Humanitarian Situation Update #344 | 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 3 or 4 December.

Key Highlights

• For the hundreds of thousands of children living in tents or amid the rubble of their former homes, the winter season is a threat multiplier, UNICEF warns.
• Winter weather is straining collective winterization efforts, driving additional emergency shelter needs and necessitating the evacuation of shoreline sites where on-site mitigation is not viable.
• During the first two weeks of November, reported acute watery diarrhoea cases increased by 13 per cent compared with the previous two-week period, while jaundice cases more than doubled, highlighting a continued deterioration in the state of public health.
• Since October 2023, more than 10,600 patients were medically evacuated from the Gaza Strip, WHO reports.
• A recent UNCTAD report finds that two years of military operations and restrictions have driven the Palestinian economy to a near-total collapse, plunging Gaza’s entire population into multidimensional poverty.

Context Overview

• Over the past week, Israeli military strikes near or east of the so-called “Yellow Line” as well as areas of the Gaza Strip from which Israeli forces withdrew under the ceasefire agreement were reported, resulting in casualties. 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. Access to the sea remains prohibited. The Site Management Cluster (SMC) reports that more than 17,000 displacement movements were recorded between 19 and 25 November, compared with over 34,000 movements in the preceding week. Most population movements continued from southern to northern Gaza, with some reverse movements and some movements from North Gaza toward Gaza city.
• In a press briefing on 21 November, the United Nations Children’s Fund (UNICEF) reported that at least 67 children have been killed in conflict-related incidents in the Gaza Strip since the ceasefire took effect, an average of nearly two children killed per day, and dozens more have been injured. For the many children with severe burns, shrapnel wounds, spinal injuries, traumatic brain injuries, or cancer (who have lost months of treatment), or those who need surgeries that cannot be performed in Gaza today, UNICEF Communication Manager and Deputy Spokesperson, Ricardo Pires, emphasized that “safe, fast and predictable medical evacuations are the difference between life and death and between recovery and life-long disability.” For the hundreds of thousands of children living in tents or amid the rubble of their former homes, he warned that the winter season is a threat multiplier, noting that UNICEF is responding at scale, but a lot more can be done if the aid was entering faster. “Our colleagues in Gaza describe what they see every day from children sleeping in the open and living with amputations to children orphaned and trembling in fear while living in flooded, makeshift shelters, stripped of their dignity […] respiratory infections are on the rise while contaminated water fuels the spread of diarrhoea,” he stated, stressing that the stakes are incredibly high especially in relation to the entry of winter and shelter supplies.
• On 22 November, the Israeli military reported that its troops came under fire from an armed individual who crossed the “Yellow Line” in southern Gaza, in response to which it carried out multiple strikes across the Strip. On 23 November, the Ministry of Health (MoH) in Gaza reported that 21 Palestinians were reportedly killed and 83 were injured in the preceding 24 hours. According to the PCD spokesperson, the fatalities included children, women, and older persons who were killed in multiple strikes targeting residential buildings and a vehicle over a two-hour period.
• On 25 November, according to official Israeli sources, the body of one deceased hostage was returned from Gaza to Israeli authorities, bringing the overall number of returned bodies of Israeli and other hostages since the ceasefire to 26. On 26 November, MoH in Gaza reported that the bodies of 15 Palestinians were returned to the Gaza Strip, bringing the total number of released bodies since the ceasefire to 345, of which 99 were identified.
• According to the MoH in Gaza, between 19 and 26 November, 65 Palestinians were killed, 217 were injured and 25 bodies were recovered from under the rubble. This brings the casualty toll among Palestinians since 7 October 2023, as reported by the MoH, to 69,785 fatalities and 170,965 injuries. According to the MoH, the total number includes 180 fatalities who were retroactively added between 14 and 21 November after their identification details were approved by a ministerial committee. MoH reported that since the ceasefire, 347 Palestinians were killed, 889 were injured and 596 bodies were retrieved from under the rubble.
• According to the Israeli military, between 19 and 26 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 2,982 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 26 November, it is estimated that the bodies of two deceased hostages remain in the Gaza Strip.
• The UN Conference on Trade and Development (UNCTAD) reports that two years of military operations and extensive damage to infrastructure and productive assets have reversed decades of socioeconomic progress and development gains in the Occupied Palestinian Territory (OPT). Against a backdrop of long-standing economic and institutional fragility, this has triggered an unprecedented economic collapse. In Gaza, per capita Gross Domestic Product (GDP) in 2024 fell to US$161 – among the lowest globally – unemployment rose to 80 per cent, and the entire population plunged into multidimensional poverty. Over 2023-2024, GDP shrank by 87 per cent, dropping to $362, and 98 per cent of banks had ceased operations by April 2025. In a press release, UNCTAD called for immediate and substantial intervention by the international community to halt the economic freefall, address the humanitarian crisis, enable meaningful recovery – including access to healthcare, education, clean water and critical infrastructure – and lay the groundwork for lasting peace and development.

