Humanitarian Situation Update #334 | Gaza Strip

The Humanitarian Situation Updates on the Gaza Strip and on the West Bank are both issued every Wednesday/Thursday. The Gaza Humanitarian Response Update is issued every other Wednesday. The next Humanitarian Situation Update on the Gaza Strip will be published on 29 or 30 October.

Key Highlights

• Two years of hostilities have more than doubled the need for mental health care in the Gaza Strip, from around 485,000 to over one million people, according to the World Health Organization.
• Only 10 per cent of all internally displaced people reside in collective centres, including UNRWA-designated emergency shelters, while the majority remain in overcrowded, makeshift sites, many of which were set up spontaneously in open or unsafe areas, the Site Management Cluster reports.
• On 22 October, the first medical evacuation from Gaza since 29 September was facilitated by the World Health Organization, with 41 patients and 145 companions exiting via Kerem Shalom/Karem Abu Salem crossing.
• The UN and its partners continue to scale up operations where possible as outlined in the 60-day plan, expanding their presence in areas that were previously inaccessible and increasing assistance to meet enormous needs.

Context Overview

• On 19 October, following an incident in Rafah in which two Israeli soldiers were killed, the Israeli military carried out airstrikes across the Gaza Strip, resulting in casualties (see more information below). About 5,000 displacement movements were subsequently recorded from the eastern areas of Khan Younis, many of whom reportedly returned the following day.
• The renewed enforcement of the ceasefire, which initially came into effect at noon on 10 October, was announced on 19 October, after which a general calm was reportedly observed across the Gaza Strip. On 20 October, the Israeli military, which maintains presence in more than 50 per cent of the Gaza Strip, announced that works began to demarcate the Yellow Line separating the ceasefire zone from the Israeli military-controlled area.
• Between 13 and 21 October, according to official reports cited in the media, 20 Israeli hostages and the bodies of 15 deceased Israeli hostages were returned from Gaza to Israeli authorities, and 1,968 Palestinian detainees were released from Israeli detention centres. According to the Ministry of Health (MoH) in Gaza, as of 22 October, the bodies of 195 Palestinians were returned to the Gaza Strip, of which only 57 were identified. MoH reported that many bodies were mutilated, with some handcuffed, blind-folded, bearing signs of being run over by military vehicles, or disfigured beyond recognition.
• According to MoH in Gaza, between 15 and 22 October, 151 Palestinians were killed, and 204 were injured, and 77 bodies were recovered from under the rubble. This brings the casualty toll among Palestinians since 7 October 2023, as reported by MoH, to 68,234 fatalities and 170,373 injuries. MoH reported that since the ceasefire came into effect, 88 Palestinians were killed, 315 were injured and 436 bodies were retrieved from under the rubble. On 20 October, the Palestinian Civil Defense (PCD) spokesperson reported that although an estimated 10,000 bodies remain buried under destroyed buildings, their teams continue to face critical shortages of heavy and specialized equipment, along with grave risks from unexploded ordnance, that hinder retrieval efforts. The handling of decomposed bodies also exposes rescuers to serious infection and health risks, PCD spokesperson added.
• According to the Israeli military, between 15 and 22 October, as of noon, two Israeli soldiers were killed in Gaza, bringing the casualty toll among Israeli soldiers since the beginning of the Israeli ground operation in October 2023 to 470 fatalities and 2,967 injuries. According to Israeli forces and official Israeli sources cited in the media, more than 1,670 Israelis and foreign nationals have been killed, the majority on 7 October 2023 and its immediate aftermath. As of noon on 22 October 2025, it is estimated that the bodies of 13 deceased hostages remain in the Gaza Strip.
• Over the past week, airstrikes and artillery shelling were reported across the Gaza Strip, particularly on 17 and 19 October. On 17 October, a bus carrying internally displaced people (IDPs) was hit, killing 11 Palestinians, including seven children, two women and two men, who were reportedly heading to check on their homes in Az Zaytoun area in eastern Gaza city. According to PCD, its teams initially recovered nine bodies when they were able to reach the area the next day, following approval by Israeli authorities. On 19 October, at least four Palestinian children were reportedly killed and several others were injured when an UNRWA school-turned-shelter was shelled by Israeli forces in An Nuseirat refugee camp, in Deir al Balah, according to UNRWA. Other key incidents on 19 October mainly took place in Deir al Balah, including: a strike at the entrance of a coffeeshop that reportedly killed six Palestinians; a strike on a chalet that served as the main office of the Palestinian Media Production (PMP) company that reportedly killed a journalist and the son of another journalist; a strike on an IDP tent that reportedly killed six Palestinians; and a strike on a house that reportedly killed four Palestinians.
• As of 21 October, according to the UN 2720 mechanism, about 199,000 metric tons (MT) of aid, of which about 73 per cent are food supplies, are in the pipeline after being approved and cleared by the Israeli authorities. These supplies are positioned across the region, including Jordan, Egypt, Israel, Cyprus, and the West Bank, and are ready for dispatch, with some shipments already on the way to Gaza, as daily deliveries continue. Between 10 and 21 October, according to the UN 2720 mechanism, 43 aid cargo requests submitted by 12 local and international NGOs were denied by Israeli authorities on the grounds that the organizations were not authorized to bring relief items into Gaza. The rejected items comprised about 2,712 MT of relief materials and included supplies from the food security, health, water, sanitation and hygiene (WASH), and shelter clusters.
• As of 13 October, following the withdrawal of Israeli forces from parts of the Gaza Strip under the ceasefire agreement, coordination requests for humanitarian movements within these areas are no longer required. Coordination with Israeli authorities continues to be required for convoy movements to Gaza’s crossings as well as other areas that remain under Israeli military control. Between 15 and 21 October, aid organizations coordinated with the Israeli authorities to collect cargo from the two operational crossings (Kerem Shalom/Karem Abu Salem and Kissufim), as well as to conduct rescue and road repair missions, carry out assessments, and for the crossing of humanitarian personnel; out of 59 missions, 31 were facilitated, 10 were cancelled, 15 were impeded, and three were denied. Since the ceasefire took effect, according to the UN 2720 Mechanism, there has been a reduction in the interception of supplies collected by the UN and its partners from Gaza’s crossings. Between 10 and 21 October, nine per cent of collected supplies were reportedly intercepted, compared with about 80 per cent previously.

