Humanitarian Situation Update #237 | 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 14 November.

Key Highlights

• So far in November, every attempt by the UN to access besieged areas of North Gaza governorate with food and health missions to support tens of thousands of people remaining there was either denied or impeded.
• Between 100,000 and 130,000 people have been displaced from North Gaza amid intensification of attacks and Israeli evacuation orders.
• The Famine Review Committee has warned that famine thresholds may have already been crossed in northern Gaza, or else will be in the near future, urging action within days, not weeks.
• Schools, the majority sheltering displaced people, continue to be attacked with a total of 64 attacks against schools recorded in October, according to UNICEF.
• Access to health care across Gaza remains precarious, with partners of the UN Population Fund reporting a recent rise in premature births and maternal deaths.

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. The tightened Israeli siege imposed since then has hindered humanitarian access to Jabalya, Beit Hanoun and Beit Lahiya. At the same time, the area has seen severe disruptions in communications, including internet. On 10 November, Israeli military operations in An Nuseirat refugee camp in Deir al Balah intensified considerably, with people reportedly appealing to rescue teams to be evacuated following the sudden advancement of forces amid heavy fire. On 10 and 11 November, at least 14 Palestinians, including four children and three women, were reportedly killed in western An Nuseirat and 30 others were reported injured or missing. On the night of 11 November, the ground incursion in Beit Hanoun in North Gaza also reportedly intensified, with accounts that Israeli forces ordered the evacuation of hundreds of civilians from the area, according to Palestinian Civil Defense (PCD).
• On 8 November, the Integrated Food Security Phase Classification (IPC) Famine Review Committee (FRC) issued an alert, warning about an imminent and substantial likelihood of famine occurring in areas within northern Gaza because the worst-case scenario the FRC had warned about is already unfolding. The recent IPC analysis for the Strip had projected that under a worst-case scenario, involving inter alia an intensification of hostilities, growing displacement, and a reduction in humanitarian assistance, a risk of famine existed for the whole of Gaza between November 2024 and April 2025. Based on rapidly deteriorating humanitarian conditions, the FRC noted that it can now be “assumed that starvation, malnutrition, and excess mortality due to malnutrition and disease, are rapidly increasing” in areas of northern Gaza and that “[f]amine thresholds may have already been crossed or else will be in the near future.” The FRC further warned: “Immediate action, within days not weeks, is required from all actors who are directly taking part in the conflict, or have influence on its conduct, to avert and alleviate this catastrophic situation.”
• Between the afternoons of 5 and 12 November, according to the Ministry of Health (MoH) in Gaza, 274 Palestinians were killed and 729 were injured. Between 7 October 2023 and 12 November 2024, at least 43,665 Palestinians were killed and 103,076 were injured, according to MoH in Gaza.
• Between the afternoons of 5 and 12 November, five Israeli soldiers were reportedly killed in Gaza, according to the Israeli military. Between 7 October 2023 and 12 November 2024, according to the Israeli military and official Israeli sources cited in the media, more than 1,573 Israelis and foreign nationals were killed, the majority on 7 October 2023 and its immediate aftermath. The figure includes 373 soldiers killed in Gaza or along the border in Israel since the beginning of the ground operation. In addition, 2,425 Israeli soldiers were reported injured since the beginning of the ground operation.
• Between 4 and 10 November, at least five mass casualty incidents took place in North Gaza and Gaza city.
  • On 4 November, at about 19:00, 25 Palestinians including 13 children, were reportedly killed and others went missing under the rubble when a house was hit in Beit Lahiya, in North Gaza.
  • On 5 November, at about 10:00, 15 Palestinians were reportedly killed and others injured when a house was hit in Al Fakhoura area, south Beit Lahiya, in North Gaza.
  • On 7 November, at about 15:30, dozens of Palestinians, estimated between 25 to 30 people and including women and children, were reportedly killed and several others injured when a house was hit in Jabalya refugee camp. Due to the inability of PCD crews to operate and restricted media access to the area, the precise number of fatalities remains unknown.
  • On the same day, at about 14:15, at least 15 Palestinians, including 11 from a single family, and among them eight women, were reportedly killed and several others injured when an UNRWA school, sheltering internally displaced persons (IDPs), was hit in Ash Shati’ (Beach) refugee camp, west of Gaza city.
