Humanitarian Situation Update #342 | Gaza Strip

The Humanitarian Situation Updates on the Gaza Strip and on the West Bank are both issued every Wednesday/Thursday. The next Humanitarian Situation Update on the Gaza Strip will be published on 26 or 27 November.

Key Highlights

• As heavy rains flooded thousands of tents and makeshift shelters, the UN and its partners are supporting joint winterization, flood-mitigation and hygiene-enhancement efforts and calling for the entry of more humanitarian assistance.
• Access to markets and food consumption continued to show modest improvements in the first 10 days of November, but dietary diversity remains low and 25 per cent of households reported eating only one meal daily, according to the World Food Programme.
• While efforts are ongoing since 3 November to gain access to and repair the damaged main fibre line near Erez crossing, further delays can lead to a complete communications blackout and disrupt humanitarian operations.
• With about 93 per cent of school buildings damaged, learning cannot resume at scale in Gaza without reconstruction or the ability to establish new learning spaces, the Education Cluster reports.

Context Overview

• Following the withdrawal of Israeli forces from parts of the Gaza Strip under the ceasefire agreement, Israeli military strikes near or east of the so-called “Yellow Line” continue to be reported, resulting in casualties. Access to the sea remains prohibited. In areas beyond the “Yellow Line,” where the Israeli military remains deployed (over 50 per cent of the Gaza Strip), daily detonations of residential buildings continue to be reported and access to humanitarian assets, public infrastructure and agricultural land remains restricted or altogether barred. On the evening of 19 November, the Israeli military reported that its troops came under fire in Khan Younis, in response to which it carried out multiple strikes across the Strip. According to the Ministry of Health (MoH) in Gaza, as of 20:00 on 19 November, 25 Palestinians were reportedly killed and over 77 others were injured due to the strikes. According to the Palestinian Civil Defence (PCD) spokesperson, casualties, mostly women and children, were reported in eastern Gaza city and Khan Younis.
• As recent rains and floodwaters destroyed what little shelter and belongings thousands of Palestinians in Gaza had left (see more information below), the UN Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, Tom Fletcher, stressed that while the UN and partners are working to respond and reach those affected, much more is needed. He called for the immediate lifting of remaining restrictions to enable the entry of more humanitarian assistance into Gaza.
• The Site Management Cluster (SMC) reports that population movements have decreased over the past week, likely due to unfavourable weather conditions. More than 34,000 displacement movements were recorded between 10 and 17 November, compared with over 46,000 movements in the preceding week. Overall, between 10 October and 17 November, more than 730,000 movements of people were recorded by SMC partners, including more than 637,000 movements crossing from southern to northern Gaza, primarily through Al Rasheed Road. Over 113,000 movements were observed from western to eastern Khan Younis during the same period.
• On 13 November, according to official Israeli sources, the body of one hostage was returned from Gaza to Israeli authorities, bringing the overall number of returned bodies of Israeli and other hostages since the ceasefire to 25. On 15 November, according to the MoH in Gaza, the bodies of 15 Palestinians were returned to the Gaza Strip, bringing the total number of released bodies since the ceasefire to 330, of which only 97 were identified.
• According to the MoH in Gaza, between 12 and 14:30 on 19 November, eight Palestinians were killed, 41 were injured and 18 bodies were recovered from under the rubble. This brings the casualty toll among Palestinians since 7 October 2023, as reported by the MoH, to 69,513 fatalities and 170,745 injuries. According to the MoH, the total number includes 279 fatalities who were retroactively added between 7 and 14 November after their identification details were approved by a ministerial committee. MoH reported that since the ceasefire, 280 Palestinians were killed, 672 were injured and 571 bodies were retrieved from under the rubble.
• According to the Israeli military, between 12 and 19 November, as of noon, no Israeli soldiers were killed in Gaza. The casualty toll among Israeli soldiers since the beginning of the Israeli ground operation in October 2023 stands at 471 fatalities and 2,978 injuries. According to Israeli forces and official Israeli sources cited in the media, more than 1,671 Israelis and foreign nationals have been killed, the majority on 7 October 2023 and its immediate aftermath. As of noon on 19 November, it is estimated that the bodies of three deceased hostages remain in the Gaza Strip.
• According to a recent assessment by the Education Cluster, which relies on satellite imagery collected on 11 October, about 93 per cent of school buildings in the Gaza Strip (526 out of 564) were directly hit or damaged and are estimated to require either full reconstruction or major rehabilitation work to be functional again. These include 95 school buildings in North Gaza, 208 in Gaza, 70 in Deir al Balah, 125 in Khan Younis and 66 in Rafah governorates. North Gaza and Rafah governorates are the most affected, with 100 per cent of their school buildings either directly hit or damaged. About one-third of school buildings that were directly hit or damaged are operated by UNRWA. Eighty-seven per cent of damaged school buildings (459) were directly hit, including 267 that served as emergency shelters. This is an increase of 27 school buildings compared with the last assessment – which was based on satellite imagery collected on 8 July – and includes schools that were previously classified as damaged. Of the 27 newly hit schools, 18 are government-run schools, five are UNRWA schools and four are private schools. Of schools that served as shelters for internally displaced people (IDPs), 77 per cent (267 out of 459) were directly hit. According to the Education Cluster, without reconstruction or the ability to establish new learning spaces, learning cannot resume at scale in Gaza.