Humanitarian Access

• Between 14 November, when Zikim crossing was re-opened following a two-month closure, and 25 November, the UN and its partners collected over 19,800 metric tons (MT) of aid from three operational crossings, according to the UN 2720 Mechanism. This is compared with about 23,500 MT collected from two operational crossings in the preceding 12 days and 18,700 MT during the corresponding period in October (14-25 October). Located in the north, the Zikim crossing is now one of three points for the entry of aid into Gaza and has been operating on an alternating offload-and-uplift schedule with Kissufim crossing.
• As of 25 November, more than 179,000 metric tons (MT) of the aid positioned across the region were approved and cleared by Israeli authorities for transfer into Gaza, of which about 71 per cent are food supplies, according to the UN 2720 Mechanism. The Mechanism further reports that out of 560 requests submitted for the entry of aid in October, 121 requests (24 per cent) were rejected as of 26 November. In comparison, 47 out of 438 requests (11 per cent) for aid entry into Gaza were rejected in September. The 121 rejected requests in October comprise more than 5,600 MT of humanitarian aid, of which 64 requests (nearly 3,000 MT of aid) were rejected on the grounds that the organizations were not ‘’authorized’’ or ‘’approved’’ to bring relief items into Gaza. The majority (50 requests) concern the entry of health, shelter, and water and sanitation supplies. The remaining requests were denied by the Israeli authorities either on the basis that the items did not fall within the “humanitarian” category, or because they were classified as “dual-use.” In October, such rejected requests included frozen meat, pesticides, vehicles, power equipment, construction materials, specialized machinery, and learning and recreational materials for children.
• 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 Israeli forces remain deployed. Between 19 and 25 November, humanitarian organizations coordinated 55 missions with the Israeli authorities, of which 29 were facilitated, four were cancelled, 11 were impeded and 11 were denied.
• According to the Emergency Telecommunications Cluster (ETC), based on information from the telecom operator, on 22 and 23 November, after repeated denials in previous weeks, the Internet Service Provider’s technical team was granted access to repair the severed main fibre line near the Erez crossing reported on 3 November. During the mission, the team identified three additional fibre cuts requiring repair. Two were repaired, but subsequent denials, most recently on 25 and 26 November, prevented full restoration. Coordination is ongoing to facilitate continued operator access, as the backup redundancy internet communication links remain fragile and further damage could trigger a full connectivity blackout in Gaza.
• On 24 November, the World Health Organization (WHO) facilitated the medical evacuation from Gaza of 33 patients, in addition to 109 companions. WHO expressed concerns “about the long delays patients faced moving from the Kerem Shalom crossing out of Gaza to Allenby [Bridge border] crossing, where, together with the WHO team, they waited over four hours before being allowed to proceed, putting their fragile health at further risk.” According to WHO, since October 2023, more than 10,600 patients were evacuated along with over 12,000 companions. More than 16,500 patients, including 4,000 children, still require medical evacuation, as the advanced care they need is not available in the Strip. WHO called for additional support, as well as the opening of all evacuation routes, particularly to the West Bank, including East Jerusalem, and for movements of medical evacuation convoys to be expedited at crossings.

