Humanitarian Situation Update #176 | Gaza Strip

The Humanitarian Situation Update is issued by OCHA Occupied Palestinian Territory three times per week. The Gaza Strip is covered on Mondays and Fridays, and the West Bank is covered on Wednesdays. The “Humanitarian Situation Update” is a rebranding of the “Flash Update”. The next Humanitarian Situation Update will be published on 10 June, and the next Humanitarian Response Update will be published on 12 June.

Key Highlights

• The UN Human Rights Office reports that the airstrike on a UN school in An Nuseirat Refugee Camp suggests a failure of the Israeli military to ensure strict compliance with International Humanitarian Law.   
• Al Aqsa Hospital in Deir al Balah is overwhelmed with patients and one of its two generators went out of service.  
• All medical evacuations outside of Gaza continue to be suspended since 7 May.  
• Nine out of 10 children in Gaza are experiencing severe food poverty, UNICEF reports.

Humanitarian Developments

• Israeli bombardment from the air, land, and sea continues to be reported across much of the Gaza Strip, resulting in further civilian casualties, displacement, and destruction of houses and other civilian infrastructure. Airstrikes have reportedly been especially intense in central Gaza, particularly in Al Bureij, Al Maghazi, and An Nuseirat refugee camps and eastern Deir Al Balah. Ground incursions and heavy fighting also continue to be reported, particularly in Rafah. Intensified hostilities and military operations in Rafah have so far forced the displacement of more than one million people, deepening the humanitarian crisis and significantly destabilizing humanitarian aid flows. Less than 100,000 people are estimated to have remained in Rafah governorate.   
• Between the afternoons of 3 and 7 June, according to MoH in Gaza, 252 Palestinians were killed and 753 were injured, including 77 killed and 221 injured in the past 24 hours. Between 7 October 2023 and 7 June 2024, at least 36,731 Palestinians were killed and 83,530 were injured in Gaza, according to MoH in Gaza.  
• On 6 June, a United Nations school sheltering about 6,000 internally displaced persons (IDPs) was struck overnight in An Nuseirat Refugee Camp, according to UNRWA. MoH in Gaza reported that the strike resulted in the killing of 40 people, including 14 children and nine women, and the injury of 74 others, with some casualties still under rubble. The Israeli military reported that nine members of Palestinian armed groups were operating from inside the school and were killed in the strike. Noting that the school was hit without prior warning, the Commissioner-General of UNRWA Philippe Lazzarini stated: “Since the war in Gaza began, over 180 UNRWA buildings were hit and more than 450 displaced people were killed as a result. UNRWA shares the coordinates of all its facilities (including this school) with the Israeli Army and other parties to the conflict. Targeting UN premises or using them for military purposes cannot become the new norm.” Furthermore, the UN Human Rights Office in the occupied Palestinian territories expressed deep concern “that this strike suggests a failure by the IDF to ensure strict compliance with international humanitarian law, particularly the basic principles of distinction, proportionality and precaution in attack. While Israel has claimed that armed Palestinians were using the school as a base of operations, which itself would amount to a violation of IHL, this would not allow or justify violations of these principles. We note with concern that this attack follows a strike last week on an IDPs camp in Rafah that left at least 45 Palestinians dead.” 
• The following are among other deadly incidents reported between 2 and 6 June:  
  • On 2 June, at about 23:30, six Palestinians, including three children, were reportedly killed and others injured when a house was hit near Al Farouq Mosque, in Block Number 9 of Al Bureij Refugee Camp, in Deir al Balah.  
  • On 2 June, at about 12:00, eight Palestinians, including five children and a woman, were reportedly killed when a house was hit in As Sabra neighbourhood in central Gaza city. 
  • On 3 June, at about 02:50, ten Palestinians, including four women and three children, were reportedly killed when two houses were hit east of the Islamic University in western Khan Younis. 
  • On 4 June, eight Palestinian police officers were reportedly killed and others injured when a vehicle and a group of Palestinians in front of an IDP centre were hit in Abu Sitta Street, in northern Deir al Balah.  
  • On 5 June, at about 6:45, eight Palestinians were reportedly killed when a house was hit in Al Maghazi Refugee Camp, in Deir al Balah.  
  • On 6 June, at about 04:25, six Palestinians were reportedly killed and others injured when a house was hit in the second camp of An Nuseirat, in Deir al Balah.  
• Between the afternoons of 3 and 7 June, one Israeli soldier was reported killed in Gaza. As of 7 June, 294 soldiers have been killed and 1,902 soldiers have been injured in Gaza or along the border in Israel since the beginning of the ground operation, according to the Israeli military. In addition, according to the Israeli media citing official Israeli sources, over 1,200 Israelis and foreign nationals, including 33 children, have been killed in Israel, the vast majority on 7 October. As of 7 June, it is estimated that 124 Israelis and foreign nationals remain captive in Gaza, including fatalities whose bodies are withheld. 
• On 31 May 2024, UNOSAT published an updated preliminary analysis of structural damage and destruction in the Gaza Strip, based on satellite imagery collected on 3 May 2024.  The assessment identified 137,297 damaged structures, constituting about 55 per cent of all structures in the Gaza Strip. These include 36,591 structures identified as destroyed, 16,513 severely damaged, 47,368 moderately damaged, and 36,825 possibly damaged. Compared with the 1 April analysis, the Deir al Balah and Gaza governorates experienced the sharpest increase in damage, with 2,613 and 2,368 newly damaged structures, respectively. At the municipality level, Gaza city had the highlest overall count of damaged structures (34,803), followed by Khan Younis city (19,202), Jabalya (11,886), and Beit Lahiya (9,450)—noting that the UNOSAT analysis was conducted prior to the most recent three-week ground operation in northern Gaza that resulted in the reported destruction of 50,000 housing units, UNRWA shelters, and more than 15 water wells and other public infrastructure, according to the emergency committee of North Gaza municipalities, which include Jabalya, Beit Lahiya and Beit Hanoun. UNOSAT added that within Deir al Balah governorate, An Nuseirat Municipality had the highest number of newly damaged structures at 1,216, and highlighted that this analysis is preliminary and yet to be validated in the field. According to data collected between October 2023 and January 2024 in a previous interim damage assessment by the World Bank, the EU and the UN, more than 60 per cent of homes in the Gaza Strip have been destroyed or damaged, accounting for 72 per cent of the total estimated cost of direct damage to critical infrastructure (US$13.29 billion out of $18.5 billion). 
