Gaza humanitarian response update | 27 October - 9 November 2024

The information below is provided every other week by Clusters and select technical working groups operating in the Occupied Palestinian Territory (OPT). For an overview of priority needs and activities by cluster, please see the Flash Appeal.

Health

Response

• The second round of the emergency polio vaccination campaign has been completed, reaching 94 per cent of all children under the age of 10 throughout the Gaza Strip.
• On 6 November, WHO and its partners medically evacuated 90 critical patients, alongside their 139 companions, outside Gaza; 84 patients were transferred to the United Arab Emirates and 20 to Romania to receive necessary health care. This was the largest medical evacuation in one day outside Gaza since the closure of the Rafah crossing in May 2023.
• On 3 November, critical medical and surgical supplies and medications, including 150 units of blood, 20,000 litres of fuel and 60 boxes of dry food and water, the latter provided by the World Food Programme, were delivered to the Kamal Adwan Hospital in North Gaza.
• During the reporting period, a total of 55 patients and their 67 companions were transferred from the Kamal Adwan and Al Awda hospitals in North Gaza to the Al Shifa Hospital in Gaza city in two consecutive WHO-led missions. Five patients and three companions were also transferred from Al Shifa Hospital to Nasser Medical Complex in Khan Younis to receive higher-level care.
• A scale-up plan for health services in the Gaza governorate is ongoing to support the influx of displaced people, including patients, from North Gaza. During the reporting period, two new surgical Specialized Care Teams were deployed to the Public Aid and Al Ahli Arab hospitals in Gaza city. Sexual and reproductive health (SRH) medical supplies and equipment as well as individual kits were also delivered to the Gaza governorate to support 20,000 beneficiaries and 15 health facilities.
• Field visits were conducted to the Al Mawasi area to identify all SRH service providers and strengthen mapping and referral services.

Challenges

• Active military operations in the North Gaza governorate and lack of access have prevented the conduct of the second round of the polio vaccination campaign in the area. The Cluster estimates that between 6,800 and 13,700 children across northern Gaza may have been missed in the second round of the polio vaccination campaign.
• Due to ongoing hostilities, access to the Kamal Adwan, Al Awda and Indonesian hospitals in North Gaza remains restricted; the three facilities are barely managing to continue providing health services amid major supply shortages and lack of fuel.
• Efforts to scale up health services in the Gaza governorate are hampered by unpredictable access between the areas north and south of Wadi Gaza.

Nutrition

Response

• The findings of a recent UNICEF survey on dietary diversity among children and pregnant and breastfeeding women (PBW) in Gaza highlights the severe impact on nutrition of shrinking humanitarian aid and commercial truck entries into the Strip. The data collected between 18 and 24 October reveals a significant decline in dietary diversity. Ninety-five (95) per cent of parents with children aged 6 to 23 months reported that their children had consumed only two or fewer types of food the day prior to the survey. This is compared with 90 per cent in September, 79 per cent in July, and 94 per cent in May when nearly the entire population in Rafah was displaced to Deir al Balah and Khan Younis.
• Throughout the second round of the polio vaccination campaign, UNICEF facilitated the distribution of Vitamin A supplements to address the growing scarcity of Vitamin A-rich foods in the Gaza Strip. Accordingly, between 10 October and 5 November, 448,425 children aged between two and ten years, 92.4 per cent of the target, received Vitamin A supplements.
• In Gaza city, nutrition services continue to be scaled up in response to increasing displacement from North Gaza. Juzoor for Health and Development, a local NGO, opened a new medical point and plans to open three additional points while UNRWA is in the process of re-opening one health center that had been closed since October 2023.
• WFP and its partners are scaling up the Blanket Supplementary Feeding Programme (BSFP), with 102,000 children and 45,000 PBW reached in October 2024 across the Strip. They also successfully resumed the BSFP in the areas of An Nuseirat and Al Maghazi refugee camps in Deir al Balah during the second half of October, following months of restricted access by Israeli authorities.
• During the reporting period, UNICEF’s partners distributed Lipid-based Nutrient Supplements (LNS-SQ) to 24,200 children across the Gaza Strip.
• In October, 4,107 children were admitted for outpatient treatment of acute malnutrition. Between July and October, more than 18,800 children were admitted for outpatient treatment of acute malnutrition, or 65 per cent of the total number of children admitted for treatment since the beginning of 2024 (29,054), reflecting a marked increase in cases in recent months.

Challenges

• In North Gaza, due to the escalation of hostilities, evacuation orders and tightened siege, Nutrition Cluster partners had to stop all their activities, including the treatment of acutely malnourished children and supplementary feeding for children and PBW. The massive displacement of people from North Gaza to Gaza city has caused delays in detecting and initiating treatment for malnutrition cases and compromised required follow ups for children already under treatment.
• The drastic reduction of commercial trucks entering the Gaza Strip has not only driven commodity prices up and threatened market stability but also worsened the nutritional status of vulnerable children and women, who for months have faced severely limited access to adequate food, water and hygiene products.
• Shrinking humanitarian space and continued supply chain complications, including the inability to reliably pick up supplies from the Kerem Shalom crossing due to insecurity and the risk of looting, have prevented full coverage of the needs, despite the prepositioning of adequate quantities of supplies outside the Gaza Strip.

