Hostilities in the Gaza Strip and Israel | Flash Update #85

Key points

• Heavy Israeli bombardment from air, land, and sea continued across much of the Gaza Strip, including central Gaza, the southern town of Khan Younis, and Jabalya Camp in northern Gaza. The firing of rockets by Palestinian armed groups into Israel also continued. Additionally, ground operations and fighting between Israeli forces and Palestinian armed groups continue to be reported over the past 24 hours, resulting in additional fatalities inside the Strip. 
• Between the afternoons of 4 and 5 January, 162 Palestinians were reported killed, and another 296 people were reported injured, by the Ministry of Health (MoH) in Gaza. Overall, between 7 October and 12:00 on 5 January, at least 22,600 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, 57,910 Palestinians were reportedly is injured.  
• Since 4 January and as of 5 January, no additional Israeli soldiers have been reported killed in Gaza. Overall, since the start of the ground operation, 173 soldiers have been killed, and 1,020 soldiers injured, in Gaza, according to the Israeli military. 
• On 5 January, UNICEF announced that a survey conducted on 26 December found that about 90 per cent of children under two years of age are consuming two or fewer food groups. Most children are reportedly only getting grains (including bread) or milk, meeting the definition of “severe food poverty.” Dietary diversity for pregnant and breastfeeding women are reportedly severely compromised with 25 per cent having only consumed one food group the day before the survey, and almost 65 per cent only two groups. According to UNICEF, the malnutrition is particularly worrisome for over 155,000 pregnant women and breastfeeding mothers, as well as more than 135,000 children under two, given their specific nutrition needs and vulnerability.  
• On 5 January, UNICEF’s Executive Director stated that “time is running out. Many children already face severe acute malnutrition in Gaza. As the threat of famine intensifies, hundreds of thousands more young children could soon be severely malnourished, with some at risk of death. We cannot allow that to happen.”   
• According to UNICEF, cases of diarrhea in children under five years of age rose from 48,000 to 71,000 in just one week starting 17 December. This is equivalent to 3,200 new cases of diarrhea per day. Before the escalation in hostilities, an average of 2,000 cases of diarrhea in children under five were recorded per month. It has been reported that displaced children and adults are unable to maintain the necessary hygiene levels, with some resorting to open defecation. The inability to prevent diseases is attributed to the lack of safe water and sanitation due to damaged or destroyed essential water and sanitation systems in the Gaza Strip. Additionally, UNRWA reported that diaper supplies are not sufficient, as they cover only 25 per cent of the babies in shelters. 
• On 5 January, the World Food Programme (WFP) provided wheat flour, salt, yeast to nine bakeries in Deir al Balah and Rafah to produce bread at a subsidized price. Six of the nine bakeries have started operations, while three remain non-functional, as a result of evacuation orders, but are expected to be operational soon. Bread is the most requested food item, particularly as many families lack the basic means for cooking. On 4 January, WFP had reached more than 100,000 people with rolling distribution of food parcels sufficient for 10 days for each family in Rafah, Khan Younis and Deir al Balah.  
• As of 5 January, media reports indicate that the Jabalya Refugee Camp has been severely flooded with water and waste. This is noted to have been the consequence of damage to the Abu Rasheed reservoir pumping station and infiltration from the lagoon in Jabalya. This poses life-threatening risks of contamination and outbreak of communicable diseases among already vulnerable communities residing in overcrowded conditions. 
• On 5 January, 80 trucks with food, medicine and other supplies entered the Gaza Strip through the Rafah and Kerem Shalom crossings. 
• On 5 January, the Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, stated that “the humanitarian community has been left with the impossible mission of supporting more than 2 million people, even as its own staff are being killed and displaced, as communication blackouts continue, as roads are damaged and convoys are shot at, and as commercial supplies vital to survival are almost non-existent... medical facilities are under relentless attacks while they  are overwhelmed with trauma cases, critically short of all supplies and inundated by desperate people seeking safety.” 

Hostilities and casualties (Gaza Strip)

• The following are among the deadliest incidents reported between 4 January and 5 January: 
  • On 4 January, eight people were reportedly killed and tens people injured when a residential building in Sheikh Radwan neighborhood in Gaza city was struck.  
  • On 4 January, at about 15:30, five people were reportedly killed when a drone hit a civilian vehicle in Abu Sarar area of the new An Nuseirat Refugee Camp in central Gaza.  
  • On 4 January, at about 21:00, three people, including a 10-year-old girl, were reportedly killed and another five were injured by a missile attack in Al Mawasi area.  
  • On 4 January, at about 21:30, five people, including two children and a woman, were reportedly killed and another three were injured when a residential building in Rafah was struck.  
  • On 5 January, at about 9:45, five people were reportedly killed when the Fallouja cemetery in Jabalya Refugee Camp was struck.  
  • On 5 January, at about 10:00, four people were reportedly killed when the Al-Ishreen street in An Nuseirat Refugee Camp in central Gaza was struck.  

