Hostilities in the Gaza Strip and Israel | Flash Update #82

Key points

• Heavy Israeli bombardment from air, land, and sea have continued across most of the Gaza Strip, with intense ground battles reported in the refugee camps in central Gaza and the southern town of Khan Younis, and heavy strikes reported in Gaza city. The firing of rockets by Palestinian armed groups into Israel also continued. Ground operations and intense fighting between Israeli forces and Palestinian armed groups, with airstrikes and missiles striking housing units and infrastructure, reportedly resulted in high numbers of fatalities. This occurred in areas where Palestinians have relocated following orders from Israeli forces to move from northern Gaza.
• Between the afternoons of 1 and 2 January, 207 Palestinians were killed, and another 338 people were injured, according to the Ministry of Health (MoH) in Gaza. Overall, between 7 October and 12:00 on 2 January, at least 22,185 Palestinians were killed in Gaza, according to the MoH in Gaza. About 70 per cent of those killed are said to be women and children. During the same period, 57,035 Palestinians were reportedly injured. Up to 7,000 people are estimated to be missing, with many presumalyed to be buried under the rubble.
• Since 30 December and as of 1 January, the Israeli military have announced that three additional soldiers had been killed in Gaza. Overall, since the start of the ground operation, 171 soldiers have been killed, and 983 soldiers injured, in Gaza, according to the Israeli military.
• On 2 January, Al Amal hospital in Khan Younis was struck, reportedly resulting in five fatalities, including a five-day-old baby. A training centre run by the Palestine Red Crescent Society (PRCS) within the hospital complex was severely damaged. OCHA and the World Health Organization (WHO) visited the hospital, witnessing extensive damage and displacement of civilians. An estimated 14,000 people were sheltering at the hospital at the time of the attack. A WHO statement indicated that many of the IDPs have now left, and that those remaining are extremely fearful for their safety and planning to leave the place which they had previously turned to for refuge and protection. The WHO Director-General stated that "Hospitals, ambulances, health workers, and people seeking care must be protected, at all times, under international humanitarian law. Today's bombardments are unconscionable. Gaza’s health system is already on its knees, with health and aid workers continuously stymied in their efforts to save lives due to the hostilities."
• On 30 December, the MoH in Gaza declared that it had succeeded in resuming some services, thereby increasing the capacity of a number of hospitals in the north of Gaza, including Al Ahli Arab Hospital, the Patients Friends charity hospital, Al Helou International hospital, and Al Awda hospital, in addition to various other primary care centres. This occurred amid great risks surrounding the movement and work of medical teams due to the continuous bombing of residential neighbourhoods and the vicinity of health facilities.
• On 30 December, the MoH in Gaza emphasized the need to prioritize the evacuation of more than 5,300 wounded and sick people who are facing serious and complex medical conditions in Gaza. The MoH and WHO are attempting to secure effective mechanisms with all parties to facilitate the exit of the wounded and sick for treatment abroad.

Hostilities and casualties (Gaza Strip)

• The following are examples of incidents resulting in fatalities reported between late 30 December and 1 January:
  • On the night of 30 December, 40 Palestinians were reportedly killed when a house in As Sabra area of Gaza city was struck. That same night, 15 members of one family were reportedly killed when a house in Az Zaitoun area of Gaza city, was struck; they were sheltering there after evacuating their house in Jabalya.
  • On 31 December, at about 12:30, according to media reports, 48 Palestinians and another 20 Palestinians were killed in two separate strikes in the Az Zaitoun neighbourhood of Gaza city.
  • On 31 December, about 5:00, eight family members were reportedly killed and another ten were injured, including women and children, when a family home was hit in Al Maghazi Camp (Deir al Balah).
  • On 1 January, at about 12:30, 15 Palestinians were reportedly killed, and others were injured when another house was struck in Al Maghazi Camp.
  • On 1 January, at about 16:00, another 15 Palestinians were reportedly killed, and tens were injured when a family house sheltering Internally Displaced Persons (IDPs) in Deir al Balah, was struck.
• As of 27 December, 144 UN staff members have been killed in hosilities in Gaza, including 142 UNRWA staff , one UNDP staff member and one WHO staff member.

