Gaza Humanitarian Response Update | 13-26 April 2025

Response

• Between 18 and 24 April, the Palestinian Water Authority and Coastal Municipalities Water Utility reported an average daily production of 105,047 cubic metres of water across the Gaza Strip. On 16 April, the Al Muntar water line from Israel was repaired, after being out of service since 3 April 2025. Of the total amount of water production, 35 per cent (36,575 cubic metres) was produced by operating seawater desalination plants and through Mekorot pipelines from Israel. The remaining 65 per cent (68,472 cubic metres) were produced by municipal groundwater wells that have high levels of salinity. The WASH Cluster estimates that 50 to 65 per cent of the water produced is lost due to leaks in the damaged distribution network before it reaches people.
• As of 24 April, WASH Cluster partners report that over 1,492 water collection points are operational across the Gaza Strip. More than 97 per cent of these points support water trucking activities by 28 partners, where 20,401 cubic metres of drinking water and 10,787 cubic metres of domestic water are delivered daily on average.
• During the reporting period, UNRWA significantly expanded cleaning activities at about 50 displacement sites. These activities included spraying to control insects and pests, running environmental and health awareness campaigns, and engaging with communities to address the spread of insects, fleas, rodents, solid waste and sewage. Furthermore, one partner reported distributing 450 basic hygiene kits across five displacement sites in Khan Younis and Deir al Balah governorates.
• WASH Cluster partners have over 9,000 pallets of items ready to enter Gaza as soon as restrictions are lifted. These include hygiene supplies as well as materials for the construction of latrines, water treatment and network repairs.

Challenges

• The full blockade and movement restrictions imposed within Gaza limit access to fuel, forcing partners to ration supplies more tightly. As a result, water production and distribution have decreased, solid waste collection has been reduced, and sewage is only being pumped in the most hazardous situations.
• The blockade and movement restrictions have also reduced the ability of WASH partners to maintain and repair facilities or restore the functionality of damaged water and sewage infrastructure. This is compounded by the near depletion of stocks of critical chemicals, such as chlorine, which is necessary for water disinfection to decrease the risk of water-borne diseases.
• Market supplies of pesticides have been depleted, and UNRWA’s supply is also expected to run out soon, leaving no effective alternative method to control the proliferation of pests and rodents once these supplies are exhausted. With hundreds of thousands of tons of trash accumulating, there are increasing concerns about the risk of disease outbreaks.
• As of mid-April 2025, over 50 per cent of WASH facilities (334 out of 615) have been rendered inaccessible by displacement orders and the imposition of a “no-go” zone.
• Over 30 bulldozers and other heavy equipment vehicles, some donated during the ceasefire, were bombed by Israeli forces in Gaza city, North Gaza and Khan Younis on 21 and 22 April. This includes critical equipment for waste removal, sewage maintenance, and water supply further limiting waste removal, maintenance of sewage infrastructure, and water services and raising serious public health concerns amid the ongoing crisis.

Response

• On 20 April, World Health Organization (WHO) facilitated the deployment of a new emergency medical team (EMT) to the Indonesian Hospital aimed at enhancing the hospital's surgical capacity. As of 26 April, there are 21 EMTs, including two national and 19 international in the Gaza Strip; these include two in Gaza governorate, two in North Gaza, eight in Deir al Balah, eight in Khan Younis, and one in Rafah.
• During the reporting period, WHO and UNFPA conducted a joint orientation session for 40 participants from 30 health cluster partners on maternal and newborn health and the use of inter-agency kits for sexual and reproductive health (SRH), alongside a training on mental health and psychosocial support services (MHPSS) and SRH. Moreover, on 19 April, the two agencies conducted a joint visit to the European Gaza Hospital to explore the introduction of SRH services, including urgent delivery services.
• During the reporting period, WHO distributed five mental health kits to primary health care centres operated by a Health Cluster partner. Additionally, WHO trained 30 medical professionals from various primary health care centres on trauma care, strengthening the capacity of partners to respond to conflict-related injuries and psychological distress.
• UNICEF began renovating the Newborn Intensive Care Unit (NICU) at As Sahaba hospital to expand bed capacity by 15 beds. Additionally, UNICEF distributed five phototherapy irradiance metres to the newborn intensive care units (NICU) at Al Aqsa, European Gaza, As Sahaba and Patient Friendly hospitals and the International Medical Corps (IMC) field hospital.
• On 22 April, MDM-France opened a primary health care centre in Al Azhar University in Gaza city.
• During the reporting period, UNRWA conducted a blood donation campaign in Khan Younis, successfully collecting 184 blood units.
• One patient and two caregivers were medically evacuated during the reporting period.

