Hostilities in the Gaza Strip and Israel | Flash Update #124 [EN/AR/HE]

Key points

• Intense Israeli bombardment from air, land and sea continues to be reported across much of the Gaza Strip, resulting in further civilian casualties, displacement, and destruction of civilian infrastructure. Ground operations and heavy fighting between Israeli forces and Palestinian armed groups also continue to be reported, particularly in Gaza city, Deir al Balah and Khan Younis.
• Between the afternoon of 21 February and 10:30 on 22 February, according to the Ministry of Health (MoH) in Gaza, 97 Palestinians were killed, and 132 Palestinians were injured. Between 7 October 2023 and 10:30 on 22 February 2024, at least 29,410 Palestinians were killed in Gaza and 69,465 Palestinians were injured, according to MoH in Gaza.
• Between the afternoons of 21 and 22 February, no Israeli soldiers were reported killed in Gaza. As of 22 February, 235 soldiers have been killed and 1,396 soldiers injured in Gaza since the beginning of the ground operation, according to the Israeli military. In addition, over 1,200 Israelis and foreign nationals have been killed in Israel, according to the Israeli authorities, the vast majority on 7 October. As of 22 February, the Israeli authorities estimate that some 134 Israelis and foreign nationals remain captive in Gaza and include fatalities whose bodies are being withheld.
• A new report by the London School of Hygiene and Tropical Medicine and the Johns Hopkins Center for Humanitarian Health estimates the potential public health impact of the current conflict in the Gaza Strip, focusing on the deaths in excess of what would have been expected in the absence of hostilities. The report, which draws on a range of publicly available data, expert consultations, and peer-reviewed research, provides a range of projections of what could happen under three distinct scenarios and covers a six-month period from 7 February to 6 August 2024. The projections are designed to help humanitarian organizations, governments, and other actors plan their response to the crisis and take sound, evidence-based decisions. Under an immediate permanent ceasefire scenario, 6,550 excess deaths are projected, mainly due to the time needed to improve water, sanitation and shelter conditions, reduce malnutrition, and restore functioning healthcare services. Under the 'current status quo' and 'escalation of the conflict' scenarios, the projections rise sharply to 58,260 and 74,290 excess deaths, with traumatic injuries followed by infectious diseases being the main causes of additional fatalities in both cases. These figures are based on the absence of epidemics; should outbreaks of infectious disease such as cholera occur, the projections rise significantly to 11,580, 66,720 and 85,750 excess deaths, respectively. The report underscores the lasting impact of the conflict on the civilian population and emphasizes the urgent need for improved sanitation, nutrition, and healthcare services in Gaza.
• Humanitarian operations continue to face immense challenges, with aid workers themselves killed, displaced, or facing mounting movement restrictions and a breakdown of civil order. On 21 February, Principals of the Inter-Agency Standing Committee (IASC) emphasized that the humanitarian response "is already on its knees," warning that "no amount of humanitarian response will make up for the months of deprivation that families in Gaza have endured." The Principals put forth ten requirements to avoid an even worse catastrophe. These requirements include, among others, an immediate ceasefire, reliable entry points to bring in relief supplies to distribute throughout Gaza, security assurances, a reliable humanitarian notification system, and a stable communication network. The Principals also called on Israel to fulfil its legal obligation to provide food and medical supplies as well as facilitate aid operations.
• On 21 February, Médecins Sans Frontières (MSF) General Director Meinie Nicolai condemned the strike on a house in Al Mawasi area in Khan Younis, where 64 people including MSF staff and their families were sheltering: "The amount of force being used in densely populated urban environments is staggering, and targeting a building knowing it is full of humanitarian workers and their families is unconscionable." The attack resulted in the killing of two family members of MSF staff and the injury of six others. According to MSF, the site's location had been notified to Israeli forces, an MSF flag was hung on the building, and no evacuation orders were issued before the strike. In response to the incident, the UN Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, Martin Griffiths, stated: "Humanitarians are putting their lives on the line. Like all civilians, they must be protected."
• The provision of lifesaving services across Gaza is taking place amid intense hostilities, limitations on the entry and delivery of aid, and growing insecurity. On 20 February, the Palestine Red Crescent Society (PRCS) reported receiving a delivery of 7,500 litres of fuel, in coordination with OCHA, to operate the generator at Al Amal Hospital, but the hospital still urgently requires food and medical supplies as well as additional fuel. Moreover, since 18 February, PCRS, OCHA and the World Health Organization (WHO) have coordinated the medical evacuation of 51* patients from Nasser hospital in Khan Younis, where 325 people, including some 140 sick and injured patients, their families, and healthcare workers, still remain. As of 22 February, Nasser hospital is struggling to operate, however minimally, with no electricity, running water, sufficient food supplies, or drinking water as well as a heavy Israeli military presence inside the hospital and heavy fighting in its vicinity. At least 12 patients still require medical evacuation and there are ongoing attempts to restore electricity. According to WHO, as of 22 February, there are 12 partially functional hospitals in the Gaza Strip, including six in northern Gaza and six in the south, in addition to three partly functional field hospitals.
• Between 1 and 15 February, only two out of 21 planned fuel missions by humanitarian partners to the north of Wadi Gaza were facilitated by the Israeli authorities, allowing the delivery of 38,400 litres of fuel. During this period, all 16 planned fuel or assessment missions to water and wastewater pumping stations in the north were denied access. In contrast, 25 out of 42 fuel missions to areas to the south of Wadi Gaza that require prior coordination were facilitated by the Israeli authorities, resulting in the delivery of 457,000 litres of fuel.
• Warning that the Gaza Strip is on the brink of a public health catastrophe, the Water, Sanitation and Hygiene (WASH) and the Health Clusters emphasize that there is a crucial need for adequate WASH infrastructiure to respond to the scale of the crisis. According to the WASH and Health Clusters, the majority of people in Gaza have no access to clean drinking water and water and sanitation infrastructure lacks the fuel necessary for its effective operation. Only one in three water pipelines from Israel remains operational, but only at 47 per cent of its full capacity. Additionally, two of the three main water desalination plants are only partially functional and wastewater treatment systems are all not operational. On 19 February, the Gaza Municipality reported widespread destruction of sewage facilities in the city, including severe damage to pump stations, drainage lines and power generators, which has led to the outflow of large amounts of untreated sewage.
• The following are among the deadliest incidents reported on 20 and 21 February, mainly in Deir al Balah:
  • On 20 February, at about 14:00, 12 Palestinians were reportedly killed, and at least five others injured, when a residential square in western An Nuseirat, in Deir al Balah, was struck.
  • On 20 February, at about 21:00, one Palestinian body was reportedly recovered from under the rubble of a residential building in Az Zawayda, in Deir al Balah, that was struck on 18 February, bringing the total number of fatalities from the incident to 33.
  • On 20 February, at about 21:00, at least 25 Palestinians were reportedly killed, and tens of others injured, when a residential building in Deir al Balah was struck.
  • On 20 February, at about 22:00, eight Palestinians were reportedly killed, including the Dean of the Faculty of Nursing at the Islamic University of Gaza, along with seven members of his family, when several residential buildings in eastern Rafah were struck.
  • On 21 February, at about 7:00, nine Palestinians, including three children (siblings), were reportedly killed during an incursion in the vicinity of Khan Younis port.
  • On 21 February, at about 9:00, six Palestinians were reportedly killed, when a civilian vehicle in Deir al Balah was struck.