Growing Winterization Needs

• According to the Shelter Cluster, collective efforts to prepare for the winter season are under strain due to new winter storms, driving a cycle of renewed emergency needs. The UN and its partners continue to address widespread shelter needs arising from the 17 November rainstorm. Between 17 and 26 November, Shelter Cluster partners distributed UN-coordinated shelter assistance across the Gaza Strip, including more than 5,500 tents, over 71,000 tarpaulins, and more than 133,000 bedding items to more than 20,000 households. In addition, clothing vouchers were distributed to about 2,800 households. The Shelter Cluster estimates that 1.48 million people are in need of emergency shelter assistance across the Strip. Partners who can bring shelter materials into Gaza warn that existing efforts cannot meet the scale of need.
• Most people in Gaza continue to reside in a range of inadequate shelter types that fail to meet basic emergency standards, including tents, makeshift tents, and partially or heavily damaged buildings. According to the SMC, although the need for tents remains critical, structural conditions in some sites are such that the provision of tents alone does not provide an adequate or sustainable shelter solution. Where feasible, SMC partners are undertaking winter preparedness measures in displacement sites to reduce flooding risks, such as drainage improvements and sandbag reinforcements. However, according to SMC, most available flood-mitigation efforts remain largely ineffective due to severe shortages in the needed materials and tools over the past two years. In addition, many sites are situated in low-lying, debris-laden areas without drainage or protective perimeters, leaving them highly exposed and limiting the effectiveness of any on-site mitigation. Particularly, for the shoreline displacement sites estimated to be hosting 4,300 people and facing heightened flooding risks, discussions are underway with municipal authorities and affected communities on possible evacuation, as no viable on-site mitigation measures exist.
• On 23 November, the PCD reported that its teams had been mobilized, despite extremely limited resources, to respond to the anticipated impacts of the harsh weather, particularly for the thousands of displaced families living in tents and temporary shelters. However, PCD warned that the lack of fuel for its operations, compounded by extensive damage to infrastructure and public services, is threatening to deepen the suffering of displaced communities, especially in sites at high risk of flooding from rainwater or seawater surges. Gaza Municipality also reported that it is facing the winter season with extremely limited resources, including a severe shortage of heavy machinery required to address rainwater accumulation and sewage overflows. This is compounded by the unavailability of pipes, cement, and essential materials needed to repair damaged manholes and stormwater drainage networks amid extensive infrastructural damage that has increased the risk of flooding. The destruction of wastewater treatment facilities and rainwater pumping stations has slowed the discharge process and led to rainwater pools and flooding in several neighbourhoods and displacement shelters, especially those located in low-elevation zones.
• According to the Protection Cluster, winter challenges are aggravating deplorable water and sanitation conditions as well as privacy and safety risks faced by women and girls in displacement sites. In recent remarks, Sofia Calltorp, the UN Women Chief of Humanitarian Action highlighted the particularly harsh impact of the winter season on women and girls in the Gaza Strip. Calltorp reported that entire neighbourhoods lie in ruins and that women are facing hunger, fear, repeated displacement and winter conditions in makeshift shelters that offer little protection. Describing severe destruction and the struggles facing women, especially more than 57,000 who now head their households amid high prices and a lack of income, Calltorp said: ''We arrived in Gaza just after a weekend of severe rain and cold. Women showed me how water soaked through their makeshift tents, leaving their children shivering through the night. This is what it means to be a woman in Gaza today: to know that winter is coming, and to know you cannot protect your children from it.''
• Winter conditions are additionally exposing temporary learning spaces (TLSs) to deterioration, heightening the risk of further disruptions to learning and constraining already limited options for school-aged children, according to the Education Cluster. Between 14 and 17 November, flash floods caused damage to at least 38 TLSs in Gaza city, Deir al Balah and Khan Younis, affecting 103 tents and 10 latrines and preventing in-person learning for an estimated 9,528 students and 235 teachers, the Education Cluster reported. Out of the total affected TLSs, 14 TLS serving 2,500 students have resumed operations.* Over the past week, two TLSs have been newly established, bringing the overall number of TLSs as of 26 November to 305, serving over 155,800 children, or only a quarter of some 637,000 school-aged children. The Cluster emphasizes that the extent of damage has increased the need for more durable shelter materials and reinforcement of existing structures to maintain safe access to education.