Challenges

• The intensification of hostilities and attacks on health care continue. For example, on 22 April, the gate of the Kuwaiti Field Hospital in Khan Younis was hit, resulting in the death of one staff member and destruction of four ambulances. On 23 April, attacks on Al Durrah Paediatric Hospital in Gaza city resulted in damage to the intensive care unit (ICU) department and the hospital's solar panels, which are critical amid the ongoing electricity and fuel crisis.
• The full blockade has had a detrimental impact on the availability of essential medicines, critical blood units, medical consumables and vaccines, hampering the delivery of lifesaving health services. For instance, 87 per cent of the medical consumable items required for orthopaedic surgeries and 99 per cent of medicines used for cardiac catheterization are currently out of stock. The rota vaccine for children has been fully depleted. A critical shortage of medical equipment is also hampering support for maternal and newborn care. Moreover, spare parts for urgent repairs of ambulances and generators are lacking, along with fuel (benzene) shortages to run ambulances.
• The fourth round of the polio vaccination campaign targeting 602,795 children, which was scheduled to take place in early April, is currently pending due to ongoing displacement orders, movement restrictions, and depletion of vaccines. This has serious public health implications. Service delivery at 13 routine immunization health service delivery points has been interrupted due to displacement orders.
• Since 18 March, Israeli authorities have increased the denial rate of EMT personnel, particularly affecting specialized doctors.
• There is an ongoing shortage of assistive devices across Gaza, where over 150,000 people are estimated to need them. Lack of timely and appropriate assistive devices increases the risk of complications for people with life-changing injuries, particularly given limited limb reconstructive surgeries.
• Overcrowding, warmer weather, the near-collapse of the health system, limited access to clean water and sanitation facilities, and increased vulnerabilities, such as injuries and weakened immunity, are contributing to the spread of vaccine-preventable and skin diseases. During the reporting period, UNRWA medical points in Al Mawasi area of Khan Younis have reported a rise in medical consultations related to skin diseases.

Response

• Between 1 and 25 April, at least 56,770 children received blanket supplementary feeding – medium-quantity, lipid-based nutrient supplements (LNS-MQ) – compared with 84,509 children in February, during the ceasefire, and 22,318 children in March. During the same period, 15,335 children received nutrients vitamins and minerals supplementation through small-quantity LNS. This represents less than half the number of children reached in March (about 32,600), as the Blanket Supplementary Feeding Programme expanded. Additionally, 8,000 children received vitamin A though the routine programme.
• During the first two weeks of April, 7,272 children received ready-to-use complementary food (RUCF) to support dietary diversity, compared with 18,409 children who received this assistance in March; data for the reporting period is not yet available. Of the children who received RUCF, two-thirds were between six and 11 months old. During the same period, 9,542 pregnant and breastfeeding women (PBW) received LNS-MQ, compared with 5,370 PBW during the full month of February. In addition, 371 PBW received iron folate supplements, while 468 were provided with micronutrient supplements. These multiple malnutrition prevention interventions (supplementation, micronutrients, complementary feeding) are critical within the context of declining dietary diversity, helping to prevent the further deterioration of the nutritional status of children and PBW and to address rising micronutrient deficiencies.
• In the first two weeks of April, at least 32,000 children and 8,169 PBW were screened for acute malnutrition. A total of 984 children were diagnosed with severe or moderate acute malnutrition (SAM or MAM) and were enrolled in treatment programmes supported by 13 partners. Recent screening data analyzed by the Nutrition Cluster show an increase in acute malnutrition in the first weeks of April compared with March. Additionally, 40 women were integrated in the newly launched targeted supplementary feeding programme, which provides additional nutritional support for PBW diagnosed with acute malnutrition, through two implementing partners.

Challenges

• Amid ongoing hostilities, the blockade, displacement orders and the expansion of the “no-go”’ zone, humanitarian space has continued to shrink. Out of 195 nutrition treatment sites open before 18 March, only 122 remain operational, with 23 closed and 50 non-operational due to security concerns. Meanwhile, the initial April plan envisioned blanket supplementary feeding at 130 nutrition sites, but about 25 of these sites have paused activities, delaying and limiting the programme’s outreach, especially in southern Gaza where some partners lost access to their warehouses while evacuating.

