Humanitarian Situation Update #220 | 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 23 September.

Key Highlights

• Women and girls are disproportionately affected by the deteriorating health crisis in Gaza−over 5,000 female cancer patients are unable to access treatment; twenty-five percent of women reported skin infections, twice as many as men; and they account for most hepatitis A and gastrointestinal diseases. 
• Seventy per cent of medications and 83 per cent of health supplies have been exhausted from stockpiles, according to the Ministry of Health in Gaza (MoH); forcing hospitals and health-care facilities to suspend services such as heart surgeries, cardiac catheterization, and joint replacements. 
• Internally displaced persons (IDPs) are at risk of further displacement as the rainy season approaches, increasing seasonal flooding and high tides. 

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 16 and 18 September, according to the Ministry of Health (MoH) in Gaza, 46 Palestinians were killed and 138 were injured. Between 7 October 2023 and 18 September 2024, at least 41,272 Palestinians were killed and 95,551 were injured, according to MoH in Gaza.  
• The following are some of the deadly incidents reported between 15 and 19 September: 
  • On 15 September, at least five Palestinians, including three women, were reportedly killed and others injured when they were hit on Salah Ad Deen Street in Az Zaytoun, in Gaza city. 
  • On 15 September, six Palestinians, including one woman and two children, were reportedly killed and others injured when a residential building was hit in Az Zaytun area, in Gaza city. 
  • On 16 September, nine Palestinians, including four woman and a girl, were reportedly killed and 15 others injured when a house was hit in An Nuseirat, in Deir al Balah. 
  • On 16 September, six Palestinians, including a girl, a boy, and four men, were reportedly killed and others injured when an IDP tent was hit next to a makeshift bakery in As Sumoud Camp in Al Mawasi area, southwestern Khan Younis. 
  • On 17 September, five Palestinians were reportedly killed when houses were hit in east Al Bureij Camp, in Deir al Balah, according to the Palestinian Civil Defense (PCD). PCD stated that they received distress calls from trapped and injured people, but its crew was forced to withdraw after they were struck, and one crew member was injured. On 18 September, the PCD stated that 12 bodies were retrieved from under the rubble of the houses.  
  • On 18 September, at least seven Palestinians, including three children and a woman, were reportedly killed and others injured when a house was hit in Qizan An Najjar, south of Khan Younis. 
  • On 18 September, eight Palestinians including at least four children, and two women were reportedly killed and others injured when Ibn Haytham School (which was sheltering IDPs), was hit in Ash Shuja’iyeh area, Gaza city. 
  • On 19 September, at least five Palestinians were reportedly killed and others injured when a residential building was hit on Al Jarjeer Street in Jabalya, in Gaza North. 
• Between the afternoons of 16 and 20 September, four Israeli soldiers were reportedly killed in Gaza, according to the Israeli military. Between 7 October 2023 and 20 September 2024, according to the Israeli military and official Israeli sources cited in the media, more than 1,546 Israelis and foreign nationals were killed, the majority on 7 October and its immediate aftermath. The figure includes 346 soldiers killed in Gaza or along the border in Israel since the beginning of the ground operation. In addition, 2,284 Israeli soldiers were reported injured since the beginning of the ground operation. 
• A recent report by the UN Trade and Development (UNCTAD) describes the severe economic devastation in the Occupied Palestinian Territory following the escalation of hostilities in Gaza. The economic impact has been more devastating than in previous escalations (2008, 2012, 2014, and 2021), marked by soaring inflation, rising unemployment in Gaza, and plummeting incomes that have left Palestinians in dire poverty. By early 2024, between 80 to 96 per cent of Gaza’s agricultural assets were destroyed, crippling food production and exacerbating food insecurity. The private sector has also suffered, with 82 per cent of businesses damaged or destroyed. Gaza’s GDP dropped by 81 per cent in the last quarter of 2023, resulting in a 22 per cent annual contraction, and by mid-2024, the economy had shrunk to less than one-sixth of its 2022 size. Two-thirds of pre-October jobs (201,000) were lost by January 2024, further worsening the economic and humanitarian crisis. 
• IDPs are at risk of further displacement as the rainy season approaches, increasing flooding and high tides. Many of those displaced due to hostilities have been forced to shelter along the Mediterranean coast, where Israeli-issued evacuation orders have instructed them to go. Several municipalities across Gaza have warned of such risks. The Khan Younis municipality called on people present within rainwater collection ponds and temporary sewage treatment basins in Al Muhararat area, and all low-lying areas to immediately leave and seek safer places due to the danger of overflows. The municipality has stated that the ongoing escalation caused massive damage to infrastructure where 70 per cent of the transmission lines and rainwater drainage networks, 80 per cent of the sewage transmission lines, pumps and stations, and 1,800, out of 2,200, rainwater filters are destroyed. The emergency committee of Deir al Balah municipality has warned residents living near Wadi as Salqa and Sahn al Baraka areas to evacuate before it starts raining, as flooding in these areas will be a threat to people’s lives. According to the municipality of Gaza, Sheikh Radwan Pond, designed for rainwater collection, is now accumulating over 450,000 cubic metres of wastewater, which threatens to overflow once it rains. The municipality is unable to drain water due to the damage sustained by the pond's drainage line and its facilities. Furthermore, the Khan Younis and Deir al Balah municipalities warned displaced people to move to higher ground and stay away from the shore, as high tides may lead to the drifting of their tents and other risks. Humanitarian actors on the ground have amplified these warnings by sending out mass text messages to people in the area. 
