Humanitarian operations in Deir al Balah, where hostilities have intensified, are severely curtailed. Warehouses, health centres and shelters fall within areas that have been newly issued with evacuation orders. As casualties rise, the ability to treat people is in jeopardy, with hospitals at risk of closure. Photo portraying the delivery of blankets to Nasser hospital last month, by UNICEF/El Baba
Humanitarian operations in Deir al Balah, where hostilities have intensified, are severely curtailed. Warehouses, health centres and shelters fall within areas that have been newly issued with evacuation orders. As casualties rise, the ability to treat people is in jeopardy, with hospitals at risk of closure. Photo portraying the delivery of blankets to Nasser hospital last month, by UNICEF/El Baba

Hostilities in the Gaza Strip and Israel | Flash Update #87

Key points

  • Heavy Israeli bombardments from air, land, and sea intensified across much of the Gaza Strip on 8 January. The firing of rockets by Palestinian armed groups into Israel also continued. Ground operations and fighting between Israeli forces and Palestinian armed groups were reported across much of the Gaza Strip, particularly in the Middle Area and Khan Younis, resulting in additional casualties. 
  • Between the afternoons of 7 and 8 January, according to the Ministry of Health (MoH) in Gaza, 249 Palestinians were reportedly killed, and another 510 people were reportedly injured. Overall, between 7 October and 12:00 on 7 January, at least 23,084 Palestinians were killed in Gaza, according to the MoH in Gaza. During the same period, 58,926 Palestinians were reportedly injured. 
  • Since 7 January and as of 8 January, no additional Israeli soldiers have been reportedly killed in Gaza. Overall, since the start of the ground operation, 174 soldiers have been killed, and 1,042 soldiers have been injured in Gaza, according to the Israeli military. 
  • Partners report that denials of coordinated movement requests are critically inhibiting time-sensitive response. For instance, on 8 January, a planned mission by OCHA and WHO to deliver urgent medical supplies to the Central Drug Store in Gaza city and Al Awda Hospital in Jabalya, as well as planned missions to deliver vital fuel to water and sanitation facilities in Gaza City and the north, have been denied by the Israeli authorities. This marked the fifth denial of a mission to Al Awda Hospital in Jabalya and Central Drug Store in Gaza city since 26 December, leaving five hospitals in northern Gaza without access to life-saving medical supplies and equipment. At the same time, the continued denial of fuel delivery to water and sanitation facilities is leaving tens of thousands of people without access to clean water and increasing the risk of sewage overflows, significantly heightening the risk of the spread of communicable diseases. 
  • The intensifying offensive in Gaza’s Middle Area and Khan Younis is causing rapidly rising casualties and having devastating consequences for tens of thousands of civilians, many of whom had already fled for safety from Gaza city and the north to the Middle Area. An UNRWA warehouse was struck on 4 January resulting in one fatality of a UN staff and subsequent detention of five UNRWA staff, three of whom were subsequently released while two remain detained. Humanitarian operations in Deir al Balah have also been severely curtailed with multiple critical installations – including warehouses, distribution centres, health centres and shelters – issued with new evacuation orders. Several bakeries supported by the UN and humanitarian partners have been forced to shut down operations in Deir al Balah, as a result of the fighting. As casualties rise, the ability to treat them continues to be in jeopardy, with three hospitals in the Middle Area and Khan Younis– Al Aqsa, Nasser, and Gaza European – at risk of closure due to the issuance of evacuation orders in nearby areas and the ongoing conduct of hostilities nearby. 
  • On the morning of 8 January, MSF reported a shell broke through the wall of an MSF shelter housing over 100 staff and their families in Khan Yunis. Consequently, five people were injured, including a 5-year-old child of one of its staff members who is in critical condition. MSF further noted that the shelter did not receive evacuation orders beforehand. MSF stated that they “condemn this latest attack which shows, yet again, that no one and nowhere is safe in Gaza.” 

