Hostilities in the Gaza Strip and Israel | Flash Update #125

Key points

• Intense Israeli bombardment from air, land and sea continues to be reported across much of the Gaza Strip, resulting in further civilian casualties, displacement, and destruction of civilian infrastructure. Ground operations and heavy fighting between Israeli forces and Palestinian armed groups also continue to be reported, particularly in Jabalya (northern Gaza), Gaza city, Deir al Balah and Khan Younis.
• Between the afternoon of 22 February and 10:30 on 23 February, according to the Ministry of Health (MoH) in Gaza, 104 Palestinians were killed, and 160 Palestinians were injured. Between 7 October 2023 and 10:30 on 23 February 2024, at least 29,514 Palestinians were killed in Gaza and 69,616 Palestinians were injured, according to MoH in Gaza.
• On 22 February, Israeli forces conducted airstrikes reportedly on residential buildings, mainly in Deir al Balah and Rafah, without prior warning, resulting in the death and injury of multiple people from the same family, including children. The following are among the deadliest incidents reported on 21 and 22 February:
  • On 21 February, at about 20:20, 22 Palestinians were reportedly killed, and tens of others were injured, when a residential building in western An Nuseirat Camp, in Deir al Balah, was struck.
  • On 22 February, at about 0:15, three Palestinians, including one child, were reportedly killed, and others were injured, when a residential building sheltering internally displaced persons (IDPs) in Al Geneina neighbourhood, northern Rafah, was struck.
  • On 22 February, at about 1:30, four Palestinians were reportedly killed, including three children, when a residential building in Deir al Balah was struck.
  • On 22 February, at about 7:20, four Palestinians were reportedly killed, when a residential building in Az Zawayda, Deir al Balah, was struck.
  • On 22 February, In the Zaytoun neighbourhood of Gaza city, up to eighteen people from the same family were reportedly killed, and several remained unaccounted for, in a strike on a residential building
• Between the afternoons of 22 and 23 February, no Israeli soldiers were reported killed in Gaza. As of 23 February, 235 soldiers have been killed and 1,396 soldiers injured in Gaza since the beginning of the ground operation, according to the Israeli military. In addition, over 1,200 Israelis and foreign nationals have been killed in Israel, according to the Israeli authorities, the vast majority on 7 October. As of 23 February, the Israeli authorities estimate that some 134 Israelis and foreign nationals remain captive in Gaza and include fatalities whose bodies are being withheld.
• On 22 February, Christopher Lockyear, Secretary-General of Médecins Sans Frontières (MSF), briefed the UN Security Council. On 21 February, a shelter hosting MSF staff and their families in Gaza was shelled, killing two family members of MSF staff and injuring six others. MSF staff are treating patients with catastrophic injuries, amputations, crushed limbs, and severe burns, despite a lack of hospital beds, medications and supplies. Surgeons are reusing basic gauze on their patients and have had to carry out amputations without anaesthesia on children. Patients need sophisticated care and long and intensive rehabilitation, but since 7 October, MSF have been forced to evacuate nine different health facilities. The MSF Secretary-General again called for an immediate and sustained ceasefire in Gaza and for the unequivocal protection of medical facilities, staff and patients. Also on 22 February, UN Security Council members expressed their deep concern regarding the extremely difficult and dangerous conditions under which UN personnel and the broader humanitarian and health care community are operating in Gaza and stressed the importance of respecting deconflicting mechanisms for the safety and security of UN personnel and facilities.
• A new report by the London School of Hygiene and Tropical Medicine and the Johns Hopkins Center for Humanitarian Health estimates the potential public health impact of the current conflict in the Gaza Strip, focusing on the deaths in excess of what would have been expected in the absence of hostilities. The report provides a range of projections of what could happen under three distinct scenarios and covers a six-month period from 7 February to 6 August 2024. Under an immediate permanent ceasefire scenario, 6,550 excess deaths are projected, mainly due to the time needed to improve water, sanitation and shelter conditions, reduce malnutrition, and restore functioning healthcare services. Under the ‘current status quo’ and ‘escalation of the conflict’ scenarios, the projections rise sharply to 58,260 and 74,290 excess deaths, with traumatic injuries followed by infectious diseases being the main causes of additional fatalities in both cases. These figures are based on the absence of epidemics; should outbreaks of infectious disease such as cholera occur, the projections rise significantly to 11,580, 66,720 and 85,750 excess deaths, respectively. The report underscores the lasting impact of the conflict on the civilian population and emphasizes the urgent need for improved sanitation, nutrition, and healthcare services in Gaza.
• On 22 February, the Palestine Red Crescent Society (PRCS) reported that its VHF system had been disabled, due to artillery shelling near Al Amal Hospital in Khan Younis, aggravating challenges in communicating with field teams, in particular ambulances. On 20 February, 7,500 litres of fuel were delivered to the hospital, to operate the back-up power generator, but the hospital urgently requires additional fuel, as well as food and medical supplies. Some 140 sick and injured patients, their families, and healthcare workers, still remain in Nasser Hospital, also in Khan Younis, which is struggling to operate, with no electricity, running water, sufficient food supplies, or drinking water. According to the World Health Organization (WHO), as of 22 February, there are 12 partially functional hospitals in the Gaza Strip, including six in northern Gaza and six in the south, in addition to three partly functional field hospitals. On 22 February, the newly appointed Regional Director for the Eastern Mediterranean for WHO stressed that funding cuts to UNRWA would result in ‘further catastrophic consequences’ for people in Gaza, and stated that ‘no agency, including WHO, can meet the critical gaps left if UNRWA is unable to fully operate.’
• Catastrophic levels of acute food insecurity are reportedly intensifying across Gaza, with Save the Children reporting that families are forced to “forage for scraps or food left by rats and eating leaves out of desperation to survive,” amid rapidly declining aid supplies. Without an increased access to adequate food, water, sanitation, hygiene and comprehensive health and nutrition services for children and families, the risk of famine is projected to increase, the organization added. Recently, the Global Nutrition Cluster reported a steep rise in malnutrition among children and pregnant and breastfeeding women in Gaza, with serious concerns in northern Gaza (see Cluster updates below). To avert the threat of mass starvation, Save the Children is calling for safe unfettered humanitarian aid access for a massive scale-up in humanitarian aid supplies and the personnel needed to deliver it, particularly in northern Gaza.