Food Security

Response

• As of the end of October, approximately 460,000 cooked meals prepared in 140 kitchens were distributed daily to families across the Strip except in North Gaza. This represents a 25 per cent decrease in meal production compared to late September. As supplies continue to dwindle, more kitchens will be forced to close, and for those that remain operational, partners have had to adjust the meal content or reduce the number of meals prepared to cope with supply shortages.
• On 7 November, following a month of impediments that have thwarted all attempts by humanitarian partners to gain access to and deliver food to the besieged areas of North Gaza, a convoy comprising 10 trucks of food and one truck of bottled water departed from Gaza city to reach Beit Hanoun in the North Gaza governorate. Along the route, some of the food was spontaneously distributed to crowds of people who surrounded the trucks; the mission was then forced to offload the rest of the food before reaching its final destination. Although the food did not reach the intended shelters in Beit Hanoun, this delivery marks the first time in weeks that food has entered North Gaza. There is an urgent need for continued, sustained, and safe access to deliver life-saving food to families facing an imminent risk of famine in North Gaza.
• As of 11 November, 12 out of 19 bakeries supported by WFP remained functional across the Strip – four in Gaza city, seven in Deir al Balah and one in Khan Younis. All the eight bakeries in central Gaza, however, are operating at 70 per cent of their capacity due to supply shortages and remain at risk of shutting down within days if no additional flour is received.
• In Gaza city, more than 150,000 people received at least one food parcel in October, including some who also received a 25-kilogramme bag of wheat flour. As of 10 November, food parcel distributions by multiple partners continued, with at least 5,000 people assisted daily in Gaza city, prioritizing the needs of those newly displaced from North Gaza. Moreover, every day, partners serve about 100,000 cooked meals prepared in 15 kitchens and 9,800 bread parcels from the subsidized bakeries are also delivered to some of the shelters and community kitchens to be distributed along with cooked meals.

Challenges

• Insecurity and looting, fueled by the breakdown in public order and safety, in the area around the Kerem Shalom crossing, combined with access impediments within the Strip continue to significantly disrupt the supply chain, causing reverberating impacts:
  • More than 100 kitchens producing about 400,000 meals per day in central and southern Gaza are at constant risk of shutdown.
  • Bakeries have had fluctuating production levels since early October, and many community-led baking initiatives have already been forced to suspend operations.
  • Due to very limited distributions of food parcels and fresh produce in the central and southern governorates, monitoring data by partners showed a growing number of households experiencing severe hunger, with people increasingly relying on the most severe coping strategies, such as reducing adults’ food intake in favor of children. Partners have also had to prioritize households that have not received any assistance for over two months.
  • Overall, in October, around 1.7 million people, or 80 per cent of the population, did not receive their monthly food rations across the Strip, compared with 1.4 million people in September and one million in August. People have run out of ways to cope, food systems have collapsed, and the risk of famine persists, necessitating an immediate, at scale resumption of humanitarian supply flows into the Strip.
  • The ongoing lack of food assistance is exposing the most vulnerable groups to heightened protection risks and psychosocial distress. Protection partners report that children are now increasingly searching through piles of solid waste for food scraps, which places them at a higher risk of not only contracting diseases but also encountering explosive ordnance. Unaccompanied or separated children are particularly at risk of being neglected as, with many mouths to feed, caregivers tend to prioritize their own children over extended family members. According to Education Cluster partners, living in a state of persistent food insecurity, alongside ongoing violence and displacement, has had profound psychological effects on school-aged children who are experiencing heightening levels of anxiety, depression, and trauma, making it increasingly difficult for them to focus and engage in learning activities. Hunger also contributes to absenteeism due to fatigue or illness, which in turn disrupts children’s educational progress.
  • Food scarcity is also having a severe impact on pregnant women, with their babies more likely to be born with health complications. Moreover, this is fueling an increasing inability of new mothers to breastfeed, placing infants at higher risk of contracting infectious diseases, particularly as the winter approaches.
• Local markets across the Gaza Strip are facing a severe crisis as many goods are on the brink of running out. Nearly all the trucks that entered Gaza in October were humanitarian, with extremely few commercial trucks crossing into the Strip. It is vital to urgently resume commercial deliveries at scale to complement humanitarian efforts, increase dietary diversity, stimulate the local economy by increasing the affordability and availability of goods, and improve cash liquidity.
• The energy crisis is further worsening, with a growing reliance on burning waste for cooking fuel in northern Gaza, where cooking gas has not been entering for months. This continues to hinder proper food preparation and the intake of nutritious food, exacerbates health and protection risks, and causes environmental hazards. In central and southern Gaza, firewood is increasingly scarce in highly congested areas along the coast, so women and children venture into the eastern parts in search for firewood, being particularly exposed to explosive ordnance risks.