Humanitarian Access

• Coordination with Israeli authorities continues to be required for humanitarian convoy movements in Gaza, to crossings as well as in or near other areas where the Israeli military remains deployed. Between 12 and 18 November, humanitarian organizations coordinated 51 missions with the Israeli authorities, of which 27 were facilitated, five were cancelled, 15 were impeded and four were denied. Movements included, among others, 28 movements to collect cargo from the three operational crossings (Kerem Shalom, Zikim, and Kissufim), one search-and-rescue mission, two road repair, assessment and clearance missions, and four movements related to the crossing of humanitarian personnel.
• According to the Emergency Telecommunications Cluster (ETC), the main fibre line near the Erez crossing, where Israeli ground forces remain deployed, was damaged on 3 November and remains unrepaired. Since 3 November, all coordination requests submitted to facilitate an urgent repair mission have been denied. Cluster partners warn that given the fragility of the remaining backup fibre, any delays in repairs can lead to a complete communications blackout across the Gaza Strip. Such a blackout will significantly disrupt humanitarian operations, impede emergency response mechanisms, and further isolate people, the majority of whom are displaced and have limited access to essential information and services. Repair efforts are made difficult by a lack of locally available spare parts compounded by restrictions on the entry of Information and Communication Technology (ICT) equipment. The Cluster is exploring alternative solutions, such as long-distance radio links, to strengthen secure communication systems and to mitigate the risk of further disruptions to humanitarian operations.
• Between 12 and 18 November, according to the UN 2720 Mechanism, more than 10,600 metric tons (MT) of aid were collected by the UN and its partners, including nearly 6,800 MT from Kerem Shalom crossing, over 1,600 MT from Kissufim crossing, and about 2,200 MT from the recently re-opened Zikim (Erez West) crossing. None of the supplies collected over the past week were reportedly intercepted en route, and the last such reported incident took place on 6 November. Zikim crossing, which allows aid to enter directly to the north, resumed operations on 14 November following a two-month closure. The crossing is operating on an alternating entry and collection schedule, rotating with Kissufim crossing. Collected aid movements continue to be directed through the Philadelphi Corridor and Al Rasheed Road while Salah ad Din Road remains closed to humanitarian movements. According to the Logistics Cluster, the Al Rasheed route is congested and exposes trucks to operational challenges, such as extended mission durations and heightened risk of opportunistic looting, while limiting the size of the convoys.

