Humanitarian Situation Update #245 | 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 12 December.

Key Highlights

• Lifesaving aid to besieged areas in North Gaza governorate has been largely blocked for the past 66 days; recently, about 5,500 people were forcibly displaced from three schools in Beit Lahiya.
• Fewer than 400 patients have been evacuated to receive lifesaving medical treatment outside of Gaza over the past seven months; about 14,000 await approval to exit.
• Only four UN-supported bakeries are currently operational across Gaza, all in Gaza city.
• Twenty-one attacks on schools, mostly serving as shelters for internally displaced people, were documented in November.
• An estimated 26,000 Palestinians have suffered lifechanging injuries over the past 14 months; persons with disabilities continue to disproportionately suffer from severe trauma, lack of rehabilitation services, and limited availability of assistive devices.

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 2024, with fighting reported between Israeli forces and Palestinian armed groups. Israeli forces have continued to impose a tightened siege on Beit Lahiya, Beit Hanoun and parts of Jabalya and humanitarian assistance has been largely denied for 66 days (see data below), leaving between 65,000 and 75,000 people without access to food, water, electricity or reliable health care, as mass casualty incidents continue to be reported. Large-scale forced displacement from Beit Lahiya was reported over the past week, including 5,500 people forcibly displaced on 4 December from three schools in Beit Lahiya to Gaza city.
• Between the afternoons of 3 and 10 December, according to the Ministry of Health (MoH) in Gaza, 284 Palestinians were killed and 734 were injured. Between 7 October 2023 and 10 December 2024, at least 44,786 Palestinians were killed and 106,188 were injured, according to MoH in Gaza.
• Between the afternoons of 3 and 10 December, four Israeli soldiers were killed in Gaza, according to the Israeli military. Between 7 October 2023 and 10 December 2024, according to the Israeli military and official Israeli sources cited in the media, more than 1,584 Israelis and foreign nationals were killed, the majority on 7 October 2023 and its immediate aftermath. The figure includes 384 soldiers killed in Gaza or along the border in Israel since the beginning of the ground operation. In addition, 2,485 Israeli soldiers were reported injured since the beginning of the ground operation. According to the Israeli military, on 4 December, the body of an Israeli hostage was recovered from Gaza and returned to Israel. As of 4 December, it is estimated that 100 Israelis and foreign nationals remain captive in Gaza, including hostages who have been declared dead and whose bodies are withheld in Gaza.
• On 4 December, an Israeli airstrike hit a makeshift tent encampment sheltering 21 families in the Al Mawasi area in Khan Younis. The strike, together with secondary explosions, which appear to have been caused by gas cylinders according to the UN Human Rights Office (OHCHR) in the OPT, destroyed all 21 tents and killed at least 23 Palestinians, including at least four children and two women – one of them pregnant – while seriously injuring others. A rapid assessment conducted by humanitarian actors found that the damage caused the displacement of about 110 people, who are now in need of urgent shelter, food, and water and sanitation assistance. This was the seventh attack on an IDP tent encampment in the past two weeks, OHCHR reported, altogether killing at least 34 Palestinians, including ten children and three women. Four of these attacks occurred in the area in Al Mawasi to which Israel has instructed Palestinians to go, killing at least 11 Palestinians including a woman who died with her two daughters, and four additional children. Medical Aid for Palestinians (MAP) reported that one of the burnt tents was sheltering a MAP staff member. No MAP staff were injured or killed in the incident. Commenting on the incident, MAP’s Gaza Director said that it “has proven once again that nowhere is safe in Gaza from Israeli military attacks. People there have been left in a constant state of fear and psychological distress, haunted by the fact that there is no place for them to shelter.” Moreover, SOS Children’s Villages International condemned the attack, which was adjacent to a temporary tent encampment accommodating 46 children under its care, noting that no staff or children were physically harmed.
• The following are among other deadly incidents reported between 3 and 8 December:
  • On 3 December, at about 14:25, six Palestinians were reportedly killed and at least ten others injured when the third floor of an UNRWA school was hit in Az Zaytoun neighbourhood, in southeastern Gaza city. According to the latest data from the United Nations Children’s Fund (UNICEF) and its partners, 19 out of 21 attacks on schools, which mostly serve as shelters for internally displaced people (IDP), documented in November were in the North Gaza and Gaza governorates. An estimated 73 people were killed in these attacks, many of them children.
  • On 4 December, at about 18:45, 25 Palestinians were reportedly killed and others injured when three houses were hit near An Nafaq Street in Gaza city. According to the Palestinian Civil Defense (PCD), the three houses were destroyed.
