Humanitarian Situation Update #196 | 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 29 July.

Key Highlights

• More than 190,000 Palestinians have been displaced in four days in Khan Younis and Deir al Balah, humanitarian partners estimate. 
• Efforts are underway to restore emergency care at Al Shifa Hospital in Gaza city, and the facility’s rehabilitated hemodialysis unit now supports 60 patients, down from 450 before the war. 
• The average daily volume of humanitarian aid cargo entering Gaza has decreased by 56 per cent since April. 

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. 
• On 26 July, UN Secretary-General, António Guterres, stated in response to a question in a press briefing that “the humanitarian situation in Gaza is a total disaster,” providing two main reasons for this. First, a military campaign with a “certain chaotic nature” has resulted in the highest level of killing and destruction since he came into office in 2017, where people are repeatedly told to move from one place to another “in search of a safety that doesn’t exist in any place.” Second, the level of humanitarian aid is “totally out of proportion with the needs.” The Secretary-General further stated that there is “total insecurity and total lawlessness” and mentioned a set of obstacles “in relation to [the entry of] security equipment [and] the so-called ‘dual use’ items,” among other requirements for an effective humanitarian operation. 
• Between the afternoons of 22 and 25 July, according to the Ministry of Health (MoH) in Gaza, 169 Palestinians were killed and 585 were injured. Between 7 October 2023 and 25 July 2024, at least 39,175 Palestinians were killed and 90,403 were injured, according to MoH in Gaza. Casualty figures covering the period until the afternoon of 26 July are not available as of the time of reporting. 
• The following are among the deadliest incidents reported between 20 and 24 July: 
  • On 20 July, at about 22:15, 10 Palestinian family members, including at least five females, were reportedly killed and others injured when barracks sheltering internally displaced people (IDPs) were hit in Rumaydah area in Bani Suhaila, in eastern Khan Younis. 
  • On 20 July, at about 23:00, five Palestinians, including two girls, were reportedly killed and others injured when a house was hit in An Nuseirat new camp, in Deir al Balah.  
  • On 20 July, at about 23:15, seven Palestinians, including an unidentified number of women and children, were reportedly killed and others injured when a house was hit near As Safa Mosque in Al Bureij Refugee Camp, in Deir al Balah. 
  • On 22 July, at about 7:35, six Palestinian family members were reportedly killed and others injured when a house was hit in Al Fajem area of Bani Suheila, in eastern Khan Younis. 
  • On 23 July, at about 13:35, nine Palestinians, including four children, were reportedly killed and seven others injured when a house was hit near the main entrance of Al Bureij Refugee Camp, in Deir al Balah.  
  • On 24 July, at about 21:10, six Palestinians, including an unidentified number of children, were reportedly killed and others injured when a group of Palestinians was hit in Beit Lahiya Project, in North Gaza.  
• Between the afternoons of 22 and 26 July, two Israeli soldiers were reported killed in Gaza, according to the Israeli military. Between 7 October 2023 and 26 July 2024, according to the Israeli military and official Israeli sources cited in the media, over 1,528 Israelis and foreign nationals were killed, the majority on 7 October and its immediate aftermath and including 328 soldiers killed in Gaza or along the border in Israel since the beginning of the ground operation. In addition, 2,161 soldiers were reported injured since the beginning of the ground operation. On 25 July, the Israeli military, as cited in the media, stated that its forces retrieved on 24 July the bodies of five Israelis who were killed on 7 October and taken hostage to Gaza. The Israeli military added that the bodies were retrieved from an area of Khan Younis that it previously designated as a “Humanitarian Area.” As of 26 July, it is estimated that 115 Israelis and foreign nationals remain captive in Gaza, including hostages who have been declared dead. 
• Repeated mass casualty incidents have strained hospitals’ capacities to respond to trauma and emergency cases. On 23 July, the Nasser Medical Complex announced that, due to the lack of medicines and supplies, a number of patients who were transported to the facility following the 22 July bombardments in Khan Younis succumbed to their injuries, and many of those who volunteered to donate blood were found to be medically unfit to do so due to wasting and malnutrition. According to MoH, the casualty toll in Khan Younis rose to 73 fatalities and 270 injuries as of 23 July. While the majority of casualties were transported to Nasser, 40 were taken to Al Aqsa Hospital in Deir al Balah, which is now at full capacity, and others to the IMC and UK-Med field hospitals, according to the World Health Organization (WHO).  
• Tens of thousands of people are experiencing new waves of internal displacement across Gaza due to the issuance of evacuation orders by the Israeli military and intensified hostilities. The Site Management Working Group estimates that, between 22 and 25 July, about 182,000 people were displaced from central and eastern Khan Younis to Al Mawasi area, which is labelled as a “humanitarian zone” by the Israeli authorities, and about 12,600 were displaced from Al Bureij Refugee Camp to Al Maghazi and An Nuseirat Refugee Camp, in Deir al Balah. Hundreds of other people remain stranded in eastern Khan Younis amid intense hostilities. They include people with reduced mobility and family members supporting them. Among those stranded are about 300 people identified as sheltering in schools, and UN personnel have engaged with conflict parties to ensure their safety. According to Palestinian Civil Defense (PCD), it has received many distress calls from families stranded in eastern Khan Younis but has been unable to reach them due the denial of access by the Israeli military. Among the thousands of IDPs who were able to move, hundreds were observed carrying only minimal belongings and arriving at the already overcrowded Al Mawasi area, with many having to spend nights in the streets exhausted and in need of tarpaulins for shelter, hot meals, drinking water, diapers, mobile latrines and dignity kits. 