Displacement Movements and Shelter Conditions

• According to the Site Management Cluster (SMC), movements of people across the Gaza Strip continue to be fluid, as people attempt to return to their hometowns if accessible or seek to settle in areas that have relatively better access to essential services. Since 10 October, about 546,000 movements of people were recorded by SMC partners, including nearly 435,000 movements crossing from southern to northern Gaza, primarily through Al Rashid Road. Some reverse movements to southern Gaza were recorded, reportedly due to the lack of essential services in the north, and over 96,000 movements were observed from western to eastern Khan Younis.
• Since 10 October, SMC partners have documented the (re-)establishment of 12 displacement sites in northern Gaza (mainly in Gaza city), with an estimated population of about 10,000 people. Over the past week, field assessments by humanitarian partners in the area indicate that most people in these sites report that drinking water, adequate shelter and food aid are their key priorities. Based on Shelter Cluster partners’ observations, many people in Gaza city are living in unsafe buildings that have been fully or partially damaged, noting that extensive destruction and massive rubble obstruct access to homes and neighbourhoods and limit the amount of land available for setting up displacement sites.
• In southern Gaza, an SMC partner recently gained access to, and conducted an assessment at, six displacement sites hosting about 6,500 people in Al Mawasi area of Rafah. These sites had largely been isolated and underserved due to their proximity to former Israeli military operation zones. While families have shown strong self-organization through informal committees and local solidarity networks, the assessment identified acute humanitarian needs, including fragile shelter conditions, limited water delivery, lack of sanitation, high flood risk, and limited access to healthcare.
• The SMC estimates that, as of 21 October, around one million people are residing in about 800 displacement sites across the Gaza Strip, noting that these figures fluctuate daily as people move in response to changing conditions. The vast majority of IDPs are in makeshift and scattered sites in Deir al Balah and Khan Younis, where severe overcrowding persists. Many of these sites were spontaneously established by displaced families along roads, in open areas, agricultural lands, or along the coast. Some displaced families have been forced to set up shelters in hazardous areas, where soil erosion poses severe risks, especially with the imminent onset of rain. SMC estimates that only about 10 per cent of IDPs live in collective centres, such as former schools, markets, and health facilities, including UNRWA-designated emergency shelters, many of which have sustained significant damage during recent military incursions, further constraining available capacity. According to UNRWA, as of 16 October, about 70,000 people are estimated to reside in over 70 designated UNRWA shelters and surrounding areas.
• Overall, according to the Shelter Cluster, access to adequate shelter remains a top priority, with about 1.5 million people estimated to require emergency shelter items. Between 10 and 21 October, tents and other shelter items entered the Gaza Strip, mainly through bilateral donations. Shelter Cluster partners continue to face major limitations in bringing into Gaza their supply pipeline, with only four out of 18 partners currently approved by Israeli authorities to bring shelter items into Gaza. According to the Shelter Cluster, since shelter items were approved for entry into Gaza on 16 September, more than 4,700 tents, about 25,000 blankets and 5,000 tarpaulins were distributed by partners in Khan Younis and Deir al Balah. According to the Shelter Cluster, partners are gradually reestablishing their presence in northern Gaza, including by addressing logistical challenges related to securing office spaces and identifying suitable distribution points and warehouses.