  • Lastly, on 10 November, at about 6:00, 36 Palestinians, including women and children, were reportedly killed while others were injured, including some remaining under the rubble, when a multi-storey building was hit in Old Gaza Street in Jabalya Al Balad, in North Gaza.
• According to the latest data from the United Nations Children’s Fund (UNICEF) and its partners, a total of 64 attacks against schools, which mostly serve as IDP shelters, were documented in October, including 25 in northern Gaza, with an estimated 128 people killed as a result, many of them children. Last month’s attacks, an average of two per day, comprise 28 per cent of the overall number of attacks on schools recorded since October 2023 (226 attacks), according to UNICEF. Reiterating the agency’s call to all parties to end grave violations against children, and to end attacks on civilians and civilian infrastructure, UNICEF Executive Director, Catherine Russell, stated: “Schools should never be on the frontlines of war, and children should never be indiscriminately attacked while seeking shelter,” adding that children “must be shielded from harm, and their right to education must be upheld, even amidst conflict.”
• The following are other key deadly incidents reported between 4 and 8 November:
  • On 4 November, at about 13:00, seven Palestinians were reportedly killed and others injured when two houses were hit in Beit Lahiya, in North Gaza.
  • On 6 November, at about 14:00, at least seven Palestinians, including women and children, were reportedly killed when a house was hit in Al Khazan neighbourhood in Beit Lahiya, in North Gaza.
  • On 6 November, at about 22:00, six Palestinians were reportedly killed and others injured when a house was hit in Beit Lahiya, in North Gaza.
  • On 6 November, at about 19:50, at least seven Palestinians, including women and children, were reportedly killed, including some remaining under the rubble, and 17 others injured, when a house was hit in the New Camp, north of An Nuseirat refugee camp, in Deir al Balah.
  • On 7 November, at about 18:30, six Palestinians, including one woman, were reportedly killed and others injured when the schoolyard of Al Rimal UNRWA school, sheltering IDPs, was hit, west of Gaza city.
  • On 7 November, at about 23:50, nine Palestinians, including two children and four women, were reportedly killed and others injured when a house was hit in the vicinity of Ad Daraj health Clinic, in central Gaza city.
  • On 7 November, at about 8:00, six Palestinians were reportedly killed and others injured when a group of people was hit near Abu Sharikh junction, west of Jabalya refugee camp, in North Gaza.
  • On 8 November, at about 23:45, six Palestinians, including two journalists, were reportedly killed and others injured when Fahed as Sabah governmental school, designated as an IDP shelter, was hit in At Tuffah neighbourhood, northeast of Gaza city.
• As of 9 November, the UN and its partners estimated that between 100,000 and 130,000 people had been displaced over the preceding five weeks from North Gaza governorate to Gaza city and between 50,000 and 75,000 people were estimated to remain in North Gaza. Moreover, based on humanitarian partners observations, about 500 people have been displaced from northern to southern Gaza since 6 October 2024. Humanitarian assistance to North Gaza has been largely denied, except for one mission by the World Food Programme (WFP) on 11 November (see below) and some medical supplies provided to hospitals during medical evacuations missions; no fuel has been delivered to water, sanitation and hygiene (WASH) facilities in the area since 1 October. Overall, between 1 and 11 November, every attempt by the UN to access besieged areas of North Gaza with food and health missions was either denied or impeded (see more below). Hospitals in North Gaza are also hardly functioning with the bare minimum of capacities and resources. According to the World Health Organization (WHO), access to the Kamal Adwan, Al Awda and Indonesian hospitals remains severely restricted and since 3 November, due to critical fuel shortages, Al Awda Hospital has been forced to operate its generators only three hours per day, disrupting life-saving surgeries and other healthcare services, WHO added. Moreover, while the second round of the emergency polio vaccination campaign has now been concluded in northern Gaza, with a total of 105,558 children under the age of 10 immunised, the Health Cluster estimates that between 6,800 and 13,700 children in inaccessible areas of North Gaza, such as Jabalya, Beit Hanoun and Beit Lahiya, could not be reached with a second vaccination dose and remain vulnerable to the poliovirus.
