Humanitarian Situation Update #235 | 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. The Gaza Humanitarian Response Update is issued every other Tuesday. The next Humanitarian Situation Update will be issued on 7 November.

Key Highlights

• For almost a month, all attempts by humanitarian organizations to deliver food to people in the besieged areas of North Gaza governorate have been blocked by the Israeli authorities.
• In central and southern Gaza, more than 100 kitchens producing 400,000 meals a day are at risk of shutting down due to supply shortages.
• Health-care conditions in North Gaza remain critical with the Kamal Adwan Hospital hit twice in the past week and the delivery of life-saving supplies to the Al Awda Hospital denied.
• Over 42 million tons of rubble and a large concentration of explosive hazards pose an imminent threat to civilians, while the entry of specialized personnel and equipment and the conduct of explosive ordnance disposal activities are restricted.
• Ten per cent of all journalists working in Gaza have been killed since October 2023, reports the Palestinian Journalists Syndicate, as the Israeli authorities still ban the entry of foreign journalists.

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. In the North Gaza governorate, the Israeli military has been carrying out a ground offensive since 6 October, with fighting reported between Israeli forces and Palestinian armed groups. A tightened Israeli siege imposed since then, particularly around the area of Jabalya refugee camp, has meant that almost no humanitarian aid has been able to enter. At the same time, the area has seen severe disruptions in communications, including internet. As of 4 November, the UN and its partners estimated that about 100,000 people had been displaced over four weeks from North Gaza governorate to Gaza city and between 75,000 and 95,000 people were estimated to remain in North Gaza. The death toll in the North Gaza governorate over the past month is thought to be in the hundreds, possibly over 1,000, with one source – the Palestinian Civil Defense (PCD) – estimating it has reached 1,300. Moreover, since 31 October, dozens of Palestinians were observed evacuating from northern An Nuseirat, in Deir al Balah, southward amid intensified hostilities, including airstrikes and shelling, that reportedly resulted in several mass casualty incidents (see below).
• Between the afternoons of 29 October and 5 November, according to the Ministry of Health (MoH) in Gaza, 330 Palestinians were killed and 1,124 were injured. Between 7 October 2023 and 5 November 2024*, at least 43,391 Palestinians were killed and 102,347 were injured, according to MoH in Gaza.
• Between the afternoons of 29 October and 5 November, three Israeli soldiers were reportedly killed in Gaza, according to the Israeli military. Between 7 October 2023 and 5 November 2024, according to the Israeli military and official Israeli sources cited in the media, more than 1,568 Israelis and foreign nationals were killed, the majority on 7 October 2023 and its immediate aftermath. The figure includes 368 soldiers killed in Gaza or along the border in Israel since the beginning of the ground operation. In addition, 2,394 Israeli soldiers were reported injured since the beginning of the ground operation.
• The following are key deadly incidents reported between 28 October and 3 November, primarily in North Gaza governorate and An Nuseirat refugee camp in Deir al Balah governorate:
  • On 28 October, at about 15:00, a residential block was hit near Al Fakhoura School, in Beit Lahiya Project, resulting in an unconfirmed large number of Palestinian fatalities and injuries who were either trapped under the rubble or remained on the streets.
  • On 29 October, at about 1:00, seven Palestinians were reportedly killed and others injured when a house was hit in Beit Lahiya Project, in North Gaza.
  • On 29 October, at about 18:00, 16 Palestinians, including women and children, were reportedly killed and dozens injured when a house, reportedly sheltering internally displaced persons (IDPs), was hit in Beit Lahiya.
  • On 30 October, at about 13:30, nine Palestinians, including children, were reportedly killed and others injured when As Souk (market) Street was hit in Beit Lahiya Project, in North Gaza.
  • On 31 October and 1 November, two residential buildings sheltering IDPs were reportedly hit, one in Jabalya camp and the other in Tal Az Za’tar area. Many dozens were reportedly killed, including children.