Hostilities and casualties (Gaza Strip) 

  • The following are among the deadliest incidents reported between 7 January and 8 January: 
    • On 7 January at about 13:30, six people, including two girls, were reportedly killed when a group of people, near the customs police office, east of the Khan Yunis, were struck.  
    • On 7 January, during the night, 10 people were reportedly killed and tens injured when multiple residential houses in Deir al Balah were struck.  
    • On 8 January, at about 03:00, eight people were reportedly killed and tens were injured, including women and children, when a residential building in Al Basa, west Deir al Balah, Middle Gaza was struck. People are reportedly remaining under the rubble. 
    • On 8 January, at about 09:00, UNRWA Preparatory School of Al Maghazi, Middle Gaza, which serves as a shelter for internally displaced people (IDPs) was struck. An unconfirmed number of fatalities and injuries were reported.   
    • On 8 January, at about 12:30, five people were reportedly killed when a group of people in Al Zawayda, Middle Gaza were struck.  
    • On 8 January, at about 09:10, four people, including children, were reportedly killed and tens injured when a residential unit near the Canada Hall, south Khan Yunis, was struck.  
    • On 8 January, in the morning, eight people, including children, were reportedly killed in Al Manara neighbourhood, southeast of Khan Yunis. The ambulance crews were reportedly having difficulty entering the area.  
  • On 7 January, at about 23:20, the College of Science and Technology in Qizan Al Najjar, Khan Yunis, was struck. On 8 January, the vicinity of Abu Bakr Al Siddiq School, also in Qizan Al Najjar, was surrounded and besieged by Israeli forces with unconfirmed number of casualties reportedly trapped inside and around the school. 

Displacement (Gaza Strip)

  • By the end of 2023, according to UNRWA, 1.9 million people, or nearly 85 per cent of the total population of Gaza, were estimated to be internally displaced, including many who have been displaced multiple times, as families are forced to move repeatedly in search of safety. Nearly 1.4 million IDPs are sheltering in 155 UNRWA facilities across all five governorates; facilities are far exceeding their intended capacity. Rafah governorate is now the main refuge for those displaced, with over one million people squeezed into an extremely overcrowded space, following the intensification of hostilities in Khan Younis and Deir al Balah and the Israeli military’s evacuation orders. Obtaining an accurate figure of the total number of IDPs remains challenging.  
  • Some 220 incidents affecting UNRWA premises and people inside them have been reported since 7 October (some with multiple incidents affecting the same location), including at least 23 incidents of military use and/or interference at UNRWA premises. This includes 63 direct hits on UNRWA installations and 69 different UNRWA installations sustaining damage when a nearby object was hit. In total, at least 319 IDPs sheltering in UNRWA shelters have been killed and at least another 1,135 were injured since 7 October. 


  • Since 11 October, the Gaza Strip has been under an electricity blackout, after the Israeli authorities cut off the electricity supply and fuel reserves for Gaza’s sole power plant were depleted. The communications and fuel shutdown continues to significantly hinder the aid community’s efforts to assess the full extent of needs in Gaza and to adequately respond to the deepening humanitarian crisis. For more information on electricity supply to the Gaza Strip, please see this dashboard.

Health care, including attacks (Gaza Strip)