West Bank Updates

• On 22 February, an Israeli drone struck a vehicle travelling in Jenin refugee camp, killing two Palestinians, a man and a 17-year-old child, and injuring 13 other Palestinians, including one in a critical condition. According to the Israeli military, the man was involved in attacks against Israelis and was on his way to carry out another attack.
• Since 7 October 2023, 399 Palestinians have been killed, including 102 children, and 4,545 Palestinians have been injured, including 702 children, in conflict-related incidents across the West Bank, including East Jerusalem, and Israel. During the same period, 13 Israelis, including four members of Israeli forces, were killed and 86 injured in conflict-related incidents in the West Bank, including East Jerusalem, and Israel.
• On 21 February, OCHA issued a report highlighting trends in displacement in the West Bank, including East Jerusalem, in 2023. About 4,000 Palestinians were displaced from their homes in 2023, of whom 29 per cent (1,153) were displaced when 214 homes were demolished in Area C and East Jerusalem for lacking building permits issued by the Israeli authorities, the highest such figure documented by OCHA since 2009. Israeli settler violence and shrinking access to grazing land were also a main cause of displacement; at least 1,539 Palestinians (39 per cent of total displacement) were displaced in this context in 2023, the majority in the aftermath of 7 October, with at least 14 Palestinian communities now completely depopulated. Nearly twenty-five per cent of the overall displacement (911) took place as a result of operations carried out by the Israeli army, particularly in refugee camps in the northern West Bank. Some 200 Palestinians (5 per cent) were additionally displaced from Masafer Yatta and H2 areas of Hebron, citing heightened access and movement restrictions and search-and-arrest operations by the Israeli army after 7 October. Finally, 173 people were displaced as a result of the punitive demolition of homes belonging to the families of Palestinians allegedly responsible for attacks against Israelis, accounting for 4 per cent of overall displacement.
• On 21 February, a Palestinian family in Ath Thuri in East Jerusalem was forced to demolish the two upper floors of their three-storey residential building, due to the lack of Israeli-issued permits. The first floor was built before 1967 and did not receive a demolition order. As a result, five families comprising 23 children  (people), including 12 children, were displaced. Since 7 October 2023, 576 people, including 276 children, have been displaced in Area C, and East Jerusalem, after their homes were demolished due to the lack of Israeli-issued building permits, which are almost impossible to obtain.
• Since 7 October 2023, Israeli forces punitively demolished or sealed off 24 Palestinian-owned homes, displacing 117 Palestinians, including 51 children.
• Since 7 October 2023, 830 Palestinians, including 337 children, have been displaced, following the destruction of 131 homes during operations carried out by Israeli forces across the West Bank. About 95 per cent of the displacement was reported in the refugee camps of Jenin, Nur Shams and Tulkarm.
• On 23 February, an Israeli settler from an outpost associated with Nili settlement, near Qibya village (west of Ramallah), shot and injured a Palestinian man, with live ammunition reportedly after the settler brought his livestock to graze on cultivated Palestinian land. Also on 23 February, settlers from Bracha settlement raided the village of Burin in Nablus and set fire to a Palestinian vehicle. Since 7 October 2023, OCHA has recorded 583 Israeli settler attacks against Palestinians that resulted in Palestinian casualties (52 incidents), damage to Palestinian-owned property (467 incidents), or both casualties and damage to property (64 incidents).