Food Security

• Food Security Sector (FSS) partners continue to expand efforts to address the urgent food security situation in the Gaza Strip through a combination of daily hot meals, bread production and food parcel distribution. As of 21 October, daily meal production had reached 945,000 across Gaza, with 165 kitchens in Deir al Balah and Khan Younis governorates providing 872,000 daily meals and 14 kitchens in Gaza Governorate providing 73,000 daily meals. Days before the ceasefire, the World Food Programme (WFP) restarted nine bakeries it once supported, which are producing more than 100,000 two-kilogramme flatbread bundles. Partners are focusing on enhancing bread quality by adjusting production hours and improving storage practices and pickup schedules. Food parcel distribution, which resumed on 13 October, has reached more than 30,000 households as of 20 October. Food parcels are available at 27 distribution points in neighbourhoods where people live in Deir al Balah and Khan Younis and seven distribution points in Gaza city, with plans underway to expand to 145 sites since, according to WFP, this is a central pillar of pushing back hunger by ensuring that families have a steady supply of food and begin rebuilding a minimum level of food security.
• It has been more than 40 days since humanitarian food convoys directly entered northern Gaza and on 21 October, WFP reported that there had not been large scale convoys into northern Gaza since the ceasefire took effect on 10 October; this is the area where the Integrated Food Security Phase Classification (IPC) confirmed a famine in August. FSS notes that it is taking more time for partners to resume their operations compared with the previous ceasefire due to the level of destruction and the resupply challenges, but partners are working this week to send more food supplies to the north to resume general food parcel distribution and bread production as well as expand cooked meal delivery. FSS stresses that the opening of direct crossings to the north is vital to ensure that sufficient aid reaches people as soon as possible. According to the IPC global initiative, due to the highly volatile conditions in recent weeks and significant population movements, it has not been feasible to conduct a reliable analysis. The next IPC analysis for the Gaza Strip is tentatively planned for November, with the aim of capturing the latest developments more comprehensively, it reported.
• Between 15 October and 20 October, 150 MT of concentrated animal fodder was collected from Kerem Shalom/Karem Abu Salem crossing. The fodder for small ruminants (mostly sheep, goats, cattle, donkeys supporting humanitarian service delivery) is being repackaged for distribution to animal herders in Deir al Balah. FSS underscores the importance of protecting surviving livestock to improve access to a diversity of foods, resuming local production of milk and dairy products, and securing animal transport which supports “last mile” delivery of water and other essential supplies. This is especially critical given widespread destruction of agricultural lands, severe soil contamination with war remnants, and hindered access to arable land, making large areas either inaccessible, dangerous or unsuitable for agricultural use and the expansion of local food production.

