Humanitarian Situation Update #229 | Gaza Strip

The Humanitarian Situation Update is issued by OCHA Occupied Palestinian Territory twice a week. The Gaza Strip is covered on Tuesdays and the West Bank on Thursdays. As of this week, the Gaza Humanitarian Response Update is issued every other Tuesday. The next Humanitarian Situation Update will be issued on 17 October.

Key Highlights

• The Israeli military has intensified, with few exceptions, a siege on northern Gaza, while areas in central Gaza have seen at least two mass casualty incidents on Sunday and Monday.
• The only three hospitals in North Gaza are operating at minimum capacity and no primary health-care centres remain operational, reports the Health Cluster.
• No food aid entered northern Gaza for 12 days, people have run out of ways to cope, food systems have collapsed, and the risk of famine is real, the World Food Programme warns.
• Preparations by the Water, Sanitation and Hygiene Cluster for the rainy season have been limited due to fuel shortages, access impediments, lack of supplies and resources, and widespread damage.

Humanitarian Developments

• Israeli bombardment from the air, land and sea continues to be reported across the Gaza Strip, resulting in further civilian casualties, displacement, and destruction of civilian infrastructure. On 6 October, the Israeli military announced that a military operation commenced the night before in Jabalya and, since 1 October, has tightened a siege on northern Gaza. Heavy fighting in and around Jabaliya continues to be reported, so is rocket fire by Palestinian armed groups toward Israel.
• “In the past two weeks, over 50,000 people have been displaced from the Jabalya area, which is cut off, while others remain stranded in their homes amid increased bombardment and fighting. A military siege that deprives civilians of essential means of survival is unacceptable,” stressed the Humanitarian Coordinator for the Occupied Palestinian Territory (OPT), Muhannad Hadi, on 13 October. Warning that “civilians must not be forced to choose between displacement and starvation” and must have “a safe place to go, with shelter, food, medicine and water,” Mr. Hadi urged the opening of multiple entry routes for critical supplies and safe humanitarian response efforts to immediately reach people in need as well as emphasized that civilians must be protected and their basic needs met.
• Between the afternoons of 8 and 15 October, according to the Ministry of Health (MoH) in Gaza, 379 Palestinians were killed and 1,423 were injured. Between 7 October 2023 and 15 October 2024, at least 42,344 Palestinians were killed and 99,013 were injured, according to MoH in Gaza.
• On 13 and 14 October, at least two mass casualty incidents took place in Deir al Balah governorate. On 13 October, at about 21:30, 22 Palestinians, including 15 children, were killed and 80 others injured, according to the Government Media Office, when Al Mufti UNRWA school sheltering over 6,200 IDPs was shelled in An Nuseirat refugee camp. According to UNRWA, this school was going to be used as a Polio vaccination site the following day. On 14 October, at about 1:20, an Israeli airstrike hit the courtyard of Al Aqsa hospital, in Deir al Balah, where internally displaced people (IDPs) took shelter. At least four people were burned to death and at least 40 others were injured, including women and children, according to MoH. Médecins sans Frontières (MSF) reported that Al Aqsa hospital treated 40 patients, including 10 children and eight women, many of whom with severe burns, and another 25 patients had to be referred to other health facilities due to the lack of capacity at Al Aqsa, which a few hours earlier had already received dozens of people injured in the strike on Al Mufti school. According to an assessment by UN agencies, out of the hundreds of displaced families sheltering in the courtyard, some 40 families were affected, half of whom lost their shelter and other belongings in the fire. Referring to these incidents, Acting Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, Ms. Joyce Msuya, stated: “There seems to be no end to the horrors that Palestinians in Gaza are forced to endure… There really is no safe place in Gaza for people to go. Fighting is intensifying in the north and essential supplies for survival are running out… These atrocities must end. Civilians and civilian infrastructure must always be protected.”
• The following are some of the other deadly incidents reported between 6 and 14 October:
  • On 6 October, according to MSF, after strikes hit a mosque and a school in Deir al Balah, Al Aqsa hospital received 53 wounded patients and 22 fatalities. Many patients had injuries to the head, thorax and abdomen and several had to be treated on the floor due to the shortage of beds.
  • On 7 October, at about 15:00, 13 Palestinians were reportedly killed and others injured when a group of people was hit near Abu Qamar petrol station, in Jabalya refugee camp, in North Gaza.
