Humanitarian Situation Update #218 | 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 18 September.

Key Highlights

• According to new data published by the Ministry of Health in Gaza (MoH), of 34,344 fatalities who were killed as of 31 August and whose full information has been identified, over 11,000 were children.
• Humanitarian actors specializing in health, water, sanitation, and hygiene urgently call for increased access to soap, detergents, and other cleaning materials to combat diarrhea and skin infections.
• As of 23 July, about 22,500 people who have been injured – a quarter of the all MoH-reported injuries – are estimated to have life-changing injuries that require rehabilitation, according to the World Health Organization.
• Multiple Israeli-issued evacuation orders in recent months have delayed or interrupted support to people facing gender-based violence (GBV), including medical care to GBV survivors, by forcing the closure or relocation of service delivery points.

Humanitarian Developments

• Israeli bombardment from the air and land continues to be reported across the Gaza Strip, resulting in further civilian casualties, displacement, and destruction of houses and other civilian infrastructure. Ground operations, particularly in Beit Hanoun, southwest Gaza city, eastern Khan Younis and Deir al Balah, and east as well as south Rafah, with heavy fighting, also continue to be reported, alongside Palestinian rocket fire at Israel.
• Between the afternoons of 12 and 16 September, according to the Ministry of Health (MoH) in Gaza, 108 Palestinians were killed and 288 were injured. Between 7 October 2023 and 16 September 2024, at least 41,226 Palestinians were killed and 95,413 were injured, according to MoH in Gaza. The MoH documents the full identification details of casualties and has recently published the breakdown of 34,344 out of 40,738 fatalities as of 31 August for whom full details have been documented by MoH (also available on the Health Cluster’s Unified Dashboard here); according to MoH, these reportedly include 11,355 children, 6,297 women, 2,955 elderly, and 13,737 men. The documentation process is ongoing by the MoH.
• The following are some of the deadly incidents reported between 12 and 14 September:
  • On 12 September, six Palestinians, including four women, a girl, and a boy, were reportedly killed and others injured when a house was hit in northern An Nuseirat, in Deir al Balah.
  • On 12 September, four Palestinian men were reportedly killed and others injured when a house was hit near the European Hospital in eastern Khan Younis.
  • On 13 September, five Palestinians, including two men, one woman and two children were reportedly killed and others injured when a house was hit in Al Mawasi area, in western Rafah.
  • On 14 September, ten Palestinians, including three children and a woman, were reportedly killed and others injured when a house was hit near Ash Shuja’iyeh School in At Tuffah area, northeast of Gaza city.
  • On 14 September, five Palestinians were reportedly killed and others injured when a fuel-filling facility was reportedly hit near Dar al Arkam school in An Nasr area northwest of Gaza city.
• Between the afternoons of 13 and 16 September, no Israeli soldiers were reportedly killed in Gaza, according to the Israeli military. Between 7 October 2023 and 16 September 2024, according to the Israeli military and official Israeli sources cited in the media, more than 1,542 Israelis and foreign nationals were killed, the majority on 7 October and its immediate aftermath. The figure includes 342 soldiers killed in Gaza or along the border in Israel since the beginning of the ground operation. In addition, 2,281 Israeli soldiers were reported injured since the beginning of the ground operation.
• At least 22,500 people, or one-quarter of all MoH-reported injuries in Gaza by 23 July, are estimated to have life-changing injuries that require rehabilitation services “now and for years to come,” highlights the World Health Organization (WHO) in a recent analysis. Severe limb injuries – estimated to be between 13,455 and 17,550 –are the main driver of long-term rehabilitation needs. WHO also assesses that between 3,000 and 4,000 limb amputations have occurred, in addition to about 2,000 spinal cord and severe traumatic brain injuries and at least 2,000 major burns. Amid a decimated health-care system, “acute rehabilitation services are severely disrupted and specialized care for complex injuries is not available, placing patients’ lives at risk,” warned WHO. Gaza’s only limb reconstruction and rehabilitation centre, located in the Nasser Medical Complex in Khan Younis, became non-functional in December 2023, and was damaged in February 2024. Most of the rehabilitation workforce in Gaza has been displaced and 39 physiotherapists have reportedly been killed as of 10 May. No in-patient rehabilitation and prosthetic services are present, and even the most essential assistive devices, like wheelchairs and crutches, are lacking due to the restricted flow of aid. Tens of thousands of Palestinians in the Strip were already living with pre-existing chronic conditions and impairments before the latest escalation, making it even more critical to integrate rehabilitation services in the ongoing response. Beyond the lack of acute trauma care options, stocks of the most essential medical supplies continue to decrease in Gaza due to persistent obstacles hampering the entry of aid. According to the Health Cluster, public health facilities in southern Gaza are reporting an over 70 per cent shortage of critical health items, including consumables, complete blood count kits and laboratory equipment.
• On 14 September, the Israeli military issued an evacuation order affecting three neighbourhoods in central Beit Lahia in northern Gaza. According to the order, it followed rocket launches into Israel from the area, and the orders excluded health facilities in the neighbourhoods. According to the Site Management Working Group, this order affects two IDP collective centres and one makeshift site, hosting a total of 850 people. Initial mapping indicates that before 7 October, over 17,500 people were residing in these areas, with most reportedly forced out by ongoing hostilities and previous evacuation orders, the most recent ones affecting these neighbourhoods issued on 7 and 16 August. The ongoing issuance of mass evacuation orders without ensuring that those displaced have safe and adequate places to stay, is worsening the humanitarian crisis for hundreds of thousands, especially those who are repeatedly forcibly displaced. As of 16 September, more than 55 evacuation orders remain in effect, covering about 86 per cent of Gaza.
