Humanitarian Situation Update #247 | 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 19 December. 

Key Highlights

• Attacks on civilian infrastructure continue, particularly in North Gaza, where WHO reports appalling conditions at Kamal Adwan Hospital and where 61 out of 95 attacks on school buildings since 6 October 2024 took place. 
• Humanitarian organizations are struggling to meet growing shelter needs amid recurrent displacement, limited entry of shelter supplies, and skyrocketing prices of winterization items on the local market. 
• Women are being heavily affected by the scarcity of diagnostic tests and essential medical treatments, often facing delayed or inadequate care.

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 more than 10 weeks (see data below). Rocket firing by Palestinian armed groups towards Israel was reported.  
• Between the afternoons of 10 and 17 December, according to the Ministry of Health (MoH) in Gaza, 273 Palestinians were killed and 853 were injured. Between 7 October 2023 and 17 December 2024, at least 45,059 Palestinians were killed and 107,041 were injured, according to MoH in Gaza. 
• Between the afternoons of 10 and 17 December, two Israeli soldiers were killed in Gaza, according to the Israeli military. Between 7 October 2023 and 17 December 2024, according to the Israeli military and official Israeli sources cited in the media, more than 1,586 Israelis and foreign nationals were killed, the majority on 7 October 2023 and its immediate aftermath. The figure includes 386 soldiers killed in Gaza or along the border in Israel since the beginning of the ground operation. In addition, 2,488 Israeli soldiers were reported injured since the beginning of the ground operation. As of 17 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. 
• Attacks on schools sheltering internally displaced people (IDPs) in Gaza continue to be reported, with nine such incidents documented so far in December 2024 by the UN Human Rights Office (OHCHR). According to the Education Cluster, between 6 October and 15 December 2024, 95 incidents involving attacks on school buildings, mostly serving as IDP shelters, were documented, including 61 incidents in North Gaza governorate. On 14 and 15 December alone, four schools were hit, as follows: 
  • On 14 December, two schools-turned shelters were reportedly hit in Gaza city, resulting in the killing of seven Palestinians, including three children, and the injury of tens of others, according to Palestinian Civil Defense (PCD).  
  • On 15 December, Israeli troops reportedly surrounded and raided Khalil Owaidah School sheltering IDPs in 'Izbat Beit Hanun, in North Gaza, where it was reported that male IDPs were detained while women and children were forced to move southwards. Tens of people were reported killed, but the exact circumstances remain unclear. Citing IDP testimonies, PCD reported that fatalities included 10-15 people who were incinerated, and the school was destroyed.  
  • On 15 December, the third floor of an UNRWA school sheltering IDPs in Al Mawasi, in Khan Younis, was hit. Within minutes, the emergency department of the nearby Nasser Medical Complex was flooded with casualties, most of them women and children. Many were severely injured and died on site or en route to the hospital, reported international doctors from Medical Aid for Palestinians (MAP) operating in the facility as part of a joint Emergency Medical Team (EMT) with the International Rescue Committee. An internal medicine and emergency care consultant counted at least 18 people dying in the emergency department, including 12 children under the age of 12. The first patient arrived in the facility was “a three-year-old girl who had the left side of her forehead torn open by shrapnel fragments which had penetrated her skull,” and who, due to shortages of painkillers and anaesthetics, had to be treated “with very little access to medications,” added the consultant. A plastic surgeon also noted that his first patient was a 12 to 14-year-old boy whose face was entirely burnt, and who had open wounds on his chest and on both of his legs.  
• Other deadly incidents reported between 10 and 15 December include: 
  • On 10 December, at about 23:00, 22 Palestinians were reportedly killed and others injured when a three-story building was hit near Kamal Adwan Hospital in Beit Lahiya in North Gaza. 
  • On 12 December, at about 00:30, seven Palestinians including children and women were reportedly killed and others injured when two apartments in a residential tower were hit in northwestern Gaza city. 
  • On 12 December, on two occasions at about 00:01 and 00:55, 22 Palestinians were reportedly killed and others injured when people were hit in Khan Younis and Rafah. According to the Government Media Office (GMO), fatalities included 15 people tasked with securing the movement of aid trucks, raising the number of people killed while securing aid trucks to 720 so far. 
