Hostilities in the Gaza Strip and Israel | Flash Update #10

KEY POINTS

• As hostilities entered the tenth day, heavy Israeli bombardments on Gaza, from the air, sea and land, have continued almost uninterrupted. In the last 27 hours (as of 21:00), 138 Palestinians have been killed, bringing the cumulative fatality toll in the Gaza Strip to 2,808, according to the Ministry of Health in Gaza.^[1] Additional hundreds are missing and believed to be trapped under the rubble.

• Today (Monday), seven Civil Defense members were killed during an airstrike, bringing the total number of humanitarian staff killed while on duty to 31.

• In the wake of the Israeli order to evacuate the northern part of the Gaza Strip on 13 October, the number of internally displaced people (IDPs) since the start of hostilities may have reached one million, including about 333,000 IDPs staying in UNRWA schools in central and southern Gaza, in increasingly dire conditions.
• The siege of Gaza continues. The Rafah Crossing has remained closed, preventing the entry of desperately needed humanitarian aid, including food, water and medicines awaiting on the Egyptian side.
• Gaza has been under full electricity blackout for the sixth consecutive day. Hospitals are on the brink of collapse as their fuel reserves used to operate backup generators have been almost totally depleted, endangering the lives of thousands of patients.
• On Sunday, the Israeli authorities resumed partial water supply to the eastern Khan Younis area, providing less than four percent of the water consumed in the Gaza Strip prior to the hostilities. Given the collapse of virtually all water and sanitation services in Gaza, the UNICEF-led WASH Cluster stated that the population “is at imminent risk of death or infectious disease outbreak if water and fuel are not immediately allowed to enter the Strip.
• Palestinian armed groups in Gaza continued firing rockets indiscriminately towards Israeli population centres, including at the Tel Aviv and Jerusalem metropolitan areas. No Israeli fatalities were reported during the past 24 hours (as of 21:00).
• An almost full evacuation of Sderot city, in southern Israel, was completed yesterday (15 October). Smaller Israeli communities around Gaza had been fully vacated in previous days, while a large proportion of Ashqelon city’s residents have also reportedly left.
• In the West Bank, since Sunday afternoon, Israeli forces killed one Palestinian, bringing the fatality toll by Israeli forces since 7 October to 53 Palestinians, including 14 children.
• According to the Israeli military, at least 199 people are held captive in Gaza, including Israelis and foreign nationals. On 16 October, UN’s emergency relief chief Martin Griffiths expressed deep concern about the deepening humanitarian crisis in Gaza and about the fate of Israeli hostages, stressing that “they have to be let out straight away.”

HUMANITARIAN OVERVIEW

Hostilities and casualties

Israeli airstrikes and shelling continued. Multiple residential buildings in densely populated areas have been targeted and destroyed. This included a residential building in Jabalia, northern Gaza, where ten Palestinians were killed; a residential building in the Musabah area of Rafah, where at least 11 Palestinians, including women and children, were killed; and a charity organization’s building in Rafah, where 11 Palestinians were killed, and several others were injured. On 16 October, in the morning, Israeli forces reportedly targeted a residential building in Khan Yunis, killing 22 Palestinians. Several attacks occurred in close proximity to a hospital and main roads, creating significant access challenges.

Additionally, at dawn on Monday, an Israeli airstrike hit the Palestinian Civil Defense (PCD) headquarters in the At Tuffah area, east of Gaza City, killing seven staff, adding an additional challenge to their rescue operations, already affected due to safety concerns, equipment shortages, and severely damaged streets.

Since the start of hostilities, 2,808 Palestinians have been killed and 10,850 have been injured.^[2] The fatality toll in Gaza during the ten days of hostilities has already surpassed the total number of fatalities during the 2014 escalation, which lasted for over 50 days (2,251 Palestinian fatalities). According to the Ministry of Health in Gaza, as of 16 October at 18:00, 47 entire families have been killed, amounting to about 500 people.