  • On 7 October, at about 22:10, 19 Palestinians, including nine women and an unknown number of children, were reportedly killed when a house was hit in Block 10 in Al Bureij refugee camp, in Deir al Balah.
  • On 7 October, at about 14:50, 10 Palestinians, including four women and three children, were reportedly killed when a house was hit in Al Atatrah neighbourhood in An Naser area in northeastern Rafah.
  • On 9 October, at about 1:40, nine Palestinians were reportedly killed and others injured when a house was hit in Ash Shujai’yeh neighbourhood in eastern Gaza city.
  • On 9 October, according to the UN Human Rights Office (OHCHR), a strike on Al Yaman As Saeed Hospital, where IDPs were sheltering, reportedly killed 17 people.
  • On 10 October, around noon, eight Palestinians were reportedly killed and others injured when people attempting to evacuate from Jabalya refugee camp through Abu Sharakh roundabout were shot at from the air.
  • On 10 October, at about 11:20, 28 Palestinians, including women and children, were reportedly killed and more than 54 were injured, including five severely injured children, when Rufaydah school sheltering IDPs was hit west of Deir Al Balah.
  • On 11 October, at about 21:00, 22 Palestinians, including women and children, were reportedly killed and 90 others injured when several houses in a residential block were hit in Jabalya Al Balad, in North Gaza.
  • On 12 October, at about 16:00, nine Palestinians were reportedly killed and others injured when a house was hit in Al Yafawi Street, in Jabalya refugee camp, in North Gaza.
  • On 12 October, at about 22:30, eight Palestinians were reportedly killed and others injured when a house was hit in An Nuseirat refugee camp, in Deir al Balah.
  • On 13 October, at about 16:30, five Palestinian children were reportedly killed and others injured when a group of Palestinian children was hit while playing in front of a kindergarten in As Shati’ (Beach) camp, west of Gaza city.
  • On 14 October, at about 10:00, ten Palestinians were reportedly killed and around 40 others were injured when a group of people was hit outside the UNRWA distribution centre in Jabalya refugee camp. According to UNRWA, this happened while people were trying to collect food and flour from the centre.
• Between the afternoons of 8 and 15 October, five Israeli soldiers were reportedly killed in Gaza, according to the Israeli military. Between 7 October 2023 and 15 October 2024, according to the Israeli military and official Israeli sources cited in the media, more than 1,553 Israelis and foreign nationals were killed, the majority on 7 October 2023 and its immediate aftermath. The figure includes 353 soldiers killed in Gaza or along the border in Israel since the beginning of the ground operation. In addition, 2,345 Israeli soldiers were reported injured since the beginning of the ground operation.
• During the first half October, two journalists were killed and three others were injured in Gaza, according to Committee to Protect Journalists (CPJ). On 6 October, a Palestinian journalist and freelance photographer was killed by a missile fired from an Israeli drone, and on 9 October another journalist was killed and one injured when an Israeli drone fired close to a TV crew covering Israeli forces operations in Jabalya refugee camp in North Gaza, CPJ reported. According to the Palestinian Journalists Syndicate (PJS), between 7 October 2023 and 10 October 2024, 168 Palestinian journalists and media workers were killed in the Gaza Strip, including 17 women, 360 were injured, and 60 were detained.
• Evacuation orders continue to severely affect hundreds of thousands of people across Gaza, trigger recurrent waves of displacement, and restrict access to essential services. Since 7 October 2023, the Israeli military has issued over 65 evacuation orders, including five since 1 October 2024. As a result, about 84 per cent of the Gaza Strip are currently under evacuation orders, excluding those that had been revoked. This month’s orders cover about 70 square kilometres, or 19 per cent of the Strip, and include areas that were previously ordered to evacuate. According to initial estimates by the UN and its partners, at least 75,000 people have been displaced over the past 10 days, mostly within the north; about 100 people have crossed from northern Gaza southward via Salah Ad Din or Al Rashid roads; and the orders issued this month applied to tens of critical service facilities, including 16 health facilities, tens of water, sanitation and hygiene (WASH) facilities, 28 schools sheltering IDPs, and one bakery.
• All three hospitals in the North Gaza governorate – Kamal Adwan, Al Awda and the Indonesian Hospital – are operating at minimum capacity amid dire shortages of fuel, blood units, trauma disposables, medications for patients with non-communicable diseases, and the ongoing military activities nearby, reports the Health Cluster. In total, 285 patients remain in these facilities, including eight children and five adults receiving mechanical ventilation in Intensive Care Units and 161 patients in emergency departments. Many patients urgently need advanced procedures, such as neurosurgery and vascular surgery, which cannot be conducted under current conditions. Following three consecutive failed attempts to reach these hospitals on 8, 9 and 10 October, which were impeded by long delays at Israeli military checkpoints and intense fighting in the area of Jabalya, on 12 October, two missions led by the World Health Organization (WHO), together with OCHA, UNMAS and other partners, finally managed to transfer 19 critical patients from Kamal Adwan to Al Shifa Hospital in Gaza city and to deliver 15,000 litres of fuel to Kamal Adwan and 5,000 to Al Awda.