  • On 8 January at about 01:40, the vicinity of the European Hospital in Khan Younis was reportedly struck by drones with no clear reports on casualties. This follows a number of reported hits in the vicinity of the Al Aqsa Hospital in Deir al Balah, central Gaza on 7 January, forcing medical staff and patients to evacuate.*
  • On 7 January, staff from the World Health Organization (WHO) and OCHA visited the Al Aqsa Hospital, the only functioning hospital in the governorate of Deir al Balah in central Gaza. According to the hospital director, because of increasing hostilities and ongoing evacuation orders, most of the local health workers and about 600 patients have been forced to leave the facility to unknown locations. Medical Aid for Palestinians (MAP) and the International Rescue Committee (IRC) stated that their emergency medical team had been forced to cease life-saving and other critical activities at the hospital and leave the facility, as a result of increasing Israeli military activity.  
  • According to a post from the WHO Director-General, Dr. Tedros Adhanom Ghebreyesus, his staff witnessed “sickening scenes of people of all ages being treated on blood-streaked floors and in chaotic corridors.” The hospital reported immense needs, notably health workers, medical supplies, beds and the need to be protected from strikes and hostilities. The WHO team delivered medical supplies to support 4,500 patients needing dialysis for three months and 500 patients requiring trauma care. “Al Aqsa is the most important hospital remaining in Gaza’s Middle Area and must remain functional, and protected, to deliver its lifesaving services,” Dr. Ghebreyesus stated. “Further erosion of its functionality cannot be permitted – doing so in the face of such trauma, injury and humanitarian suffering would be a moral and medical outrage.”   
  • According to WHO, as of 3 January, 13 out of Gaza’s 36 hospitals are partially functional; nine in the south and four in the north. Those in the north have been offering maternity, trauma, and emergency care services. However, they face challenges such as a shortage of medical staff, including specialized surgeons, neurosurgeons, and intensive care staff, as well as a lack of medical supplies such as anesthesia, antibiotics, pain relief medicines, and external fixators. Additionally, they have an urgent need for fuel, food, and drinking water. The situation of hospitals and the level of functionality depend on fluctuating capacity and minimum level of supplies that can reach the facilities. The nine partially functional hospitals in the south are operating at three times their capacity, while facing critical shortages of basic supplies and fuel. MoH in Gaza, occupancy rates are reaching 206 per cent in inpatient departments and 250 per cent in intensive care units. 

Food security

  • The Famine Review Committee (FRC), activated due to evidence surpassing the acute food insecurity Phase 5 (Catastrophic threshold) in the Gaza Strip, warns that the risk of famine is increasing daily amid intense conflict and restricted humanitarian access. The FRC stated that, to eliminate the risk of famine it is imperative to halt the deterioration of the health, nutrition, food security, and mortality situation through the restoration of health, water, sanitation, and hygiene (WASH) services. In addition, the FRC has called for the cessation of hostilities and the restoration of humanitarian space for delivering multisectoral assistance as vital first steps to eliminate any risk of famine.  

Hostilities and casualties (Israel)

  • Over 1,200 Israelis and foreign nationals have been killed in Israel, including 36 children, according to the Israeli authorities, the vast majority on 7 October. 
  • The Israeli authorities estimate that about 136 Israelis and foreign nationals remain captive in Gaza. During the humanitarian pause (24-30 November), 86 Israeli and 24 foreign national hostages were released. 

Violence and casualties (West Bank)

  • On 8 January, Israeli forces shot and killed three Palestinians during an undercover raid in Tulkarm city. According to video footage which is widely circulating in the media, and which cannot be verified, Israeli soldiers appear continue shooting at an injured Palestinian while he appeared to be lying incapacitated on the ground and a military jeep appeared to run over another injured individual.     
  • A total of 329 Palestinians has been killed in the West Bank, including East Jerusalem, since 7 October 2023 and as of 8 January 2024. Among the fatalities were 84 children. Additionally, two Palestinians from the West Bank were killed while carrying out an attack in Israel on 30 November. Of those killed in the West Bank (329); 320 were killed by Israeli forces, eight by Israeli settlers and another one by either Israeli forces or settlers. The number of Palestinians killed in the West Bank, including East Jerusalem, in 2023 (507) marks the highest number of Palestinians killed in the West Bank since OCHA started recording casualties in 2005. 
  • Since 7 October 2023 and as of 8 January 2024, five Israelis, including four members of the Israeli forces, have been killed in attacks by Palestinians in the West Bank, including East Jerusalem. Another four Israelis were killed in an attack by Palestinians from the West Bank in West Jerusalem (one of the four was killed by Israeli forces who misidentified him). The number of Israelis killed in the West Bank and Israel in 2023 in attacks by Palestinians from the West Bank (36) is the highest since OCHA started recording casualties in 2005. 
  • Since 7 October 2023 and as of 7 January 2024, a total of 4,068 Palestinians, including 614 children, were injured in the West Bank, including East Jerusalem. Of them, 3,952 have been injured by Israeli forces, 95 by settlers and 21 by either Israeli forces or settlers. Of the total injuries, 51 per cent were reported in the context of search-and-arrest and other operations, 37 per cent in demonstrations and 8 per cent during settler related attacks against Palestinians. Some 33 per cent of those injuries have been caused by live ammunition, compared with 9 per cent in the first nine months of 2023.  