Funding

• The Flash Appeal for the occupied Palestinian territory (OPT), which requests US$1.2 billion to meet critical needs of 2.7 million people across the OPT (2.2 million in the Gaza Strip and 500,000 in the West Bank, including East Jerusalem), was extended through the end of March 2024. As of 19 February, member states disbursed nearly $901 million against the updated Flash Appeal (73 per cent); this includes $612 million out of $629 million (97 per cent) requested for October-December 2023 and $289 million out of $600 million (48 per cent) requested for January-March 2024. For funding analysis, please see the Flash Appeal Financial Tracking dashboard.
• The occupied Palestinian territory Humanitarian Fund (OPT HF) and the Central Emergency Relief Fund (CERF) are currently funding more than 94 ongoing projects in the Gaza Strip to meet urgent humanitarian needs, notwithstanding constraints on the entry and delivery of aid into and within the Gaza Strip. These interventions, totalling about $88 million, address needs in the areas of food security, shelter, water, sanitation and hygiene (WASH), health and protection. Since October 7, the OPT HF has received a total of $88 million in contributions from member states and private donors. Private donations are collected directly through the Humanitarian Fund.

HUMANITARIAN NEEDS AND RESPONSE UPDATES | 13–19 February

Health

Needs

• There is a growing need for: primary health services in informal shelters; increasing routine immunization coverage and conducting catch-up campaigns; reducing overcrowding in maternity hospitals; anaesthetic and analgesic medications which are in short supply;
• There is an urgent need for medication for non-communicable diseases and psychotropics; laboratory equipment and reagents to support diagnostics; and blood and blood products to ensure patients receive timely and necessary transfusions.
• The continued siege on some hospitals is greatly affecting case management capacity of hospitals leading to overcrowding of the ones that are still accessible.
• There is a need to strengthen referral mechanisms between hospitals.

Response:

• On average, partners are reaching about 450,000 people in need of various health services per week.
• Ongoing disease surveillance at all health facilities to ensure early diagnosis and treatment of cases as well as early detection of any potential outbreak.
• Plans to open stabilization centres for acute malnutrition cases with medical complications are underway.
• On average, partners provided nearly 300,000 primary health care consultations per week.

