Hostilities in the Gaza Strip and Israel | Flash Update #71

🛈 The next Flash Update will be issued following a one-day hiatus, covering 17-18 December.

Key points

• The shutdown of telecommunications and internet services in Gaza, which started on 14 December, continues as of midnight on 16 December. This marks the fifth blackout since 7 October. As a result, this Flash Update provides limited updated information about the humanitarian situation in Gaza over the past 24 hours. 
• On 16 December, heavy Israeli bombardments from air, land, and sea across Gaza continued, with the most intense airstrikes reported in Khan Younis, in the south, and Ash Shuja’iyeh, At Tuffah and Ad Darraj areas of Gaza city. Intense ground operations and fighting between Israeli forces and Palestinian armed groups continued on 16 December, especially in Khan Younis and Rafah, in southern Gaza. The firing of rockets by Palestinian armed groups into Israel continued. 
• Since 14 December afternoon, the Ministry of Health (MoH) in Gaza has not updated its casualty figures, which stood at 18,787 fatalities. About 70 per cent of those killed are said to be women and children. As of then, about 50,589 Palestinians have been injured, according to MoH. Many people are missing, presumably buried under the rubble, waiting for rescue or recovery.  According to the Israeli military, since the start of the ground operations, 119 soldiers have been killed in Gaza, and 681 have been injured.  
• On 16 December, Israeli forces withdrew from Kamal Adwan hospital after four days of besieging the facility. According to initial reports by media and video footage, an Israeli military bulldozer flattened the tents of a number of internally displaced persons (IDPs) outside the hospital, killing and wounding an unconfirmed number of people. The MoH in Ramallah has called for an investigation into the incident. According to the Israeli army, it has detained 90 people, and found weapons and munitions inside the hospital. 
• On the morning of 16 December, Israeli forces reportedly struck the Young Men's Christian Association (YMCA) building in Al Remal area of Gaza city, reportedly killing six Palestinians and injuring many others. Some 250 IDPs were reportedly sheltering in the premises at the time. Also on 16 December, in the Middle Area, Palestinians were reportedly killed in an Israeli attack hit the vicinity of UNRWA’s Al Mazra’a school.  
• Since 7 October and as of 15 December, UNRWA reported that at least 288 IDPs seeking refuge in its shelters had been killed and at least 998 injured. A total of 342 school buildings have sustained damage (about 70 per cent of all school buildings in Gaza). Seventy of the schools damaged are UNRWA schools, with at least 56 serving as shelters for IDPs. Several schools, including UNRWA schools, have been directly hit by Israeli airstrikes or tank shells. 
• On 16 December, a convoy operated by the World Health Organization (WHO), departing from Rafah, managed to deliver medical supplies for about 500 people in Shifa Hospital, in Gaza city. This is the third humanitarian convoy that has managed to access north Gaza since the end of the humanitarian pause on 1 December. According to the Director-General of WHO, “Gaza’s largest hospital is at the moment able to provide limited trauma stabilization and some dialysis support. Surgery is not yet possible; the hospital has no blood for transfusion, and hardly any staff to care for the constant flow of patients. The hospital needs sustained supplies of medicines, equipment, water, food, fuel, and additional human resources.” 
• On 16 December, 121 trucks carrying humanitarian supplies and four tankers of fuel entered Gaza, based on initial reports as of 22:00. This is well below the daily average of 500 truckloads (including fuel and private sector goods) that entered every working day prior to 7 October. 
• On 15 December, 471 dual nationals and no injured people were evacuated from Gaza to Egypt. The total number of wounded Palestinians and other medical cases evacuated since 7 October, 500 people, represents one per cent of the reported 50,500 injury toll, while about 8,000 injured are said to require immediate medical intervention. 

Hostilities and casualties (Gaza Strip)

• The following are among the deadliest incidents reported on 15 and 16 December: 
  • On 16 December, during the morning, 14 people were reportedly killed when two houses were struck in Jabalia, North Gaza. Many other people are said to have remained trapped under the rubble. 
  • On 15 December, at about 19:50, four people were reportedly killed and 10 others injured as a residential building was struck in Al Bureij, Middle Area. 