  • On 5 December, at about 11:15, seven Palestinians were reportedly killed when a house was hit behind Kamal Adwan Hospital in Beit Lahiya in North Gaza.
  • On 5 December, at about 15:15, 15 Palestinians were reportedly killed and others injured when a house was hit in Beit Lahiya, in North Gaza.
  • On 6 December, at about 18:45, 34 people, including at least six children and four women, were reportedly killed when a residential building was hit in Block C of An Nuseirat Refugee Camp, in Deir al Balah.
  • On 8 December, at about 15:20, at least 11 Palestinians, including children and women, were reportedly killed, with several bodies recovered in pieces, when a house was hit in Al Bureij refugee camp in Deir al Balah.
  • On 8 December, at about 12:00, ten Palestinians were reportedly killed and about 15 others injured when a group of people was hit near the municipality park in central Gaza city.
• Attacks on health facilities across the Gaza Strip continue to be reported, particularly in North Gaza governorate, where hospitals are barely functioning amid severe supply shortages and ongoing hostilities. On four occasions between 3 and 7 December, Kamal Adwan Hospital in Beit Lahiya, which currently hosts 90 patients and 66 medical staff, was reportedly attacked by fire, bombs and shells, resulting in the killing of seven people including four medics and a child, the injury of at least three medical staff as well as patients and companions, and damage to water and fuel tanks and the oxygen station. According to MoH, the 16-year-old boy who was killed at the hospital’s entrance was in a wheelchair and on his way to the radiology department. On 6 December, Israeli tanks reportedly surrounded the hospital and ordered people to evacuate. The Indonesian Emergency Medical Team (EMT), which had been deployed to the hospital by the World Health Organization (WHO) on 1 December following five access denials, was forced to evacuate as displaced people, caregivers, and many injured patients began fleeing the hospital and panic spread, according to the WHO Director-General, Tedros Adhanom Ghebreyesus. The WHO chief added that 33 people were killed just outside Kamal Adwan amid intense bombardment and hostilities near the hospital, which he described as one of the last lifelines for the people of North Gaza. Moreover, on four occasions between 2 and 8 December, the Indonesian Hospital in Beit Lahiya was attacked, resulting in the injury of three medical staff and six patients and damage to its electricity generator and water tanks. Also in North Gaza, the fifth floor and courtyard of Al Awda Hospital in Jabalya were reportedly hit on 3 December, with no casualties reported.
• In response to the dire health situation in North Gaza, on 3 December, WHO completed a three-day mission during which it delivered to Kamal Adwan Hospital 10,000 litres of fuel, 200 food parcels from the World Food Programme (WFP), blood units and medical supplies, and evacuated 23 patients to Al Shifa Hospital in Gaza city. WHO also delivered 24,000 litres of fuel and medical supplies to Al Shifa hospital for further distribution. On 6 December, ICRC delivered medical supplies to Al Awda Hospital in Beit Lahiya and evacuated 11 patients to Gaza city.
• On 3 December, 11 cancer patients, all children, along with 20 companions were evacuated by WHO from the Gaza Strip to receive specialized medical treatment in Jordan. The following day, eight patients, along with 25 companions, were evacuated outside Gaza by WHO with the support of the European Commission (ECHO) under the European Union Civil Protection Mechanism. According to ECHO, with support from 10 European countries, 59 patients from Gaza, together with 143 relatives, have been evacuated to date to European hospitals. As of 6 December, according to WHO, 378 patients including 217 children have been exceptionally evacuated from Gaza abroad since early May 2024, following the Israeli ground operation in Rafah and subsequent closure of Rafah crossing. Amid the collapse of Gaza’s health-care system and acute shortages of medical supplies and specialized care, at least 14,000 patients across Gaza are estimated to require life-saving medical evacuation.
• “The levels of hunger, devastation and destruction in Gaza … [are now] worse than ever before,” reported the WFP Palestine Country Director, Antoine Renard, on 5 December. Markets are empty, barely any food is coming in, and worsening weather conditions are forcing people into “a daily struggle for survival,” he added. Looting and attacks on humanitarian convoys continue to strain aid delivery in southern and central Gaza, while ongoing attempts by Food Security Sector (FSS) partners to deliver lifesaving aid into the besieged areas of North Gaza continue to be largely blocked after 60 days of tightened siege. As of 9 December, only four out of 19 bakeries supported by WFP remained operational across the Gaza Strip, all of them in Gaza governorate where the flow of wheat flour has been generally constant and the price of a 25-kilogramme bag of flour is about NIS 20-30 (US$5.6-8.4). This is in contrast to central and southern Gaza, where anecdotal market observations indicated that the price of a bag of flour was at least NIS 1,000 ($280) on 1 December in Deir al Balah and NIS 875 ($245) in Khan Younis.