  • On 12 December, at about 02:00, 15 Palestinians including at least one woman and seven children were reportedly killed, and several others injured, when a house sheltering IDPs was hit in western An Nuseirat refugee camp in northern Deir al Balah. 
  • On 12 December, at about 20:30, at least 34 Palestinians were reportedly killed and 40 others injured, when two residential buildings were hit in central An Nuseirat refugee camp, in Deir al Balah, according to PCD. According to the UN Children’s Fund (UNICEF), at least eight children were among the fatalities (see below). Extensive damage of the residential block was also reported.  
  • On 14 December, at about 13:45, 12 Palestinians, including at least two girls, one woman and the mayor, were reportedly killed and others injured when Deir al Balah Municipality in central Deir al Balah was hit. 
  • On 15 December, at about 21:05, at least ten Palestinians were reportedly killed and others injured when a house was hit in Ash Shuja’iyeh neighbourhood in eastern Gaza city. 
  • On 15 December, six people were reportedly killed and others injured when a PCD centre was hit in An Nuseirat refugee camp, in northern Deir al Balah. Fatalities reportedly included a cameraperson and four PCD staff and volunteers. The cameraman is among four journalists reported killed in Gaza between 11 and 15 December, according to the Committee to Protect Journalists (CPJ). As of 17 December, the Palestinian Journalists Syndicate reported that 188 journalists and media workers have been killed in Gaza.  
• Between 11 and 17 December, the Director of Kamal Adwan Hospital in North Gaza reported near daily attacks on or very close to the facility, which currently hospitalizes 60 injured people, with debris and explosions shattering doors and windows, causing further damage to water tanks, the electricity generators and the oxygen supply network, and igniting a fire on the hospital’s third floor on one occasion. Due to ongoing insecurity and the lack of ambulances and equipment, medical staff have generally been unable to assist people trapped under the rubble in the surrounding areas or have themselves been hit. On 12 December, MoH announced that Dr. Saeed Judeh, the last orthopaedic doctor in North Gaza, was killed while en route from Kamal Adwan to the nearby Al Awda Hospital to treat patients. On the same day, according to the World Health Organization (WHO), a nurse was killed while travelling to Kamal Adwan. On 14 December, following four denied attempts by WHO to urgently deliver life-saving supplies to the hospital, the Organization and its partners reached Kamal Adwan, describing conditions in the health facility as “appalling”. The team delivered 5,000 litres of fuel, food and medicines, and transferred three critical patients and six companions to Al-Shifa Hospital in Gaza city. However, WHO’s request to re-deploy the Indonesian Emergency Medical Team (EMT) to the hospital continued to be denied, despite the need for immediate surgical interventions for injured patients. On 16 December, the facility’s Director informed that the intensive care department was targeted by snipers, with all windows hit, forcing medical staff to treat some of the injured in the corridors. As of 4 December 2024, WHO had recorded 591 health attacks across the Gaza Strip, including 23 since 20 November. 
• On 11 December, the Humanitarian Coordinator (HC) for the Occupied Palestinian Territory, Muhannad Hadi, concluded a two-day visit to the Gaza Strip, where he met with displaced people and youth groups and witnessed first-hand the decimation of Gaza’s health sector. On 10 December, the HC visited a medical point operated by a network of local NGOs in An Nuseirat refugee camp, in Deir al Balah. Due to security concerns, the facility was temporarily evacuated five times, three of them in November 2024. It handles an average of 3,000 consultations per month, a quarter of which relate to infectious diseases. Urinary tract infections are prevalent among pregnant women due to the lack of clean water, amid shortages of microbiology tests to identify the types of bacteria. Other diagnostic procedures for women are completely unavailable, resulting in late diagnoses of cancer and invasive procedures as hysterectomies having to be performed instead of being able to treat conditions like uterine bleeding. The facility also suffers from severe shortages of medical supplies, including analgesics and Infection Prevention and Control (IPC) material, and medications are sufficient for only five per cent of the 80-100 patients visiting the medical point daily. The HC also visited the Nasser Medical Complex in Khan Younis, which had 655 admitted patients, with paediatric bed occupancy being at 250 per cent. All heart surgeries have been halted due to the lack of supplies for cardiac catheterization, and only other life-saving activities are being performed, while chemotherapy and other procedures have stopped. On 11 December, the HC visited the Al Aqsa Hospital in Deir al Balah, where he heard from hospital staff and management – as well as patients – about the struggles the heath system is facing. Speaking to journalists from Al Aqsa, the HC paid tribute to the medical teams who continue their work amid catastrophic conditions.  