Displacement (Gaza Strip)

• Areas encompassing nearly 30 per cent of the Gaza Strip (excluding the orders to evacuate the areas north of Wadi Gaza) have been marked for evacuation on the Israeli military’s online map that was launched on 1 December. Access to this information is impaired by recurrent interruptions in telecommunications and the lack of electricity. 
• Since 3 December, tens of thousands of IDPs, who have arrived in Rafah governorate continue to face extremely overcrowded conditions both inside and outside shelters. With an estimated fourfold increase in population density, exceeding 12,000 people per square kilometre, Rafah governorate is now the most densely populated area within the Gaza Strip. 
• Obtaining an accurate figure of the total number of IDPs remains challenging. According to UNRWA, almost 1.9 million people in Gaza, or nearly 85 per cent of the population, are estimated to be internally displaced, including people who have been displaced multiple times.  
• Nearly 1.3 million of these IDPs are registered in 155 UNRWA facilities across Gaza, including more than 1.2 million in 98 UNRWA shelters in the Middle Area, Khan Younis and Rafah governorates. The average number of IDPs in UNRWA shelters located in the middle and southern areas is about 12,400, more than four times their capacity. 

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

Health care, including attacks (Gaza Strip)

• On 16 December, the director of Al Awda hospital in northern Gaza was quoted in media, stating that medical aid had not reached the facility for the past 67 days, and that oxygen supplies and support for patients had run out. Israeli forces, including tanks, have reportedly surrounded the hospital, blocking the entrance. Additionally, two floors of the hospital have reportedly been hit in attacks, with the surgical wards destroyed, according to the hospital director. 
• Currently, only eight out of 36 hospitals across the Gaza Strip are functional and able to admit new patients, although services are limited. Only one of these hospitals is in the north, according to WHO. The two major hospitals in southern Gaza are operating at three times their bed capacity, while facing critical shortages of basic supplies and fuel. According to the MoH in Gaza, occupancy rates are now reaching 206 per cent in inpatient departments and 250 per cent in intensive care units. Additionally, these hospitals are providing shelter to thousands of IDPs.  
• On 14 December, an airstrike hit the vicinity of Al Ahli Hospital in the east of Gaza city, causing large damage in the hospital facilities with no reported casualties.  

Food security

• On 15 December, the World Food Programme (WFP), through its partners distributed 9,270 hot meals to IDPs outside shelters and with host families and food parcels to IDPs in UNRWA shelters in three locations in Rafah and Deir Al Balah. 
• Between 3 and 12 December, WFP conducted a rapid food security assessment, following the significant deterioration of the food security situation in the south of Gaza, following the large influx of IDPs with the resumption of hostilities on 1 December. Very severe hunger levels were reported in 44 per cent of respondent households, compared with 24 per cent in a previous assessment conducted on 27-30 November. The proportion of IDP households reporting members going to sleep hungry at night increased from 34 to 50 per cent of all assessed households. The acute shortage of cooking gas has led to heavy dependence on firewood, wood residues, and waste burning, raising the risk of respiratory diseases. The food security situation in the northern governorates of Gaza is believed to be significantly worse. 

Hostilities and casualties (Israel)

• Over 1,200 Israelis and foreign nationals have been killed in Israel, including 36 children, 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 were released. The Israeli authorities estimate that about 129 people remain captive in Gaza, including Israelis and foreign nationals. On 16 December, the body of a hostage was discovered in Gaza, according to Israeli officials. 

Violence and casualties (West Bank)

• Since 7 October, 278 Palestinians, including 70 children, have been 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, 268 have been killed by Israeli forces, eight by Israeli settlers and another two either by forces or settlers. This toll represents more than half of all Palestinians killed in the West Bank this year. With a total of 477 Palestinians killed in the West Bank, 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 Israelis were killed in an attack by Palestinians from the West Bank in West Jerusalem (one of the four 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 3,607 Palestinians, including at least 552 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. Another 85 Palestinians have been injured by settlers and 18 other Palestinians injured either by Israeli forces or settlers. Some 33 per cent of those injuries have been caused by live ammunition, compared with 9 per cent in the first nine months of 2023.  

Settler Violence

• Since 7 October, OCHA has recorded 344 Israeli settler attacks against Palestinians, resulting in Palestinian casualties (35 incidents), damage to Palestinian-owned property (264 incidents), or both casualties and damage to property (45 incidents).  
• The weekly average of incidents since 7 October stands at 34, compared with 21 incidents per week between 1 January and 6 October 2023. The number of incidents since 7 October has declined from 80 incidents in the first week (7-14 October) to 21 incidents between 9 and 14 December. One-third of these incidents included firearms, including shootings and threats of shootings. In nearly half of all recorded incidents, Israeli forces were either accompanying or reportedly seen as supporting the attackers.

