Hostilities in the Gaza Strip and Israel | Flash Update #79

Key points

• On 28 December, heavy Israeli bombardment from air, land, and sea, continued across most of the Gaza Strip. Intense ground operations and fighting between Israeli forces and Palestinian armed groups also continued in most areas, except for Rafah, as did the firing of rockets by Palestinian armed groups into Israel.  
• Between the afternoons of 27 and 28 December, 210 Palestinians were reportedly killed, and another 325 people were injured, according to the Ministry of Health (MoH) in Gaza. According to the MoH in Gaza, between 7 October and 7:00 on 28 December, at least 21,320 Palestinians were killed in Gaza. About 70 per cent of those killed are said to be women and children. As of then, 55,603 Palestinians have been injured. Many people are missing, presumably buried under the rubble, waiting for rescue or recovery.  
• On 28 December, the Israeli military announced that three additional soldiers had been killed in Gaza. Overall, since the start of the ground operation, 165 soldiers have been killed, and 921 soldiers have been injured in Gaza, according to the Israeli military. 
• Preliminary estimates by humanitarian actors on the ground indicate that at least 100,000 internally displaced persons (IDPs) have arrived in Rafah over the past days, following the intensification of hostilities in Khan Younis and Deir al Balah, and the Israeli army’s evacuation orders. Already on 20 December, Rafah was estimated to be the most densely populated area in Gaza, exceeding 12,000 people per square kilometre. The new influx of IDPs has further exacerbated conditions related to the already overcrowded space and limited resources. 
• Reflecting of the findings of a new report on the West Bank, UN High Commissioner for Human Rights, Volker Türk, stated on 28 December that “the use of military tactics means and weapons in law enforcement contexts, the use of unnecessary or disproportionate force, and the enforcement of broad, arbitrary and discriminatory movement restrictions that affect Palestinians are extremely troubling.” 
• Also on 28 December, UNICEF’s Regional Director for the Middle East and North Africa stated that “this year has been the deadliest year on record for children in the West Bank, including East Jerusalem, with conflict-related violence reaching unprecedented levels.”  The number of children killed in West Bank in twelve weeks since 7 October is more than double the number of children killed in twelve months of 2022.  
• On 28 December, the MoH in Gaza stated that, within shelters, 50 per cent of pregnant women suffer from thirst, malnutrition, and a lack of health care, and that 50 per cent of displaced children and are exposed to dehydration, malnutrition, respiratory and skin diseases, severe cold and lack of vaccinations for newborns. 
• Supplies of medical aid and food have continued to entered Gaza in the past days through Rafah crossing with Egypt. This included 110 trucks on 27 December and another 76 trucks on 28 December. These quantities remain well below the daily average of 500 truckloads (including fuel and private sector goods) that entered every working day prior to 7 October. Key impediments remain on carrying out humanitarian operations inside Gaza. As noted by the Secretary-General, “an effective aid operation in Gaza requires security; staff who can work in safety; logistical capacity; and the resumption of commercial activity. These four elements do not exist.” 

Hostilities and casualties (Gaza Strip)

• The following are among the deadliest incidents reported between 27 December and 28 December: 
  • On 28 December, at about 09:45, a residential bloc was hit in Beit Lahia, northern Gaza, killing at least 30 people, reportedly including two Palestinian journalists, and injuring several others. 
  • On 27 December, at about 13:50, a residential building was struck in front of Al Amal Hospital in western Khan Yunis, southern Gaza, killing at least 25 people, and injuring tens of others. 
  • On 28 December, at about 00:10 hours, a house was hit in Deir Al Balah, killing eight people, and injuring several others. At about 00:30 a civilian car transporting the victims of the incident to Al Aqsa hospital was reportedly hit by an Israeli military drone on the Al Mashaalah Bridge, Deir al Balah, where at least one Palestinian was killed, and several others injured. 
• According to the Palestinian Journalist Syndicate in Gaza, 103 Palestinian journalists and media workers have been killed in airstrikes since 7 October. According to the Gaza MoH, 311 Palestinian medics have been killed. According to the Palestinian Civil Defense, at least 40 of their members have been killed since the start of hostilities. 