• Displacement from northern Gaza to the south has witnessed a notable decrease in recent days, with only about a dozen people who have arrived at reception points established by aid actors on Salah ad Din Road on 24 and 25 July. This has coincided with media reports citing the PCD spokesperson advising people to avoid movement via Salah ad Din checkpoint following the reported shooting of a Palestinian man while moving southwards on 25 July. Furthermore, PCD highlighted that it received tens of calls indicating that many people went missing while moving from northern Gaza to the south and their whereabouts remain unknown. 
• Recent evacuation orders by the Israeli military and intensified hostilities have also significantly destabilized aid operations and further diminished the ability of humanitarian organizations to provide relief to people in need in Khan Younis governorate. For example, this week, six education partners have suspended activities, affecting 1,500 children in ten Temporary Learning Spaces and about 20,000 children who were benefiting from mental health and recreational activities. Ten Palestinian Authority schools that were serving as IDP shelters have become non-functional, affecting 8,232 people. Food security has similarly been compromised, with twelve food distribution points and eight cooked meal provision points suspending their operations, and nutrition programmes at two shelters supporting over 2,800 children and pregnant women have been disrupted. In addition, protection services, including child protection and Gender-Based Violence response, have been halted, leaving thousands of women and girls at risk. Ten critical water and sanitation facilities, including water desalination plants, water reservoirs and sewage pumping stations, have also ceased operations, exacerbating public health risks due to overcrowding and inadequate sanitation. Furthermore, on 24 July, PRCS stated that seven out of 27 shelters the Society is running across Gaza have become out of service as a result of repeated evacuation orders and displacement sites coming under attack. 
• Efforts by WHO and partners are ongoing to restore emergency care at Al Shifa Hospital in Gaza city. On 22 July, an assessment mission to the facility, which was destroyed in March 2024, was conducted to identify the next steps. The plan is to rehabilitate the emergency department and resume at least key services, such as triage of trauma patients and emergency treatment of both communicable and non-communicable diseases, explained the WHO Team Lead for Emergency Programmes in the Occupied Palestinian Territory (OPT), Dr. Ayadil Saparbekov, during a press briefing on 23 July. Presently, only one stationary X-ray machine remains functional at the hospital, while all other equipment, such as ventilation and anesthesia machines, have been destroyed. Inter-agency work has begun to rehabilitate the structure, ahead of bringing new equipment and restoring electricity, water and sanitation services. Meanwhile, Al Shifa’s hemodialysis department, that was already rehabilitated in late May, continues to operate, with 22 dialysis machines supporting 60 patients from Gaza city and North Gaza. WHO reports, however, that more nurses, devices, medications and consumables, as well as the restoration of water treatment, are needed to expand vital services at the dialysis hub that prior to the war supported over 450 kidney patients. While the WHO-led team was able to visit Al Shifa, similar planned assessments to Al Helou and Patients Friends Association hospitals, which were affected by evacuation orders in Gaza city, had to be cancelled due to delays at checkpoints. 
• A highly insecure operating environment, combined with the designation of only one access point (Kerem Shalom Crossing) for the movement of humanitarian staff, has limited the number of aid workers who are able to rotate in and out of Gaza and hampered efforts to deploy additional Emergency Medical Teams (EMTs) who are critically needed to support the exhausted local health force. Overall, none of Gaza’s 36 hospitals is fully functional. Sixteen of them remain partially functional, but some of them provide only minimal health-care services and 12 are only partially accessible due to insecurity or infrastructural and road damages. Severe shortages of medical supplies, hospital beds and fuel to operate generators continue to pose daily challenges for Gaza’s crippled health-care system, with UNRWA reporting that up to 60 per cent of medicines are either fully depleted or available in very low quantities due to constraints on bringing new stocks into Gaza and dispatching them to health facilities. On 24 July, WHO and its partners were able to deliver 48,000 litres of fuel to the Kamal Adwan and Indonesian hospitals in North Gaza. 