Displacement (West Bank)

• Since 7 October, at least 189 Palestinian households comprising 1,257 people, including 582 children, have been displaced amid settler violence and access restrictions. The displaced households are from 15 herding/Bedouin communities. More than half of the displacements occurred on 12, 15, and 28 October, affecting seven communities. 
• Also, since 7 October, 338 Palestinians, including 182 children, have been displaced following the demolition of their homes in Area C and East Jerusalem, due to lack of Israeli-issued building permits in Area C of the West Bank and East Jerusalem, which are almost impossible to obtain. The monthly average of displacement between 7 October and 7 December represents 27 per cent increase compared with the monthly average of displacement in the first nine months of the year.  
• Another 86 Palestinians, including 40 children, have been displaced following the demolition of 18 homes on punitive grounds since 7 October, compared with 16 homes punitively demolished in the first nine months of the year. The Human Rights Committee, in its review of the fourth periodic report of Israel, in 2014, concluded that punitive demolitions are a form of collective punishment and as such are illegal under international law.  
• Another 269 Palestinians, including 121 children, have been displaced since 7 October following the destruction of 42 residential structures during other operations carried out by Israeli forces across the West Bank; 61 per cent of the displacement was reported in Jenin Refugee Camp, and 29 per cent in Nur Shams and Tulkarm Refugee Camps (both in Tulkarm). 

Funding

• As of 16 December, Member States have disbursed US$525 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 nearly 43 per cent of the $1.2 billion requested. Private donations are collected through the Humanitarian Fund.

HUMANITARIAN NEEDS AND RESPONSES: 4 December – 10 December

Health

UNRWA carried out the following health activities across Gaza between 7 and 9 December:

• Some 97 medical teams attended about 30,000 IDPs in UNRWA shelters.
• Some 10,700 medical consultations were provided at health centres daily.
• Some 18,208 patients received health care in eight UNRWA health centres in the middle and south areas of Gaza.
• Mental health and psycho-social support services (MHPSS) were delivered to about 2,000 people.

Protection

• Explosive Ordnance Risk Education and Conflict Preparedness and Protection messages continue to be disseminated via available channels.
• UNMAS, Mines Advisory Group and NPA continue with social media campaigns and HI and UNMAS are planning SMS campaigns to educate the public and to mitigate Explosive Remnants of War risks.
• A total of 35 Child Protection Case Management actors attended remote training on Identification, Documentation, Tracing and Reunification of unaccompanied and separated children.
• Child protection partners reached 35,290 boys and girls and 13,780 women and men in the past 15 days with awareness raising messages regarding protection issues, MHPSS support, case management and winter clothing kits.
• Temporary alternative care shelter in Rafah has been arranged for unaccompanied children who are identified and registered. Hosting capacity for children will be arranged in phases, with 15 children accommodated in the first phase.
• Partners specializing in addressing gender-based violence continue to provide support to women and girls in the south. During the reporting period, partners distributed 17,000 menstrual health management (MHM) kits and 9,500 dignity kits to 26,500 women and girls of reproductive age in the south.

Food security

Most food distribution focused on IDPs in UNRWA shelters, public shelters, and host families. Food security partners have provided the following responses during the reporting period:

• UNRWA distributed flour to about 160,000 people in the north of Gaza. In the south, flour distribution reached about 1,153,020 people.
• About 100,000 people received food parcels and about 130,000 people received hot meals in southern Gaza.

Nutrition

Nutrition partners provided the following essential nutrition preventive and curative supplies during the reporting period to prevent malnutrition among children and mothers:

• UNICEF delivered Ready to Use Therapeutic Food (RUTF) for over 4,850 high-risk children with severe and moderate acute malnutrition.
• UNICEF delivered additional quantities of High Energy Biscuits (HEB) to 11,760 children under the age of five. To date, 24,000 children have received HEB since the start of the response on 9 November.
• WFP delivered medium-quantity lipid-based supplements to cover the needs of 57,500 pregnant-breastfeeding women and children under two years of age.
• Some 500 pregnant and breastfeeding women received iron-folate supplementation to prevent malnutrition.