Displacement (Gaza Strip)

• On 27 December, and for the third consecutive day, the Israeli military reiterated its call upon residents to leave an area, originally designated for evacuation on 22 December, covering about 15 per cent, or roughly nine square kilometres, of Deir Al Balah governorate in central Gaza. Before the onset of hostilities, it was home to nearly 90,000 people, and it now includes six shelters that have accommodated about 61,000 IDPs, mostly from the north. The affected areas include Al Bureij and An Nuseirat Refugee Camps and north of An Nuseirat (Az Zaharaa, and Al Moughraga). Instructions accompanying an online map published by the Israeli authorities call on residents to move immediately to shelters in Deir al Balah, which are already overcrowded, hosting several hundred thousand IDPs. The scope of displacement resulting from this evacuation order remains unclear. 
• Obtaining an accurate figure of the total number of IDPs remains challenging. According to UNRWA, 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, as families are forced to move repeatedly in search of safety. Lack of food, basic survival items, and poor hygiene, further exacerbate the already dire living conditions of IDPs, amplify protection and mental health issues, and increase the spread of disease.  

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 28 December, the vicinity of Al Amal hospital was struck for the second day in a row and for the fifth time this week, according to the Palestine Red Crescent Society (PRCS). Ten people were reportedly killed as a result of this latest strike and 31 were reported killed the previous day. In both incidents, dozens were reportedly wounded. It is estimated that 14,000 IDPs are sheltering in the hospital and its surroundings. 
• On 27 December, at about 16:30, Israeli forces reportedly hit the Maghazi Health Centre, causing fire in the premises. No casualties were reported. Furthermore, the vicinity of Nasser Medical Complex in Khan Yunis was struck several times, according to MoH in Gaza. 
• According to the World Health Organization (WHO), as of 27 December, 13 out of Gaza’s 36 hospitals are partially functional; nine in the south and four in the north. The four hospitals that are partially functional in the north have been offering maternity, trauma, and emergency care services. However, they face challenges such as a shortage of medical staff, including specialized surgeons, neurosurgeons, and intensive care staff, as well as a lack of medical supplies such as anesthesia, antibiotics, pain relief medicines, and external fixators. Additionally, they have an urgent need for fuel, food, and drinking water. The situation of hospitals and the level of functionality depend on fluctuating capacity and minimum level of supplies being able to reach the facilities. 
• The nine partially functional hospitals in the south are operating at three times their capacity, while facing critical shortages of basic supplies and fuel. According to the MoH in Gaza, occupancy rates are reaching 206 per cent in inpatient departments and 250 per cent in intensive care units.  

Food security

• On 28 December, World Food Programme (WFP) conducted a large-scale distribution of food parcels for 10,000 displaced families in makeshift camps in Rafah. About 200 community leaders were identified to collect assistance on behalf of surrounding families in their communities – each parcel covers a family’s food needs for ten days. This distribution was done in cooperation with Global Communities, and UNRWA. Due to time and safety constraints, only 45 per cent of people targeted with assistance were reached on the first day, and the distribution is set to continue on 29 December. WFP also distributed food parcels to 10,000 people across two distributions sites in Rafah. Additional distributions also took place across 4 WFP-contracted shops. 
• The Famine Review Committee (FRC), activated due to evidence surpassing the acute food insecurity Phase 5 (Catastrophic threshold) in the Gaza Strip, warns that the risk of famine increases daily amid intense conflict and restricted humanitarian access. The committee added that, to eliminate the famine risk, it is imperative to halt the deterioration of health, nutrition, food security, and mortality situation through the restoration of health, water, sanitation, and hygiene (WASH) services. In addition, FRC call for the cessation of hostilities and the restoration of humanitarian space for delivering multisectoral assistance are vital first steps to eliminate any risk of famine. 

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. On 28 December, according to Israeli media, it was announced that an Israeli who had been listed among those presumed to be hostage had been killed on 7 October and her body was being held in Gaza. The Israeli authorities estimate that about 128 Israelis and foreign nationals remain captive in Gaza. On 22 December, the UN Secretary-General reiterated his call for all remaining hostages to be released immediately and unconditionally.  

Violence and casualties (West Bank)