Displacement (Gaza Strip)

• By the end of 2023, according to UNRWA, 1.9 million people, or nearly 85 per cent of the total population of Gaza, were estimated to be internally displaced, including some who have been displaced multiple times, as families are forced to move repeatedly in search of safety. Nearly 1.4 million IDPs are sheltering in 155 UNRWA facilities across all five governorates. Rafah governorate is now the main refuge for those displaced, with over one million people, squeezed into an extremely overcrowded space, following the intensification of hostilities in Khan Younis and Deir al Balah, and the Israeli military’s evacuation orders. Obtaining an accurate figure of the total number of IDPs remains challenging. The number of IDPs in the northern governorates has not been updated since 12 October, due to access constraints and the security situation preventing verification.
• On 2 January, the United Nations High Commissioner for Human Rights reiterated that there is no safe space in Gaza. "We cannot talk about safety anywhere. People are sleeping in the streets, out in the open. Some of them have not been able to even follow the evacuation orders."
• The spread of diseases in Gaza has reportedly intensified, particularly due to the recent mass displacements across the south of Gaza. This situation adds strain to an already overwhelmed health system, which is struggling to meet people’s immense needs. On 29 December, the head of WHO in the occupied Palestinian territory stated that people living in shelters in Gaza have continued to fall ill. Close to 180,000 people are suffering from upper respiratory infections; there are 136,400 cases of diarrhea (half of these among children under the age of five); 55,400 cases of lice and scabies; 5,330 cases of chickenpox; 42,700 cases of skin rash (including 4,722 cases of impetigo); 4,683 cases of Acute Jaundice Syndrome; and 126 cases of meningitis (data covering mid-October to mid-December).
• On 1 January, PRCS in collaboration with the Egyptian Red Crescent (ERC), reportedly established the first organized IDP camp in Khan Younis. Initially hosting 300 families, with PRCS medical, ambulance, and relief teams, its capacity is to be expanded to 1,000 tents, providing shelter for hundreds in southern Gaza.
• According to the Protection Cluster, an estimated 30 to 40 per cent of people in Gaza have lost their identification documents during displacement. Although in-kind assistance is not requiring people to produce identification, the lack of such documents presents a significant obstacle to obtaining Multi-purpose Cash Assistance (MPCA). The Protection Cluster assists in issuing attorney attestations for people who have lost their legal documents, to provide sufficient proof for them to access specific types of humanitarian assistance, including cash support.

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. The communications and fuel shutdown continues to significantly hinder the aid community’s efforts to assess the full extent of needs in Gaza and to adequately respond to the deepening humanitarian crisis. For more information on electricity supply to the Gaza Strip, please see this dashboard.

Health care, including attacks (Gaza Strip)

• According to WHO, as of 27 December, 13 out of Gaza’s 36 hospitals are partially functional; nine in the south and four in the north. Those 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 MoH in Gaza, occupancy rates are reaching 206 per cent in inpatient departments and 250 per cent in intensive care units.

Food security

• 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, the FRC has called for the cessation of hostilities and the restoration of humanitarian space for delivering multisectoral assistance, noting these were 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. The Israeli authorities estimate that about 128 Israelis and foreign nationals remain captive in Gaza.