Additionally, it is estimated that hundreds of individuals are still trapped beneath the rubble, raising both humanitarian and environmental concerns, including regarding the decomposition of bodies under collapsed buildings.

Human rights organizations have expressed deep concern over incidents in which civilians and civilian objects appear to have been directly targeted by Israeli airstrikes.

As of 21:00 16 October, no new Israeli fatalities have been reported. According to official Israeli sources, at least 1,300 Israelis and foreign nationals have been killed in Israel, and at least 4,121 have been injured, the vast majority on 7 October. The fatality toll is over three-fold the cumulative number of Israelis killed since OCHA began recording casualties in 2005 (nearly 400).

According to the Gaza Ministry of Public Works, as of 14 October, 8,840 housing units have been destroyed and 5,434 housing units have been damaged and rendered uninhabitable. The World Health Organization (WHO) has documented 48 attacks on health care in the Gaza Strip since 7 October, resulting in damage to 24 hospitals and other healthcare facilities, including six hospitals. Three of the latter in northern Gaza (Beit Hanoun, Hamad Rehabilitation, and Ad Dura) had to be evacuated.

The scope of damage sustained by education and other civilian infrastructure as a result of bombardments is also of increasing concern. As of 16 October, 164 educational facilities have been hit by airstrikes, including at least 20 UNRWA schools, two of which were used as emergency shelters for IDPs, and 140 Palestinian Authority (PA) schools, one of which was destroyed. One university building was also severely damaged, at least eleven mosques were targeted and destroyed, and seven churches and mosques were damaged.

Water and sanitation facilities have also been severely damaged. As of 12 October, at least six water wells, three water pumping stations, one water reservoir, and one desalination plant serving over 1,100,000 people were damaged.

Displacement

The cumulative number of internally displaced people (IDPs) since the start of hostilities may have reached one million, including nearly 333,000 IDPs staying in UNRWA designated emergency shelters (DES) in central and southern Gaza alone. The number of IDPs in UNRWA’s DES in Gaza city and North Gaza is currently unavailable. In addition, about 54,500 IDPs are staying in 51 non-UNRWA shelters, most of which are in Gaza city and northern Gaza.

UNRWA's DES in the central and southern regions are overcrowded, forcing many displaced people to sleep outdoors. This includes children, the elderly, those in need of medical care, people with disabilities, and pregnant women. Essential resources like water, food, and medicine are in critically short supply, leading to rising frustration and tensions among IDPs.

Anecdotal reports indicate that many displaced families have been returning to Gaza city and the north of Gaza (west of Wadi Gaza) due to ongoing airstrikes targeting the southern areas, compounded by the difficult living conditions in the South, with cramped temporary shelters, lack of water, electricity, sanitation.

Basic services and livelihoods

For the sixth consecutive day (since 11 October), Gaza has been under a full electricity blackout, following Israel’s halt of its electricity and fuel supply to Gaza, which in turn triggered the shutdown of Gaza’s sole power plant. Forcing essential service infrastructure to rely on backup generators, which are limited by the scarcity of fuel in the Strip.

Twenty out of 23 governmental and NGO hospitals are partially operational and continue to treat an average of 1,000 injured patients per day, far exceeding their capacity. Fuel reserves at hospitals are not expected to last more than a few hours. Therefore, some hospitals have further reduced essential services, such as dialysis, to remain operational. Additionally, today (Monday) the Ministry of Health reallocated limited amounts of fuel still available in some public facilities to hospitals, thus preventing the shutdown of generators.

The shutdown of backup generators would place the lives of thousands of patients at immediate risk. The International Committee of the Red Cross (ICRC) stated that “hospitals in Gaza risk turning into morgues without electricity.”