• Repeated forced displacement has resulted in the separation of families, eroding social protection systems, specifically for women and children in Gaza. According to UNFPA, this, compounded with the lack of law enforcement, is exposing women and girls to heightened risks of violence, including gender-based violence (GBV). Severe overcrowding in shelters, coupled with abysmal water and sanitation conditions and the scarcity of soap and hygiene products (see below), are also depriving women and girls of their privacy and dignity, while making them more vulnerable to infections and diseases. Despite the high surge in needs, aid workers are facing immense challenges in reaching women and girls. The multiple Israeli-issued evacuation orders in recent months have forced GBV-response service delivery points to close or relocate, while displacing beneficiaries, making them difficult to trace and ultimately delaying or interrupting service provision, including medical care for GBV survivors. The shortage of tents and facilities that may be converted into safe operational spaces is also hampering partners’ efforts to scale up GBV prevention and response services, including case management and specialized mental health and psychosocial support. These obstacles are exacerbated by unstable internet connection and the ongoing electricity outage, transport restrictions and the lack of cash liquidity, which are further constraining efforts to engage with communities, strengthen GBV-response referral pathways and increase protection activities.
• The upcoming rainy season, along with the already-poor shelter conditions in Gaza, requires immediate, intensive interventions. With the magnitude of destruction to urban areas, roads, and critical infrastructure this year, flooding patterns can be expected to be unpredictable and disastrous for those seeking shelter. Most displaced people are sheltering in small, overcrowded makeshift shelters on self-settled sites, typically having deteriorated plastic sheeting for roofing, while the remaining live in tents, many of which are overcrowded. Others are sheltering in damaged or unfinished buildings which are unsafe. The Shelter Cluster has reported that 1.13 million people need sealing-off kits for makeshift shelters or tents and 1.34 million people need bedding kits. Despite the ongoing efforts to bring shelter items into Gaza, there is a gap of 760,000 people who will not receive aid in the south, where the vast majority of IDPs are currently sheltering. With an average of only two truckloads of shelter-related items per week entering south Gaza in August, the Shelter Cluster is estimating that partners would need two years to deliver the equivalent of the most basic winterization support needed now. At least 25,000 sealing-off kits (25 truckloads) need to be delivered per week to south Gaza for people to be supported before more significant rainfall and lower temperatures arrive in November.
• On 13 September, the WASH and Health Clusters published an urgent call on the lack of access to soap, shampoo, and detergent to combat diarrhea and skin infections in Gaza. Ongoing constraints by the Israeli authorities on the entry of essential supplies are particularly harmful for children, pregnant women, and people with compromised immune systems and are increasing stress and anxiety in overcrowded shelters. Currently, shampoo, detergent (including laundry detergent), and dishwashing liquid are largely absent from the market. As a result, community kitchens cannot thoroughly clean pots, shelters are left unclean, and families are struggling to wash their clothes, vegetables, and cooking utensils or shower. Health-care facilities also struggle to find essential cleaning materials to protect patients, staff, and caregivers. The Clusters emphasized that handwashing with soap is crucial for preventing diseases and can reduce diarrheal diseases by up to 40 per cent and respiratory infections by about 20 per cent. However, soap is either unavailable or sold at unaffordable prices.
• Ongoing hostilities, access constraints, and damaged infrastructure, along with the deteriorating security situation, including looting and frequent Israeli-issued evacuation orders, are obstructing the delivery of life-saving aid across the Gaza Strip. Between 1 and 15 September of the 94 planned humanitarian missions coordinated with the Israeli authorities for northern Gaza, only 37 (39 per cent) were facilitated and 25 (27 per cent) were denied access. In southern Gaza, out of 243 coordinated humanitarian movements, 129 (53 per cent) were facilitated, and 41 (17 per cent) were denied access. OCHA has not been able to access northern Gaza for 28 days. Israeli access denials or impediments alongside other obstacles are preventing humanitarian missions to assess needs, to coordinate response, to take supplies and to prepare for the rainy season in the north. Aid convoys are being fired on or otherwise exposed to life-risking conditions, stopped, and delayed for hours in combat zones. The limited access to northern Gaza continues to affect hundreds of thousands of vulnerable people, leaving them in dire conditions with a severe shortage of essential supplies and restricted access to basic services.

Funding

• As of 16 September, Member States have disbursed about US$1.61 billion out of the $3.42 billion (47 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. (*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.)
• During August 2024, the occupied Palestinian territory Humanitarian Fund (oPt HF) managed 93 ongoing projects, totalling $79.7 million. These projects aimed to address urgent needs in the Gaza Strip (89 per cent) and the West Bank (11 per cent). They were strategically focused on education, food security, health, protection, emergency shelter and non-food items, water, sanitation, and hygiene, coordination and support services, multi-purpose cash assistance and nutrition. Of these projects, 52 projects are being implemented by international non-governmental organizations, 29 by national NGOs and 12 by UN agencies. Notably, 32 out of the 64 projects implemented by INGOs or the UN are being implemented in collaboration with national NGOs. Monthly updates, annual reports, and a list of all funded projects per year, are available on the oPt Humanitarian Fund webpage, under the financing section.