  • On 31 October, at least 26 Palestinians, including four children and four women, were reportedly killed when two houses were hit in the New Camp north of An Nuseirat. The second house was hit when medical and PCD crews were reportedly gathered around the first house, resulting in the injury of at least 30 people, including a medic and two journalists.
  • On 1 November, at about 12:50, 12 Palestinians were reportedly killed and dozens of others injured when the entrance of a school hosting IDPs was hit in An Nuseirat refugee camp. Caritas Jerusalem reported that two of its team members were injured during intense shelling in An Nuseirat refugee camp on 1 November 2024.
  • On 1 November, at about 17:00, eight Palestinians were reportedly killed when a residential building was hit in An Nuseirat refugee camp.
  • On 2 November, at about 10:00, 10 Palestinians were reportedly killed and others, including women and children, were injured when Al Berka area was hit in Beit Lahiya.
  • On 2 November, around midnight, 12 Palestinian men, including a journalist, were reportedly killed when a four-storey residential building, reportedly sheltering IDPs from the north, was hit in camp 5 in An Nuseirat refugee camp. According to the Director of Al Awda Hospital in An Nuseirat, 42 fatalities and 150 injured patients were received as of the afternoon on 2 November.
• Referencing some of these incidents, in addition to two incidents in which a UNICEF staff member’s vehicle came under fire in North Gaza and several children were injured near a polio vaccination clinic in Gaza governorate, UNICEF Executive Director, Catherine Russell, stated that these “are yet further examples of the grave consequences of the indiscriminate strikes on civilians in the Gaza strip.” Save the Children’s Regional Director additionally warned that if “the international community does not intervene soon, an entire generation of children in Gaza will be erased, along with their futures.”
• Describing the situation in North Gaza as “apocalyptic,” the principals of 15 UN and humanitarian organizations and consortia who are part of the Inter-Agency Standing Committee (IASC), the longest-standing and highest-level humanitarian coordination forum of the United Nations system, renewed their appeal to all parties fighting in Gaza to protect civilians, called on the State of Israel to “cease its assault on Gaza and on the humanitarians trying to help,” and appealed to Member States to exercise their leverage to ensure respect for international law. Noting that basic aid and life-saving supplies have been denied while bombardment and other attacks continue, the principals stressed that “blatant disregard for basic humanity and for the laws of war must stop”, attacks against civilians and remaining civilian infrastructure must cease, humanitarian relief must be facilitated, and commercial goods must be allowed to enter Gaza.
• The health situation remains critical at the Kamal Adwan, Al Awda and Indonesian hospitals in the North Gaza governorate. Kamal Adwan “has been reduced from a hospital helping hundreds of patients with dozens of health workers, to a shell of itself,” reported the WHO Director-General, Tedros Adhanom Ghebreyesus, on 1 November. The third floor of the hospital was directly hit twice on 31 October and 3 November. The first attack ignited a fire that affected the medicine warehouse, destroying some of the supplies that WHO had delivered, and damaged the desalination station for the haemodialysis department. The hospital’s director reported that four medical staff were injured while trying to manually extinguish the fire due to the lack of resources. The second reported attack on 3 November injured six children hospitalized in the facility, one of them critically, and damaged water tanks. It took place shortly after a WHO-led mission, conducted jointly with OCHA, UNMAS and OHCHR amid heavy bombardment, managed to deliver 20,000 litres of fuel, as well as medical and surgical supplies, 150 blood units and 60 boxes of dry food and water to Kamal Adwan, and transferred 25 patients, alongside 37 companions, to Al Shifa Hospital in Gaza city. In reference to the second incident, the WHO chief stated that it is “appalling that hospitals in Gaza continue to be attacked, patients continue to be harmed, and health workers and humanitarians continue to work under life-threatening conditions.” Earlier, on 31 October, Médecins Sans Frontières (MSF) received confirmation that an MSF orthopaedic surgeon, who had been sheltering and supporting the health emergency response at Kamal Adwan Hospital, was detained by Israeli forces, along with several other medical staff, during the raid on Kamal Adwan on 26 October. In an audio message on 4 November, the hospital’s director reiterated the urgent need for ambulances and specialized surgical teams to be deployed, stressing that patients continued to arrive at Kamal Adwan’s reception and emergency department, while those unable to access it were “left to their fate” in the streets and many remained trapped under rubble with no possibility to save them.