Growing Winterization Needs

• According to the Shelter Cluster, on 14 and 15 November, heavy rains and stormy weather flooded thousands of tents and makeshift shelters across the Gaza Strip, leaving an estimated 13,000 tents completely damaged and exacerbating already crisis-level shelter needs. The SMC estimates that the weather events affected more than 740,000 people across 715 displacement sites, including 384 located in high flood-risk areas. Of the affected sites, 130 were in northern Gaza, 264 in Deir Al Balah, 308 in Khan Younis, and 13 in Rafah. Streets and low-lying areas were flooded, restricting movement and flooding tents and makeshift shelters. Many returning families, particularly to northern Gaza, have no choice but to remain in unsafe, destroyed structures, with winter rains further heightening risks as weakened walls and roofs deteriorate and water intrusion increases. Ahead of the storm, the PCD issued public guidance urging residents to clear drainage paths between tents, secure shelters against strong coastal winds, avoid unsafe or damaged buildings, refrain from lighting fires inside tents, and avoid flooded or hazardous roads. Still, people living in overcrowded and exposed sites, many in makeshift tents, were ill-prepared for the season’s first rains, exposing severe gaps in winter readiness amid deplorable living conditions, the Shelter Cluster reported.
• At the beginning of October, the Shelter Cluster launched a winterization plan for the Gaza Strip. The plan entailed the distribution of winterized tents as well as Emergency Shelter Kits (ESKs) and other essential materials for building shelters or enhancing waterproofing and insulation, such as plastic sheeting, ropes and tools. In addition, partners planned to distribute winter clothing alongside other non-food items (NFIs), such as blankets and mattresses. The full rollout of planned activities, however, requires the entry of shelter materials at scale, which, despite some improvements, continues to be severely constrained by Israeli authorities’ restrictions on the entry of shelter supplies coordinated through the UN. Between 6 and 17 November, the Cluster collected from crossings 8,000 tents, 98,000 tarpaulins and 110,000 blankets through UN coordination, bringing the total number of tents and tarpaulins collected since 10 October to more than 13,000 tents and roughly 290,000 tarpaulins.
• Municipalities across Gaza have carried out emergency repairs to sewage and stormwater infrastructure to drain rainwater and manage overflows despite extremely limited resources, equipment, and machinery. Due to extensive damage to stormwater and sewage systems across the Strip, heavy rainfall resulted in overflows mixed with untreated sewage, heightening health risks. According to the water, sanitation and hygiene (WASH) Cluster, partners have prioritized a range of preparedness measures for flood mitigation, including the repair or rehabilitation of numerous wastewater pumping stations and infrastructure, cleaning and clearing stormwater drains, gullies and wadis vulnerable to flooring, as well as emptying and rehabilitating critical stormwater basins, such as Al Amal, Al Qarara, Ash Sheikh Radwan, Abu Rashed and Al Saftawi. However, this requires the urgent entry of critical specialized equipment, such as pumps, pipes and other electromechanical components, which continue to be denied entry, and a consistent supply of fuel.
• In response to the rains, between 14 and 17 November, Shelter partners were able to distribute more than 3,600 tents, 129,000 tarpaulins and 87,000 blankets and other NFIs, reaching nearly 130,000 people in need. The Cluster estimates that available stocks are expected to be depleted within a week. Separately, between 14 and 17 November, the Shelter Cluster, in collaboration with several partners, supported the Qatari Committee in the distribution of 9,500 tents brought into Gaza through bilateral donations. Meanwhile, partners across the humanitarian system are supporting joint winterization, flood-mitigation and hygiene-enhancement efforts. For example, WASH Cluster partners are distributing hygiene items and specialized kits, installing and repairing of latrines, desludging septic tanks, clearing stormwater drainage systems, and collecting and managing solid waste, among other emergency interventions. Food Security partners are donating empty flour and rice bags from bakeries and community kitchens to SMC partners for use as sandbags in emergency shelters. Child Protection partners have distributed over 7,000 winter clothing kits to affected families and maternity hospitals, bringing the number of these kits distributed since the ceasefire to over 48,000. Recognizing the urgent winter needs, the UN is rapidly mobilizing additional funding to support ongoing response efforts. The Humanitarian Coordinator for the Occupied Palestinian Territory, Dr. Ramiz Alakbarov, allocated US$18 million from the oPt Humanitarian Fund to sustain critical operations across Gaza as winter sets in.
• According to the Protection Cluster, winter weather has worsened protection risks across Gaza and disrupted services, causing damage to tents used to run protection activities. Protection Cluster partners report that deteriorating conditions have increased psychological distress and created mobility challenges, particularly affecting women, children, older persons and persons with disabilities. Despite these challenges, service providers are adapting by shifting sessions closer to displacement sites, opening new safe spaces, and employing mobile and remote models to maintain crucial support services related to child protection, mental health support, and addressing gender-based violence.
• Partners continued to mobilize efforts to conduct assessments in areas severely affected by the heavy rain. For example, on 16 November, an assessment conducted by SMC partners found that more than 4,300 displaced households living along the shoreline of Khan Younis and Al Mawasi area of Rafah were facing extremely severe conditions. During the assessment, families voiced serious concerns about overcrowding and unsafe living conditions, particularly due to inadequate shelter with the onset of rainy and cold weather. Heavy rainfall flooded tents and threatened to submerge entire areas, while strong coastal winds collapsed shelters and latrines. The situation was further compounded by a lack of adequate heating and limited WASH facilities. Proper faecal waste disposal was absent, forcing families to resort to unsafe alternatives and posing additional water contamination and public health risks. According to the latest WASH Cluster assessment between 17 August and 5 September, only 53 per cent of households had access to basic sanitation, while nine per cent relied on unimproved facilities (such as pit latrines without a slab or platform, hanging latrines, or bucket latrines) and four per cent practiced open defecation.
• Save The Children reported that after two years of bombardment and a collapsed sanitation system, rainwater no longer drains and is now mixing with sewage, soaking clothes, blankets, food and shelter materials. It noted that about 700,000 children are living in worn-out tents that cannot withstand winter conditions, with very little access to shoes, warm clothes, mattresses or blankets: “Despite the past month seeing more items in the markets, blankets and mattresses are almost nowhere to be seen, new clothes are also near-impossible to come by, with children still wearing summer clothes of shorts and t-shirts, and most of them barefoot. With families desperate for the basics to survive, they spend what little they have on food rather than new clothes.”