Challenges and Gaps

• Increased insecurity in Rafah is greatly affecting response activities. The influx of IDPs migrating to Rafah has overwhelmed available bed capacities at hospitals.
• High insecurity and limited access to health facilities in the northern and middle governorates continue to present major challenges to partners’ response activities.
• Persistent siege of hospitals impedes access and the implementation of response activities.
• The waiting list for patient referrals outside of Gaza continues to grow.
• Partner operations continue to be negatively affected by the displacement of staff, social stresses and telecommunication challenges.
• Limited access to proper WASH facilities is hindering prevention.  

Nutrition

Needs

• Ongoing collaboration with partners is still needed to enhance capacity in Mid-Upper Arm Circumference (MUAC) screening, identify cases of Severe Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM), and the delivery of effective treatment.
• The Gaza nutrition vulnerability situation analysis results have been published on the Global Nutrition Cluster (GNC) website and shared across GNC's social media platforms. This assessment was carried out by the NIS-E Task Force under the leadership of GNC and co-chaired by WFP and UNICEF. The findings show:
• Over 90 per cent of children aged 6-23 months and pregnant and breastfeeding women (PBWs) face severe food poverty (consuming two or fewer food groups each day).
  • Some 90 per cent of children under 5 are affected by one or more infectious diseases.
  • Some 81 per cent of households lack safe and clean water with average household access estimated at less than one litre per person per day.
  • One in six (15 per cent) children aged 6-23 in north Gaza are acutely malnourished.
  • In Rafah, five per cent of children aged 6-23 are acutely malnourished; this lower rate is mainly due to the limited humanitarian assistance provided, demonstrating that humanitarian assistance can mitigate the worst outcomes.

Response

• Thirty-six staff members (17 Female, 19 male) received training on MUAC screening to enhance early case identification and treatment. The training is crucial for enhancing the capacity of our partners and expanding MUAC screening across affected areas.
• Five implementing partners continue conducting screenings for malnutrition among children aged 6 to 59 months, using MUAC measurements in shelters and health facilities. Children who are detected with MAM and SAM are referred for treatment using simplified treatment protocol. Cumulative MUAC assessment data are as follows:
  • Total Children Screened (Cumulative): 7,479
  • Average number of children Screened per week: 1,247
  • Total SAM children identified: 83
  • Total MAM Children Identified: 378

Challenges and Gaps

• Ongoing hostilities in Gaza have caused significant food shortages, poor access to clean water and sanitation facilities, and disruptions to healthcare services. This situation is putting children under five and pregnant or lactating women (PLW) at a relatively higher risk of malnutrition.
• Without private areas for breastfeeding women, it is challenging to encourage and sustain breastfeeding practices. This lack of privacy could have lasting negative effects, particularly on children under two years of age and new-born babies.

Food Security

Needs

• The humanitarian situation in North Gaza and Gaza governorates is extremely critical. The food security situation in Deir al Balah and the southern governorates is particularly acute, with the majority of the population in extreme hunger. In Rafah, the situation is becoming increasingly concerning. People in Rafah are reported to be stopping aid trucks to take food, highlighting the severity of their desperation and hunger.
• There is an urgent need to augment the fleet of delivery trucks to ensure the entire population's nutritional requirements are met and to improve healthcare services, including primary health services, routine immunization coverage, and the provision of medication for non-communicable diseases.
• Gaza's food production sector is severely impacted, eliminating the local production of essential fresh foods like eggs, vegetables, and milk. There is a critical need to restart the import of these vital inputs to revive local production and ensure the availability of balanced nutrition, especially for children and the broader population. Without this, achieving dietary balance remains an unattainable goal.
• Vulnerable segments of the population, including children, the elderly, and individuals with underlying health conditions, are particularly susceptible to the risk of malnutrition. Partners are working to ensure that aid reaches these vulnerable groups.
• Establishing secure and uninterrupted humanitarian corridors in Gaza, with the support of the private sector and a focus on critical resources like fuel and cooking gas, is essential to address the immediate needs of the affected population and support the overall humanitarian response.

Response

• Between 12 and 18 February, a total of 15 partners engaged in providing food assistance across the Gaza Strip. Around 1.7 million people were reached, with Rafah Governorate receiving about 32 per cent of the total food assistance, followed by Deir al Balah (28 per cent), Khan Younis (26 per cent), and northern Gaza Strip (14 per cent).

