Humanitarian Situation Update #193 | 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 next update will be issued on 22 July.  

Key Highlights

• About 1,500 hospital beds are currently available in Gaza to cover the needs of more than two million people, compared with 3,500 beds before the war, according to the Health Cluster.  
• Variant poliovirus (VDPV) type 2 detected in environmental surveillance samples collected from Khan Younis and Deir al Balah, warns WHO. 
• At least three mass casualty events took place on 16 and 17 July, two of them in schools hosting internally displaced persons. In total, eight schools have been hit in the space of ten days, reports UNRWA. 

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. Ground incursions and heavy fighting also continue to be reported. 
• Between the afternoons of 15 and 18 July, according to the Ministry of Health (MoH) in Gaza, 184 Palestinians were killed and 362 were injured. Between 7 October 2023 and 18 July 2024, at least 38,848 Palestinians were killed and 89,459 were injured, according to MoH in Gaza. Casualty figures covering the period until the afternoon of 19 July are not available as of the time of reporting.  
• At least three mass casualty incidents took place on 16 and 17 July. On the afternoon of 16 July, the Israeli military reportedly struck Al Attar Street in Al Mawasi area of Khan Younis, where many internally displaced people (IDPs) were gathering, including to buy food from a market of street vendors. According to the MoH in Gaza, 17 people, including at least four children, were killed, and more than 26 others were injured. On the same day, at about 14:15, the guard room inside the UNRWA Nuseirat Boys' Preparatory School (also known as Al Razi school), where IDPs were sheltering, was hit; according to the Government Media Office (GMO), the incident resulted in the killing of 23 Palestinians and the injury of another 73. According to the Israeli military, armed Palestinians were operating from inside the school. Additionally, on 17 July, at about 13:00, 11 Palestinians, including children, were reportedly killed and others injured when a strike hit the entrance of Cairo Governmental School in Al Rimal, in Gaza city. On 17 July, UNRWA’s Commissioner-General, Philippe Lazzarini, noted that at least eight schools, including six UNRWA schools, were hit in the past 10 days, and stated: “The war robbed the girls and boys in Gaza of their childhood [and] education. Schools must never be used for fighting or military purposes by any party to the conflict.”  
• The following are among other deadly incidents reported between 14 and 18 July: 
  • On 14 July, at about 19:00, seven Palestinians were reportedly killed when the project area (Al Mashrou’ area) was hit east of Rafah city. 
  • On 14 July, at about 23:50, at least five Palestinians, including three children, were reportedly killed and others injured when an apartment was hit near As Salehat roundabout, northwest of Al Maghazi Refugee Camp, in Deir al Balah. 
  • On 15 July, at about 17:10, five Palestinians, including a girl, were reportedly killed and others injured when a house was hit near Ad Da’wa mosque in Al Maghazi Refugee Camp, in Deir al Balah. 
  • On 15 July, at about 20:30, 11 Palestinians, including five children, were reportedly killed and others injured when a house was hit in An Nuseirat Camp 1, in Deir al Balah. 
  • On 16 July, at about 16:45, five Palestinians, including three females, were reportedly killed and others injured when a house was hit on Al Ashrin Street, east of An Nuseirat Refugee Camp, in Deir al Balah. 
  • On 16 July, at about 22:50, eight Palestinians were reportedly killed and others injured when a house was hit near As Sunna Mosque, south of An Nuseirat Refugee Camp, in Deir al Balah. 
  • On 17 July, at about 13:50, four Palestinians were reportedly killed and several others injured when a house was hit near Al Awda Schools in Abasan Al Kabira, east of Khan Younis.  
  • On 18 July, at about 1:15, seven Palestinians, including at least one girl, were reportedly killed and several others injured, including at least three children and one woman, when a house was hit near Ibn Rushd School in Az Zawaida, north of An Nuseirat Refugee Camp, in Deir al Balah. 
• Between the afternoons of 15 and 19 July, no Israeli soldiers were reported killed in Gaza, according to the Israeli military. Between 7 October 2023 and 19 July 2024, according to the Israeli military and official Israeli sources cited in the media, over 1,526 Israelis and foreign nationals were killed, the majority on 7 October and its immediate aftermath and including 326 killed in Gaza or along the border in Israel since the beginning of the ground operation. In addition, 2,134 soldiers were reported injured since the beginning of the ground operation. As of 19 July, it is estimated that 120 Israelis and foreign nationals remain captive in Gaza, including fatalities whose bodies are withheld. 
• On 18 July, the International Committee of the Red Cross (ICRC) stressed that repeated mass casualty events “have stretched to breaking point” the response capacity of the 60-bed Red Cross Field Hospital in Rafah, which is nearly at full capacity. Following the 13 July airstrikes on Al Mawasi area in Khan Younis, the facility treated 26 wounded patients (including children), eight of whom required immediate surgeries due to severe life- and limb-threatening injuries. The field hospital’s outpatient department also received 850 patients in the second week of July, nearly half were women and a third children, ICRC stated.  
• Conditions are similarly critical at other health facilities in central Gaza. Médecins sans Frontières (MSF) reports that, so far in July, its teams at the MSF clinic and Nasser Medical Complex in Khan Younis and at Al Aqsa Hospital in Deir al Balah have responded to four mass casualty incidents, most recently on 16 July. The pediatric emergency department at Nasser hospital, which is already overstretched and under-resourced, provided consultations to a daily average of more than 300 children between 29 June and 5 July, and children admitted for inpatient care are being forced to share beds, MSF added. Visiting Nasser recently, UNFPA reported seeing “babies, children, newborns and mothers on mattresses in the corridor” due to the lack of sufficient capacity. Pre-term deliveries and maternal complications, including eclampsia, haemorrhage and sepsis, have been rising, according to MSF, as pregnant women struggle to access health-care facilities, being forced to navigate unsafe routes to reach hospitals amid active conflict. After giving birth, they are rapidly discharged, returning to tents and shelters where they and their newborns face manifold health risks. Nasser Medical Complex is currently the only tertiary hospital providing maternal and pediatric care in Khan Younis, and efforts have begun to restore services at the European Gaza Hospital, also in Khan Younis, after it was evacuated on 2 July, according to the MoH. 
• About 1,500 hospital beds are now available at functional hospitals and field hospitals across the Gaza Strip to cover the needs of over two million people, compared with 3,500 beds that were available prior to the war, according to the Health Cluster. The lack of bed capacity is compounded by the lack of medical supplies and equipment, leading to “unnecessary deaths, infected wounds and unnecessary amputations,” warned the WHO Regional Director for the Eastern Mediterranean, Dr. Hanan Balkhy. She further noted that WHO’s mission requests on 16 July to deliver health supplies to Al Ahli and Patient Friendly hospitals in Gaza governorate were denied.  
• Infectious diseases continue to spread due to shortages of clean water, overcrowding, and abysmal sanitation and hygiene conditions. According to WHO data, 990,000 cases of acute respiratory infections, 574,000 of acute watery diarrhea, 107,000 of jaundice syndrome and 12,000 of bloody diarrhea were recorded as of 7 July, with the real number of infections likely much higher. Rashes and skin infections, particularly among children, are also on the rise, highlights UNRWA. 
