Al Shifa Hospital is now in ruins and no longer able to function as a hospital, according to the World Health Organization. Photo by WHO

Hostilities in the Gaza Strip and Israel | Flash Update #149

03 Apr 2024

The OCHA oPt Flash Update is published three times a week, with an update on the West Bank included once a week. The next update will be issued on 5 April.

Key Highlights

Seven World Central Kitchen staff members were killed in multiple Israeli airstrikes while travelling in a convoy in Deir al Balah after reportedly informing the Israeli army of their movement.*
According to the World Health Organization, Al Shifa Hospital is now in ruins and no longer able to function as a hospital and 21 patients had died during the siege.
OCHA has documented more than 700 settler violence incidents across the West Bank, including East Jerusalem, since 7 October, constituting a daily average of four incidents.

Gaza Strip Updates

Intense Israeli bombardment and ground operations as well as heavy fighting between Israeli forces and Palestinian armed groups continue to be reported across much of the Gaza Strip, resulting in further civilian casualties, displacement, and destruction of houses and other civilian infrastructure.
Between the afternoon of 29 March and 11:30 on 3 April, according to the Ministry of Health (MoH) in Gaza, 352 Palestinians were killed, and 485 Palestinians were injured, including 59 killed and 83 injured in the past 24 hours. Between 7 October 2023 and 11:30 on 3 April 2024, at least 32,975 Palestinians were killed in Gaza and 75,577 Palestinians were injured, according to MoH in Gaza.
The following are among the deadly incidents reported between 29 and 31 March:
- On 29 March, seven Palestinians, including a woman and her six children, were reportedly killed when a building near Al Shifa Hospital in Gaza city, was hit.
- On 29 March, at about 13:55, ten Palestinians were reportedly killed when a building near Al Shifa Hospital, in Gaza city, was hit.
- On 29 March, at about 13:50, ten Palestinians were reportedly killed when a building near Al Shifa Hospital, in Gaza city, was hit.
- On 29 March, at about 9:30, at least 15 Palestinians, including 10 police officials and a woman, were reportedly killed when a sports club sheltering internally displaced persons (IDPs) in Ash Shujai’yeh, in Gaza city, was hit. Another woman was killed, and others injured, in a second strike on the club at about 14:10.
- On 30 March, at about 21:00, at least 12 Palestinians were reportedly killed, and 30 others injured, in a strike near Al Kuwaiti roundabout, in south-eastern Gaza city. The strike allegedly targeted members of the popular and tribal committees responsible for securing the delivery of aid.
- On 31 March, at about 13:00, four Palestinians were reportedly killed, and at least 17 others injured, including eight journalists, when an IDP tent was hit in the courtyard of Al Aqsa Hospital in Deir al Balah. A World Health Organization (WHO) team was at the medical facility at the time of the strike to assess needs and collect incubators to be sent to northern Gaza.
- On 31 March, at about 19:00, two Palestinians were reportedly killed, and three injured, when a group of people around Al Kuwaiti roundabout, in eastern Gaza city, were fired on.
Between the afternoons of 29 March and 3 April, three Israeli soldiers were reported killed in Gaza. As of 3 April, 255 soldiers have been killed and 1,549 soldiers have been 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, the vast majority on 7 October. As of 3 April, the Israeli authorities estimate that 134 Israelis and foreign nationals remain captive in Gaza, including fatalities whose bodies are withheld.
On 1 April, seven World Central Kitchen (WCK) aid workers were killed in multiple Israeli airstrikes on their convoy, as they were departing their warehouse in Deir al Balah after unloading more than 100 tons of humanitarian aid supplies brought to Gaza via the maritime route. In a statement issued on 2 April, the WCK Chief Executive Officer, Erin Gore, said: “This is not only an attack against WCK, this is an attack on humanitarian organizations showing up in the most dire of situations where food is being used as a weapon of war. This is unforgivable.” The organization has paused its operations in the region. Since the onset of hostilities, WCK estimates that it has provided more than 35 million hot meals across Gaza and established more than 60 community kitchens. WCK confirmed that their team members were travelling in two armoured vehicles branded with the organization’s logo