bani Hassan (see above), three settler attacks took place on 2 December, resulting in damage to Palestinian-owned property. In one of the incidents, settlers accompanied by Israeli forces threw stones at Palestinian homes and vehicles in Madama village (Nablus), damaging at least two vehicles and one home, and setting fire to another vehicle. In Yassuf village (Salfit), Israeli settlers attacked Palestinian families picking their olives, opened fire, threw stones at Palestinian-plated vehicles and vandalized four vehicles. In Qusra village (Nablus) Israeli settlers physically assaulted three farmers and reportedly vandalized 50 olive trees.
• Since 7 October, OCHA has recorded 308 settler attacks against Palestinians, resulting in Palestinian casualties (33 incidents), damage to Palestinian-owned property (233 incidents), or both casualties and damage to property (41 incidents). The weekly average of such incidents during this period stands at 39, compared with 21 incidents between 1 January and 6 October 2023. However, the number of incidents since 7 October has gradually declined from 80 incidents in the first week (7-14 October) to 18 incidents in the last (27 November - 3 December). 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, 235 Palestinians, including 125 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 3 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.

Factors 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. Onnly nine out of 20 partners 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. OCHA is supporting the import 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 metres 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 metres of water, the distribution of 522 cubic metres 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.