• In a particularly worrying development, WHO reports that the Global Polio Laboratory Network (GPLN) detected variant poliovirus (VDPV) type 2 in six environmental surveillance samples collected on 23 June from Khan Younis and Deir al Balah. Thus far, the virus has only been isolated from the environment, with no associated paralytic cases detected. As part of response efforts, WHO is working with the MoH, UNICEF, UNRWA and partners to assess the scope of poliovirus spread and decide appropriate responses, including prompt vaccination campaigns. According to WHO-UNICEF routine immunization data, polio vaccination coverage in the Occupied Palestinian Territory was estimated at 89 per cent in 2023. However, nine months of hostilities have lowered routine immunization rates and increased the risk of vaccine-preventable diseases, including polio, for children; this is due to the decimation of Gaza’s health-care system, lack of security, access obstructions, repeated population displacement, medical supply shortages, poor water quality and dire sanitation conditions. To effectively mitigate the risk of poliovirus spread in Gaza, the MoH, the UN and partners are urging all stakeholders to support polio eradication efforts by ensuring that all children are vaccinated against polio at every opportunity. “A ceasefire is essential to allow an effective response,” underscored WHO. 
• On 29 June and 12 July, the UN and its partners conducted two inter-agency assessments in Gaza city to identify priority needs following the evacuation orders issued by Israeli forces on 27 June, 7 and 8 July in the eastern and central parts of Gaza city and intensified hostilities in the area. The 29 June assessment covered three schools, including two UNRWA schools, hosting 2,670 IDPs, and the 12 July assessment covered 1,512 IDPs sheltering at one UNRWA school and two informal displacement sites. Key assessment findings include:  
  • Overcrowding and lack of safety: Displacement sites are overcrowded, with up to five or six households sharing the same classroom. They are also largely unsafe due to damage and potential explosive ordnance contamination.  
  • Lack of shelter materials: While all households face severe shelter shortages, conditions are particularly difficult for hundreds of people who arrived from Ash Shuja'iyeh and other parts of eastern Gaza city in late June and are in dire need of mattresses and bedding, in addition to clothes, shoes and food. They are among tens of thousands of people who were forced to hastily flee amid active hostilities and were unable to collect even the most necessary belongings.  
  • Water scarcity: Desalinated water for drinking purposes is distributed by water trucks at highly irregular intervals. Coupled with storage challenges, this often prompts households to rely on highly saline water for drinking, which causes stomach pain. Water on the market is expensive, costing 5NIS (US$1.4) for a jerrycan. 
  • Degrading sanitation conditions: Most toilets in collective sites are not functional, due to network damage and septic issues, resulting in sewage spillage onto streets at some sites and a limited number of toilets available that had doors missing or lacked water for flushing. Personal hygiene is compromised due to the lack of privacy and water and extremely limited hygiene supplies, including sanitary pads for women. The scorching heat and nearby solid waste accumulation attract insects and mosquitos, and piles of waste are often burnt by communities in an effort to contain the proliferation of insects and disease transmission, with toxic fumes posing additional health hazards. 
  • Widespread food insecurity: Food assistance is deeply insufficient and not reaching all households equally. Lack of dietary diversity is widespread, partly owing to the lack of private sector commodities, especially in northern Gaza, and the exorbitantly high prices of the few commodities available on the market. For example, there has been a 50-fold increase in the prices of green peppers, from NIS10 ($2.7) prior to 7 October to NIS500 ($137) per kilogramme (kg), and a 45-fold increase in the price of tomatoes, from NIS3.3 ($0.9) to NIS150 ($41) per kg. At one site, IDPs reported having lost over 15 kgs of body weight over the past eight to nine months. 
  • Poor health access and nutrition: Lack of transportation and ambulance services, combined with a critical shortage of essential medications, limit access to health care. Women are struggling to breastfeed their newborns due to nutritional deficiencies, lack of privacy, stress and trauma, amid a lack of milk formula, limited screenings to detect malnutrition and erratic distributions of nutrition supplements. At one site, IDPs reported that stillbirth is increasing. A widespread increase in Hepatitis A was reported, alongside gastroenteritis (stomach flu), dysentery (intestinal infection), and skin and eye infections. Assistive devices for people with disabilities, including children, are lacking.  
  • Lack of materials for educational activities: Limited non-formal education activities have been organized by volunteers and UNRWA at some sites for children between five and 10 years of age but lacked dedicated spaces and essential materials. Children above the age of 10 at one site were found to be mainly collecting wood for energy and fetching water. 
• A surge in population movements from northern to southern Gaza has been observed by aid actors over the past two weeks, after the Israeli military airdropped flyers instructing residents of Gaza city to evacuate southward via two designated routes. According to the Site Management Working Group (SMWG), initial estimates by aid actors monitoring the movement of IDPs at ‘welcome points’ indicate that about 2,550 people have been displaced from northern Gaza between 11 and 18 July, primarily arriving in Deir al Balah via Salah ad Din Road, and humanitarian partners provided them with relief assistance, including drinking water, food, hygiene supplies, and some shelter materials. Efforts are ongoing to provide additional assistance to vulnerable groups, including pregnant women, the elderly and people with disabilities, and to incoming IDPs. High risks, however, continue to face IDPs, staff at ‘welcome points’, and relatives waiting for IDPs to cross. For example, on 17 July, several people were injured when Israeli tanks stationed near the Netzarim corridor reportedly fired at a group of people who were assembled 800 metres south of the checkpoint, waiting for their relatives to cross, as observed by aid actors. On 18 July, a military strike on a building in An Nuseirat Refugee camp prompted nearby humanitarian staff at ‘welcome points’ on Salah ad Din Road to withdraw and a multi-agency protection cluster mission to cancel its operations. 
• Access constraints, combined with ongoing hostilities, damaged roads and the breakdown of public order and safety, continue to severely disrupt and destabilize the entry of humanitarian aid supplies and their collection and distribution by aid actors to people in need across the Gaza Strip. Between 1 and 15 July, 1,288 truckloads of aid supplies entered Gaza, according to the UN, the majority being food aid. This is an average of 86 trucks per day, which is higher than the June daily average of 76 humanitarian aid trucks per day but lower than the May average of 94 aid trucks per day. These numbers refer to humanitarian supplies collected from the Palestinian side of any of the crossing points and exclude commercial goods. Within Gaza, between 1 and 18 July, out of 72 planned humanitarian assistance missions coordinated with the Israeli authorities to northern Gaza, 29 were facilitated, 20 were impeded, 18 were denied access, and five were cancelled due to logistical, operational, or security reasons. In southern Gaza, out of 240 coordinated humanitarian assistance movements, 177 were facilitated by the Israeli authorities, 22 were impeded, 17 were denied, and 24 were cancelled. 