Violence and casualties (West Bank)

• On 2 January 2024, Israeli forces killed four Palestinians during an operation that they carried out in Azzun (Qalqiliya); the operation lasted for about than six hours and involved exchanges of fire with Palestinians. One Israeli soldier was also injured during the operation.
• Since 7 October 2023 and as of 2 January 2024, 313 Palestinians, including 80 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, 304 were killed by Israeli forces, eight by Israeli settlers and another one by either Israeli forces or settlers, which is being verified.
• Since 7 October 2023 and as of 2 January 2024, 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). The number of Israelis killed in the West Bank and Israel in 2023 (36) in attacks by Palestinians from the West Bank marks the highest number of Israelis killed in the West Bank since OCHA started recording casualties in 2005.
• Of the 507 Palestinians killed in 2023, which was the deadliest year for Palestinians in the West Bank, including East Jerusalem, since the UN started recording casualties there in 2005, 72 per cent were killed 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. The number of Palestinians killed in operations carried out by Israeli forces in 2023 is more than four times higher than its equivalent in 2022.
• Since 7 October 2023 and as of 2 January 2024, Israeli forces have injured 3,949 Palestinians, including at least 593 children; 52 per cent in the context of search-and-arrest and other operations and 40 per cent of them in the context of demonstrations. Another 91 Palestinians have been injured by settlers and 12 other Palestinians were injured by either 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 2023 and as of 2 January 2024, OCHA has recorded 372 Israeli settler attacks against Palestinians, resulting in Palestinian casualties (36 incidents), damage to Palestinian-owned property (289 incidents), or both casualties and damage to property (47 incidents). The number of such incidents represents almost one third of all settler attacks against Palestinians in the West Bank recorded from 1 January 2023 to date. In a 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.”
• In 2023, 1,227 incidents involving settlers (with or without Israeli forces) resulted in Palestinian casualties and/or property damage in the West Bank, including East Jerusalem. Some 911 of these incidents resulted in damage, 163 resulted in casualties and 153 resulted in both. This is the highest number in any given year since OCHA started recording incidents involving settlers in 2006.
• The weekly average of such incidents since 7 October stands at 30, compared with 21 incidents per week between 1 January and 6 October 2023. The number of incidents since 7 October has declined from 127 incidents in the first week (7-13 October) to 18 incidents between 23 and 28 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 2023 and as of 2 January, 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. They represent 78 per cent of all displacement reported due to settler violence and access restrictions since the beginning of 2023 (1,539 people, including 756 children).
• Additionally, Since 7 October and as of 2 January, a total of 422 Palestinians, including 217 children, were displaced following the demolition of their homes due to lack of Israeli-issued permits in Area C and East Jerusalem. This represents 36 per cent of all displacement reported due to the lack of building permit since 1 January 2023 (1,153 people).
• A total of 19 homes have been demolished on punitive grounds since 7 October, resulting in the displacement of 95 Palestinians, including 42 children. Between January and September 2023, 16 homes were punitively demolished, resulting in the displacement of 78 Palestinians. Punitive demolitions are a form of collective punishment and as such are illegal under international law.
• Another 537 Palestinians, including 238 children, have been displaced since 7 October following the destruction of 82 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). This represents 59 per cent of all displacement reported due to the destruction of homes during Israeli military operations since January 2023 (908 people).

Funding

• As of 30 December, Member States have disbursed $633 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

• The security situation, access, transport, and deconfliction remain extremely challenging, especially for hospitals in the northern governorates. Despite these challenges, health partners carried out missions to Al Shifa, As Sahaba Medical Complex, Patient Friendly and Al Helou hospitals in these governorates and provided them with medical supplies and fuel. The need for fuel medical supplies and support to health workers remain high.
• Humanitarian partners continue to provide health care to IDPs in shelters through 150 medical teams.
• Some 98 health workers have been deployed to Nasser, Najjar, European, Al Amal, and the Emirati hospitals to strengthen case management in health facilities.
• Some 3,400 hygiene kits, eight sexual and reproductive health kits (SRH), and ten Interagency Emergency Health Kits were provided to four hospitals to serve over 100,000 people for three months.
• Mental health, and psychosocial support (MHPSS) services were provided to 13,000 IDPs in Deir al Balah, Khan Younis and Rafah, with a team of two psychiatrists and 16 counsellors and supervisors to assist special cases referred from health centres and shelters.
• Currently, only 150 out of 325 shelters have medical points. Health partners are working to expand access to primary healthcare service by increasing the number of medical points in designated shelters. Additionally, health partners aim to re-open some of the 55 primary healthcare facilities that have been forced to close since the start of hostilities.
• In the West Bank, health partners continue supporting the MoH and designated private hospitals in responding to the high number of causalities resulting both from Israeli forces operations and settler violence. In addition, 23 mobile teams continue providing primary health care services to 180 communities across Area C, where over 400 people benefited from MHPSS services during the reporting period.