• Combined, access impediments, ongoing hostilities, the breakdown of public order and safety, the near total lack of commercial good entries, and exorbitant prices of the few basic commodities still available on the market have all contributed to a deterioration in dietary diversity across the Strip. In November, bread and pulses have dominated household diets for the second consecutive month, with almost no consumption of vegetables, meat and eggs. Between 24 November and 6 December, UNICEF conducted a new post-distribution monitoring survey, which showed that nearly 100 per cent of children between six and 23 months of age and pregnant and breastfeeding women in Gaza city, Deir al Balah and Khan Younis are not meeting minimum dietary diversity, which is defined as receiving foods from at least four out of seven food groups.
• An analysis published by the Protection Cluster, with support from FSS, highlights that “children and women are now increasingly searching through piles of rubbish for food scraps,” often barefoot and without gloves, facing heightened risks of disease and injury from sharp edges or metal in solid waste and being extremely exposed to the threat of unexploded ordnance. Shrinking food supplies have also triggered physical violence at the still functional bakeries and distribution points, with six women and girls killed as of 2 December in violent incidents that erupted while they were waiting for bread at bakeries. Reliance on negative coping strategies is also increasing, including child labour and begging, while gender-based violence partners report that women and girls are engaging in survival sex in exchange for food, increasing their exposure to exploitation and abuse.
• “Women and girls across Gaza, including 50,000 pregnant women, have been left without the essentials to survive,” highlights the United Nations Population Fund (UNFPA). Maternal deaths, miscarriages and preterm births continue to rise, with conditions being particularly critical in besieged areas of the North Gaza governorate, where an estimated 1,720 pregnant women, and adolescent girls, have remained largely cut off from essential aid for over 60 days. Repeated attacks and damages to the Kamal Adwan Hospital, the last major facility providing maternal and newborn care in the governorate, have hampered pregnant women’s access to critical care, with newborns having “died due to a lack of incubators, electricity, and medical supplies.” Meanwhile, an estimated 90,000 women and girls – or about 70 per cent of the population displaced from North Gaza since the intensification of hostilities in October 2024 – have sought refuge in overcrowded shelters and damaged buildings in Gaza city, struggling to access increasingly strained services. Despite ongoing efforts to expand emergency obstetric and newborn care and sexual and reproductive health services across the Strip, aid restrictions continue to pose a challenge. UNFPA reports that 49 of its trucks, loaded with reproductive health equipment and supplies, including medicines that prevent women hemorrhaging during childbirth, tents, sanitary pads, hygiene kits, and generators, are presently stalled at the border.
• Persons with Disabilities (PwD) are among the worst affected groups by the catastrophic humanitarian conditions in the Gaza Strip. Enduring specific challenges in addition to those faced by everyone else such as limited access to basic services, repeated displacement, and severe psychological trauma. According to the Palestinian Central Bureau of Statistics (PCBS), there were 58,000 PwD in the Gaza Strip prior to the escalation in October 2023 and, based on a recent WHO analysis, about 26,000 people or 25 per cent of the total number injuries as of 24 November now have serious life-changing injuries that require continuous rehabilitation. While about 20 per cent of families surveyed before the war had at least one PwD, the war has now caused “an epidemic of traumatic injuries with no rehabilitation services available,” stated UNRWA’s Commissioner-General Philippe Lazzarini. Speaking on behalf of UN Secretary-General António Guterres at the 2 December Cairo ministerial conference on humanitarian aid for Gaza, UN deputy chief, Amina Mohammed, also highlighted that "Gaza now has the highest number of children amputees per capita anywhere in the world — many losing limbs and undergoing surgeries without even anaesthesia." Conditions have been especially grave due to the destruction of hospitals and rehabilitation centres, restrictions on medical evacuation, and the limited entry of assistive devices such as wheelchairs, crutches and hearing aids, and the severe shortage of medical supplies and basic consumables. Based on a participatory assessment conducted by the Protection Cluster between September and November 2024, the lack of access to essential assistive devices, including basic mobility aids, for PwD significantly hinders their ability to carry out daily activities and participate fully in society. Similarly, the scarcity of hearing aids and batteries exacerbates communication barriers, isolating individuals from social interactions and support networks. This absence of necessary equipment not only affects their physical mobility but also their mental health, leading to widespread feelings of frustration and helplessness.