• While the recent evacuation of patients from Kamal Adwan hospital aimed at alleviating the pressure on the hospital’s limited resources, the facility remains overwhelmed, receiving at least 50-70 newly injured patients daily, reports WHO. While emergency obstetric care continues to be provided at Kamal Adwan and Al Awda, “the lives of newborns in incubators and women with pregnancy complications are hanging by a thread,” highlights the UN Population Fund (UNFPA), stressing that over 9,000 pregnant women have been forced to move yet again due to the latest evacuation orders. Meanwhile, none of the 25 primary health-care centres (PHCs) in the North Gaza governorate are functional, and only five out of 15 medical points that had been operational in recent months continue to provide basic services, according to the Health Cluster.
• In Gaza governorate, the situation is also deeply concerning. On 12 October, WHO managed to deliver 800 blood units, essential medicines and supplies, and 23,000 litres of fuel to Al Sahaba Hospital after several failed attempts. While currently seven hospitals, 10 PHCs and 23 medical points remain operational in the governorate, they are all near closure due to severe fuel shortages, warns the Health Cluster. Stressing that “one-off missions are not enough,” as there is a continuous need to resupply health facilities to keep them functional, the WHO Director-General, Tedros Adhanom Ghebreyesus, reiterated on 14 October his plea for the “sustained facilitation of humanitarian missions.”
• On 14 October, the second round of the emergency polio vaccination campaign was kickstarted in central Gaza and is expected to move to the south on 19 October and then to the north of the Strip. As with the first round, which was implemented between 1 and 12 September, this second round is taking place in three phases, each lasting up to four days in each area. On the first day, 92,821 children received the vaccine and 76,394 received vitamin A supplements, based on initial reports from WHO. The target is to administer a second dose of the Novel Oral Polio Vaccine Type 2 (nOPV2) to an estimated 591,700 children under 10 years of age, in addition to administering Vitamin A supplements to boost the overall immunity of children aged between two and nine years. WHO and the UN Children’s Fund (UNICEF) have been appealing to all parties to the conflict to implement the necessary humanitarian pauses to ensure the safety of children and their families, vaccination teams and health facilities. This is particularly critical in the north, where evacuation orders “are threatening access to hospitals and protection of health facilities and health and community workers,” stressed the two UN agencies.
• As of 12 October, no humanitarian food assistance has entered northern Gaza since 2 October as all crossings have been closed, and entire kitchens, bakeries and food distribution points in the North Gaza governorate have been forced to shut down due to airstrikes, military ground operations and evacuation orders, warned the World Food Programme (WFP) and the Food Security Cluster (FSS). The escalating violence and the severing of all critical food aid lifelines is having a disastrous impact on food security in the northern part of the Strip, where at least three quarters of the population have been relying on food aid to survive. Essential goods are also largely unavailable on the market and the prices of what remains available are exorbitantly high. Left with no other coping mechanisms, families have resorted to selling their remaining belongings and searching through the rubble for money or food, highlights FSS.
• FSS partners have been endeavouring, while often risking their lives, to alleviate suffering by distributing all aid supplies that are available. Between 11 and 13 October, partners distributed more than 1,500 food parcels and 1,500 bags of wheat flour to IDPs trapped or sheltering in and near schools in Beit Hanoun and Beit Lahya, in North Gaza. In Gaza city, 10 kitchens are distributing over 110,000 meals daily, including a new kitchen set up on 9 October in Ash Shati’ (Beach) refugee camp to support the influx of IDPs from North Gaza. On 10 October, WFP crossed from southern to northern Gaza to deliver fuel to the four remaining bakeries in the Gaza governorate, which has allowed for the free distribution of bread alongside cooked meals at most kitchens as well as in some shelters. There are now barely any food parcels left to distribute, and bakeries will be forced to shut down again within the span of a few days if no additional fuel is delivered, reports FSS.