Settler Violence

  • Since 7 October 2023 and as of 8 January 2024, OCHA has recorded 386 Israeli settler attacks against Palestinians, resulting in Palestinian casualties (36 incidents), damage to Palestinian-owned property (302 incidents), or both casualties and damage to property (48 incidents). The number of such incidents represents almost one third of all settler attacks against Palestinians in the West Bank recorded from 1 January 2023 to date. And reflects a daily average of four incidents, compared with seven daily incidents reported between 7 October and 10 November 2023. This is the highest daily average of settler-related incidents affecting Palestinians since 2006.  
  • One-third of the settler attacks against Palestinians after 7 October included firearms, including shootings and threats of shootings. In nearly half of all recorded incidents after 7 October Israeli forces were either accompanying or reported to be supporting the attackers. 
  • In 2023, 1,229 incidents involving settlers in the West Bank, including East Jerusalem (with or without Israeli forces), resulted in Palestinian casualties, property damage or both. Some 913 of these incidents resulted in damage, 163 resulted in casualties and 153 resulted in both. This is the highest number of settler attacks against Palestinians in any given year since OCHA started recording incidents involving settlers in 2006. 

Displacement (West Bank)

  • Since 7 October 2023 and as of 8 January, at least 198 Palestinian households comprising 1,208 people, including 586 children, have been displaced amid settler violence and access restrictions. The displaced households are from at least 15 herding/Bedouin communities. More than half of the displacements occurred on 12, 15, and 28 October, affecting seven communities. The displacement toll since 7 October 2023, represents 78 per cent of all displacement reported due to settler violence and access restrictions since 1 January 2023 (1,539 people, including 756 children).  
  • Additionally, 444 Palestinians, including 224 children, have been displaced since 7 October, following the demolition of their homes, due to lack of Israeli issued permits in Area C and East Jerusalem, which are almost impossible to obtain. This is compared to 233 people, of whom 112 were children, displaced in the equivalent period of 2022-2023.  
  • A total of 19 homes have been demolished and 95 Palestinians, including 42 children, displaced due to punitive demolitions in the last three months of 2023. The numbers exceed those reported in the past nine months of the same year, during which 16 homes demolished and 78 people displaced. No punitive demolitions have taken place since the beginning of the year 2024.  
  • Another 587 Palestinians, including 257 children, have been displaced since 7 October following the destruction of 92 homes during other 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 and Nur Shams and Tulkarm, both in Tulkarm. This represents 65 per cent of all displacement reported due to the destruction of homes during Israeli military operations since January 2023 (908 people). 


  • As of 8 January, Member States have disbursed $637.6 million against the updated Flash Appeal launched by the UN and its partners to implement its response plan in support of 2.2 million people in the Gaza Strip and 500,000 in the West Bank. This constitutes 53 per cent of the $1.2 billion requested. Private donations are collected through the Humanitarian Fund.



  • Since the start of hostilities, Health Cluster partners have provided healthcare and medical services to an estimated 500,000 people.  
  • The Health Cluster estimated that about 5,000 beds are required to meet trauma and emergency needs. A total of 59 out of 77 primary health centers are not functioning leaving many without access to basic health services. 
  • Only 26 per cent of the requested medical supplies needs have been met and only 120 out of 353 formal and informal IDP shelters have access to medical points.  
  • About 350,000 people with chronic illnesses and about 485,000 people with mental health disorders continue to experience disruptions in their treatments. 
  • 1.9 million IDPs remain at high risk of communicable disease due to poor living conditions, notably overcrowding of IDP sites and lack of access to proper water sanitation and hygiene facilities. 