• Meanwhile, Al Awda Hospital is almost at the point of being forced to cease operations. Although the WHO-led mission of 3 November was able to reach Al Awda and transfer five critical patients and their five companions to Al Shifa Hospital, no permission was granted by the Israeli authorities to deliver life-saving supplies to the facility. In a press statement, the Director-General of Al Awda Health and Community Association warned that fuel, medicines, medical consumables, blood units, food and water were desperately needed, adding that since the intensification of military operations in North Gaza, six hospital employees had been injured in attacks impacting the facility, one of whom lost a limb, and all ambulances had been rendered out of service. For its part, the Indonesian Hospital, which was previously out of service, reportedly resumed partial functionality and received patients on 29 October, although no information is available to the Health Cluster regarding conditions in the facility and no fuel, nor other essential medical supplies, could be delivered to it.
• On 5 November, the Humanitarian Coordinator (HC) for the Occupied Palestinian Territory (OPT), Muhannad Hadi, began a two-day visit to the Gaza Strip. In Gaza city, he visited an UNRWA school that is sheltering hundreds of families, most of whom are among those newly displaced from the North Gaza governorate. Mr. Hadi described conditions at the Al Moumanya School as unbearable; the facility lacks food, water and functioning toilets. Speaking from the school, he said sewage is running everywhere and waste is ubiquitous. “This is not a place for humans to survive. This is beyond imagination,” he said. The HC also visited a waste collection point, where humanitarian partners are working to dispose of trash from communities to prevent health and environmental hazards. He reiterated his call for an end to the conflict and the horror it has caused – and stressed that there is an urgent need for an environment that enables aid operations across Gaza. Mr. Hadi further visited two temporary learning spaces that are supporting students with hearing loss. As the children of Gaza go without schooling for a second straight year, the Al Nayzak and Atfaluna centres are providing educational activities and psychological support to thousands of students traumatized by months of conflict.
• Also in Gaza city, the newly rehabilitated “mini hospital” at Al Shifa, which represents only a part of the larger health-care structure that was destroyed in April, is now a critical referral point for northern Gaza and an “example of resilience,” stressed the WHO Representative in OPT, Dr. Richard Peeperkorn. The facility comprises an emergency ward, operating theaters and an Intensive Care Unit, with an average of nine surgical operations conducted every day. A hemodialysis unit with 25 machines also provides life-saving support to 63 kidney patients. Efforts continue to scale up capacities, with new Emergency Medical Teams deployed both to Al Shifa and the nearby Al Ahli Hospital on 3 November to support the local health workforce. In another positive news, Al Rantisi Paediatric Hospital in Gaza city is expected to resume functionality next week, after being hit and forced to close in November 2023, reports the Health Cluster.
• The third phase of the emergency polio vaccination campaign commenced on 2 November in parts of northern Gaza, with a total of 105,261 children under the age of 10 vaccinated as of 4 November, and 83,867 children aged between two and 10 having also received vitamin A supplementation. Overall, 216 vaccination teams were deployed across 106 fixed sites and 209 social mobilizers engaged with communities to raise awareness about the vaccination endeavour. To ensure the greatest possible coverage, four sites continued to administer the vaccine on 5 November. WHO reports that, compared to the first round conducted in September, the area of the agreed humanitarian pause was substantially reduced, being limited to Gaza city, but the Polio Technical Committee decided to pursue the campaign to mitigate the risk of a long delay and seize the opportunity to vaccinate children who were recently displaced from North Gaza to Gaza city. Albeit more confined geographically, the campaign was not without incidents. On 2 November, WHO reported that the Sheikh Radwan primary health-care centre was hit while parents were bringing their children to be vaccinated, resulting in six people, including four children, injured.