Challenges and Gaps

• Ongoing airstrikes and heavy fighting in Gaza continue to affect the flow of food supply, posing challenges for the conduct of safe and efficient humanitarian operations. Frequent border closures, restrictions, and security concerns hinder the ability to ensure a consistent and dependable food supply.
• The escalation of hostilities has substantially damaged critical infrastructure, including roads, electricity, and water supply systems, exacerbating severe impediments to the efficient distribution of food.

Shelter and Non-Food Items (NFI)

Needs

• Some 1.7 million people need shelter and NFI assistance across the Gaza Strip.
• Urgent needs are tents, sealing-off kits (SOKs) and NFIs, including bedding, kitchen sets, and winter clothing. SOKs can be used to consolidate makeshift shelters or to protect damaged housing to facilitate return where possible.
• Partners estimate that the amount of debris generated by the destruction of residential housing residential housing units will exceed 12,000 metric tons and will take over four years to remove, given Gaza’s current capabilities.

Response

• Since the start of hostilities, cluster partners reached about 900,000 people with partial shelter and NFI assistance. Partial assistance means that although a household has received some shelter and NFI items, not all their needs have been met.
• During the reporting period, cluster partners distributed 7,900 bedding items, 1,600 SOKs and 340 clothing kits to IDPs sheltering outside of UN shelters in Rafah.
• Some 28,000 tents, 7,600 SOKs, and 35,000 NFI kits are currently in the pipeline.
• At present, there are 26 cluster partners operating in Gaza. Most of the assistance is currently provided in-kind; cash will be pursued further when market conditions allow.
• Further details in the Cluster response strategy and website dashboard.

Challenges and Gaps:

• Slow entry of items into Gaza due to limited aid trucks and complicated bureaucratic and procurement processes.
• Rising prices of shelter materials in neighbouring markets, including high freight rates and shipping costs.
• Need to restore commercial imports and re-establish local markets to relieve pressure on in-kind provision.
• Restrictions on or denial of the entry of key shelter items including timber, hand tools, and cooking stoves.
• Lack of security and access to IDP locations, lack of fuel, and rising social tensions because of the limited quantity of aid available in comparison to outstanding needs.
• Unplanned sites and lack of adequate equipment is leading to water damage to makeshift shelters and tents, and recurrent displacement resulting in the need for re-distribution of assistance.
• Urgent funding is needed to address the key gaps in the supply of shelter and NFIs. As of 19 February, only 28 per cent of the Shelter Cluster funding requirement ($209.2M) has been funded.

Protection

Needs

• Main needs include identification, tracing and reunification, and interim and alternative care arrangements of unaccompanied, previously detained and separated children.
• There is an urgent need to provide Mental Health and Psychological Support (MHPSS), including psychological first aid (PFA); winterization materials, including warm clothing and blanket, for children and new-born babies.
• There is urgent need to provide essential supplies, including menstrual management (MHM) kits and hygiene kits for women and girls.

Response

• In January, Child Protection Area of Responsibility (AoR) partners reached 111,202 boys and girls, and 2,633 women and men through awareness raising interventions; MHPSS for children and caregivers; identification and registration of Unaccompanied and Separated Children (USAC); and distribution of clothing kits.
• Partners distributed essential supplies, including Menstrual Hygiene Management (MHM) kits and hygiene kits for women and girls. A total of 3,500 Dignity Kits and 8,926 MHM kits have been distributed by Gender-Based Violence (GBV) Sub-Cluster partners.
• GBV responders are conducting procurement and distribution of Clinical Management of Rape (CMR) kits, and identification of health service points to provide CMR. Partners are also trying to establish emergency safe spaces, to provide PFA and recreational activities for vulnerable women and girls. Partners continue to expand PFA services for vulnerable groups, including GBV survivors, through frontline responders.

Challenges and Gaps:

• The increased hostilities in Rafah governorate pose a significant threat for partners providing lifesaving protection services in the governorate. There is a lack of available space to provide group-based psychosocial support activities, due to the population density.
• Limited access to other governorates prevents thousands of affected people from being reached with critical protection services.