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 many 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; facilities that are far exceeding their intended capacity. 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.  
• On 4 January, the United Nations High Commissioner for Human Rights stated that he was “very disturbed by high-level Israeli officials' statements on plans to transfer civilians from Gaza to third countries. 85 per cent of people in Gaza are already internally displaced. They have the right to return to their homes. International law prohibits forcible transfer of protected persons within or deportation from occupied territory.” 
• On 3 January, the Israeli military designated two additional blocks for evacuation in Deir al Balah governorate, issuing orders via air-dropped leaflets. The orders cover an estimated 1.2 square kilometres, home to about 4,700 people and where one UN-supported health centre (Nusseriat) is located. Since 1 December, evacuation orders have been issued for several areas, estimated to cover 128 square kilometres south of Wadi Gaza alone (35 per cent of the Gaza Strip) and previously home to just over 1 million people (44 per cent of Gaza’s population). This area encompasses 13 hospitals, 29 health facilities and 143 shelters where over 550,000 internally displaced persons (IDPs) were taking refuge. 

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 3 January, 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 that can 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. 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 is increasing daily amid intense conflict and restricted humanitarian access. The FRC stated that, to eliminate the risk of famine it is imperative to halt the deterioration of the 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 as vital first steps to eliminate any risk of famine.  
• WFP plans to scale its Gaza Bread Programme as the existing ready-to-eat food options are falling short of meeting people’s crucial caloric needs. Bread, made from fortified flour, holds the potential to address some of the unmet requirements for essential vitamins and minerals, which the current ready-to-eat baskets fail to provide. Moreover, the provision of bread as a no-cook food option becomes especially crucial when households lack the means to cook meals. Thus, incorporating bread into aid provisions emerges not only as a practical solution but also as a key strategy to fulfil immediate nutritional needs effectively. 

Hostilities and casualties (Israel)

• On 4 January 2024, the Israeli military stated that additional Israelis who had previously been classified as missing, had been identified as hostages in Gaza. The Israeli authorities estimate that about 136 Israelis and foreign nationals remain captive in Gaza. During the humanitarian pause (24-30 November), 86 Israeli and 24 foreign national hostages were released. 
• 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

Violence and casualties (West Bank)

• On 5 January 2024, Israeli forces shot and killed a 17-year-old Palestinian child in the village of Beit Rima (Ramallah) during a search-and-arrest operation. The boy was shot with live ammunition in the chest while attempting to assist another injured person who was also shot by Israeli forces. Another four Palestinians were injured with live ammunition during the same incident.  
• This brings to 315 the number of Palestinian fatalities in the West Bank, including East Jerusalem, since 7 October 2023 and as of 5 January 2024. Among the fatalities were 81 children. 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, 306 were killed by Israeli forces, eight by Israeli settlers and another one by either Israeli forces or settlers. The number of Palestinians killed in the West Bank, including East Jerusalem, in 2023 (507) marks the highest number of Palestinians killed in the West Bank since OCHA started recording casualties in 2005. 
• Since 7 October 2023 and as of 5 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 in attacks by Palestinians from the West Bank (36) is the highest since OCHA started recording casualties in 2005. 
• Since 7 October 2023 and as of 5 January 2024, 4,021 Palestinians, including 604 children were injured in the West Bank, including East Jerusalem. Of whom 3,918 have been injured by forces, 92 by settlers and eleven by either Israeli forces or settlers. Of the total injuries, 51 per cent were reported in the context of search-and-arrest and other operations, 37 per cent in demonstrations and 8 per cent during settler related attacks against Palestinians. 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 5 January 2024, OCHA has recorded 381 Israeli settler attacks against Palestinians, resulting in Palestinian casualties (36 incidents), damage to Palestinian-owned property (297 incidents), or both casualties and damage to property (48 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 2023, 1,229 incidents involving settlers in the West Bank, including East Jerusalem (with or without Israeli forces), resulted in Palestinian casualties, property damage or both. Some 913 of these incidents resulted in damage, 163 resulted in casualties and 153 resulted in both. This is the highest number of settler attacks against Palestinians in any given year since OCHA started recording incidents involving settlers in 2006. 
• The weekly average of such incidents since 7 October is 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 those incidents after 7 October included firearms, including shootings and threats of shootings. In nearly half of all recorded incidents after 7 October Israeli forces were either accompanying or reported to be supporting the attackers. 

Displacement (West Bank)

• Since 7 October 2023 and as of 5 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. The displacement toll since 7 October 2023, represents 78 per cent of all displacement reported due to settler violence and access restrictions since 1 January 2023 (1,539 people, including 756 children).  
• Additionally, 444 Palestinians, including 224 children, have been displaced since 7 October, 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 5 January, Member States have disbursed $637.6 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 52 per cent of the $1.2 billion requested. Private donations are collected through the Humanitarian Fund.

HUMANITARIAN NEEDS AND RESPONSES: 26 December to 2 January

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 49 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, 18 mobile teams continue providing primary health care services to 124 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.
• 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 organizations, 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 in Gaza. 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. The figures demonstrate an adaptive response to a dynamic operating environment, ensuring that the most vulnerable populations continue to receive life-sustaining assistance.
• This includes:
  • Some 3,000 food parcels and 15,000 hot meals 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;
  • Flour to nearly 882,000 people in the south; and
  • Cash-based transfers for nearly 5,000 people across the Strip.
• 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.

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 has 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.
• An 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.