Access to Markets and Emergency Food Assistance

• Access to markets has generally improved, according to the market monitoring report of the World Food Programme (WFP) covering the first 10 days of November. While prices generally remain significantly above October 2023 levels, there were noticeable decreases in the prices of vegetables, and wheat flour prices stabilized across governorates at about NIS 4-5 (US$1-1.4) per kilogramme (kg). Compared with the second week of October, several staple food items saw notable price decreases. For example, three litres of sunflower oil dropped from NIS 30 ($8) to NIS 24 ($7). Similarly, in Khan Younis, tomato prices fell sharply, decreasing from NIS 25 ($7.6) in the second week of October to NIS 7 ($2) in early November. In Deir al Balah, prices for cucumbers decreased by half over the past month, to NIS 14 ($4). Nonetheless, drastic price fluctuations continue to pose a major challenge to market functionality, with 75 per cent of surveyed shops reporting facing this issue in November. WFP noted that “this price instability makes it harder for people to purchase and for shops to keep essential goods in stock.” Two-thirds of surveyed households reported difficulty in accessing markets, of whom 98 per cent cited a lack of cash and 39 per cent said they could not afford basic food items despite recent price drops.
• According to the Cash Working Group (CWG), Gaza’s financial and market conditions continued a gradual yet noticeable recovery throughout November, supported by improved banking services, expanded digital payment channels, and the entry of both humanitarian and commercial goods. The Palestine Monetary Authority reports that five banks are now operating through nine active branches, up from five branches in October. Banks have resumed opening new accounts, re-activating frozen ones, and issuing digital wallets, while financial service providers have restarted wallet creation. These developments are strengthening the digital payment ecosystem and improving household access to electronic liquidity. Average cash-out commissions have also dropped to 19 per cent, compared with 35-40 per cent in September. Between 10 October and 19 November, CWG partners delivered multi-purpose cash assistance to more than 93,000 households, which comprises about 78 per cent of the ceasefire response target of 120,000.
• Between 1 and 18 November, Food Security Sector (FSS) partners reached more than 530,000 people (106,000 households) with monthly general food assistance. In northern Gaza, between 12 and 15 November, food parcel shortages forced partners to alter rations mid-month and use contingency wheat flour and high energy biscuits, instead of providing each family with two food parcels (covering 50 per cent of daily caloric needs). Following the slight improvement in daily cargo inspection speed at Ashdod port, more food parcels have arrived, and starting from 16 November, the ration size across the Strip has been adjusted to two food parcels and one 25-kilogramme (kg) flour bag per family (covering 75 per cent of daily caloric needs), FSS reported. This is in addition to some 160,000 bread bundles and 1.4 million meals distributed per day, as of 17 November, through 18 UN-supported bakeries and 199 community kitchens run by partners. About 87 per cent of daily meals are distributed in central and southern Gaza, with the remaining 13 per cent in northern Gaza.
• Food consumption continued to show modest improvements in the first 10 days of November, according to WFP. About 10 per cent of surveyed households reported going an entire day without eating at least once during the 30 days preceding the survey, down from 20 per cent in the first two weeks of October. One in four households consumed only one meal daily during the first 10 days of November. Overall, similar to October, households reported eating an average of two meals per day, up from one daily meal in July, and dietary diversity remains low, with access to vegetables, fruits and protein still out of reach for many families. Essential protein-rich items like eggs and meat remain scarce or unaffordable. This is also linked to the fact that commercial imports often consist of high-cost, low-nutritional-value goods, such as soft drinks and chocolate. To assess the current severity and scale of food insecurity and malnutrition across Gaza, a new joint Integrated Phase Classification (IPC) acute food insecurity and acute malnutrition analysis began on 17 November and is expected to conclude on 21 November.