Education

Needs

• More than 625,000 students and nearly 23,000 teachers in the Gaza Strip have been affected by school closures and attacks on education, leaving them with no access to education or safe places.
• According to the Ministry of Education, as of 13 February, more than 5,055 students and 246 educational staff have been killed and more than 8,497 students and 836 teachers have been injured in Gaza since 7 October.
• Some 92 per cent of all school buildings in Gaza are being used as shelters for IDPs and/or have sustained varying levels of damage. Some 394 schools (79.5 per cent of the total school buildings in Gaza) have sustained damage, including 142 schools that sustained major damage or were destroyed. Combined, these schools previously served some 459,231 children and more than 17,110 teachers. The North, Gaza, and Khan Younis governorates have been especially impacted, accounting for 76 per cent of all damaged schools (source: Education Cluster Damaged School Dashboard.)
• The Education Cluster conducted a Satellite-derived Damage Assessment of all Gaza schools to verify damage to schools based on proximity to damaged sites. Key findings include:
  • Satellite-derived Damage verification exercise confirmed the large level of damage to schools previously reported by the cluster in Gaza.
  • Actual damages to school infrastructure might be 15 to 20 per cent higher than what has been previously reported by the Education Cluster.
  • At least 55 per cent of schools in Gaza will either need full reconstruction or major rehabilitation work to be functional again.
  • One quarter of directly hit and damaged schools are UNRWA-run schools.
  • Forty-five per cent of school buildings that have been used by IDPs as shelters, have been either directly hit or damaged.
  • The satellite-derived images provide evidence for the military use of schools.
• Education partners are concerned about reports, videos and pictures depicting schools being used for military operations by Israeli forces, including their use as detention and interrogation centres, or as military bases.
• Key priorities include the provision of Education in Emergencies (EiE) recreational activities and psychological support, including Social Emotional Learning (SEL) activities to children in shelters and designated emergency shelters (DESs); establishing Temporary Learning Spaces (TLS) in shelters/DESs to start non-formal learning for children; and provision of emergency supplies and learning kits. In addition, a key need is to identify and support of children with disabilities and other needs, with assistive devices for learning.

Response

• Since October 2023, eleven partners have reached more than 160,975 students and teachers with psychosocial support, emergency learning, recreational supplies and activities, and awareness sessions in the Deir al Balah, Khan Younis, and Rafah governorates. Most of the cluster responses are delivered by local partners (source: Education Cluster 5W dashboard).

Challenges and Gaps:

• No activities have been undertaken in the North Gaza and Gaza governorates due to ongoing hostilities and access challenges.
• As of 18 February, the education response remains significantly underfunded, receiving less than 10 per cent of its requirements. Urgent funding is required to meet immediate response requirements.

Logistics

Response:

• As of 18 February 2024, the Logistics Cluster has stored 7,256 cubic metres of cargo on behalf of 17 organisations, and supported 21 organisations with cargo notification service in Rafah.
• Of relief items transported through the Jordanian corridor, the Logistics Cluster facilitated partners` access to the inter-agency convoy, transporting a total of 6,159 metric tons of relief items on 463 WFP trucks on behalf of six partners.
• The Logistics Cluster has circulated the Compiled Logistics Supplier List through the mailing list. The aggregated list comes from partners to partners and is intended to ease access to and exchange of information; it is the list is based on partners' vendors’/suppliers’ contributions. The list will be circulated on a regular basis.
• Challenges and Gaps:
• The storage and transport capacity inside Gaza remains limited. The Logistics Cluster continues to facilitate access to temporary storage, transport from handover points to common warehouses, and cargo notification trans-shipment services.
• The Logistics Cluster is coordinating the pipeline for incoming cargo through the Egyptian and Jordanian corridors for the coming three months. This is a vital exercise for operational planning, in terms of understanding the resources available and making allocations based on the prioritization list. Partners have received a dedicated form and are requested to update it weekly. Partners who have not received the form can reach out to [email protected].