• More than 160 children, or an average of four children every day, have reportedly been killed in Gaza since the beginning of November 2024, stressed UNICEF’s Executive Director, Catherine RusselI, in a statement condemning the latest attack on An Nuseirat camp on 12 December (see above). Reiterating that there is no safe space in Gaza and that children lack everything, from food to safe water, medical supplies and warm clothes, the UN official added: “The world cannot look away when so many children are exposed to daily bloodshed, hunger, disease, and cold.” A recently released study based on data collected in June 2024 by the Community Training Centre for Crisis Management in Gaza, with support from the Dutch Relief Alliance and the War Child Alliance, reveals that 96 per cent of children in the surveyed households, where at least one child is injured, disabled, unaccompanied or separated from parents, felt that their death was imminent while 49 per cent expressed a desire to die. The study also found that 92 per cent of children were not accepting reality, 83 per cent experienced severe fear and 73 per cent exhibited aggressive behaviour, with many more showing signs of withdrawal and anxiety, alongside a pervasive sense of hopelessness.  
• Between 11 and 14 December, four evacuation orders were announced by the Israeli military, affecting at least 69,000 people in parts of Gaza city, North Gaza, Deir Al Balah and Khan Younis for which several evacuation orders had already been issued. The first order covered approximately 3.2 square kilometres in Deir al Balah and affected an estimated 10,000 people, including about 5,200 people residing across nine displacement sites. The second order covered about 1.8 square kilometres in Gaza city, affected at least 20,000 people, including IDPs in one UNRWA shelter, and resulted in the temporary closure of one UN-supported bakery and the suspension of water, sanitation and nutrition services. The area affected by this order includes the Patients Friends Association Hospital and three other health facilities. The first two orders triggered limited displacement according to reports by humanitarian partners. The third evacuation order covered about 5.5 square kilometres in both Gaza city and parts of North Gaza, including ten IDP sites, two health facilities, two distribution centres and 24 water trucking points, and affected an estimated 35,000 people. The displacement of about 250 families (~1,250 people) from this area southward, particularly toward As Sabra neighbourhood in Gaza city, was reported. The last evacuation order covered about 4.3 square kilometres in Deir al Balah and Khan Younis, affecting approximately 4,000 people, and resulting in the reported displacement of 450 families (~2,250 people). Since October 2023, about 80.5 per cent of the Gaza Strip’s territory has been placed under evacuation orders that remain active, excluding orders that were subsequently rescinded.  
• On 8 December, OCHA conducted an assessment in East Khan Younis, visiting two of the neighbourhoods with the highest number of households - Ma’an, which hosts approximately 6,700 families (36,000 people), and parts of Bani Suhaila east of the Salah Al Din Road, where 9,200 families (45,000 people) are presently sheltering. The aim was to identify key needs in these communities after the multiple evacuation orders issued by the Israeli forces in East Khan Younis between May and October 2024 were revoked in parts of the area on 11 November, prompting the return of many families and the arrival of new IDPs from Rafah. The key findings are as follows:  
  • In both locations, people are residing in or near severely damaged or completely destroyed homes, with many having erected makeshift shelters on the ruins, which are precarious and at risk of collapse as the winter and rainy season begins.  
  • Access to domestic and drinking water is particularly scarce in Ma’an, with the community relying on low-pressure branches from the Mekorot supply line, which provide insufficient water to meet needs. Moreover, only a few private filling points, with small tanks of two to five cubic metres, are available. 
  • Sanitation and hygiene conditions are critical, with many in Ma’an relying on pit latrines. In Bani Suhaila, the sewage system has been destroyed, with sewage pools observed on the streets and the community highlighting the pressing need for rodent control. 
  • Due to the widespread destruction of infrastructure, people from both communities must travel two and a half kilometres to reach the closest market in Khan Younis city, and four kilometres to visit the nearest partially functional hospital, the Nasser Medical Complex, with access being challenging. Although medical points are available within closer reach, they only offer consultations and do not provide any medications.  