Access to Health Care

• On 12 November, the World Health Organization (WHO) facilitated the medical evacuation of 19 patients, including 12 children, three women and four men, in addition to 33 companions. This brings the total number of patients evacuated since the ceasefire to 184 patients, including 117 children, 31 women and 36 men. According to WHO, more than 900 patients have died while waiting for medical evacuation from Gaza, underscoring the critical gaps in access to life-saving care. More than a month into the ceasefire, WHO reports that efforts to rebuild the health system and facilitate evacuations continue. Over 8,000 patients, including more than 5,100 children, have been evacuated outside Gaza in the past two years, with 30 countries receiving patients in need of care, and 119 missions have been coordinated by WHO since May 2024. WHO called for additional support, as well as the opening of all evacuation routes, particularly to the West Bank, including East Jerusalem. More than 16,500 people, nearly 4,000 of them children, remain on the medical evacuation waiting list.
• On 17 November, the Palestine Red Crescent Society (PRCS), in coordination with the Augusta Victoria and Al Makassed hospitals in East Jerusalem, transferred 76 patients, and their companions to the Kerem Shalom/Karam Abu Salem crossing for their return to the Gaza Strip. These patients had been in East Jerusalem since before 7 October 2023.
• On 11 November, the Health Cluster and WHO visited Al Rantisi and Al Shifa hospitals in Gaza city to assess progress in reactivating essential health services. At Al Rantisi Hospital, partners are supporting the refurbishment and resumption of Outpatient Department (OPD) services and inpatient care, with a capacity of 80 beds currently functional. According to the Health Cluster, significant repair work, equipment, and supplies are still required to achieve full operational capacity and resume suspended services. Required support includes an extra generator and solar systems, and a restored oxygen supply system to support intensive care services for children and neonates. Similarly, services at Al Shifa Hospital are being reactivated: OPD services and 300 inpatient beds are now available and five operating rooms and 32 haemodialysis units are now operational. To achieve full functionality, surgical care, advanced diagnostics services, emergency care, oncology and multidisciplinary in-patient services are among some of the critical services that must be resumed.
• The first round of the immunization campaign, scheduled from 9 to 20 November, is ongoing across 114 health facilities throughout the Gaza Strip, supported by 145 medical teams. According to the Health Cluster, a total of 7,119 children under three were reached during the first five days. Among them, 132 children (two per cent) received their first dose (zero dose), 1,799 children (25 per cent) caught up on missed doses, and 5,188 children (72 per cent) were vaccinated according to their schedule. Additionally, 355 children were referred for malnutrition treatment following identification during the campaign. Despite continuous population movements during the planning phase, partners aimed to maximize outreach and ensure no child is missed through a range of communication channels, including mosque announcements, SMS messages, motorized megaphones, as well as banners and posters displayed in key locations.

Funding

• As of 19 November, Member States disbursed approximately $1.51 billion out of the $4 billion (37 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 under the 2025 Flash Appeal for the Occupied Palestinian Territory. Nearly 88 per cent of the requested funds is for the humanitarian response in Gaza, with just over 12 per cent for the West Bank. In October, the oPt Humanitarian Fund managed 135 ongoing projects, totalling $77.7 million, to address urgent needs in the Gaza Strip (87 per cent) and the West Bank (13 per cent). Of these projects, 63 are being implemented by international NGOs, 56 by national NGOs and 16 by UN agencies. Notably, 69 out of the 79 projects implemented by international NGOs 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.