According to the UNICEF-led WASH cluster, on 15 October, the Israeli authorities renewed water supply to Gaza via one out of three lines that were operated prior to the hostilities and, together, contributed to some 13 per cent of Gaza’s water consumption. This line supplies about 600 cubic metres per hour to households in eastern Khan Younis area. The water has been reaching other areas of the city by gravity, benefiting a limited number of households.

The last remaining seawater desalination plant, out of the four servicing central and southern Gaza, shut down on 15 October due to lack of fuel. These plants were vital sources of water for people in Gaza.

Except in eastern Khan Younis where supply through the network resumed, the main suppliers of clean drinking water are now private vendors, who operate small desalination and water purification plants, which are mostly run by solar energy. WASH cluster partners estimate that the average water consumption from all sources and for all needs dipped to just three litres per day per person, raising the risk of dehydration. Some people have resorted to consuming brackish water extracted from agricultural wells. The latter practice increases exposure to pesticides and other chemicals that will affect the health of all people living in Gaza, including unborn, newborn, children, women and men. On 15 October, Gaza’s only remaining operational wastewater treatment plant (out of five), which relies on solar energy, was forced to shut down. Consequently, additional amounts of untreated sewage have been discharged to the sea. Most of the 65 sewage pumping stations are not operational, increasing the risk of sewage flooding. In some areas, sewage and solid waste have been accumulating in the streets, posing health and environmental hazards.

According to officials at the Gaza Power Plant, the Israeli authorities have warned that the plant would be targeted if it attempted to resume operations. The Israeli Defense Minister indicated that electricity, fuel and full water supply to Gaza would not be restored until the Israeli hostages are released. The Secretary-General stressed on Friday that “crucial life-saving supplies, including fuel, food and water, must be allowed into Gaza.”

The blackout has disrupted food security by affecting refrigeration, crop irrigation, and crop incubation devices, consequently harming various livelihoods, including poultry, cattle, fish, and other commodities.

With the number of IDPs growing, many have limited access to food. Local bakeries are unable to operate due to the shortage of essential ingredients, particularly wheat flour, which is expected to be depleted in less than a week. Moreover, only one in five mills is functioning, and there are scarcities of water and fuel. Communication issues have also hampered warehouse operations, while wholesale suppliers are facing difficulties. This crisis persists, with people in the northern areas still requiring assistance.

The lack of access to fodder and damage from the airstrikes have taken a toll on farmers, with many breeders, primarily small-scale ones, reporting substantial losses among their animals, particularly in the poultry sector. Farmers are losing their crops in agricultural lands situated in the east of Khan Yunis and other locations.

Of critical concern are an estimated 20,000 people in need of specialized mental health services, including mental health drugs, who are in precarious situations following the disruption of mental health services. People with mental health illnesses risk being exposed to violence and abuse, and of going missing during evacuation. An estimated 50,000 pregnant women face extreme challenges to accessing prenatal and maternity care due to risks related to movement, compromised functionality of health facilities, and shortage of lifesaving supplies.

Movement and access

The Rafah crossing with Egypt has remained closed preventing the entry of desperately needed humanitarian aid, including food, water, and medicines, as well as the crossing of people. Conflicting reports about agreements between the United States, Israel, Egypt, and Qatar to open Rafah crossing for the evacuation of foreign nationals to Egypt, resulted in the movement of the foreign nationals and dual citizens towards Rafah crossing in the midst of dangerous conditions. However, this agreement has not yet been confirmed by all the parties.

The Erez and Kerem Shalom crossings with Israel also remained closed. Referrals for patients and their companions to exit the Gaza Strip to reach their medical appointments in the West Bank and Israel have ceased since 7 October. People from Gaza working in Israel were not able to return home. Hundreds have been detained by Israeli authorities, while over 1,000 were transferred to the West Bank.

Access to the sea has been prohibited by the Israeli military, and all fishing activity stopped since the hostilities began. Access within 1,000 metres from Israel’s perimeter fence remains prohibited, preventing access to large areas of farming lands and, alongside safety concerns, has decreased produce yield, directly affecting hundreds of thousands of farmers.