• According to FAO’s recent rapid assessments, nearly 15,000 cattle, 95 per cent of the total, have died and almost all calves have been slaughtered, while fewer than 25,000 sheep (about 43 per cent), some 3,000 goats (approximately 37 per cent) and 34,000 birds (1 per cent of poultry sector) remain alive. This dramatic loss is coupled with large-scale damage of agricultural infrastructure and ongoing restrictions that hamper the entry of essential agricultural inputs, fodder and veterinary kits into Gaza. Combined, they represent critical impediments to rehabilitating local food systems, perpetuating people’s reliance on increasingly shrinking humanitarian aid. Not only does the latest FAO/WFP Hunger Hotspots report, issued on 31 October, place the Gaza Strip among the five “highest alert” territories in terms of catastrophic food insecurity conditions, alongside Sudan, South Sudan, Haiti and Mali, but the situation in Gaza is “the most intense”, according to the WFP Chief Economist, Arif Husain, as 91 per cent of the population is facing crisis or worse levels of food insecurity and the economy has shrunk to approximately one sixth in the space of a year, amid widespread loss of life, destruction of infrastructure, displacement and insufficient humanitarian aid.
• As winter approaches, the lack of food and other vital humanitarian supplies entering the Gaza Strip could soon escalate into famine, warns WFP. In October, approximately 1.7 million people, or 80 per cent of the population, did not receive their monthly food rations across Gaza, and the number of cooked meals distributed daily shrunk to 450,000, a 25 per cent decrease compared with late September, reports the Food Security Cluster (FSS). Many kitchens have been forced to close, and for those that remain operational, partners had to adjust the meal content to cope with supply shortages. The dramatic drop in humanitarian aid is exacerbated by a critical shortage of commercial goods, with no more than 100 trucks of commercial supplies having reportedly entered the Strip between 1 and 26 October. For almost a month, all humanitarian partners’ attempts to access and deliver food aid to the population in North Gaza have been denied and the eight kitchens that were operational in the governorate are now either not functional or inaccessible due to ongoing hostilities.
• While the Erez West crossing re-opened on 14 October, WFP reports that delays at holding points and multiple inspections have limited the quantity of aid entering the Strip, and the supplies managing to cross into northern Gaza have only been allowed to reach Gaza city, as opposed to being channelled to the besieged areas of North Gaza governorate. Faced with the impossibility to reach North Gaza, FSS partners have intensified their presence in the Gaza governorate. In total in October, more than 150,000 people in the governorate received at least one food parcel, some received one 25-kilogram bags of wheat flour, and all four UN-supported bakeries delivered bread to some shelters and community kitchens, alongside cooked meals. Meanwhile, conditions in central and southern Gaza are deteriorating, with food parcel distribution being extremely limited in October and more than 100 kitchens, producing approximately 400,000 meals a day, at risk of shutting down due to supply shortages. Moreover, bread production at the subsidized bakeries and through community-led initiatives has been fluctuating since early October. As of 3 November, all eight UN-supported bakeries in Deir al Balah and Khan Younis are operating at only 70 per cent of their capacity and are at risk of shutting down unless additional flour is immediately received.