  • The lack of food assistance is one of the most critical concerns. In Ma’an, the community reported that no food aid distribution has occurred since they returned, nor have any malnutrition screenings been conducted or nutrition supplements provided. In Bani Suhaila, only a charity community kitchen provides hot meals twice a week, but quantities are scarce, and some individuals go entire days without eating.  
  • Information access is a key obstacle in Bani Suhaila, with internet coverage being scant and the radio being the primary means of information. The community reported not being aware of the eligibility criteria and registration system for flour distribution by the UN World Food Programme (WFP). 
  • In both communities, there is a pressing need for winterization assistance to protect makeshift shelters and tents from the harsh winter conditions, with women in Bani Suhaila also stressing the urgency to support children, prioritizing the provision of clothes, diapers, and baby milk. 
• Humanitarian organizations are struggling to meet growing shelter needs due to the recurrent displacement of Palestinians within Gaza, which itself is triggered by new evacuation orders issued by the Israeli military, flooding that has already caused shelter damage, and bombardment affecting collective displacement sites. Moreover, according to the Shelter Cluster, the limited entry of shelter materials into the Gaza Strip has meant that only 285,000 people could be assisted between September and late November 2024 while at least 945,000 others now require urgent winterization support to protect them from the rain and cold weather. Waiting outside Gaza are 58,000 sealing-off kits and over 36,000 tarpaulins that have already been procured to cover the needs of about 400,000 people, but these would need two months to be brought in at the current rate of 10 shelter trucks entering Gaza per week. Meanwhile, partners from the Site Management Working Group (SMWG) continue to support committees at 75 displacement sites with financial, technical and in-kind support for maintenance and repairs, but such assistance remains limited due to the prohibitively high prices of common winterization items, such as shovels, plastic ropes and cement bags, on the local market. There is also a lack of blankets and warm clothes, disproportionately affecting children in makeshift tents, many of which had been provided by aid agencies over the past year but have become unusable due to wear and tear. The lack of adequate shelter is compounding the already massive health needs, highlights WHO. While infectious diseases already spiked during the last winter season, as malnutrition rates continue to climb, such diseases are expected to have more severe consequences this winter, particularly for children. Between January and 17 November 2024, WHO recorded 1,210,306 cases of acute respiratory infections, 574,813 cases of acute watery diarrhoea and 114,367 cases of acute jaundice syndrome.  
• Extreme insecurity in Gaza continues to negatively impact aid operations. On 11 December, a 70-truck convoy entering through the Kerem Shalom crossing was violently attacked by looters, leading to the loss of nearly all food and aid supplies. On the same day, a WFP convoy leaving the Kissufim crossing also came under fire, with four out of five trucks violently looted. “Attacks undermining humanitarian operations are unacceptable. They threaten the survival of those in desperate need of assistance,” noted the HC on 13 December. Emphasizing that “attacks on humanitarian operations can be avoided,” the HC reported that earlier in the week, “through an Israeli agreement for us to use the Philadelphi corridor, a joint UN convoy delivered urgently needed food, reaching nearly 200,000 people in southern and central Gaza.” In a statement on this important delivery, UNRWA highlighted that it “showcased how coordinated efforts can overcome logistical and operational barriers,” and added that the “the solidarity of the community was instrumental to the success of this mission, as members provided a more secure passage that allowed aid to reach families facing critical food shortages.”  
• Between 1 and 16 December, out of 339 planned aid movements across the Gaza Strip requiring coordination with Israeli authorities, 30 per cent (102) were facilitated, 42 per cent (141) were denied, 18 per cent (62) were impeded, and ten per cent (34) were cancelled due to logistical and security challenges. These included 96 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 17 per cent (16) were facilitated by the Israeli authorities, 43 per cent (41) were denied, 26 per cent (25) were impeded, and 15 per cent (14) 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 16 December, the UN attempted to reach these besieged areas 40 times, of which 38 attempts were denied and two were impeded. The first impeded mission took place on 1 December, deploying an EMT to the Kamal Adwan Hospital and evacuating patients following long delays. The second impeded mission took place on 11 December, when a UN team led by the Deputy Humanitarian Coordinator visited the Kamal Adwan and Indonesian hospitals but was not facilitated to reach areas in Jabaliya and Beit Lahiya where communities remain. 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 20 coordinated requests submitted to the Israeli authorities to access Rafah governorate between 1 and 16 December were outright denied. This excludes 47 coordinated movements to Kerem Shalom crossing, of which 70 per cent (33) were facilitated, 19 per cent (nine) were impeded, four per cent (two) were denied, and six per cent (three) were cancelled. 