Protection

• Currently, Palestinian nationals in Gaza are not permitted to exit, even if they possess a visa for a third country. Departure is only authorized when an official request for evacuation is initiated through the Foreign Affairs Ministry of the third country, using diplomatic channels and embassies, in coordination with permission from Israeli authorities. The cluster is supporting the evacuation of about 40,000 Palestinians-Egyptian dual nationals who have registered to enter Egypt.
• Child Protection partners reached 24,744 boys and girls and 1,074 women and men in the past two weeks through awareness raising interventions, MHPSS for children and caregivers, child protection case management and distribution of clothing kits. A number of partners also provided cash assistance for families in Gaza;
• There is a lack of essential items including children’s clothing, diapers, sanitary pads in the local markets.
• The Gender-based violence (GBV) Sub-Cluster member UNFPA supported 239 vulnerable women, including displaced, pregnant and lactating women (PLWs), cancer survivors, and women previously supported by the Safe Spaces programme in Gaza. Three health mobilizers with Psychological First Aid (PFA) skills and two counselors are supporting women and girls in the only currently running UNFPA-supported safe space, at Al Awdah Health and Community Association in Rafah.
• Partners working to address GBV continue to highlight the increased psychological stress among displaced women and girls and increased protection and GBV risks. GBV prevention, response, and risk mitigation interventions remain extremely difficult given the collapse of services and displacement of service providers and movement restrictions.
• Access to basic needs, including menstrual hygiene products, is challenging with market depletion, disrupted supply chains, and access restrictions on incoming aid. When possible, civil society organizations including women and youth-led are mobilizing volunteers to support limited distribution efforts and are supporting efforts to address GBV and to generally mitigate risks in limited/accessible shelter sites.

Shelter and Non-Food Items (NFI)

• As of 30 December, it is estimated that about 65,000 housing units across Gaza Strip have been destroyed or rendered uninhabitable and over 290,000 housing units have been damaged, according to the Government Media Office. It is estimated that over 500,000 people will have no home to return to and that many more will be unable to return immediately due to the level of damage to surrounding infrastructure, as well as the risk posed by of Explosive Remnants of War.
• Since the start of the hostilities, shelter partners have provided assistance to 914,500 people, the majority IDPs seeking shelter in UNRWA and non-UNRWA shelters.
• Since the start of the hostilities, shelter partners have provided cumulatively 11,500 dignity kits; 1,000 emergency shelter kits (bedding sets, washing kits, eating sets); 76,530 household kits (bedding, kitchen, washing set); 36,000 sealing off kits; 650,000 bedding set items (blankets and mattresses); 4,200 tents; 11,500 kitchen sets; and 17,250 winter clothing kits.

Food security

• In the last week of 2023, 15 Food Security partners provided food parcels to people in and outside shelters across the Gaza Strip. This includes:
  • Some 3,000 food parcels and 15,000 hot melas in northern Gaza;
  • Some 1,100 food parcels and 10,000 hot meals in Gaza governorate;
  • Nearly 21,000 food parcels and 360 ready-to-eat meals (RTE) in Central Gaza;
  • Some 11,000 food parcels, 17,000 hot meals, and more than 2,900 RTE parcels in Khan Younis;
  • More than 86,500 food parcels, nearly 22,000 hot meals and 750 RTE parcels in Rafah; and
  • And cash-based transfers for nearly 5,000 people.
• While Food Security partners have identified all 2.2 million people to be in urgent need of food assistance each day; on average, the daily assistance in the last week of December reached only eight per cent of the targeted people in need. Since October, 1.34 million people have been reached with at least one form of food assistance.