• The rapid deterioration in food security conditions in the north comes as overall food aid entering Gaza is at its lowest level in months, and commercial goods are barely trickling in. In central and southern Gaza, the situation is also at a breaking point due to insecurity, looting, access impediments, and supply shortages. On 13 October, five bakeries in Deir al Balah and Khan Younis were forced to close due to the shortage of flour. Already in September, about 1.4 million people – nearly 70 per cent of the total population – did not receive their monthly food rations, which comprised pasta, rice, oil and canned meat, and represented a lifeline for hundreds of thousands of families. If the flow of assistance does not immediately resume, almost two million people will lose this vital life-saving aid in October. While access to basic food commodities had somewhat stabilized in the Strip in June and July, all progress has now been reversed, according to WFP, and “people have run out of ways to cope, food systems have collapsed, and the risk of famine is real.”
• According to the WASH Cluster, coordination for the winterization strategy, which involves preparations for the rainy season, is ongoing despite significant operational challenges. Inter-cluster assessments have been completed in key flood-prone areas, such as Amal Basin, Al Amal Overflow, Al Berka, Sheikh Radwan and Abu Rasheed, in collaboration with the Coastal Municipal Water Utility (CMWU), Palestinian Water Authority (PWA), Oxfam, and UNICEF. Planned activities include: the removal of accumulated soil and stones; solid waste management initiatives, such as the removal of waste from streams; procurement of flood mitigation equipment, including vacuum trucks, generators and desludging pumps; and maintenance work to enhance the sewage network through desludging, removing sewage overflows, and inspecting and maintaining deep manholes, stormwater drainage systems and road gullies to prevent blockages. However, progress to implement these activities has been limited, with only a few completed in specific locations (e.g. Wadi As Salqa in Deir Al Balah; Sheikh Radwan in Gaza city) due to ongoing fuel shortages, the year-long power cut from both Israel and Gaza’s sole power plant, access impediments, lack of essential supplies and resources, and widespread damage of WASH facilities. PWA reports that up to 85 per cent of water and sanitation facilities are currently out of service, which has resulted in a drastic reduction in water supply, the discharge of untreated wastewater into the sea, and sewage leakage into populated areas.
• Between 1 and 14 October, out of 285 humanitarian movements coordinated with the Israeli authorities throughout Gaza, 49 per cent (141) were denied access, 30 per cent (85) were facilitated, 17 per cent (49) faced impediments (thus often implemented partially or aborted), and four per cent (10) were cancelled due to logistical and security issues. These include 54 coordinated movements to the north through Al Rashid checkpoint, of which only one was facilitated, 85 per cent (46) were denied, nine per cent (five) impeded and four per cent (two) were cancelled. In comparison, during September, of the 667 planned humanitarian movements within Gaza that required coordination with Israeli authorities, 46 per cent (305) were facilitated, 21 per cent (138) were denied, 27 per cent (179) were impeded, and seven per cent (45) were cancelled. These include 91 planned humanitarian movements between northern and southern Gaza through Israeli military-controlled checkpoints that were coordinated with the Israeli authorities in September, of which 82 per cent (75 movements) were either impeded or denied.
• Humanitarian partners in Gaza have conducted a revision exercise of the Gaza population per governorate, using data from the first round of Polio vaccination campaign conducted in September. As of 1 October, it was assessed that 175,000 people are staying in the North Gaza governorate, 256,000 people in Gaza governorate, 749,000 people in Deir al Balah governorate, 916,000 people in Khan Younis governorate, and 44,000 people in Rafah governorate.

Funding

• As of 15 October, Member States have disbursed about US$1.89 billion out of the $3.42 billion (55 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 September 2024, the occupied Palestinian territory Humanitarian Fund (oPt HF) managed 87 ongoing projects, totalling $77.5 million. These projects aimed to address urgent needs in the Gaza Strip (90 per cent) and the West Bank (10 per cent). They were strategically focused on education, food security, health, protection, emergency shelter and non-food items, water, sanitation, and hygiene (WASH), coordination and support services, multi-purpose cash assistance and nutrition. Of these projects, 48 projects are being implemented by international non-governmental organizations, 27 by national NGOs and 12 by UN agencies. Notably, 31 out of the 60 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.