• According to PCD, their teams have been continuously receiving appeals about and from people trapped under the rubble of destroyed houses across Gaza but lack the equipment and machinery needed to access and rescue them, reportedly resulting in the loss of the lives of thousands of people since October 2023. In North Gaza, PCD remains forcibly out of service and reports that people who survive the bombing and attacks often die from hunger, amid severe shortages of food. Many people in the area have been left trapped under rubble for days, without being evacuated, PCD added.
• On 11 November, after multiple attempts, a WFP convoy successfully reached Beit Hanoun in North Gaza governorate, delivering essential aid for the first time in over a month. The convoy included two trucks carrying life-saving ready-to-eat rations and wheat flour, and one truck carrying bottled water. Initially, WFP had planned a 14-truck mission to deliver supplies to shelters in Beit Hanoun and the Indonesian Hospital in Jabalya. However, delays in movement authorization and crowded routes led to a reduction in the convoy's size. The aid was ultimately delivered to the Mahdia Al Shawwa IDP shelter and a nearby public shelter. Following the delivery of aid, there have been reports of intense shelling and Israeli forces surrounding the area where WFP distributed the aid, ordering families to leave. WFP was planning another mission on 12 November to reach the remaining planned shelters and hospitals in Beit Hanoun, Beit Lahiya, and Jabalya, but these missions have been denied. According to PCD, on 11 November, 200 people were evacuated from Tal Zaatar area in Jabalya to Gaza city.
• Health conditions continue to deteriorate across Gaza, with nine in 10 children under the age of five affected by one or more infectious diseases, and 25 per cent of women experiencing skin conditions and other health issues. Over 11,000 cases of acute respiratory infections were reported only in the space of one week in early November, as cases of acute jaundice syndrome and bloody diarrhea also continue to rise, warns WHO. The dire conditions faced by pregnant and breastfeeding women (PBW) are especially concerning, with partners of the United Nations Population Fund (UNFPA) reporting a recent rise in premature births and maternal deaths and an estimated 155,000 PBW are deprived of access to pre-natal and postnatal care. Only nine out of the 17 partially functioning hospitals, and four field hospitals, are currently providing maternity services, according to WHO, and “[e]very day, hundreds of women give birth in traumatic, unhygienic and undignified conditions,” highlighted the WHO Director-General to the UN Security Council on 6 November. Beyond the lack of safe childbirth services, food scarcity is having a devastating impact on pregnant women, increasing the risk of babies being born with health complications, and rendering new mothers unable to breastfeed; this, in turn, places infants at a higher risk of contracting infectious diseases, including pneumonia, particularly as the winter approaches. Overall, 42,000 pregnant women are facing crisis (IPC Phase 3) or worse levels of food insecurity across the Strip, 15,000 of whom are classified in the emergency phase (IPC Phase 4) and 3,000 facing catastrophic hunger (IPC Phase 5), “a number that could surge to 8,000 as winter sets,” warns UNFPA.
• On 6 November, WHO and its partners medically evacuated 90 critically ill patients, including 38 children, outside Gaza through the Kerem Shalom Crossing. This was the largest medical evacuation in one day outside Gaza since the closure of the Rafah Crossing in May 2024. In total, 84 patients alongside their 124 companions were transferred to the United Arab Emirates, while six patients and 15 caregivers were transferred to Romania. The patients include those who have cancer, severe injuries, as well as thalassemia and cardiovascular, eye, renal, brain, autoimmune, and blood diseases. Overall, only a third of over 15,600 patients for whom medical evacuation was requested as of 9 November have been able to leave the Strip, with only 321 patients evacuated since the closure of the Rafah Crossing in May 2024. As the conflict grinds on amid decimated healthcare services, WHO continues to appeal for the urgent establishment of regular evacuation corridors, using all possible routes, to allow critical patients blocked in Gaza to access the specialized care they need.