• Mine Action technical field staff working as part of the Protection Cluster report that, while over 209 Explosive Hazard Assessments (EHAs) have been conducted in Gaza to-date, these are insufficient to allow a comprehensive understanding of the extent of Explosive Ordnance (EO) contamination in the Strip, with access restrictions severely hampering the scaling up of assessments and a comprehensive EO survey not having been possible yet. The information available, however, paint an alarming picture of the EO risk in Gaza: across all five Gaza governorates, Explosive Remnants of War (ERW) contamination is likely to be both on the surface and sub-surface, involving not only land service ammunition (projectiles, mortars, rockets, missiles, grenades and landmines), but also deep-buried bombs, as well as weapons and ammunition caches. The latest UNOSAT satellite imagery-based analysis conducted in early September showed that 66 per cent of all structures in Gaza had either been damaged or destroyed. According to UNDP, more than 42 million tons of rubble are now present in the Strip, with the large concentration of explosive hazards posing an imminent threat to hundreds of thousands of civilians who have been forcibly displaced repeatedly,* surviving amid rubble and sheltering in unsafe locations, including damaged and destroyed buildings. Beyond ERW, the highly carcinogenic asbestos being released into the air due to widespread infrastructural destruction, as well as other contaminants, will continue to affect communities in Gaza long into the future.
• While there is a critical need to immediately scale up the Mine Action response, restrictions imposed by the Israeli authorities on the entry of both specialized personnel and essential Explosive Ordnance Disposal (EOD) equipment, as well as specific regulations preventing the conduct of disposal activities, continue to curtail efforts to protect people from ERW and the safe and sustainable delivery of humanitarian aid. Currently, EOD teams can only mark and report ERW, rather than safely move or dispose of them. Access constraints further hamper mine action activities, with lengthy procedures required to obtain internal movement permission within Gaza, and many movements being either outrightly denied or cancelled at short notice. In September, for instance, 31 requests by UNMAS to conduct EHAs were denied. Mine Action partners also emphasize the need to acquire meaningful data from the Israeli authorities regarding the main types of EO and the areas with the highest likely concentration, which could help prioritize the most hazardous areas for further survey and clearance. All these obstacles are exacerbated by administrative hurdles, such as registration challenges for mine action organizations and the delayed provision of visas, which continue to disrupt the deployment of technical specialists.
• Due to the challenges being currently faced in scaling up clearance operations, Mine Action partners have focused extensively on raising people’s awareness of the EO risk. Between October 2023 and September 2024, partners reached 790,000 people with in-person Explosive Ordnance Risk Education (EORE), including 405 humanitarian aid workers, and over 1.3 million people across the Strip with digital EORE messaging using SMS, radio, and social media, prioritizing displaced communities and children. Over 67,000 information materials were also disseminated at humanitarian distribution points and during in-person EORE sessions. Presently, 19 partners are engaged in mine action-related activities, six of whom with a presence on the ground including a total of 306 mine action staff and volunteers working across EORE, EHAs and the provision of assistance to explosive ordnance victims. An additional 744 UNRWA staff are also supporting mine action by mainstreaming EORE safe messaging through their other humanitarian activities. While thus far, these operations have been taking place throughout the Strip, the intensification of military operations in northern Gaza has forced partners to abruptly halt all activities both in the North Gaza and Gaza governorates.
• Between 1 and 31 October, out of 644 planned aid movements across the Gaza Strip requiring coordination with Israeli authorities, 43 per cent (278) were denied, 37 per cent (241) were facilitated, 15 per cent (99) were impeded, and four per cent (26) were cancelled due to logistical and security challenges. The denied movements include 77 critical movements related to water, sanitation and hygiene (WASH), 42 health-related movements and 27 food-related movements. Access to northern Gaza has been significantly hindered in October; out of 98 coordinated aid movements aimed at providing humanitarian assistance to northern Gaza from the southern part of the Strip via Al Rashid checkpoint, only 11 movements (11 per cent) were facilitated by the Israeli authorities. Overall, out of 183 coordinated movements to and within northern Gaza, 29 per cent (53) were facilitated, while 44 per cent (81) were denied, 21 per cent (39) were impeded and five per cent (10) had to be cancelled. In comparison with September, denials of movements across Gaza have risen by over 100 per cent, increasing from 138 to 278, while facilitation of movements has decreased by 21 per cent, dropping from 305 to 241. Furthermore, denials of movements to northern Gaza via Al Rashid checkpoint have increased by 115 per cent, rising from 26 to 56 denied movements.