  • Mine Action partners have continued to provide Explosive Ordinance Risk Education (EORE) and Explosive Remnant of War (ERW) awareness and guidance about preparedness since the start of the hostilities, reaching over 1.1 million IDPs through in person sessions in IDP shelters, and via SMS, radio, and social media campaigns.  
  • The situation in Gaza is complex and challenging for mine action activities. This is characterized by substantial contamination from various explosive ordnance (EO) sources. The ongoing hostilities, including airstrikes, shelling, and the use of rockets is causing widespread contamination posing significant risks to people. The presence of ERW significantly hinders access and humanitarian efforts, as many areas are inaccessible or dangerous for aid workers to respond safely to humanitarian needs. A comprehensive and multi-faceted mine action response is needed to address not only the immediate threats but also the long-term implications for the community.  
  • The main challenges Mine Action actors face include shortage of Explosive Ordnance Disposal (EOD) experts in Gaza. As a result, a comprehensive ERW assessment, and provision of support on access for humanitarian response have been delayed.  
  • Child Protection partners continued to provide awareness raising interventions, MHPSS for children and caregivers, child protection case management and distribution of clothing kits.  
  • The gender-based violence (GBV) partners continued to highlight and address the increased psychological stress among displaced women and girls and increased protection and GBV risks. GBV prevention, response, and risk mitigation interventions remain extremely difficult given the collapse of services and displacement of service providers and movement restrictions.  

Shelter and Non-Food Items (NFI)

  • As of 7 January, it is estimated that about 69,000 housing units across Gaza Strip have been destroyed or rendered uninhabitable and over 290,000 housing units have been damaged, according to the Government Media Office in Gaza. It is estimated that over 500,000 people will have no home to return to and that many more will be unable to return immediately due to the level of damage to surrounding infrastructure, as well as the risk posed by ERW. 
  • Since the start of the hostilities, shelter partners have provided cumulatively 11,500 dignity kits; 36,000 sealing off kits; 650,000 bedding set items (blankets and mattresses); 26,709 tents; 11,500 kitchen sets; and 17,250 winter clothing kits to a total of 914,500 IDPS in UNRWA and non-UNRWA shelters.  
  • There is a high shortage of all essential NFIs for IDPs inside and outside the shelters. This includes 1,200,000 mattresses and blankets), 200,000 emergency shelter kits, including tarpaulin and plastic sheets, at least 50,000 winterized family tents, and 200,000 winter clothes. 
  • Shelter partners report tents and self-built makeshift shelters are over-crowded as more than 15 people live in one tent, making the space available per person less than the minimum Sphere Standards. This exposes IDPs to unhygienic conditions and communicable diseases. The self-built makeshift shelters are constructed from salvaged materials inadequate to withstand current weather conditions.  
  • The Shelter Cluster report that based on an IDPs survey conducted in Rafah; rental apartments cost over 800 per cent the normal price due to lack of availability of units in the south. 


UNICEF and other nutrition partners continued their efforts to address the nutritional needs of children and mothers through delivery of key nutrition commodities to the Gaza Strip. Nutrition partners are providing therapeutic services and supplies for children with acute malnutrition, alongside preventative nutrition supplies, including High Energy Biscuits (HEBs).  

  • During the first week of January 2024, nutrition partners delivered the following: 
  • One month supply of ready-to-Use Infant Formula (RUIF) to nearly 2,300 children under five months of age.  
  • Therapeutic milk to some 560 children with severe acute malnutrition (SAM) with medical complications.  
  • Multiple Micronutrients tables (MMS) to more than 18,000 pregnant and nursing mothers.  
  • Vitamin A supplementation to more than 30,000 children under-one year; and  
  • Iron-folate supplementation to some 40,000 pregnant and nursing mothers.  

Juzoor, a local partner, distributed 29 pallets of RUIF across several clinics. Additionally, four pallets of Ready-to-Use Therapeutic Foods (RUTF)were also provided to the Rafah Central, Deir al Balah, Al Zawaydeh and Tall as Sultan clinics. 

More than 135,000 additional cartons of HEBs have been ordered and are expected to reach some 200,000 children under-five and more than 155,000 pregnant and nursing mothers.  