Protection Risks

• According to a protection monitoring exercise conducted by Protection Cluster teams between 24 September and 15 October, communities continue to report major protection risks across the Gaza Strip. Stressors driving expanding risks include the prolonged loss of income and lack of food, and are resulting in negative coping mechanisms, especially affecting female-headed households, forcing families to sell their belongings and depend on scarce humanitarian aid. Many families continue to live in overcrowded makeshift shelters that offer little privacy or protection from weather elements. The lack of secure, lockable spaces is causing heightened anxiety and risks of harassment, particularly for women and girls. Communities also expressed limited access to safe and dignified WASH facilities, increasing risks of harassment and disease, in addition to widespread psychological distress and heightened risks of gender-based violence (GBV) amid displacement and poor living conditions.
• Heightened protection risks in Gaza affect all segments of the population, according to the Protection Cluster’s monitoring report. Women and girls bear the heavy burden of caregiving under unsafe conditions, facing increased risks of harassment and GBV, compounded by chronic stress and exhaustion. Older persons and persons with disabilities struggle to access basic services and depend heavily on caregiver support due to mobility and infrastructure barriers. Men, traditionally viewed as family providers, report severe psychological distress as displacement and loss of livelihoods undermine their ability to care for their families, eroding their sense of dignity and purpose. Children remain among the most affected, exposed to unsafe environments, poor hygiene, and disrupted education, with growing risks of child labour and early marriage.
• To enable safe service delivery, the Protection Cluster is working to mainstream awareness on explosive remnants of war (ERW) across the humanitarian response, noting that that the risk of exposure to explosive ordnance (EO) is heightened as people return to areas that witnessed heavy military presence and have become newly accessible. Since 10 October, partners have continued to carry out EO risk education sessions and mine action partners have continued to conduct explosive hazard assessments to enable partners to safely open roads and conduct repairs to damaged infrastructure.
• In parallel, protection partners are seeking to expand assessments and targeted service delivery to meet the specific needs of various vulnerable groups across the Gaza Strip. For example, a new safe space for women and girls was established within Nasser Medical Complex, in Khan Younis, to provide integrated GBV services. Service points were additionally reactivated in places that were previously inaccessible, especially in Gaza city, where offices, safe spaces and community help points have reopened and assessments have been conducted. Assessments and services remain limited in North Gaza due to safety, access and infrastructure constraints although some partners have resumed activities in the governorate, including one child protection partner who has reached children with case management services, including for separated and unaccompanied children.

Access to Health Care

• Health Cluster partners continue to restore services and expand capacity of health facilities in line with the 60-day response plan. Between 10 and 22 October, five new health service points were established, including a primary health centre and a medical point in Deir al Balah, two medical points in Khan Younis, and one medical point in Gaza city. Also in Gaza city, an international emergency medical team (EMT) was deployed to Al Shifa Hospital to boost capacity for orthopaedic surgery and trauma care and set up two new operating theatres, and construction began on a new field hospital in Al-Kateeba area, which will comprise 100 beds and is expected to be operational next month. In southern Gaza, 10 neonatal ventilators were installed across three hospitals to expand neonatal intensive care unit (ICU) capacity. In parallel, since 10 October, health partners have been able to bring into Gaza much needed diagnostic and curative medical supplies, while other critical shortages continued to be reported by partners. This week, one partner was forced to suspend rehabilitation outreach activities due to a lack of medical consumables for dressing wounds, including gauze. Elective surgeries were also suspended at St John’s Hospital and the Kuwaiti Specialist Hospital amid shortages of essential drugs, disposables, and IV solutions.
• On 22 October, the first medical evacuation since 29 September was facilitated by WHO, with 41 patients and 145 companions exiting via Kerem Shalom/Karem Abu Salem crossing. According to WHO, about 15,600 patients, including 3,800 children, urgently require medical care unavailable in Gaza and are awaiting medical evacuation. On 21 October, in an open letter calling on world leaders to ensure that the ceasefire leads to a scale up of medical evacuations, the International President of Médecins Sans Frontières (MSF) stressed: “Today, a patient with complex trauma-related injuries, or life-threatening and chronic conditions, such as cancer or kidney failure, faces the same impossible reality as before the ceasefire. For these patients, medical evacuation is their only chance of survival.”
• Mental health care needs in the Gaza Strip are equally immense, more than doubling from about 485,000 to over one million people following two years of hostilities, according to WHO Director-General, Tedros Adhanom Ghebreyesus. According to the Gaza Community Mental Health Programme (GCMHP), repeated exposure to trauma, displacement, loss, and the destruction of essential infrastructure, including healthcare facilities, have deepened the crisis, affecting children, women, the elderly, people with disabilities, IDPs, frontline workers, and survivors of detention and torture. The report found that the prevalence of mental health disorders has sharply increased, with higher rates of depression, anxiety, and trauma-related symptoms. Children and adolescents are particularly affected, showing widespread distress such as nightmares, aggression, and fear. Over 80 per cent of displaced people report anxiety, despair, and helplessness, while vulnerable groups face heightened psychological risks due to the loss of social networks, disruption of routines, and lack of specialized care.
• Since October 2023, WHO has trained over 1,000 health workers to strengthen mental health support at all levels of care. However, as people in Gaza attempt to rebuild their lives, mental health is at an all-time low and related services remain limited, WHO added.
• UNRWA, one of the largest providers of emergency learning and psychosocial support (PSS) in the Gaza Strip, has maintained and expanded its interventions. Since October 2023, and with 236 school counsellors and over 300 assistant counsellors, UNRWA has conducted more than 330,000 PSS sessions for approximately 730,000 displaced persons, including over half a million children, and supported 240,000 displaced persons through psychological first aid, case management, and family and individual activities. This included 2,793 survivors of GBV, 5,409 children (of whom 2,245 were unaccompanied), and 28,901 persons with disabilities. Between 16 and 22 October 2025, UNRWA’s health teams, including 49 psychiatrists, counsellors and supervisors, continued to provide MHPSS services in Gaza city, Deir al Balah, and Khan Younis, responding to 3,266 cases through individual consultations, psychological first aid, and awareness sessions.