WASH

• Of the 23 active WASH partners, few are able to operate across the Gaza Strip. In the last week of December, WASH partners delivered 17,305 cubic metres of water per day, bringing the total to 121,000 cubic metres since October 2023. In the same week, WASH partners distributed about 40,000 litres of fuel to support water supply/distribution.
• The combination of water trucking, water from the functional desalination plant and restoration of one of the three main water supply lines (on 30 December) yielded only seven per cent of water production in Gaza, compared with the pre-October 2023 supply. Water quality indicators also remain a major concern, with limited large-scale water quality testing campaigns or activities being undertaken.
• Between October and December 2023, a total of 138 sanitation units were installed or rehabilitated in IDP shelters, through the use of local materials and supplies.
• Overall, 1.4 million of the 2.2 million population of Gaza have been reached at least once with partial water and sanitation assistance since October 2023.

Nutrition

Nutrition partners have undertaken the following responses to prevent malnutrition among children and mothers:

• In the last week of December, Nutrition partners distributed 68 metric tons of Lipid Nutrient Supplements-Medium Quantities (LNS-MQ) to nearly 45,500 pregnant and breastfeeding women and children (6-24 months) in UNRWA shelters in Rafah.
• During the same week, Nutrition partners distributed 254,000 bottles of ready to use infant formula (RUIF) to 2,260 non-breastfed children under five months for thirty days. Therapeutic milk supplies were provided to 562 acutely malnourished children with medical complications – a life threatening condition affecting the development and survival of a child. More than 18,000 pregnant and nursing mothers received Multiple Micronutrients tables and another 40,5000 received iron-folate supplements. An additional 30,300 children under-one received vitamin A supplements as an integral part of their feeding.
• Given the current stock and funding situation, Nutrition Partners can only meet 25 per cent of the nutritional needs for malnourished children and vulnerable mothers in the next two months. Without immediate funding and an expanded response, 375,000 individuals are at risk of severe undernourishment. Urgent action is crucial to prevent this life-threatening situation.

Education

• The Education Cluster reported that 342 schools have sustained damage across the Gaza Strip, affecting the education of 400,700 students. Gaza and Khan Younis governorates as well as northern 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).
• Since 7 October, the Education Cluster’s ten partners currently active in Gaza have reached 84,262 students and teachers. This included the provision of emergency learning and recreational supplies, reaching 52,653 individuals, psychosocial support, reaching 64,854 individuals, and conducting recreational activities, reaching 83,262 individuals in areas south of Wadi Gaza.

Multi-purpose Cash Assistance (MCPA)

• Since the beginning of the hostilities, 111,254 households (comprising almost 750,000 people) have received emergency MPCA. With about 81,941 households (54,926 people) 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 the respondents report that unrestricted cash has helped them access needed goods and services, either fully or partially, while 87 per cent reported unrestricted cash as their preference for future assistance.

Logistics

• The Logistics Cluster continues to facilitate access to storage, transport, and cargo notification transshipment services.
• The cluster have thus far installed and handed over a total of 14 Mobile Storage Units (MSUs) to augment the offloading capacity in the Rafah transshipment point and the storage capacity of UN Agencies and International NGOs.
• Three installed MSUs in the Rafah transshipment point were recently destroyed.
• Additional four MSUs have been delivered in Gaza; two of them will be set up at Kerem Shalom crossing while the other two will be handed over to PRCS to enhance its storage capacity.
• The cluster is engaging with partners and conducting a logistics assessment in Jordan for potential inter-agency support.

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 has requested a follow-up meeting with COGAT during the first week of January to discuss the pending approval status.
• To date, only 20 Iridium satellite phones, purchased from an Israeli service provider, have been authorized for import. The phones are being managed by the United Nations Department for Safety and Security (UNDSS) for issuance to UN agencies to support field missions across 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.