and one soft skin vehicle, after coordinating their movement with the Israeli army. According to the Israeli military, an initial investigation found that the strike was a “grave mistake” due to a misidentification. It noted that a new humanitarian command centre will be established to improve the coordination of aid distribution, and a full independent investigation will be completed over the coming days, the findings of which will be shared with WCK and other relevant international organizations. Under-Secretary General for Humanitarian Affairs and Emergency Relief Coordinator (ERC), Martin Griffiths, expressed outrage at the incident, describing the WCK aid workers as heroes who were killed while trying to feed starving people. Similarly appalled by the incident, Humanitarian Coordinator ad interim, Jamie McGoldrick, offered his condolences to the families and colleagues of WCK staff who were killed, affirming that this was “not an isolated incident,” there is no safe place left in Gaza, and the “oPt has become one of the world’s most dangerous and difficult places to work.”
Al Shifa Medical Complex in Gaza city, the largest hospital in Gaza and in the occupied Palestinian territory, is now in ruins and no longer able to function as a hospital and 21 patients had died during the siege, according to WHO. Following the withdrawal of Israeli forces on the morning of 1 April, the Israeli army reported that 200 armed Palestinians had been killed, including three senior Hamas members, and more than 500 suspects detained during the two-week military operation. The Government Medica Office (GMO) in Gaza stated that Israeli forces destroyed all hospital buildings and departments, killed more than 400 people, including five doctors, inside and around the hospital, as well as covered and buried corpses with sand. About 1,050 houses around the hospital were also reportedly burnt or damaged, more than 300 Palestinians have been detained, and more than 100 people remain missing, GMO added, calling for an international investigation into these events, concerted efforts to help resuscitate the health system in Gaza, and the critical need for field hospitals. Similarly calling for the urgent establishment of field hospitals, Dr. Marwan Abu Saadah, the hospital’s acting director emphasized that Al Shifa was the only teaching hospital in Gaza with a 750 bed capacity, over 26 operating theatres, 32 intensive care rooms, a central laboratory, and a 62-bed emergency centre, providing services to more than 250,000 people annually, including some 17,000 surgical operations. According to the Palestinian Civil Defense, it has been difficult to ascertain the total number of fatalities as some corpses could not be identified due to decomposition and tens of corpses remain in residential buildings in the hospital’s vicinity. On 2 April, WHO spokesperson, Dr. Margaret Harris, described the destruction of Al Shifa Hospital as “ripping the heart out of the health system in Gaza,” noting that hundreds of health workers have been killed while doing their job in Gaza.
With only 10 hospitals partially functional in the Gaza Strip, the health system is struggling to address rising needs, including due to the outbreak of infectious diseases. As of 25 March, WHO has recorded 586,402 cases of acute respiratory infections, 81,259 cases of scabies and lice, 46,195 cases of skin rashes, 19,117 cases of jaundice and 7,037 cases of chickenpox. As of 3 April, according to WHO, 47 per cent (4,416 out of 9,389) of patients who submitted requests for medical evacuation abroad have been approved and 80 per cent of the approved cases (3,529) have been medically evacuated abroad. On 30 March, WHO Director-General urged the Israeli authorities to “speed up approvals for evacuations so that critical patients can be treated,” warning that thousands of patients continue to be deprived of health care, including around 9,000 people who have been either injured in bombardments, require cancer treatment, or suffer from chronic conditions such as kidney failure.
On 2 April, UNRWA Commissioner-General reported that the Israeli authorities have denied UNRWA’s participation in aid convoys to northern Gaza, including to Al Shifa Hospital, calling on the Israeli authorities to allow UNRWA to gain access to the north without delay. According to UNRWA, over half of all UN supplies that crossed into Gaza in March were UNRWA supplies. On 31 March, ERC Griffiths reaffirmed that “UNRWA is the backbone of the humanitarian operation in Gaza [and] any effort to distribute aid without them is simply doomed to fail.”