• On 28 December, Israeli forces killed a Palestinian man during a search-and-arrest operation that involved exchange of fire in Ramallah. Another Palestinian man died from wounds he sustained from Israeli forces during an operation in Nablus city on 18 December. 
• Since 7 October, 304 Palestinians, including 79 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, 295 were killed by Israeli forces, eight by Israeli settlers and another one either by forces or settlers, which is in the process of being verified. This toll represents nearly 60 per cent of all Palestinians killed in the West Bank in 2023. With a total of 504 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 the Israeli forces, have been killed in attacks by Palestinians in the West Bank, including East Jerusalem. Another 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).  
• Seventy-one per cent 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. Half of the fatalities were reported in operations that did not involve armed clashes. 
• Since 7 October, Israeli forces have injured 3,812 Palestinians, including at least 580 children; 51 per cent in the context of search-and-arrest and other operations and 41 per cent of them in the context of demonstrations. Another 91 Palestinians have been injured by settlers and 12 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 370 Israeli settler attacks against Palestinians, resulting in Palestinian casualties (36 incidents), damage to Palestinian-owned property (287 incidents), or both casualties and damage to property (47 incidents). In a new report on the situation of human rights in the occupied West Bank, including East Jerusalem, the UN Human Rights Office called on the government of Israel to “ensure that all incidents of violence by settlers and Israeli security forces against Palestinians, including violence against women, and damage to their property, are promptly, effectively, thoroughly and transparently investigated; that perpetrators are prosecuted and, if convicted, punished with appropriate sanctions, and that victims are provided with effective remedies, including adequate compensation, in accordance with international standards.” 
• The weekly average of such incidents since 7 October stands at 32, 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 11 incidents between 16 and 22 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 198 Palestinian households comprising 1,208 people, including 586 children, have been displaced amid settler violence and access restrictions. The displaced households are from at least 15 herding/Bedouin communities. More than half of the displacements occurred on 12, 15, and 28 October, affecting seven communities.  
• On 26 and 27 December, seven Palestinian families comprising 36 people, including 12 children, were displaced after their homes were demolished in Al Jwaya (Hebron) and Furush Beit Dajan (Nablus). These demolitions were carried out due to the lack of Israeli-issued building permits, which are almost impossible to obtain. This brings to 429 the number of Palestinians displaced following the demolition of their homes due to lack of Israeli issued permits in Area C and East Jerusalem. Among them are 220 children. The monthly average of displacement in this context between 7 October and 7 December represents a 27 per cent increase compared with the monthly average of displacement in the first nine months of the year.  
• A total of 19 homes have been demolished on punitive grounds since 7 October, resulting in the displacement of 95 Palestinians, including 42 children. This figure is higher than the 16 homes punitively demolished in the first nine months of the year, resulting in the displacement of 78 Palestinians. 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 483 Palestinians, including 222 children, have been displaced since 7 October following the destruction of 73 residential structures during other operations carried out by Israeli forces across the West Bank; 55 per cent of the displacement was reported in Jenin Refugee Camp, and 39 per cent in Nur Shams and Tulkarm Refugee Camps (both in Tulkarm). 

Funding

• As of 27 December, Member States have disbursed US$637.8 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 52 per cent of the $1.2 billion requested. Private donations are collected through the Humanitarian Fund.

HUMANITARIAN NEEDS AND RESPONSES: 18-25 December

Health

• Eight out of 22 UNRWA health centres are still operational south of Wadi Gaza, recording 10,095 patient visits on 21 December, including refugees and non-refugees.
• Midwives are providing care for post-natal and high-risk pregnant women at the eight operational health centres. On 21 December, 221 post-natal and high-risk pregnancy cases were attended to.
• UNRWA continues to provide health care to IDPs at shelters through 97 medical teams. Each team comprises one or two doctors and a nurse. On 21-22 December, UNRWA medical teams attended to 21,004 IDPs.
• On 20-21 December, mental health, and psychosocial support (MHPSS) services were resumed in the Middle Area and Khan Younis governorates, with a team of two psychiatrists and 16 counsellors and supervisors to assist special cases referred from health centres and shelters.

Food security

• Between 18 and 24 December, the Food Security Sector reached 1,783,565 people. Given that it aims at reaching Gaza’s 2.2 million people daily, this represents 12 per cent of the target.
• Amid immense access challenges, 800 people in the north, including IDPs residing in public shelters and those with host families, received food parcels. Additionally, 780 hot meals were provided in northern Gaza.
• In southern Gaza, food parcels reached 268,333 people in UNRWA shelters, 2,800 in public shelters, 23,841 staying with host families, and 1,000 who are not displaced. In addition, 53,000 hot meals were distributed to people in public shelters and host families; ready-to-eat rations were provided to 3,500 people in similar circumstances; and flour distribution benefited 1,722,792 people.
• Additionally, between 23-26 December, the World Food Programme (WFP) provided 18,822 people outside shelters with food parcels through partner distribution points. It also provided about 500,000 IDPs in UN shelters south of Wadi Gaza with food parcels, wheat flour, high-energy biscuits and lipid-based nutrient supplements. Additionally, it provided 16,420 hot meals in Rafah, the Middle Area, and Gaza city through five community-led kitchens. Finally, 50 metric tons of wheat flour are scheduled for dispatch to 14 bakeries.