• On 3 December, the Coastal Municipalities Water Utility (CMWU) began operating a water desalination plant in Deir al Balah that has been repaired as part of a donor-funded project to maintain and restart non-operational plants, one of the primary sources of drinking water for people across the Strip. The plant now has a capacity of 40 cubic metres per day, helping to alleviate water shortages and serving approximately 8,000 people daily. Additionally, to supply drinking water to the western neighbourhoods and the Al Mawasi area of Khan Younis, CMWU and the Khan Younis municipality have completed maintenance and repair works on the main section of the water transmission line connecting the South Gaza seawater desalination plant to the Satar/Al Israa water tank and pumping station. This work has enabled desalinated water to reach the Satar water tank for the first time since the escalation of hostilities in October 2023, providing safe drinking water to over 200,000 people. In another positive development, with UNICEF’s support, CMWU is re-constructing a water desalination plant at its main storage facility west of Khan Younis, which had been dismantled and transported from Rafah governorate under extremely dangerous conditions during the Israeli military operation in the area that began in early May 2024. Once testing and calibration are completed, the plant will have a capacity to produce 1,200 cubic metres of water per day, which would significantly improve the supply of clean and safe drinking water to about 60,000 people in various areas of Al Mawasi, in western Khan Younis.
• Between 1 and 9 December, out of 197 planned aid movements across the Gaza Strip requiring coordination with Israeli authorities, 30 per cent (60) were facilitated, 43 per cent (84) were denied, 16 per cent (32) were initially approved but then impeded, and 11 per cent (21) were cancelled due to logistical and security challenges. These included 56 aid movements that needed to pass through the Israeli military-controlled checkpoints on Al Rashid or Salah ad Din roads to reach areas north of Wadi Gaza (including both North Gaza and Gaza governorates), of which only 16 per cent (nine) were facilitated by the Israeli authorities, 46 per cent (26) were denied, 23 per cent (13) were impeded, and 14 per cent (eight) were cancelled. Aid missions to the North Gaza governorate were particularly disrupted, especially those seeking to reach Jabalya, Beit Lahiya and Beit Hanoun. Between 1 and 9 December, the UN attempted to reach these besieged areas 17 times, of which 16 attempts were denied and one was impeded. The impeded mission took place on 1 December, deploying an emergency medical team to Kamal Adwan Hospital and evacuating patients following long delays. The impeded mission took place on 1 December, deploying an emergency medical team to Kamal Adwan Hospital and evacuating patients following long delays. Coordinated aid missions to areas in Rafah governorate, where there has been an ongoing Israeli military operation since early May, have faced similar challenges. All 11 coordinated requests submitted to the Israeli authorities to access Rafah governorate between 1 and 9 December were outright denied. This excludes 30 coordinated movements to Kerem Shalom crossing, of which 70 per cent (21) were facilitated, 16 per cent (five) were impeded, seven per cent (two) were denied, and seven per cent (two) were cancelled.
• Emergency responders and aid workers continue to encounter severe challenges in delivering assistance across the Gaza Strip, often facing grave risks to their own safety. On 4 December, a Palestine Red Crescent Society (PRCS) paramedic was reportedly shot and killed in the Khan Younis area while returning from a mission to transport patients to his post at the PRCS ambulance station at the field hospital in Rafah. On 7 December, a PCD staff was also reportedly killed at the entrance of Kamal Adwan hospital in Beit Lahiya in North Gaza governorate, where he stayed to help medical teams in providing lifesaving services. Based on information collected by OCHA from humanitarian partners, since October 2023, at least 356 aid workers, including 349 Palestinians and seven foreigners have been killed; this includes 255 UN staff (of whom 251 were UNRWA staff members), 34 PRCS staff and volunteers, and at least 67 other aid workers with national and international NGOs.

Funding

• As of 10 December, Member States have disbursed about US$2.44 billion out of the $3.42 billion (71 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 November, the oPt Humanitarian Fund (oPt HF) managed 124 ongoing projects, totalling $91.7 million. These projects aimed to address urgent needs in the Gaza Strip (89 per cent) and the West Bank (11 per cent) and are 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, 70 are being implemented by international non-governmental organizations (INGOs), 40 by national NGOs and 14 by UN agencies. Notably, 50 out of the 84 projects conducted 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., 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.