Response

• During the reporting period, the Mental Health and Psychosocial (MHPSS) Technical Working Group (TWG) delivered training sessions for 38 frontline staff on MHPSS, finalized and distributed a new MHPSS service map, and provided psychosocial support (PSS) and psychological first aid (PFA) sessions in areas that remain accessible. The TWG also assessed additional training needs to inform response efforts.
• About 40 actors addressing gender-based violence (GBV) conducted case-management, delivered cash assistance, and carried out MHPSS, legal aid and other referrals to essential services at 14 Women and Girls Safe Spaces (WGSS) in Gaza, Deir al Balah and Khan Younis governorates.
  • Four WGSS in Khan Younis, Deir al Balah and Gaza city reported significant increases in the number of women seeking PSS. Similarly, online case management services experienced a surge in demand, underscoring the urgent need for increased investment in case management and PSS services, both in person and remote.
  • During the reporting period, UNRWA expanded its services addressing GBV by recruiting additional social workers and counselors at displacement shelters and health centres. Between 4 and 17 April, the agency also conducted awareness sessions on GBV for 3,231 people and distributed 2,109 dignity kits in Khan Younis, Gaza, North Gaza and Deir al Balah.
• Under the Legal TWG, partners continued awareness-raising efforts, legal counseling and paralegal services, with a focus on marginalized women and girls. Legal services include support for guardianship, custody, and civil documentation. In April, one partner conducted 80 information sessions at displacement shelters across Gaza. Additionally, amid access constraints, several partners have shifted to remote and flexible service modalities, such as toll-free hotlines for inquiries and referrals, and submitting applications for civil documents to case workers, though the issuance of death certificates is a persistent challenge. Legal and health partners are also working to establish a new medical corridor to East Jerusalem, aiming to improve access to critical health services which are unavailable in Gaza.
• Partners under the Housing, Land and Property TWG collaborated with the Palestinian Housing Council to launch a phone centre and a mapping tool to help classify land types and verify ownership, developed in coordination with local municipalities.
• During the reporting period, UNRWA protection teams continued to monitor and identify protection risks and needs across Gaza, facilitating access to specialized care for the most critical cases through a referral system and direct service provision. Between 4 and 17 April, UNRWA protection teams carried out 106 protection observations across shelters and displacement sites, 80 key informant interviews and 37 focus group discussions. Identified protection risks include: deteriorating mental health among children, increased child labour, risks of injury from unexploded ordnance, heightened exposure to violence, including GBV, in shelters, neglect and declining health among the elderly, and hazards linked to open sewage and waste accumulation. In response, UNRWA delivered 106 awareness raising sessions on MHPSS and PFA, reaching 805 people, including 344 boys, 385 girls, and 76 women; Prevention of Sexual Exploitation and Abuse (PSEA), reaching 415 females; and Explosive Ordnance Risk Education (EORE), reaching 1,980 people including 1,144 girls, 763 boys, 155 women and eight men. Additionally, UNRWA distributed material assistance to 735 people, including dignity kits, children’s clothing, diapers for children, hygiene kits, food parcels and bedding kits.

Challenges

• Ongoing bombardment, displacement orders and the full blockade have resulted in severe shortages and near total depletion of essential supplies, including food, medicines, hygiene products, and protection supplies, are critically disrupting protection services and exacerbating existing vulnerabilities.
• Demand for dignity kits, adult diapers and other essential items continues to far exceed available supplies. Movement restrictions are severely limiting the scale and reach of protection services, including referral pathways for GBV survivors and access to health services.
• The wellbeing of frontline protection workers remains a key concern, with reports of injuries among staff, displacement and elevated psychological stress.

Response

• During the reporting period, operations and attendance in temporary learning spaces (TLS) fluctuated significantly. As of 26 April, only 140 TLS supported by 2,294 teachers remained operational, serving 69,129 students. This marks a substantial decline from the ceasefire period, when 570 TLSs were established, reaching 249,020 students (about 52 per cent girls) with support from 5,941 teachers.
• While efforts are ongoing to gradually re-open more TLSs, partners continue to maintain the use of shifts and rotations to maximize access to learning, whereby each child receives a minimum of 2.5 hours of teaching per day, at least three days per week. Efforts are made to ensure that children inside and around displacement shelters are included. Meanwhile, partners continue to support remote learning.
• During the reporting period, the Education Cluster published a new brief to support planning for the return and continuity of learning in Gaza and the West Bank. The brief outlines learning losses, maps learner profiles and ongoing programs, offers recommendations aligned with the Ministry of Education and Higher Education's (MoEHE) plans, and emphasizes the need to harmonize education services with national curricula and frameworks.
• The new 2024-2025 academic year for students enrolled in UNRWA learning programmes commenced on 26 April, following the completion of the 2023-2024 academic year. At the end of March, 286,000 learners sat for end-of-year examinations and received certificates for grade progression. In line with the data-sharing agreement between UNRWA and the MoEHE, student lists from public and private schools participating in UNRWA programmes were exchanged to facilitate certification processes. Efforts to align UNRWA and MoEHE academic calendars are ongoing, although significant challenges remain.