Water, Sanitation and Hygiene (WASH)

No updates were provided for the reporting period. Below are the updates for the period, 27 November to 4 December:

• Some 3,896 cubic metres of water, and 690 cubic metres of bottled water were distributed to displaced people.
• Two desalination plants were installed in two IDP centres in Khan Younis. During the ceasefire period, WASH actors increased their activities in IDP locations. However, fewer WASH supplies entered Gaza, and there were no new deliveries of storage tanks, jerry cans, or cleaning kits to Rafah. No latrines were built. A consignment of pipes and generators was refused entry over the ceasefire period. Fuel supply to WASH facilities, currently at 19,520 litres per day is at 35 per cent of the amount needed to operate water production, treatment and distribution, sewage treatment and storm water management.

Shelter and Non-Food Items (NFI)

During the reporting period, a significant shortage of basic shelter materials was reported, which includes tents, tarpaulins, and plastic sheeting for protection during rainy days, particularly for people living outside shelters. Shelter partners distributed the following items to IDPs:

• 470 mattresses.
• 420 water jerrycans.
• 250 sleeping mats.
• 150 kitchen sets.

There is still a major gap in shelter winterization materials and essential NFIs, including sealing off kits for damaged houses; a high shortage in bedding sets, including mattresses and blankets to cover the needs of the IDPs in various settings, including UNRWA shelters, as well as winterized tents to protect IDPs in the open air.

Education

Education Cluster’s 10 partners currently active in the Gaza strip have reached 84,262 individual students and teachers since 7 October with provision of emergency learning and recreational supplies (52,653 reached), psychosocial support (64,854 reached), and recreational activities (83,262 reached), in Khan Younis, Rafah and Middle governorates.

The Gaza Education Cluster conducted an Observation Assessment between 25 to 27 November in the three Southern governorates to assess the level of damage of 41 schools and conduct a preliminary mapping of available space for setting up temporary learning spaces as well as the presence of teachers and personnel trained to carry out recreational activities at shelters. All assessed schools sustained some level of damage. The assessment report includes recommendations to the Ministry of Education and UNRWA, Education cluster partners, and for the education cluster coordination team itself. Two task forces for the Gaza response were activated following this exercise, one on MHPSS and recreational activities and one on Continuity of Education. The assessment of school damage will continue if/when security allows.

Multi-Purpose Cash assistance (MPCA)

Needs:

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

Response:

• Since the beginning of hostilities, 66,870 households (including roughly 449,000 people) received Emergency MPCA.
• Cash out rates across the response stand at 70-75 per cent but have been declining slightly.
• While distribution has been provided 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 face major challenges in re-stocking and operating. Therefore, informal markets, such as vendors, minimarts, carts, and stalls are reportedly the main source for goods.

Logistics

• The Logistics Cluster launched common storage services in Gaza and Egypt.
• In Gaza, three warehouses, managed by a Logistics Cluster partner, are available for storage in Deir al Balah (495 square metres), Khan Yunis (170 square metres), and Rafah (70 square metres).
• The Logistics Cluster also facilitates transport from Rafah to the three warehouse locations in the Gaza Strip.
• In Port Said, Egypt, 800 pallet positions are available for common storage for the humanitarian community.
• Additionally, a cargo notification service in Rafah will support the access of partners’ cargo into Gaza: details of the process in Standard Operating Procedures.
• The Logistics Cluster installed three Mobile Storage Units (MSUs) at the Rafah transshipment base to increase partners’ offloading capacity in Rafah with an additional 960 square metres. Three more MSUs have been installed at the UNRWA base in Rafah to increase warehousing capacity.
• An additional eight MSUs will be installed in Gaza by the Logistics Cluster, pending assessment with partners regarding key locations. The IMPACCT Working Group (hosted at the Global Logistics Cluster) held a national workshop on the importation of humanitarian aid with relevant ministries, authorities, the Egyptian Red Crescent, UN and INGOs.

Emergency Telecommunications

• The Emergency Telecommunications Cluster (ETC) continues to coordinate a collective approach among partners for the importation of telecommunications equipment into Gaza.
• On 3 December, the ETC team, UNDSS, the NGO Help, and OCHA met with the Israeli Coordinator of Government Activities in the Territories (COGAT) to discuss the list of technical equipment submitted for importation into Gaza and install an independent connectivity and security communications services for humanitarian responders.
• On 3 December, COGAT authorized the team to import 20 satellite phones into Gaza for humanitarian responders.

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.