Education

• The Education Cluster reported that 352 schools have sustained damage across the Gaza Strip, affecting the education of 400,700 students (52.1 per cent girls). Three governorates (Gaza, Khan Younis and North Gaza) are highly affected, accounting for 74 per cent of the total damage. About 90 per cent of school buildings are being utilized as shelters by IDPs and/or sustained damage, with the severity of damage varying from minor (128 schools), moderate (110 schools), major (96 schools) and destruction (8 schools).
• The Education Cluster’s 10 partners currently active in Gaza have reached 84,262 students and teachers since 7 October, with the provision of emergency learning and recreational supplies (52,653 reached), psychosocial support (64,854 reached), and recreational activities (83,262 reached), south of Wadi Gaza.

Nutrition

Nutrition partners provided the following essential to prevent and or cure malnutrition among children and mothers:

• Juzoor reached 21,000 pregnant and breastfeeding women with iron-foliate and multiple micronutrients supplementation in Rafah and the Middle Area.
• UNICEF delivered lipid-based supplements covering the needs of 11,200 children (ages 6-24 months) inside shelters for one month.
• UNICEF delivered ready-to-use infant formulas to address the needs of 400 non-breastfed infants (ages up to 5 months) for one month.

Multi-purpose Cash Assistance (MCPA)

• Since the beginning of hostilities, nearly 110,000 households (comprising almost 750,000 people) have received emergency MPCA. With about 80,000 households having already cashed out their assistance, cash out rates stand at 73 per cent, and are declining slightly.
• While distribution has been delivered across the Gaza Strip, the vast majority is now concentrated in the southern governorates.
• While formal markets are largely depleted, informal markets are now the key sources of basics goods and services. This includes trades of personal belongings, small household-based production (bread, vegetables), humanitarian assistance, and other items.
• Post distribution monitoring data from recipients of cash assistance point to food, medicines, debt repayment, drinking water, and transportation as the top expenditures reported. The percentage of expenditures on food has further decreased over the past weeks, while the percentage of expenditures on medicines has doubled. Some 70 per cent of respondents report that unrestricted cash has helped them access needed goods and services, either fully or partially, while 87 per cent report unrestricted cash as their preference for future assistance.

Logistics

• The results of the rapid , conducted by the Global Logistics Cluster, HELP Logistics, JSI, and partners, have been shared with partners. The assessment was conducted during November and December through field visits to 23 locations in Khan Yunis and Rafah governorates.
• The IMPACCT Working Group continues to engage with various ministries for clarifications on customs procedures for the importation of humanitarian aid. The Standard Operating Procedures on the importation processes are under development.
• The Logistics Cluster continues to facilitate access to common services in the Gaza Strip and Egypt through common storage services, road transport to the storage location, and cargo notification transshipment services. In Gaza, two warehouses in Rafah are currently available for partners’ storage, one managed by ACTED (70 square metres) and one by WFP (1,000 square metres). The common warehouses in Deir al Balah and Khan Yunis are currently on hold until further notice. The Logistics Cluster also facilitates transport services from Rafah to the Logistics Cluster common warehouses in Gaza. Additionally, a cargo notification service is available to inform partners once their cargo has arrived at the Rafah handover point. In Egypt, the Logistics Cluster facilitates common storage services in Port Said with 800 pallet positions.

Emergency Telecommunications

• The Emergency Telecommunications Cluster (ETC) and its partners continue to engage with the Israeli Coordinator of Government Activities in the Territories (COGAT) for authorization to import telecommunications equipment and set up an independent, efficient, and reliable communications platform for humanitarian responders.
• The ETC met for a technical engagement with UNDSS in Jerusalem on 18 December and discussed the status of the Very High Frequency (VHF) radio network security communications system (SCS) in Gaza, which has four repeaters in Jabalya, Gaza city, Khan Yunis, and Rafah. Only Khan Yunis and Rafah were functional when the system was reactivated on 3 December, and the Khan Yunis repeater broke down on 13 December and is currently inaccessible because of the prevailing insecurity.
• On 18 December, ETC partner, REACH, completed a communications and information needs assessment for the population in Gaza using the secondary data review methodology of all available data from sources on the ground. The report was shared with all ETC global partners on 22 December to inform and guide humanitarian responders on their current and planned activities in Gaza.

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.