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Public Health Situation Analysis (PHSA) on Hostilities in the occupied Palestinian territory (oPt) - 02 May 2024

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SUMMARY OF CRISIS AND KEY FINDINGS

Although Gaza has suffered previous escalations, the current war stands out as unprecedented in the scale of death, destruction, and human suffering it has incurred, with repercussions that will echo for generations to come. The still unfolding and intensifying military operations, along with the almost complete siege on Gaza, have created a catastrophic humanitarian situation. Between 7 October 2023 and the afternoon of 30 April 2024, at least 34 568 Palestinians were killed in Gaza and 77 765 Palestinians were injured, according to MoH in Gaza.

Since 7 October, 474 Palestinians including 116 children, have been killed in the West Bank, including East Jerusalem, and about 5 000 were injured. More than 10 000 people are estimated to be missing under rubble in Gaza, according to the Palestinian Civil Defence.

Now, the entire population of Gaza - 2.2 million people - is in urgent need of food, humanitarian assistance and protection. Among them, 1.7 million individuals have been displaced to make-shift shelters or overcrowded areas with limited access to necessities.

Famine is imminent in Gaza as the recent IPC assessment reveals that half of its population, 1.1 million people, face catastrophic food insecurity. This represents the highest share of a population ever recorded globally. Among the 677 000 on the brink of famine are an estimated 15 000 pregnant women, heightening the risks for both mothers and new-borns. Children’s acute malnutrition rates have doubled since January, with one in three under two suffering from malnutrition.10 Palestinians in Gaza now constituting some 80 per cent of all people facing famine worldwide. Gaza’s Health Ministry reported as of April 1, that 32 people, including 28 children, died of malnutrition and dehydration at hospitals in northern Gaza.

The siege enforced on Gaza by Israel, including closed crossings and lack of essential resources like water and electricity, have been critical factors contributing to the unfolding humanitarian catastrophe. As of 1 May 2024, there are 12 of 36 hospitals which are partially functioning, while 70 per cent of primary health care centres not functional (62 out of 88). The hospitals are operating at limited capacity and overwhelmed with patients, grappling with critical shortages of fuel, medicines, supplies, and medical staff.

Gaza is undergoing unparalleled humanitarian crisis marked by relentless hostilities and mounting challenges in accessing critical aid and services. Despite ongoing humanitarian efforts, the situation is exacerbated by frequent aerial bombardments in densely populated urban zones, extensive military ground operations, risks posed by unexploded ordnance (UXO), pervasive insecurity, closures of key crossing points, restrictions on movement and access by Israeli authorities, and damage to infrastructure. The killing of seven aid workers of World Central Kitchen from multiple Israeli airstrikes on April 1, 2024, was not an isolated incident. At least 254 aid workers have been killed (248 nationals, 6 foreigners), including: 185 UN staff. This total includes the highest number of UN personnel killed in a conflict in the history of the organization.

In March, the Government of Israel made clear its intention to expand military operations in Rafah irrespective of the UN Security Council’s legally binding resolution demanding an immediate ceasefire. Humanitarian and human rights organizations have repeatedly warned that the planned Israeli ground incursion into Rafah promises to decimate life and life-saving assistance for the more than 1.3 million civilians, including at least 610 000 children, who are now in the direct line of fire. There is nowhere safe for people to go in Gaza. IDPs would face a high risk of unexploded ordnance (UXOs) enroute to other areas, including Khan Younis and Deir al Balah, and aid workers would face the additional challenge of scaling up assistance when there are barely enough supplies to meet humanitarian needs under the current conditions.

In the West Bank, the post-7 October landscape has been characterized by heightened volatility. Concerns over excessive use of force are linked to the use of live ammunition, air and drone strikes, and off-shoulder missiles, including in densely populated urban areas and in refugee camps. Settler violence has been increasing across the West Bank and has exacerbated the coercive environment.

As of 15 April, 259 soldiers have been killed and 1571 soldiers have been injured in Gaza since the beginning of the ground operation, according to the Israeli military. In addition, over 1200 Israelis and foreign nationals, including 33 children, have been killed in Israel, the vast majority on 7 October.25 As of 15 April, Israeli authorities estimate that 133 Israelis and foreign nationals remain captive in Gaza, including fatalities whose bodies are withheld.

This most recent violence does not come in a vacuum. Palestine has endured a protracted cycle of hunger, conflict, and despair for over five decades. In 2023, this cycle reached unprecedented new peaks as tensions escalated in the occupied Gaza Strip and the West Bank on 7 October, resulting in civilian fatalities, widespread destruction, massive displacement, rising food prices and a declining currency. In 2022, UNRWA reported that 81 per cent of Palestine refugees in Gaza live below the national poverty line, with 33 per cent of families extremely poor. Gaza also faces high unemployment rates, with 44 per cent of the population unemployed in 2022. The unprecedented impact of the current war on Gaza demands a transformative shift in addressing mounting immediate needs, revaluating longterm systemic challenges to relief efforts, and confronting the root causes of the conflict by ending the occupation and upholding international law.