• Aid workers are struggling to respond within a continuously shrinking humanitarian space and a highly insecure operating environment. On 25 July, the Palestine Red Crescent Society (PRCS) reported that Israeli forces shot at their ambulance with live bullets while the crew was evacuating an injured person in Khan Younis. On 23 July, one clearly marked UNICEF vehicle was struck by three bullets while waiting at a designated holding point near the Wadi Gaza checkpoint. It was one of two vehicles en route to pick up five children, including a baby, to reunite them with their father after their mother was killed. Despite the high risk faced, no one was injured, and the mission proceeded, with the UNICEF team able to reunite the family. In a statement issued on 24 July, the UNICEF Executive Director Catherine Russell underscored that, while humanitarian agencies are doing everything possible to respond to the “beyond catastrophic” humanitarian situation on the ground, operating conditions and attacks against humanitarian personnel continue to obstruct these efforts. “Simply put - we do not have the necessary conditions in the Gaza Strip for a robust humanitarian response,” stressed Russell, calling for an “immediate improved security environment,” unimpeded flow of aid, and regular and safe access for humanitarian actors.   
• Access restrictions, hostilities, insecurity, lawlessness and infrastructural damage continue to impede the entry and distribution of humanitarian aid supplies. Between 1 and 24 July, 1,797 truckloads of primarily food aid entered Gaza, an average of 75 truckloads per day (excluding fuel). Since the Rafah military operation began in early May, the volume of humanitarian aid cargo entering Gaza has significantly decreased from a daily average of 169 aid trucks in April to 94 in May, 77 in June, and 75 so far in July—a decrease of 56 per cent since April. These numbers represent humanitarian cargo that was picked up from any of the entry points into Gaza. Within Gaza, access of humanitarian agencies to the north continues to be especially constrained. Between 1 and 24 July, out of 106 planned humanitarian missions to northern Gaza coordinated with the Israeli authorities, ten (nine per cent) were cancelled by humanitarian organizations due to logistical, operational or security reasons. Of the remaining 96 missions, less than half were facilitated by the Israeli authorities (43 missions), 30 missions were impeded (resulting in them being aborted or only partially accomplished) after the facilitation requests were initially accepted, and 23 missions were denied access to begin with. In central and southern Gaza, out of 307 coordinated humanitarian movements, 29 were cancelled by humanitarian organizations, and of the remaining 278 missions, 212 missions were facilitated by the Israeli authorities, 35 missions were impeded, and 31 missions were denied access.  
• Some Palestinian farmers in Gaza continue to farm despite “unimaginable challenges,” reported Action Against Hunger (AAH) on 25 July, including “the gradual depletion of essential supplies, such as nylon sheeting used for greenhouses, which is now being used to make tents.” Agricultural production, which amounted to 11 per cent of Gross Domestic Product in the Gaza Strip in 2022, has largely ceased due to more than nine months of hostilities, large-scale displacement, widespread destruction of croplands, and the lack of agricultural tools and inputs. While recognizing that the process of restoring agricultural production “will be long and complex,” AAH has prioritized several key areas to support the resumption of farming activities in Gaza. This has encompassed the provision of “emergency supplies such as seeds, fertilizers and agricultural tools” to help farmers grow staple crops of the Palestinian diet, such as tomatoes, cucumbers, onions, and eggplants. AAH has also supported the repair of damaged “greenhouses, irrigation systems and water resources,” implemented training programmes “on safe agricultural practices in the midst of conflict-induced contamination,” and promoted “renewable energy installations, water conservation, and smart agricultural technologies” to help build a resilient agricultural sector capable of functioning during the current crisis. 
• On 24 July, 16 critical patients, 15 children and one adult, alongside their 25 companions, who had been evacuated from Gaza to Egypt via the Rafah border crossing prior to its abrupt closure on 7 May, were transferred to Spain to receive specialized medical care as part of an operation jointly coordinated by WHO, the European Commission, Spain, Egypt and the Palestine Children’s Relief Fund. Most children endured severe injuries, while two suffer from chronic heart disease and one from cancer. Meanwhile, over 12,000 critical patients remain unable to exit the Strip to access the urgent health-care treatment they need. Overall, only 4,913 critical patients – 35 per cent of all those for whom medical evacuation was requested – were able to leave the Strip since October 2023, with the vast majority receiving care in Egypt, Qatar and the United Arab Emirates.  
• WHO assesses that there is a high risk of poliovirus type 2 spreading across Gaza, and potentially also beyond. This is due to the dire water, hygiene and sanitation conditions and the limited functionality of health facilities, particularly primary health-care centres (PHCs), which prior to the war played a key role in providing child immunization and other maternal and child health services, with only 45 per cent of all PHCs now operational. Briefing the press in Geneva, Dr. Saparbekov informed that WHO and its partners across the Global Polio Eradication Initiative (GPEI) are now conducting an epidemiological investigation and a risk assessment, and based on the results, will consolidate a set of recommendations on how best to respond to the outbreak, including in relation to vaccination campaigns.  

Funding

• As of 26 July, Member States have disbursed about $1.52 billion out of $3.42 billion (44 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 this updated number is now used 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.