Water and Sanitation

• According to the WASH cluster, partners are working to address critical needs generated by widespread damage to WASH infrastructure. Over the past 10 days, key achievements include: 500 metres of damaged pipes were replaced at Al Samer Sewage Pumping Station, in Gaza city; Al Rawda water wells in Az Zawaida, in Deir al Balah, were rehabilitated; and repairs were completed on one of the lines connected to the Mekorot pipeline coming from Israel to Gaza city, allowing an additional water filling station to become operational. In Gaza city, partners have prioritized the repair of two out of six destroyed wells in Al Zahra and Al Mughraqa areas. As of 20 October, partners are distributing water through trucked operations to 1,870 collection points across the Strip.
• On 19 October, the Gaza Municipality reported that severe damage to Ash Sheikh Radwan stormwater collection pond and its associated facilities included damage to the drainage pipelines connecting it to the sea and to the pumping systems and power generators, resulting in a complete halt in drainage operations. The Municipality indicated that the rising water level is caused by the infiltration of wastewater due to the destruction of sewer networks and pumping stations, warning that the failure to drain the accumulated water could pose serious flooding risks to nearby residents as the winter approaches. The Municipality further reported that the extensive damage sustained by the B7 wastewater pumping station in Az Zaytoun neighbourhood of eastern Gaza city has exacerbated the city’s sanitation crisis, characterized by sewage overflows and environmental contamination.

Funding

• As of 22 October 2025, Member States have disbursed approximately US$1.3 billion out of the $4 billion (32 per cent) requested to meet the most critical humanitarian needs of three million out of 3.3 million people identified as requiring assistance in Gaza and the West Bank, including East Jerusalem, in 2025, under the 2025 Flash Appeal for the OPT. Nearly 88 per cent of the requested funds are for humanitarian response in Gaza, with just over 12 per cent for the West Bank. During September 2025, the oPt Humanitarian Fund managed 95 ongoing projects, totalling $57.1 million, to address urgent needs in the Gaza Strip (87 per cent) and the West Bank (13 per cent). Of these projects, 43 are being implemented by INGOs, 38 by national NGOs and 14 by UN agencies. Notably, 32 out of the 57 projects implemented by INGOs or the UN are being implemented in collaboration with national NGOs. For more information, please see OCHA’s Financial Tracking Service webpage and the oPt HF webpage.