Challenges

• The escalation of hostilities and issuance of displacement orders since 18 March have triggered large-scale displacement and jeopardized the short-lived efforts to restore in-person learning activities for out-of-school children that had only recently resumed during the ceasefire. As of 26 April, the number of operational TLS have declined by over 75 per cent, and the number of children accessing learning has dropped by over 72 per cent compared with the ceasefire period. Currently, 259 TLSs are paused due to insecurity, affecting over 140,100 students. In addition, 171 TLS have been closed due to funding constraints, affecting over 39,700 children. The latest displacement orders issued on 24 and 25 April affected five government schools and three TLS, interrupting access to learning of more than 2,600 children supported by 57 teachers. Overall, since 18 March, 90 out of the 186 governmental schools that were re-opened during the ceasefire are now in areas placed under displacement orders, affecting more than 90,000 learners and over 2,000 teachers.
• The full blockade has severely affected the education sector. A lack of essential supplies, such as teaching materials, tents and classroom equipment, is also preventing the delivery of safe, dignified and effective education for children. Efforts to implement remote learning are hindered by fuel shortages and the connectivity crisis. As a result, continuity of learning is increasingly at risk and education services in Gaza face further deterioration.
• Critical fuel shortages are disrupting the operation of TLS and other education facilities, by affecting the electricity supply, internet connectivity, and the transportation of teachers and any available learning materials.
• The suspension of some TLS and governmental schools has further limited children's access to MHPSS, social and emotional learning, recreational activities, and foundational learning opportunities previously offered in these spaces. Beyond the loss of education, these closures remove safe spaces created to support children exposed to trauma, stress and anxiety, creating additional distress. Moreover, children lose the supporting network of peers and adults who are essential to foster their well-being and resilience.

Response

• Since the escalation of hostilities on 18 March, the SMC has been monitoring population movements again across Gaza to inform response planning and coordination. During the reporting period, two Population Movement Monitoring Flash Updates were published, with the most recent update, as of 29 April, indicating that over 420,000 people have been displaced since 18 March across the Gaza Strip.
• SMC partners are working with focal points at displacement sites to alert them about changes in their respective sites, highlighting needs and gaps. This includes notifying partners about new arrivals in need of assistance or flagging significant departures, which can also support the monitoring of population movements. The approach is being rolled out in the first phase at 730 sites. During the reporting period, induction sessions on the system and tools were rolled out, targeting focal points/key informants at 199 sites in Khan Younis, Deir al Balah, Gaza and North Gaza governorates.
• SMC partners are working to re-establish static and mobile reception points to provide limited food, water and other essential services to support people during their displacement journey, if additional waves of large population movements take place.

Challenges

• Access constraints and widespread insecurity have resulted in incomplete displacement data and reliance on a combination of social media monitoring, remote partner updates, and communications with key informants.
• There have been reports of skin diseases among IDPs at some displacement sites in Al Mawasi area in western Khan Younis. With limited access to water and sanitation services, there are concerns that these cases may worsen significantly and potentially spread to other displacement sites.
• With the full blockade and dwindling stocks, requests from community site focal points for assistance cannot be consistently met, reducing trust in humanitarian processes.

Response

• Following the escalation of hostilities on 18 March, Shelter Cluster partners have prioritized reaching the most vulnerable households among the newly displaced and responding to referral requests from other clusters and working groups. This includes prioritizing immediate shelter needs for families affected by airstrikes on IDP shelters and other conflict-related incidents. They have also supported existing displacement sites that are absorbing new waves of displaced people. This approach aims to prevent further fragmentation of services associated with informal site creation and make the most of depleting resources.
• During the reporting period, Shelter Cluster partners continued to deliver shelter and non-food items from remaining stocks to some of the most vulnerable households across the Gaza Strip. Between 13 and 26 April, partners distributed more than 2,900 blankets and over 1,000 clothing kits. Moreover, partners provided more than 9,772 people with tarpaulins and sealing-off kits and distributed about 90 tents across the Gaza Strip.
• At present, there are 115 UNRWA shelters across Gaza, including 26 in North Gaza governorate, 41 in Gaza governorate, 26 in Deir al Balah, 22 in Khan Younis, and none in Rafah.