Humanitarian operations

All humanitarian agencies and personnel have faced major constraints in providing humanitarian assistance, due to airstrikes, movement restrictions and shortages of electricity, fuel, water, medicines and other essential items. The prevailing insecurity is preventing safe access to people in need and essential facilities, such as warehouses.

Despite these challenging conditions, humanitarian actors are working around the clock to support the most vulnerable. The major operation entails the hosting of IDPs in UNRWA schools, where basic food, medicine and support is provided to retain dignity and a glimmer of hope. Other interventions include the distribution of food and cash assistance to IDPs and emergency fuel to WASH facilities, psychosocial support helplines, and a mass media campaign to raise awareness about the risks of unexploded ordnance (for further detail, see Humanitarian Needs and Responses).

The reach of operations will remain limited without a humanitarian pause, the opening of the crossings with Israel and Egypt and significant funding for humanitarian response.

On 12 October, the OPT Humanitarian Country Team (HCT) launched a Flash Appeal calling for US$294 million for 77 humanitarian partners to address the most urgent needs of 1,260,000 people in Gaza and the West Bank. This Flash Appeal is set to be revised given the significant increase in humanitarian needs.

WEST BANK HUMANITARIAN OVERVIEW

Casualties

In the West Bank, including East Jerusalem, confrontations between Palestinians and Israeli forces have continued for ten consecutive days. Since the start of the hostilities, until 16:00 16 October, Israeli forces have killed 53 Palestinians, including 15 children. An additional five Palestinians were killed by Israeli settlers during two consecutive settler attacks in Qusra (Nablus). Last week was the deadliest week for West Bank Palestinians since OCHA began recording casualties in 2005.

From the afternoon of Sunday to 16:00 on 16 October, Israeli forces shot and killed a Palestinian man and injured three others with live ammunition during a search-and-arrest operation in Aqbat Jaber Camp in Jericho. Confrontations erupted in the camp where Palestinians threw stones and Israeli forces shot live ammunition, sound grenades, and teargas canisters. Israeli forces injured three Palestinians, bringing the total number of Palestinians injured to 1,176, including at least 113 children. Over 1,000 Palestinians were injured, mostly by Israeli forces, in the context of demonstrations. Some 26 per cent of injuries were caused by live ammunition.

Settler-related violence

Settler violence across the West Bank, especially in Palestinian communities near Israeli settlements, has been on the rise. Since 7 October, OCHA has recorded 70 settler attacks against Palestinians resulting in casualties or property damage, including some where Israeli forces were involved. This represents an average of almost eight incidents per day, compared with a daily average of three incidents per day since the beginning of this year.

Attacks on health care

Since 7 October, WHO has documented 63 attacks against health in the West Bank, including obstruction to delivery of health care; physical violence towards health teams; detention of health staff and ambulances; and militarized search of health assets.

HUMANITARIAN NEEDS & RESPONSES

Protection

Priority Needs

• An estimated 20,000 people in need of specialized mental health services, including mental health drugs, who are in precarious situations with the disruption to mental health services.
• Documentation of violations of International Human Rights Law and Humanitarian Law.
• Opening roads, safe access to basic needs, medicines, mental health support, and ambulance services in the West Bank.

Response to Date

• Ten child protection and Mental Health Psychosocial Support (MHPSS) partners are operating in, and for, Gaza (six in the Gaza Strip and four partners in the West Bank) providing remote psychosocial support.
• The United Nations Mine Action Service (UNMAS) has initiated an emergency mass media campaign through various platforms, including social media and radio stations, to send Explosive Ordnance Risk Education (EORE) and Conflict Preparedness and Protection (CPP) messages to as wide a population as possible.
• In the West Bank, the assigned MHPSS Focal Points are responding to settler violence triggers. The MHPSS Coordination Lead Focal Points at governorate levels are intervening as needed.