  • The Education Cluster reports that more than 625,000 students and close to 23,000 teachers in the Gaza Strip have been affected by attacks on education and school closures since October 2023, and remain with no access to education and a safe place. 
  • Between 7 October 2023 and 2 January 2024, the Ministry of Education reports that 4,119 students and 221 teachers to have been killed, while 7,536 students and 703 teachers to have been injured across the Gaza Strip. 
  • 90 per cent of all school buildings in the Gaza Strip are being used as shelters for IDPs and have sustained varying levels of damage. Of these, 135 schools sustained minor damage; 126 schools sustained moderate damage; 99 schools sustained major damage and 12 were fully destroyed. Combined, these schools previously served and hosted some 433,000 children and more than 16,200 teachers. Of note, the Khan Younis, North and Gaza governorates have the highest proportion (three quarters) of all damaged schools. 
  • The Cluster’s response is guided by a three-phased response plan – supporting conflict-affected children, teachers and care givers in shelters and in host communities; preparing a safe learning environment and re-establishing a sense of normalcy as soon as hostilities stop; and preparing to restore the formal education system through the reconstruction of the education infrastructure after a reduction in hostilities. 
  • Since October 2023, nine Education partners have reached close to 93,000 students and teachers with psychosocial support, emergency learning and recreational supplies and activities in the Khan Younis, Rafah, and Middle governorates. Most of the Education Cluster response is delivered by local partners and no activities have been able to be delivered in the three northern governorates of Gaza.  
  • In the first week of January, the Education response remains severely underfunded – receiving only 3 per cent of its requirements in the Flash Appeal. Education actors and donors are urged to mobilise rapid resources to meet the immediate education response requirements and start planning for reconstruction in the medium- to long- term when hostilities subside.  

Multi-purpose Cash Assistance (MCPA)

  • Since the beginning of the hostilities, 111,254 households (comprising almost 750,000 people) have received emergency MPCA. With about 81,941 households (54,926 people) having already cashed out their assistance. Cash out rates by users stand at 73 per cent and are declining slightly.  
  • While distribution has been across the Gaza Strip, the vast majority is now concentrated in the southern governorates.  
  • While formal markets are largely depleted, informal markets are now the key sources of basics goods and services. This includes trading of personal belongings, small household-based production (bread, vegetables), humanitarian assistance, and other items.  
  • Post distribution monitoring data from recipients of cash assistance point to food, medicines, debt repayment, drinking water, and transportation as the top expenditures reported. The percentage of expenditures on food has further decreased over the past weeks, while the percentage of expenditures on medicines has doubled. Some 70 per cent of the respondents report that unrestricted cash has helped them access needed goods and services, either fully or partially, while 87 per cent reported unrestricted cash as their preference for future assistance.  


  • Logistics Cluster partners provided a total of 20 trucks to the Egyptian Red Crescent (ERC) to support the humanitarian convoys from Al Arish (Egypt) to Rafah.  
  • In addition, ERC storage capacity in Al Arish to receive and consolidate cargo was expanded by 3,200 m2 with the installation of 10 Mobile Storage Units (MSUs), with a dedicated set-up for the temperature-controlled cargo through four inflatable cold rooms.  
  • In the Gaza Strip, the Logistics Cluster has handed over and installed a total of 18 MSUs (5,760 m2) that have augmented the offloading capacity in the Rafah handover point, Kerem Shalom crossing, and the storage capacity of four UN Agencies and International NGOs. 

Emergency Telecommunications

  • The Emergency Telecommunications Cluster (ETC) and its partners continue to engage with the Israeli Coordinator of Government Activities in the Territories (COGAT) for authorization to import telecommunications equipment and set up an independent, efficient, and reliable communications platform for humanitarian responders.   
  • The ETC deployed an ICT Specialist to Gaza on 8 January for an initial technical engagement with local actors to plan initial ICT needs assessment and to set up technical coordination processes for the response. 

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 counselling and referrals for affected communities to access life-saving services. The PSEA Network monitors calls daily and will increase the number of counsellors if necessary.

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