• Across the Gaza Strip, alarmingly poor dietary diversity is being observed by Food Security Sector (FSS) and nutrition cluster partners. According to a recent food security and market monitoring report by WFP covering October, bread and pulses are the dominant foods being consumed while vegetable consumption dropped from six days per week prior to the escalation of hostilities to nearly zero in October 2024. Similarly, the consumption of meat and eggs declined from three days per week to nearly no consumption at present. Moreover, a recent UNICEF survey on dietary diversity among children and PBW highlights the severe nutritional impact due to reduced humanitarian aid and commercial food supplies entries. Data from 18 to 24 October shows a sharp decline in dietary diversity, with 95 per cent of parents of children aged 6 to 23 months reporting their children consumed only two or fewer types of food the day before the survey. This figure marks an increase from 90 per cent in September, 79 per cent in July, and 94 per cent in May when widespread displacement from Rafah to Deir al Balah and Khan Younis occurred.
• For most people in Gaza, accessing affordable basic goods has become a significant struggle, as both the economy and aid operations are increasingly overwhelmed. Frustrated by soaring prices, many residents heeded local calls for a market boycott, which lasted for about two days, citing the near-total absence of regulatory oversight as a major factor fuelling price manipulation. The market’s situation is worsened by severe Israeli restrictions on the entry of supplies into Gaza, with increasing reports of looting incidents, along with claims by Palestinian consumers that trucks carrying essential goods are being diverted by unknown Palestinian groups to private warehouses, preventing them from reaching markets and driving prices further up. Media reports have also suggested that local traders are forced to pay armed personnel extortion fees for securing safe passage of the supplies through Gaza. The protest comes as the Palestinian Central Bureau of Statistics reports that the Consumer Price Index (CPI) in Gaza has increased by 283 per cent since October 2023 due to ongoing hostilities. Moreover, WFP stated on 3 November that, in central and southern Gaza, the collapse of local markets and essential goods shortages have increased people’s reliance on small-scale aid such as ready meals. In October, a daily average of only 37 truckloads of basic humanitarian supplies could be brought into Gaza—the lowest level since October 2023.
• On 7 November, the Israeli military issued a new evacuation order for parts of Gaza city and North Gaza. Initial estimates indicate that the order affects 3.8 square kilometres and six neighbourhoods, with approximately 61,000 people staying there, based on population estimates from the Palestinian Ministry of Social Development on 4 November. Critical service facilities are also covered by the order, including three medical points, four bakeries and kitchen points, 18 water trucking points, 14 IDP sites, and a warehouse. This same area is covered by an outstanding order issued by the Israeli authorities in mid-October 2023 to evacuate the entire area north of Wadi Gaza.
• Since October 2023, over 67 evacuation orders have been issued by the Israeli authorities, for people in 150 neighbourhoods, affecting up to 88 per cent of Gaza's area. Only five of these orders – all in southern Gaza – have been subsequently rescinded, the latest being on 11 November. As of 12 November, approximately 79 per cent of the Gaza Strip remains under active evacuation orders, with people continuing to be directed to the remaining areas, which are in or around Al Mawasi in southern Gaza. That area currently covers 72.5 square kilometres, or about 20 per cent of Gaza, and faces significant challenges, including a lack of basic infrastructure, limited services, and severely constrained aid operations. Repeated forced displacement is worsening the humanitarian crisis exacerbating people’s vulnerability as resources are depleted and access to critical services becomes increasingly limited.
• Ongoing hostilities, compounded by the destruction of WASH facilities, persistent electricity cuts and critical shortages of fuel, continue to disrupt water production, distribution, and management in Gaza. According to the WASH Cluster, this has resulted in significant reductions in water output, especially in North Gaza. Between 26 October and 8 November, the Palestinian Water Authority (PWA) and Coastal Municipalities Water Utility (CMWU) reported an average daily water production of 96,394 cubic metres across Gaza — approximately one quarter of the production levels prior to October 2023. In October, WASH Cluster partners reported that only 28 per cent of the minimum daily fuel requirement of 70,000 litres — necessary for maintaining water production, sewage management, and solid waste handling — was met. The lack of fuel has forced private sector water suppliers to cease operations, severely disrupting water distribution in Gaza city, a situation exacerbated by the influx of IDPs from the North Gaza governorate.