West Bank

Between 26 March and 1 April, six Palestinians were killed by Israeli forces, five in the West Bank and one in Israel. On 31 March, an Israeli policeman shot and killed a Palestinian man from Dura village (Hebron) who injured three Israelis with a knife near a shopping mall in Ashkelon city. On 30 March, Israeli forces shot and killed a 14-year-old child and injured three Palestinians during a military operation in Qabatiya village (Jenin), reportedly during armed clashes. On 27 March, four Palestinian men were killed in an Israeli airstrike and by gunfire during a military operation in Jenin city and its refugee camp.
Since 7 October and as of 1 April, 428 Palestinians, including 110 children, have been killed by Israeli forces across the West Bank, including East Jerusalem, of whom 131 were killed since the start of 2024. In addition, nine were killed by Israeli settlers and three by either Israeli forces or settlers. Four additional Palestinians from the West Bank have been killed while perpetrating attacks in Israel. During the same period, some 4,760 Palestinians have been injured, including at least 739 children, the majority by Israeli forces. According to the Palestinian Prisoners Club, 11 Palestinians have additionally died in Israeli prisons since 7 October 2023, mainly due to reported medical negligence or abuse.
Since 7 October and as of 1 April, 16 Israelis, including five members of Israeli forces and seven settlers, have been killed and 111 injured in the West Bank, including East Jerusalem, and Israel. These include 14 killed by Palestinians and two mistakenly killed by Israeli forces during a Palestinian attack.
Between 26 March and 1 April, Israeli forces carried out at least 155 operations across the West Bank, mainly search-and-arrest operations, the majority of which were in Hebron governorate (46 operations), followed by Jerusalem and Bethlehem governorates (each 37). Since 7 October 2023, Israeli forces carried out an average of 690 operations per month, detained over 6,000 Palestinians, and caused extensive damage to civilian infrastructure including roads, water and sanitation networks, residential houses, livelihood structures, and other public properties. Consequently, over 900 Palestinians have been displaced, primarily in Jenin, Tulkarm and Nur Shams refugee camps.
Since 7 October, a monthly average of some 280 Palestinians have been displaced in the West Bank, including East Jerusalem, compared to 128 Palestinians displaced on a monthly basis in the first nine months of 2023. Moreover, since 7 October 2023, at least 206 Palestinian households comprising 1,244 people, including 603 children, have been displaced amid settler violence and access restrictions. The displaced households are from at least 20 herding/Bedouin communities.
Between 26 March and 1 April, Israeli settlers perpetrated nine attacks that led to five Palestinian casualties or damage to property. On 1 April, Israeli settlers raided the village of Huwwara in Nablus and physically assaulted and injured a Palestinian and hurled stones at Palestinian houses. In three separate incidents near the Khallet el Louza area in Bethlehem between 30 March and 1 April, settlers raided Palestinian land and vandalized gates, a solar panel and water tanks in one incident, a latrine in another incident and the door of a house and surveillance cameras in a third incident. On 30 March, Israeli settlers shot live ammunition at a Palestinian and physically assaulted three others on the outskirts of Mikhmas town in Jerusalem, injuring four people. In two incidents, Israeli settlers set fire to a vegetable stall owned by a Palestinian on Road 90 in Tubas on 29 March and to an animal shelter belonging to Al Muarrajat East Bedouin community in Ramallah on 27 March. On 26 March, Israeli settlers threw stones at a Palestinian herder in Umm al Kheir community in Hebron, killing a sheep.
Since 7 October 2023 and as of 1 April, OCHA has recorded 704 Israeli settler attacks against Palestinians, with a daily average of four incidents, resulting in Palestinian casualties (69 incidents), damage to Palestinian-owned property (558 incidents), or both casualties and damage to property (77 incidents). In total, 17 Palestinians have been killed and over 400 injured within this context, over 9,900 trees were damaged, and 40 houses were vandalized. In comparison, around 560 settler incidents were documented between 7 October 2022 and 1 April 2023.
According to the Islamic Waqf, some 125,000 worshippers performed Friday prayers in Al Aqsa Mosque on the third Friday of the month of Ramadan (29 March). Measures announced by the Israeli authorities limit the access of Palestinians holding West Bank IDs to Friday prayers at Al Aqsa Mosque in East Jerusalem to children under 10 years of age, women over 50, and men over 55, with a valid one-day permit and magnetic card. Eligible persons can cross the checkpoints starting at 4:00 and return before 17:00. In 2023, men over 55, women of all ages and children under 12 were allowed entry without a permit on Fridays during Ramadan. In addition, access for Palestinian Christians holding West Bank IDs to East Jerusalem during Easter was subject to age constraints for the first time, allowing only women and men above 45 years of age to obtain permits to access East Jerusalem on 29 and 30 March, with some reportedly denied entry on 29 March.

Funding

The Flash Appeal for the occupied Palestinian territory (oPt), which requests US$ 1.23 billion to meet the 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 3 April, member states disbursed nearly $1.176 billion for the updated Flash Appeal (96 per cent); this includes about $629 million out of $629 million (100 per cent) requested for October-December 2023 and about $547 million out of $600 million (91 per cent) requested for January-March 2024. For funding analysis, please see the Flash Appeal Financial Tracking dashboard. The Humanitarian Country Team plans to launch an updated flash appeal through the end of 2024 on 16 April, taking into account continued access constraints and security challenges.
The oPt Humanitarian Fund (oPt HF) has mobilized a total of US$ 88 million since 7 October from Member States and private donors, designated for programs throughout Gaza, with allocations of 43 per cent in Rafah, 21 per cent in Deir al Balah, 20 per cent in Khan Younis, and 16 per cent in Gaza and North Gaza governorates. However, it has experienced a delay in finalizing its First Reserve Allocation of $3.5 million for 2024 due to restrictions imposed by the Israeli authorities on importing trucks intended to enhance aid transport capacity and enable humanitarian partners to scale up the delivery of essential aid and services across the Gaza Strip. A significant cost extension allocation of $20 million is being prepared for key projects in Gaza to address the most urgent needs, marking the second phase of December allocation responses adapted to the changing operating environment.
The HF is also developing an upcoming reserve allocation to bolster the capacity of national NGOs in the central areas of the Gaza Strip and Khan Younis, taking into account anticipated complexities in aid delivery, to ensure a more robust and effective humanitarian response. In the West Bank, the HF is working on repositioning funding to key partners in order to enhance system readiness and responsiveness to sudden-onset emergencies. For a summary of the oPt HF activities and challenges in February 2024, please follow this link. Private donations are collected directly through the Humanitarian Fund.

For the Humanitarian Needs and Cluster Response Update for the period between 26 March and 1 April, please visit: Humanitarian Needs and Cluster Response Update: 26 March – 1 April 2024. It is updated throughout the week to reflect new content.