• On 13 December, UNOSAT published an updated preliminary analysis of structural damage and destruction in the Gaza Strip, based on satellite imagery collected on 1 December 2024. The assessment shows that 170,812 structures, or 69 per cent of the total throughout the Strip, have either been damaged or destroyed, up from 66 per cent identified in the 6 September analysis. The governorates of North Gaza and Rafah have experienced the highest rise in damage, with 3,138 new structures damaged in North Gaza and 3,054 in Rafah. Within North Gaza, Jabalya municipality had the highest number of newly damaged structures (1,339 structures) and the fourth largest number of damaged structures (14,470) among all municipalities, following Gaza, Rafah and Khan Younis cities.  
• According to a new assessment by the Education Cluster, which relies on satellite imagery collected on 1 December 2024, nearly 88 per cent of school buildings in the Gaza Strip (496 out of 564) have been directly hit or damaged and are currently estimated to require either full reconstruction or major rehabilitation work to be functional again. Fifty-five per cent of these schools (275) are government schools, a third (161) are UNRWA schools, and 12 per cent (57) are private schools. The increase is mainly attributed to an increase in the number of directly hit schools, particularly in North Gaza governorate where 11 out of 18 schools newly classified as “directly hit” over the past three months are located. Moreover, according to the assessment, most directly hit schools are in areas that were subject to evacuation orders by the Israeli military. Prior to the war, “direct hit” or “damaged” schools served about 542,959 students and had more than 20,320 teachers, which represented, respectively, about 88 and 87 per cent of the total student population and teaching staff in the Gaza Strip. In addition, 41 schools are now assessed as “likely damaged,” where at least one damaged site has been identified within 30 to 70 meters of school buildings, indicating the possibility that these school structures may have sustained moderate damage. 
• Given the ubiquitous threat of unexploded ordnance hidden under the rubble, the Mine Action Area of Responsibility (AoR) under the Protection Cluster continues to raise awareness about the risks posed by explosive remnants of war. The Mine Advisory Group (MAG), jointly with Save Youth Future Society, has deployed 20 risk education teams across Gaza: five in Gaza city, eight in Deir al Balah and seven in Khan Younis. The teams deliver risk education sessions and emergency briefings in communities and on the streets, including interactive sessions tailored for children whose “natural curiosity puts them at higher risk of injury, as explosive items can often appear to be a tempting toy,” explains MAG. Furthermore, Mine Action AoR partners continue to conduct explosive hazard assessments at humanitarian sites, including schools and camps sheltering IDPs, health centres and UN facilities, with 36 such assessments conducted by the UN Mine Action Service (UNMAS) in November and 283 conducted in total since October 2023. In support of debris management efforts, assessments also target sites with extensive debris contamination, coupled with risk education sessions for construction workers, to ensure that future clearance efforts can be safely carried out.  

Funding 

• On 11 December 2024, the UN and humanitarian partners launched a Flash Appeal for nearly US$4.07 billion to address the humanitarian needs of three million out of 3.3 million people identified as requiring assistance in Gaza and the West Bank, including East Jerusalem, in 2025. Nearly 90 per cent of those funds are for the humanitarian response in Gaza, with just over 10 per cent for the West Bank. The $4.07 billion ask is much less than what is actually needed to mount a full-scale humanitarian response, which would require $6.6 billion. However, the Flash Appeal reflects the expectation that aid organizations will continue to face unacceptable constraints on their operations in 2025. This will severely limit the amount of assistance that humanitarians are able to provide, which in turn will only increase the suffering that Palestinians are enduring. The appeal stresses that, to be able to implement the full scale of what is urgently needed, Israel must take immediate and effective measures to ensure the essential needs of civilians are met. This includes lifting all impediments to aid and fully facilitating humanitarian operations, including the distribution of essential goods to Palestinians in need.  
• As of 17 December, Member States have disbursed about $2.52 billion out of the $3.42 billion (73 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. 

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