• Within this constrained access environment, between 12 October and 3 November, a total of 130 critical patients were transferred from the three hospitals in North Gaza primarily to Al Shifa in Gaza city, and some of them onwards to facilities in southern Gaza to receiver higher levels of care. Of these, 109 patients were medically evacuated in seven WHO-led missions conducted jointly with OCHA and other UN agencies and partners, particularly CADUS and the Palestine Red Crescent Society (PRCS), and 21 others were transferred in a separate mission coordinated by the International Committee of the Red Cross and PRCS on 1 November. The access of these missions to the besieged areas of North Gaza governorate was the exception rather than the rule and it too was subject to impediments.
• On 28 October, the Israeli Knesset adopted two laws that prohibit the Israeli authorities from having any contact with UNRWA and ban the agency from working in areas under Israeli sovereignty, which will enter into effect after three months. If implemented, these measures would likely prevent the delivery of UNRWA operations in the Occupied Palestinian Territory, including East Jerusalem, as mandated by the UN General Assembly, including obtaining visas and work permits for staff, preserving premises, managing supply chains, and delivering health, education, water and sanitation, employment and protection services for 2.5 million registered Palestine Refugees in the OPT. In Gaza, where UNRWA is also the backbone of the humanitarian response, managing the bulk of life-saving health-care services as well as food and shelter assistance, and where nearly 70 per cent of the total population are Palestine Refugees, what is at stake is the paralysis of “the last remaining lifeline” for people, as stressed by UNRWA Commissioner-General Philippe Lazzarini, and the only entity able to re-start education for more than 660,000 children. If implemented, the passed legislation would suffocate efforts to ease human suffering in Gaza and the entire OPT and would be an enormous setback to sustainable peace efforts and undermine the internationally recognized multilateral system.
• The Palestinian Journalists Syndicate reported a staggering toll on journalists in Gaza, with 174 killed—representing 10 per cent of those working in Gaza—101 injured and 30 detained since October 2023. The syndicate also documented that 514 family members of journalists were killed in airstrikes on their homes and areas of displacement, with approximately 115 homes belonging to journalists hit. In his message to the United Nations International Media Seminar on Peace in the Middle East on 1 November, the UN Secretary-General (SG) stated: “Journalists in Gaza have been killed at a level unseen in any conflict in modern times.” Adding that the ban on international journalists’ entry into Gaza is “unacceptable,” the SG stressed that the “voices of journalists must be protected and press freedom must be safeguarded.”

Funding

• As of 5 November, Member States have disbursed about US$2 billion out of the $3.42 billion (61 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.)
• The oPt Humanitarian Fund (oPt HF) is currently managing 90 ongoing projects, totalling $79.6 million. These projects aim to address urgent needs in the Gaza Strip (91 per cent) and the West Bank (nine per cent) and are strategically focused on education, food security, health, protection, emergency shelter and non-food items, WASH, coordination and support services, multi-purpose cash assistance and nutrition. Of these projects, 49 are being implemented by international non-governmental organizations (INGOs), 29 by national NGOs and 12 by UN agencies. Notably, 32 out of the 61 projects conducted by INGOs or the UN are being implemented in collaboration with national NGOs. Moreover, in addition to the four other reserve allocations for 2024, the oPt HF is currently finalizing its critical and time-sensitive First Standard Allocation of $30 million, aligned with the 2024 oPt Flash Appeal, aiming to rapidly scale up relief efforts to meet the immediate needs of affected people in Gaza and the West Bank. The allocation includes 16 fast-tracked projects, prioritizing critical winterization preparedness and addressing urgent shelter, WASH, and other emergency needs of IDPs and other vulnerable groups in Gaza. 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.

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