Funding

• As of 19 July, Member States have disbursed about $1.21 billion out of $3.42 billion (35 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. On 10 July, the Humanitarian Coordinator Muhannad Hadi stated that “more funding is urgently needed – as is a safe, enabling environment inside Gaza. Increased funding now will enable the humanitarian community to scale up operations as soon as conditions permit. For funding analysis, please see the Flash Appeal Financial Tracking dashboard. (*2.3 million reflects the projected population of the Gaza Strip upon issuance of the Flash Appeal in April 2024. As of July 2024, the UN estimates that about 2.1 million people remain in the Gaza Strip, and it will be using this updated number for programmatic purposes.) 
• The occupied Palestinian territory Humanitarian Fund (oPt HF) has 111 ongoing projects, for a total of $88 million, addressing urgent needs in the Gaza Strip (89 per cent) and the West Bank (11 per cent). Of the total, 63 projects are being implemented by international non-governmental organizations (INGOs), 34 by national NGOs and 14 by UN agencies. Since 7 October, the oPt HF has mobilized over $112 million from Member States and private donors to support urgent humanitarian and life-saving programmes across the OPT. Of total funding, 89 per cent has been allocated to projects in Gaza. A summary of the oPt HF activities and challenges in June 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 oPt HF.

* Asterisks indicate that a figure, sentence, or section has been rectified, added, or retracted after the initial publication of this update.