• According to the Water, Sanitation and Hygiene (WASH) Cluster, from 1 to 14 September, 302,533 litres of fuel—just 31 per cent of the amount needed to operate numerous critical WASH facilities—were allowed in by Israeli authorities and delivered by the United Nations. Some 218,533 litres were distributed to southern Gaza, while the remaining 84,000 litres were distributed in the north. Fuel access in the north continues to be a critical challenge, as deliveries are frequently delayed or rejected by Israeli authorities at checkpoints. As a result, WASH operations have been forced to drastically reduce their operating hours to prevent complete shutdowns. Despite these persistent obstacles, on 16 September, the Palestinian Water Authority (PWA) successfully delivered and distributed 37,000 liters of fuel to sustain operations at 41 water facilities, including 37 wells and 4 sewage pumping stations, north of Wadi Gaza. This marked the first fuel supply delivery by PWA since 13 August.  
• Meanwhile, water production remains at just one quarter of the levels recorded before October 2023, according to WASH partners. The distribution of this limited water faces persistent challenges, such as widespread leaks, severe network damage, and spillage during trucking operations. The WASH Cluster estimates that about 70 per cent of water supplied through water networks is leaked due to damages sustained during fighting, with repairs being impeded by a combination of insecurity, lack of access and Israeli rejection of imports of spare parts. The Cluster has highlighted that restrictions on importing these essential components have left vital WASH machinery inoperable, which is destabilizing operations, particularly for severely damaged sanitation facilities. Currently, four key basins are receiving sewage, and any overflow could pose serious public health risks. In a positive development, on 18 September, the Coastal Municipalities Water Utility (CMWU) reported the successful restoration of the Al Wakala well in Al Maghazi Refugee Camp in Deir Al Balah, which had been destroyed. With support from the International Committee of the Red Cross, CMWU repaired the well's pumping system, electric motor, and manifold, effectively reconnecting it to the water distribution network. These efforts are part of broader emergency maintenance initiatives across Gaza’s municipalities, despite ongoing shortages of essential repair materials, CMWU said. 
• “More than 5,000 female cancer patients need immediate treatment, but all services have been suspended,” stressed UN Women in its latest Gender Alert based on research, including a survey conducted across Gaza. The sole cancer facility present in the Strip is no longer functional and radiotherapy and systemic therapy are lacking. Women and girls are also being disproportionately affected by infectious diseases. Twenty-five per cent of women surveyed reported skin infections, twice as many as men (12.5 per cent), and female respondents accounted for more than two thirds of hepatitis A and gastrointestinal diseases; this is likely due to women’s prevalent role in caring for sick family members. Women also reported higher rates of diabetes compared with men and were twice as likely to have hypertension, with access to medications being increasingly scarce. Meanwhile, an estimated 155,000 pregnant and breastfeeding women across Gaza are facing major obstacles in accessing prenatal and postnatal care, with rising complications during pregnancy, birth and subsequently and a shortage of essential medications for newborns. Among pregnant women interviewed, 92 per cent reported urinary tract infections, 76 per cent anaemia, 28 per cent pre-term labour, 44 per cent hypertensive disorders, 16 per cent haemorrhage and 12 per cent stillbirth. based on research, including a survey conducted across Gaza.  
• On 19 September, the UNICEF Deputy Executive Director Ted Chaiban urged the entry of more “medical supplies and medical consumable like antibiotics for skin diseases, equipment for neonatal units, syringes and bandages for surgery rooms” into Gaza and appealed for the urgent medical evacuation of critically ill and injured children, including many suffering from leukaemia and other types of cancer diseases, “whose lives can be saved only with medical treatment abroad.” The MoH in Gaza reported that 70 per cent of medications and 83 per cent of health supplies have been exhausted from its stockpiles, with this severe deficit forcing hospitals and health-care facilities to suspend services and vital procedures such as heart surgeries, cardiac catheterization, and joint replacements.  

Funding 

• As of 20 September, Member States have disbursed about US$1.63 billion out of the $3.42 billion (48 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.