Emergency Telecommunications

Needs:

• There is an urgent need for independent communications platforms for responders in Gaza to coordinate the delivery of relief items amid the ongoing telecoms blackouts and unreliable/intermittent access to telecommunication services.

Response:

• On 12 February, the UN Humanitarian Coordinator received approval from the Israeli authorities to import 30 digital Very High Frequency (VHF) handheld radios for the use of UN agencies in Gaza, and solar solutions to power radio repeaters. Since its establishment on 3 November 2023, the ETC has been engaging with the Israeli authorities to obtain authorizations to import all essential telecommunications equipment into Gaza and provide independent access to communications for humanitarian responders.
• Since 9 January, the ETC has supported humanitarian agencies with Information and Communication Technology (ICT) assessments, technical advice and information, repairs, and guidance on the use of ICT equipment in Gaza. To date, the ETC has conducted eight ICT assessments across four locations in Rafah and supported 14 humanitarian agencies with ICT repairs, technical advice, and guidance on the use of ICT equipment, in order to maximize the available telecommunications resources on the ground.

Challenges and Gaps:

• Limited access to electricity, fuel, and telecommunications services continues to hamper the humanitarian response in Gaza.
• The import of telecommunications equipment into Gaza is fraught, lengthy, and extremely challenging.

Multi-Purpose Cash Assistance (MPCA)

Response:

• Since the start of hostilities, one round of emergency MPCA was delivered to some 130,000 households, a top-up was delivered to 35,000 people (including people with disabilities and nursing mothers), and over 21,000 households have received a second round.
• Around 93,000 households have cashed out their assistance since 7 October. Around 5,400 payments have been cancelled after not being cashed out for months, despite multiple follow ups. Cash out operations are currently almost exclusively in the southern governorates.
• The assistance provided falls well short of need under the recurrent in-extremis circumstances, particularly given market collapse and price volatility. The last post-distribution monitoring data (PDMD) showed a significant decrease in the number of people who reported being able to meet all their needs, with the received assistance, combined with a major decrease in the number of people who reported not being able to cover any need. Overall, some 70 per cent of respondents reported that the assistance helped them access needed basic goods and services.
• Based on the last PDMD collected between mid-January and mid-February, food remains the most purchased item with humanitarian cash (80 per cent), followed by medicines (39 per cent), water (23 per cent), hygiene bedding (10 per cent), and transportation.

Challenges and Gaps:

• Poor electricity supply and connectivity is affecting the ability of financial service providers to make cash accessible, compromising the encashment of the MPCA package.
• Since late December, commercial trucks have sporadically entered Gaza, with 770 trucks recorded up to date. Truck vendors sell goods on the streets and in informal markets, complicating efforts to track distributions and gather market data. Informal markets are the primary source of accessible goods. Currently, there is limited market data available on informal markets/street vendors due to challenges with collecting data about informal market transactions.

IASC Protection from Sexual and Exploitation Abuse (PSEA) Network

Needs:

• There is a need to mainstream PSEA messages & safeguarding practices across the Gaza Strip and West Bank, including East Jerusalem.
• There is a pressing need to prioritize protection interventions at large. Safeguarding and SEA risk have become prominent in a context of severe aid dependency. The lack of safe aid delivery increases vulnerability and leads to exploitation and abuse.
• Provide safe and accessible reporting channels, that lead to assistance and investigations of PSEA allegations.
• Ensure that services are available for people at risk of sexual exploitation and abuse (SEA).

Response:

• Since October 2023, more than 1,500 cases have been referred by the SAWA Foundation specialized counsellors, including eight per cent from the West Bank.
• Due to the communication cuts in Gaza, a range of public communication materials were produced and distributed.
• The PSEA Network has made available MHPSS support and remote counselling sessions for PSEA focal points on the ground in Gaza, who are documenting the impact and the emerging needs by collecting complaints and feedback.

Challenges:

• Identifying cases and reaching vulnerable individuals pose significant challenges, particularly due to internet and telecommunication blackouts. Electricity and communication cuts make it challenging to establish contact with on-the-ground PSEA focal points.

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. 

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