Challenges

• Insecurity, the full blockade, and displacement orders are significantly affecting partners’ capacities and response efforts. Many staff members have themselves been displaced, critical shelter and non-food stocks have been largely depleted, and access to newly displaced people is increasingly constrained. As of 20 April, tents are out of stock and partners have been unable to access about 10,000 tarpaulins that remain in storage in Rafah, where there is an ongoing military ground operation.
• Reported airstrikes on IDP tents are affecting displaced families in various, scattered locations, making it extremely difficult for shelter partners to deliver shelter and other items.
• Needs are rapidly growing, with over 420,000 people displaced as of 29 April, according to SMC. Based on SMC documentation, the Shelter Cluster estimates that nearly half of the people who returned to their areas of origin during the ceasefire were displaced again over the past two months. In most cases, people were unable to carry their belongings. As a result, and despite aid deliveries, unmet shelter needs persist throughout the Gaza Strip, with about 1.8 million people estimated to require emergency shelter assistance and essential household items.
• Total reliance on humanitarian aid, the lack of a fully functioning market, and prohibitively expensive shelter items that remain available in limited quantities on the market are further constraining response efforts.
• Most shelter items, such as tents, have a short lifespan of just three to six months, creating a repetitive cycle of demand for shelter assistance. This is further compounded by the multiple waves of forced displacement, which often result in the loss or abandonment of shelter items.

Response

• During the reporting period, the Logistics Cluster completed the Fleet Capacity Survey with the participation of 44 partners in Gaza. The survey findings revealed that partners collectively have 1,080 vehicles and generators across the Gaza Strip. Notably, 13 organizations account for 80 per cent of the total fleet. The survey further indicated that 68 per cent of the listed equipment relies on diesel, while 32 per cent depends on benzine, which is currently in short supply. In other words, one-third of the partners’ fleet and generators in Gaza are currently non-operational due to fuel shortages.

Challenges

• Due to the full blockade, a significant backlog of cargo is accumulating in Logistic Cluster and partner warehouses across the region. In Jordan, the Cluster warehouses are full, preventing the pre-positioning of additional cargo. In Egypt, as of 21 April, 1,405 truckloads of cargo in partners’ pipelines are awaiting dispatch, according to the Egyptian Red Crescent Society. This prolonged disruption is resulting in substantial additional costs for Logistics Cluster partners.
• Since 2 March, Israeli authorities continue to deny the Logistics Cluster's request to have access to the Kerem Shalom/Karm Abu Salem platform to conduct an inventory of the remaining humanitarian aid.

Response

• During the reporting period, the ETC cluster continued to support the operational continuity of critical telecommunications systems and security communication systems, thereby enhancing the safety of humanitarian personnel. This was made possible by the continued receipt of fuel allocations, amid severe shortages.
• During the reporting period, several advocacy and coordination efforts were conducted to highlight urgent telecommunications priorities in Gaza, including the entry of telecommunications and IT equipment, such as VHF radios, and spare parts for repair and maintenance.
• On 21 April, a list of critical telecommunications infrastructure sites, critical for sustaining communication services, was submitted to Israeli authorities via WFP’s Humanitarian-Military Interaction (HMI) team for the purpose of notification.
• For more information on ETC activities, please visit:Palestine: Conflict | Emergency Telecommunications Cluster (ETC) (etcluster.org).

Challenges

• The full blockade and other access constraints have restricted the ability of the ETC to deliver critical services across Gaza, such as expansion of VHF radio coverage and internet connectivity. This includes VHF digital radios, programmed in Jerusalem, that have been awaiting approval for entry since June 2024. Deployment of this equipment is critical to sustaining telecommunications infrastructure and the Security Communications System. Meanwhile, escalating hostilities and insecurity have prevented the planned relocation of the VHF repeater from Deir al Balah to Al Mawasi in Khan Younis, hampering UN operations.
• Extensive infrastructural damage in hostilities and the lack of equipment for repairs and maintenance continue to severely limit telecommunications and internet services across Gaza. ETC partners report that telecommunications equipment has been further damaged or destroyed since the renewed escalation of hostilities on 18 March in both northern and southern Gaza, with Rafah being one of the most affected governorates.
• Only limited fuel reserves are available to sustain the operation of generators and other critical telecommunications infrastructure.
• Insufficient funding has limited the Cluster's capacity to address immediate critical communication needs for humanitarian responders in Gaza. The Cluster continues to appeal to potential donors for funding.

Protection against sexual abuse and exploitation (PSEA) remains a cross-cutting priority for all clusters. Aid distribution must be delivered with dignity and respect. Any wrongdoing can be reported through SAWA toll-free number 164. SAWA will assist and provide services free of charge and with the utmost confidentiality.

To promote accountability to affected people, the online Humanitarian Service Directory provides information on aid services, helplines, and key messages, and is available via hyperlink and QR code.

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