Shelter

Priority Needs

• Urgent need to provide services and basic Shelter and Non-Food Items (NFI) to IDPs.
• Provision of Non-Food Items and house maintenance for people displaced in urban centers and with host families.
• Provision of shelter cash assistance for IDPs (reintegration package and belongings loss compensation) for at least 3,000 families.

Response to Date

• 270,000 IDPs are hosted at 102 UNRWA schools across the Gaza Strip.
• Distribution of 3,900 NFIs in Rafah and Khan Younis, including bedding sets and dignity kits.
• Distribution of 820 hygiene kits to displaced families.
• ICRC/PRCS distributed 120NFIs for displaced families.

Health

Priority Needs

• Addressing shortages of medical supplies impacting case management.
• Fuel for hospitals and ambulances are running out.
• Urgent need to restock medical supplies given depletion of stocks in the local market.
• UNRWA have medical points in 53 out of the 108 shelters. The Health Cluster is identifying other partners to support the remaining shelters. Health Cluster partners are mobilizing and prepositioning supplies in Egypt.

Response to Date

• Partners continue to procure supplies from the local market to support hospital operations.
• Surge staff remain present in the hospitals supporting case management.
• Ambulances and emergency medical teams continue to operate despite the risk and difficult environment.

Food Security

Priority Needs

• Electricity, fuel, and water sources to maintain agriculture.
• Many shops have food supplies to last less than a week.
• Safe access to farms, livestock, fisheries, and other food livelihood.
• Urgent import of fodder.

Response to Date

• The World Food Program (WFP) reached 220,000 displaced people residing in UNRWA shelters, providing canned food and bread.
• 243,291 IDPs received CBT (cash-based transfer) for food. Of those, 139,312 have been redeemed.
• WFP is planning to reach 224,900 IDPs in 19 UN shelters in the south of Gaza. In addition, five trucks carrying 100 MT of food parcels and 15 MT of fortified biscuits from Dubai are expected to arrive in Arish, Egypt.
• 5 October, over 107,192 displaced people received fresh bread and canned tuna.

Education

Priority Needs

• Safe access to schools and communities.

Planned Responses

• Provision of school-based psychosocial support and recreational activities for at least 70,000 children and school staff as soon as the situation allows.
• Emergency rehabilitation for at least 20 damaged schools, following a cluster rapid needs assessment.
• Provision of emergency supplies and learning kits to 10,000 children in DES and 50,000 children in schools once they reopen.
• Provision of catch-up classes, especially to displaced children (at least 20,000 children).

WASH (Water, Sanitation and Hygiene)

Priority Needs

• Provision of clean drinking water to the population.
• Provision of alternative power supply and 20,000 liters/day of emergency fuel to sustain the operation of WASH facilities, along with replenishing the chlorine supply for water treatment plants.
• Support to restore disrupted municipal services, including solid waste management, water, and sanitation operations, as appealed by the Gaza Strip municipalities.
• Delivery of essential WASH services and provisions to IDPs in collective centers, including drinking water and hygiene kits.

Planned Response to Date

• Service hub planning in Rafah Egypt with supply chain from local markets and/or agency stocks (including fuel and bottled water for quick recovery, hygiene kits, water storage bladder tanks, jerrycans, materials for treatment plans) and planning IDP kits for 300,000 people.
• Reviewing and checking feasibility of water trucking operations.

Protection against sexual abuse and exploitation (PSEA) remains a cross-cutting priority for all clusters. The SAWA helpline, reachable at 121 and through WhatsApp at +972 59-4040121 (East Jerusalem at 1-800-500-121), operates 24/7. This toll-free number is widely disseminated across all areas of intervention to report cases of SEA and to facilitate emergency counseling and referrals for affected communities to access life-saving services. The PSEA Network monitors calls daily and will increase the number of counselors if necessary.

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[1] Casualty figures have been revised after the report was issued.

[2] Casualty figures have been revised after the report was issued.