Public Health Conditions and Risks

• The first round of the catch-up immunization campaign, conducted from 9 to 20 November, reached more than 13,700 children across the Gaza Strip. According to UN agencies, less than two per cent of participating children had never received any vaccines, while a quarter had missed scheduled doses, reflecting immunity gaps following two years of hostilities. Sustaining this momentum, 1.6 million syringes procured for subsequent vaccination rounds successfully entered the Strip this week, and UNICEF and WHO already have the nutrition supplies and medicines required to treat all malnourished children into early 2026. During the first vaccination round, about 500 children were identified to be acutely malnourished and referred to treatment, out of more than 6,800 screened children. To expand vaccine coverage, UN agencies call for the entry of additional cold chain equipment.
• According to the Health Cluster, Acute Respiratory Infections (ARIs) remain the most frequently reported conditions, accounting for 68 per cent of all reported cases in 2025. Moreover, overcrowding due to displacement across the Gaza Strip, a collapse of water and sanitation systems and the resulting spread of infectious diseases have triggered an uptick of Guillain-Barré Syndrome (GBS) cases, according to the Rehabilitation Task Force. GBS cases, a rare autoimmune condition affecting the nerves, have now reached 141, including nine cases reported during November. Three suspected leptospirosis cases are under investigation, of whom two are currently in intensive care. Leptospirosis is a blood infection caused by bacteria and is often called “rat fever.” No new polio cases have been reported; the Health Cluster reports that analysis of September and October environmental samples was negative for Polio, marking seven consecutive months with no detected cases in Gaza.
• Acute Watery Diarrhoea (AWD) and Acute Jaundice Syndrome (AJS, Hepatitis A) are on the rise, reflecting ongoing public health risks of overcrowded shelters and poor access to clean water and limited hygiene supplies, the Health Cluster reports. In the first two weeks of November, over 25,500 AWD cases were recorded by health partners, compared with about 22,600 cases in the previous two weeks, constituting a 13-per-cent increase and accounting for 8.4 per cent of all reportable disease consultations. AJS cases more than doubled, increasing to 307 from 132 in the preceding two weeks. According to the latest WASH Cluster assessment between 17 August and 5 September, 63 per cent of households across the Strip did not have soap at their shelters.
• At least three Hepatitis A cases in community kitchens in southern Gaza were recently identified, according to the Health Cluster. Following this development, the Food Security Sector (FSS) highlighted the urgency of strengthening safe food handling and infection prevention and control measures across all cooking facilities. FSS is working with the WASH and Health clusters to develop a harmonized minimum infection prevention and control package, including hygiene items, cleaning supplies and water-testing consumables, to support cooked-meal partners in quantifying needs and advocating for the humanitarian entry of essential infection prevention and control supplies, many of which remain restricted for humanitarian partners, such as chlorine-based surface disinfectants.
• On 23 November, the MoH in Gaza announced that the Public Health Laboratory has been reactivated following its destruction during the escalation, enabling the resumption of many essential tests. According to the Director of the Public Health Laboratory, testing has restarted for medicines, drinking water, wastewater, and a range of food items, including infant formula and nutritional supplements. Microbiological and chemical analyses have also been restored, with plans to further expand testing capacity once destroyed critical equipment is replaced.

Funding

• As of 27 November, Member States disbursed approximately $1.6 billion out of the $4 billion (40 per cent) requested to meet the most critical humanitarian needs of 3 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 Servicewebpage and the oPt HF webpage.