• Intensified hostilities are deeply crippling healthcare provision across Gaza, amid supply shortages and reduced bed capacity. Available bed capacity at existing hospitals reached 439 per cent as of 13 May, or more than four times their capacity, according to MoH. For example, in Deir al Balah governorate in central Gaza, the few still partially functional hospitals are increasingly overwhelmed by the influx of casualties from continued airstrikes, with the situation being particularly severe at Al Aqsa Hospital according to Health Cluster partners. Following the 4 June airstrikes on Al Bureij and Al Maghazi refugee camps, Médecins Sans Frontières (MSF) reported that the facility received at least 70 dead and more than 300 injured, the majority women and children and many critically injured with severe burns, shrapnel wounds, fractures and other traumatic injuries. Describing conditions at the hospital, the MSF Medical Adviser in Gaza, Karin Huster, indicated that wounded people were lying on the floor and outside the facility, while dead bodies were being brought to the hospital in white plastic bags and “the odour of blood” in the emergency room “was overwhelming.”  MSF explained that people in critical condition who arrive at Al Aqsa “stay in Al Aqsa and die in Al Aqsa,” calling the facility “a sinking ship.” A second mass influx of casualties occurred overnight on 5 June, stretching the hospital’s capacities to the limit as it continues to struggle with a shortage of operating theatres, beds and equipment, highlighted Medical Aid for Palestinians (MAP). The hospital is also currently running on one generator to produce electricity, with another one out of service, reported the hospital’s administration in a statement on 5 June, warning that the lives of dozens of injured and sick patients in intensive care units, as well as premature babies receiving breathing support from ventilators, are at risk. The hospital appealed to the UN and international organizations to urgently intervene to save patients and provide new generators, noting that it is currently hosting 700 patients and serving more than a million people in central Gaza.  
• On 5 June, the International Medical Corps (IMC) announced that the escalation of fighting had forced it to relocate all equipment and operations from its 160-bed field hospital in Rafah governorate to its second field hospital in Deir al Balah, thereby allowing it to continue to provide critical health services “while protecting the safety and security of its patients and staff.” With An Najjar, Al Kuwaiti and Al Emirati hospitals out of service and the IMC facility now closed, only two field hospitals continue to provide health services in Rafah governorate: the ICRC Field Hospital in Al Mawasi area and the UAE Field Hospital in Rafah city, the latter being increasingly difficult to reach due to ongoing hostilities, reports the World Health Organization (WHO).  
• All medical evacuations of critically ill and injured patients remain suspended since the closure of Rafah Crossing on 7 May, exacerbating the challenges facing health facilities where service provision is hanging by a thread. More than 1,200 patients, or an average of 50 patients per day, have been unable to leave Gaza to receive the necessary treatment abroad as of 30 May, according to WHO. WHO further estimates that at least 14,000 patients now require medical evacuation outside the Strip, with this figure expected to further increase due to shrinking hospital bed capacity amid the ongoing escalation. Already prior to 7 May, only 46 per cent of critical patients (5,857 out of 12,761) for whom medical evacuation outside Gaza had been requested were approved by Israeli authorities. However, only 4,895 patients, or 38 per cent of the total, were evacuated while the remaining 962 patients were unable to travel due to movement restrictions or limitations on people accompanying them. Given the overwhelming number of conflict-related injuries, critically wounded patients had also been prioritized over people suffering from chronic illnesses, such as kidney failure and heart disease, leaving the latter in extremely precarious conditions. Moreover, thousands of people who have suffered from amputations and other life-threatening injuries now lack access to adequate nursing and rehabilitative care in Gaza, underscored Humanity & Inclusion (HI) on 4 June, cautioning that the “growing pile of unexploded ordnance in the rubble of destroyed buildings” will continue to pose a threat for the entire population of Gaza in the future. 
• On 6 June, a World Food Programme (WFP) warehouse in Deir al Balah sustained damage after an Israeli projectile missile hit the adjoining flour mill building - one of only two flour mills in Deir al Balah, where the warehouse is used as a main storage and transit hub for commodities in the Gaza Strip. While all WFP and partner staff working in the warehouse have been accounted for, WFP was forced to temporarily suspend its operations at the warehouse. WFP resumed its activities at the warehouse on 7 June and plans to conduct a damage assessment. The food agency urged all parties to the conflict to uphold their obligations to respect the integrity of humanitarian premises and assets, as well as aid workers serving people in desperate need of assistance. 
• Nine out of 10 children in the Gaza Strip are experiencing severe food poverty, surviving on two or fewer food groups per day, reported UNICEF on 6 June, based on five rounds of data collected between December 2023 and April 2024. Moreover, in an analysis published on 31 May, the Famine Early Warning Systems Network (FEWS NET) indicated that the Israeli military operation in Rafah has disrupted food distribution channels and diminished access to food. FEWS NET emphasized that irrespective of whether famine thresholds have been reached or surpassed – an accurate assessment of which is not possible due to limitations on humanitarian access and data collection – malnutrition is extremely high among children and “people are dying of hunger-related causes across Gaza.” On 4 June, Action Against Hunger​​​​​​​ stressed that many malnourished children, especially those under the age of two, require urgent care.  The NGO’s nutrition and health coordinator in Gaza reported that the lack of food is impacting children’s development, delaying their growth, weakening vital organs as the heart, kidneys and lungs, and making them more vulnerable to infections such as pneumonia. A similar message was conveyed by the WFP Executive Director, Cindy McCain, who, commenting on the recent WFP-FAO global “Hunger Hotspots” outlook report, stressed that “once a famine is declared, it is too late - many people will have already starved to death.”  
• Military operations have significantly destabilized humanitarian aid flows, forcing UN and partners to reorganize the entire operation. At present, aid convoys need to navigate active hostilities, barely passable roads, unexploded ordnance and recurrent delays. The humanitarian community is engaging with Israeli authorities to ensure sustained, secure and unimpeded access for humanitarian aid into and within the Strip. A Humanitarian Notification System is in place to notify and coordinate humanitarian movements—the notification system is designed to inform all parties to the conflict about the location of humanitarian compounds and the movements of humanitarian entities with a view towards avoiding collateral harm or damages and enhancing the safety and security of humanitarian sites, operations, and personnel. Yet, impediments, delays, and denials of missions continue to restrict and undermine the ability of humanitarian organizations to reach affected communities in Gaza to provide essential assistance and services. Between 1 and 6 June, out of the 17 coordinated humanitarian assistance missions to northern Gaza, 8 (47 per cent) were facilitated by the Israeli authorities, 3 (18 per cent) were denied access, 4 (23 per cent) were impeded, and 2 (12 per cent) were cancelled, due to operational or security reasons. In addition, out of the 74 coordinated humanitarian assistance missions to areas in southern Gaza, 52 (70 per cent) were facilitated by the Israeli authorities, 3 (4 per cent) were denied, 12 (16 per cent) were impeded, and 7 (10 per cent) were cancelled. Many missions classified as impeded experienced extended delays, with some delays reaching up to nine hours at sensitive and insecure locations, placing humanitarian personnel at increased security risks. 