• Preparations for the winter season, such as clearing stormwater drains, unblocking manholes, and removing debris, are ongoing in accessible areas, according to the WASH Cluster, but are hindered by the limited entry of essential equipment and materials and the challenges of moving supplies from southern to northern Gaza. The dewatering of three critical lagoons — Abu Rasheed, Sheikh Radwan, and Al Amal — has not progressed at the required pace ahead of the forthcoming rains. Similarly, the relocation of IDPs from flood-prone areas and the transfer of 10 temporary solid waste sites have stalled, due to lack of essential resource. Moreover, the Israeli authorities’ continued denials of fuel delivery requests for water points and solid waste management in the North Gaza governorate since early October have severely hindered operations, posing significant public health concerns. Solid waste management is further strained by the lack of spare parts and restricted access to safe disposal sites. The absence of a dedicated medical waste management system also poses serious health risks, as medical waste, including sharps and infectious materials, is being mixed with domestic waste.
• As winter approaches, Gaza faces severe and unprecedented risks due to ongoing hostilities, widespread infrastructure damage, and critical shortages across all sectors. According to a recent anticipatory note by ACAPS, issued on 30 October, the 2024–2025 winter season arrives amid the ongoing displacement of at least 90 per cent of people in Gaza. A significant increase in humanitarian needs is expected this winter, but the profound changes and deterioration in Gaza’s context since last winter make it extremely difficult to gauge the scale or scope of these needs. Flood patterns are harder to anticipate due to extensive infrastructural damage and the accumulation of rubble, with many displaced people now living in low-lying coastal areas prone to flooding. In this regard, the municipality of Khan Younis has recently warned about the risk of flooding in over 60 hotspot areas across Khan Younis, noting that the situation will be catastrophic for people living in those areas. Additionally, according to ACAPS, the shelter situation has drastically changed, with most displaced people now living in tents and makeshift structures that offer minimal protection against harsh winter conditions. This shift significantly increases vulnerability to health and safety risks. In parallel, the humanitarian response is hampered by the ongoing blockade, which limits the entry of essential resources, including winterization items, fuel, and spare parts, all of which are already in short supply, and hampers preparedness activities. The note adds that the road network, already damaged by airstrikes and ground operations, will deteriorate further as seasonal rains impair road conditions, making it even harder to deliver critical supplies. By September 2024, according to this note, 68 per cent of Gaza's roads were damaged, and approximately 12,000 metric tonnes of rubble obstructed transportation routes. The Israeli authorities have kept the Gaza Strip disconnected from electricity since October 2023, resulting in full reliance on alternative power sources that are insufficient.
• Access restrictions have continued to severely disrupt humanitarian aid operations throughout the Gaza strip, particularly affecting the North Gaza governorate, where needs are most critical and have been escalating due to the ongoing Israeli military operation that began on 6 October. These limitations have hindered the flow of food, medical supplies, fuel for key infrastructure such as water pumps for drinking water, and other essential resources to tens of thousands of people, leaving them without much-needed, life-saving assistance. Between 1 and 11 November, out of 195 planned aid movements across the Gaza Strip which were coordinated with the Israeli authorities, 31 per cent (61) were denied, 42 per cent (83) were facilitated, 16 per cent (32) were impeded, and 10 per cent (19) were cancelled due to logistical and security challenges. This includes 69 coordinated aid movements intended to provide humanitarian assistance in North Gaza and the Gaza governorates, of which 37 needed to pass via the Israeli military-controlled Al Rashid and Salah ad Din checkpoints. Of those using the checkpoints, only 27 per cent (10) were facilitated by Israeli authorities, 32 per cent (12) were impeded, 30 per cent (11) were denied, and 11 per cent (4) cancelled. Aid missions to the North Gaza governorate were particularly disrupted. Between 1 and 11 November, 19 coordination requests for critical aid missions targeting Jabalya, Beit Hanoun, and Beit Lahya were submitted, with requests at best impeded, resulting in partial aid delivery, or more commonly completely denied, severely hampering efforts to deliver life-saving assistance to critical facilities and families trapped in high-risk zones. In one instance, on 10 November, PRCS reported that a patient died due to prolonged delays at a military checkpoint between North Gaza governorate and Gaza city. According to the Humanitarian Access Snapshot issued on 11 November, the operating environment for humanitarian operations in Gaza significantly worsened in October, with approximately 43 per cent of all humanitarian movements coordinated with Israeli authorities to reach those in need across the Gaza Strip being denied — marking the highest rate of access denial recorded since the hostilities began in October 2023.

Funding

• As of 12 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.