October saw a severe deterioration in the already restrictive operating environment for humanitarian operations in Gaza. The Israeli authorities closed Erez crossing and imposed a siege on vast areas of North Gaza governorate, including Beit Lahia, Beit Hanoun and most of Jabalya. Access to northern Gaza, which also includes Gaza city, remained severely restricted, while south of Wadi Gaza, humanitarian access remained severely constrained due to insecurity, limited facilitation by Israeli forces, and organized, armed looting fueled by the breakdown of public order and safety.
Some 43 per cent of all humanitarian movements coordinated with the Israeli authorities to reach people in need across the Gaza strip in October were denied, and a further 16 per cent impeded. Thirty-seven per cent were facilitated without major issues.
Humanitarian access to northern Gaza, particularly north Gaza governorate, was extremely limited. OCHA registered 98 attempts for coordinated movements to northern Gaza[1] via the checkpoint along Wadi Gaza, of which 85 per cent were denied or impeded. Only 9 were able to move through the checkpoint without issues. Since approximately 6 October, the main towns of North Gaza governorate – Jabalya, Beit Hanoun and Beit Lahia – have been under an Israeli forces siege, with the access of humanitarian missions being blocked, with very few exceptions.
During October, humanitarian organizations submitted 53 requests to the Israeli authorities to access North Gaza governorate. Of those requests, thirty-three (33) were rejected outright, nine (9) were facilitated and eleven (11) were initially accepted but then faced impediments on the way. An additional nineteen (19) movement requests were submitted to Israeli authorities to pick up humanitarian supplies from West Erez crossing, of which six (6) were denied, twelve (12) impeded and one (1) withdrawn.
With the intensification of Israeli military operations starting on 6 October in North Gaza, fighting resulted in forced displacement and the destruction or damage to critical civilian infrastructure, including medical facilities. Men, women, and children have been caught up in the violence. In one week alone, OCHA submitted five requests to reach those trapped under the rubble, all of which were denied.
From 6 to 31 October, no humanitarian movements were facilitated by the Israeli authorities to Jabalya, Beit Hanoun and Beit Lahiya, the main towns in North Gaza. During this period, thirty-six (36) mission requests were submitted to access these areas, of which twenty-seven (27) were denied and nine (9) were impeded. Of the impeded missions, only three (3) were able to fulfill some of their objectives and three (3) were impeded so significantly it was not possible to achieve any movement objectives. In addition, 14 Erez West humanitarian cargo pick up missions intended to distribute humanitarian supplies in Jabalya were not facilitated to reach people in dire need of assistance.
Attempts to coordinate the evacuation of an injured UN staff member from the Jabalya area was also denied, with Israeli authorities suggesting that this person could attempt to be carried out on foot by relatives waving white flags to identify themselves.
Access to medical care has been severely affected by Israeli military actions in North Gaza. As Kamal Adwan hospital came under intensified threat from fighting and critical medical supplies dwindled, requests to transfer severely ill patients to Al Shifa hospital were denied on 8 and 9 October, only to be permitted on 10 October. On 12 October, during the transfer of critically ill patients an ambulance driver was stripped, blindfolded, and restrained at a checkpoint by the Israeli soldiers, despite being part of the approved convoy. Israeli soldiers also instructed a UN staff to position their vehicle so to shield military personnel during this incident.
On 20 October, a coordinated mission to Kamal Adwan hospital was prevented from delivering essential medical supplies —including blood, anesthesia and fuel— allowing only patient transfers to Al Shifa hospital. This decision blocked vital resources from reaching the hospital, leaving patients in dire need. Patients waited five hours in the back of ambulances as their forward movement to Al Shifa hospital could not be facilitated due to the intensity of military activity, resulting in the humanitarian team having to stay overnight at the hospital to attempt the transfer the following day. The caregiver of a patient was detained at an ad hoc checkpoint en route to Gaza city, with no subsequent information provided on their status.
During a similar mission on 28 October, intended to deliver medical supplies, fuel, and food to Kamal Adwan hospital and transfer critically ill patients, three patients were detained by Israeli forces at a checkpoint; only two were allowed to continue with the convoy.
Beyond obstructing supplies and denying access to medical care for those in need, medical staff have faced distressing conditions as they attempt to provide lifesaving care. Medical facilities have sustained extensive damage, and medical personnel have been placed in life-threatening situations. In a particularly concerning case, several medical professionals, including an orthopedic surgeon from Médecins Sans Frontières (MSF), were detained by Israeli forces at Kamal Adwan hospital. Efforts to confirm his status and ensure his wellbeing have so far been unsuccessful.