Funding 

• As of 7 June, Member States have disbursed about $1.05 billion out of $3.4 billion (31 per cent) requested to meet the most critical needs of 2.3 million people in Gaza and 800,000 people in the West Bank, including East Jerusalem, between January and December 2024. For funding analysis, please see the Flash Appeal Financial Tracking dashboard.    
• The oPt HF has 109 ongoing projects, for a total of $78.9 million, addressing urgent needs in the Gaza Strip (86 per cent) and West Bank (14 per cent). Of these projects, 69 projects are being implemented by international non-governmental organizations (INGOs), 26 by national NGOs and 14 by UN agencies. Notably, 43 out of the 83 projects implemented by INGOs or the UN are being implemented in collaboration with national NGOs. Since 7 October, the oPt HF has mobilized over $100 million from Member States and private donors, designated for programmes throughout Gaza. A summary of the oPt HF activities and challenges in May 2024 is available through this link and the 2023 Annual Report of the oPt HF can be accessed here. Private donations are collected directly through the Humanitarian Fund. 

 For the most recent Gaza Humanitarian Response Update for the period between 20 and 26 May, please visit: Gaza Humanitarian Response Update | 20–26 May 2024. As of 3 June, the Gaza Humanitarian Response Update will be issued every two weeks. The next update will be issued on 12 June, covering the two-week period between 27 May and 9 June.