UNRWA Situation Report #145 on the situation in the Gaza Strip and the West Bank, including East Jerusalem. All information from 17-24 October 2024, is valid as of 24 October 2024 at 22:30 (local time) [EN/AR]

Days 376-383 of Hostilities

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Key Points

The Gaza Strip

• Strikes by Israeli Security Forces (ISF) continue, with aerial, land and maritime bombardments across the Gaza Strip, resulting in civilian casualties and the destruction of residential structures and public infrastructure.
• On 17 October, the Integrated Food Security Phase Classification (IPC) published its IPC Food Insecurity and Acute Malnutrition Special Snapshot on the Gaza Strip, covering the period between September 2024 and April 2025. According to IPC findings, one year into the war, the risk of famine persists across the whole Gaza Strip. Given the recent surge in hostilities, there are growing concerns that this worst-case scenario may materialize. Over 1.8 million people across the Strip are experiencing high levels of acute food insecurity, classified in IPC Phase 3 – crisis or above, including nearly 133,000 people facing catastrophic food insecurity, classified in IPC Phase 5. Acute malnutrition is ten times higher than before the war.
• In a statement issued on 20 October, the UN Human Rights Office (OHCHR) highlighted its increasing concern "that the manner in which the Israeli military is conducting hostilities in north Gaza, along with unlawful interference with humanitarian assistance and orders that are leading to forced displacement, may be causing the destruction of the Palestinian population in Gaza's northernmost governorate."
• On 22 October, UNRWA Commissioner-General Philippe Lazzarini posted on X (formerly known as Twitter) that, after nearly three weeks of non-stop bombardments from the Israeli Forces in northern Gaza, the death toll increases, and our staff there report they cannot find food, water or medical care.
• UNRWA Jabalia health centre has been closed since 6 October 2024 due to heavy and continuous Israeli military operations in Jabalia Camp.
• On 22 October, the UN Development Programme (UNDP) and the UN Economic and Social Commission for Western Asia (UNESCWA) launched a new assessment estimating that poverty in the State of Palestine will rise to 74.3 per cent in 2024, affecting 4.1 million people, including 2.61 million people who are newly impoverished. According to the report, impacts of the war have set development in Gaza back to the 1950s. Without lifting economic restrictions, enabling recovery, and investing in development, the Palestinian economy may not be able to restore pre-war levels and advance forward by relying on humanitarian aid alone.
• According to the Palestinian Central Bureau of Statistics, the Consumer Price Index (CPI) in the Gaza Strip has sharply increased by 283 per cent since October 2023 up to the end of September 2024 as a result of the ongoing war. On 24 October, FAO posted on X (formerly known as Twitter) that, compared to last year, potatoes in southern Gaza can cost up to 5.7 times more, while in northern Gaza up to 66.7 times more: "hostilities in Gaza have severely damaged cropland and agricultural infrastructure, making it increasingly difficult for families to access nutritious foods. Rising food inflation is impacting everyone there.”
• The second round of the polio vaccination campaign took place in southern Gaza between 19-22 October. Since 14 October 2024, UNRWA, WHO, UNICEF, and partners vaccinated over 440,000 children and provided nearly 358,000 children with Vitamin A doses in Gaza middle and southern areas.
• UNRWA, WHO, UNICEF, and partners announced on 23 October that escalating violence, intense bombardment, mass displacement and lack of assured humanitarian pauses forced the postponement of the third phase of the polio vaccination campaign’s second round, set to start on the same day in northern Gaza. This final phase of the campaign is aimed at vaccinating 119,279 children across northern Gaza.
• According to the latest data published on 16 October by the Health Resources and Services Availability Monitoring System (HeRAMS), covering the period up to 30 September, only 17 out of 35 hospitals evaluated (or 49 per cent) are partially functioning. The report highlights that 76 per cent of still partially functioning hospitals across the Strip have insufficient water supply, 94 per cent struggle with insufficient sanitation facilities, 71 per cent are unable to follow proper hand hygiene practices, 82 per cent have insufficient personal protective equipment (PPE), and all hospitals lack sufficient means to maintain adequate environmental cleaning standards. Moreover, all hospitals have insufficient or unreliable power available.
• According to the UN, at least 1.9 million people – or about 90 per cent of the population – across the Gaza Strip are internally displaced. Many have been displaced repeatedly, some 10 times or more.
• According to OCHA, approximately 84 per cent of the Gaza Strip is under Israeli-issued evacuation orders as at 22 October, excluding those that have been revoked as of 15 October.
• As of 22 October 2024, according to the Ministry of Health (MoH) in Gaza as reported by OCHA, at least 42,718 Palestinians have reportedly been killed in Gaza and 100,282 have been reported injured (between 7 October 2023 and 22 October 2024).
• OCHA reports that, on 20 October, the MoH published the breakdown of 40,717 out of 42,010 fatalities as of 7 October 2024. These reportedly include 13,319 children, 7,216 women, 3,447 elderly, and 16,735 men. Among the child fatalities, 786 children are under one year of age, representing about six per cent of killed children whose full identification details have been documented, MoH further reported. Additionally, as of 7 October 2024, MoH noted that 35,055 children had lost one or both parents over the past year.
• As of 20 October, the total number of UNRWA team members killed since 7 October 2023 is 233.
• Several challenges continue to stand in the way of collecting much needed humanitarian supplies from the Karem Abu Salem (Kerem Shalom) crossing point in southern Gaza. These include deteriorating law and order, war and insecurity, damaged infrastructure, fuel shortages and access restrictions. According to OCHA, only 552 humanitarian trucks were permitted to enter the Gaza Strip through the Kerem Shalom crossing from 1 to 20 October 2024. This represents a daily average of only 28 humanitarian trucks, among the lowest since October 2023. This is well below the pre-crisis average of 500 trucks per working day.
• OCHA reported that, of the 448 humanitarian movements coordinated with Israeli Authorities across Gaza from 1 to 21 October 2024, 201 were denied access, 67 impeded, 18 cancelled due to logistical and security challenges and only 162 facilitated. Moreover, requests to facilitate OCHA access to northern Gaza to support rescuing people trapped under rubble have been repeatedly denied by Israeli Authorities.
• According to OCHA, between 1 and 21 October, only six per cent (four out of 70) of coordinated aid movements that aimed to provide humanitarian assistance in north Gaza and Gaza governorates via Al Rashid checkpoint were facilitated by Israeli Authorities. Access conditions have especially worsened following the onset of the Israeli military operation in Jabalia on 6 October: between 6 and 21 October, 29 coordination requests requiring coordination with the Israeli military for critical aid missions to Jabalia, Beit Hanoun, and Beit Lahya were denied, six were impeded and 13 were facilitated. Denied movements included a critical mission to rescue about 40 people trapped under rubble in the Falouja area of Jabalia, which has been repeatedly denied since 18 October, underscoring the severe limitations on lifesaving, humanitarian efforts. Similarly, a mission to transport critical life-saving supplies including blood, medical supplies such as anaesthesia, food parcels and fuel to Kamal Adwan Hospital was denied on 20 October.
• The latest information on supplies entering Gaza can be accessed through the below link:

Gaza Supplies and Dispatch Tracking | UNRWA

The West Bank, including East Jerusalem

The West Bank, including East Jerusalem update is now once a week.

• According to OCHA, between 7 October 2023 and 21 October 2024, 732 Palestinians have been killed in the West Bank, including East Jerusalem.
• Between 14 and 20 October, eight Palestinians were reported killed in the West Bank, including East Jerusalem. During this period, there were at least 147 Israeli Forces operations recorded inside the West Bank, including inside refugee camps.
• On 14 October, the Israeli Forces carried out a nine-hour operation in Jenin camp, in northern West Bank, with exchange of fire and detonation of improvised explosive devices in clashes with Palestinian armed groups. During the course of this operation, two Palestinians, including one child, were killed, and at least eight Palestinians were injured. The operation started while all UNRWA services were ongoing and students and patients had to be evacuated from UNRWA’s schools and health centre inside the camp. No damage to UNRWA installations was recorded. During the operation, armoured bulldozers damaged the roads and caused electricity outages. On 15 October, another Israeli Forces operation in Jenin camp saw one Palestinian killed and six Palestinians injured after the Israeli Forces deployed anti-tank missiles against a house inside the camp. During this operation, two windows of an UNRWA school in the camp were damaged. On 15 October, another Palestinian from Jenin camp died of injuries incurred during a previous Israeli Forces operation in July.
• Two Palestinians were killed after allegedly attacking Israeli Forces personnel: one who was involved in a shooting incident near Ashdod on 15 October and one who purportedly attempted a ramming attack near Ofra Israeli settlement on 19 October. A Palestinian died of his injuries following a vehicle chase with Israeli Forces in Anabta on 19 October.
• Harassment and violence directed at Palestinians participating in the annual olive harvest continued during the period of 14 to 20 October. On 17 October a Palestinian woman picking olives was shot and killed by the Israeli Forces in Faqqu’a, near the West Bank Barrier. Throughout the week at least six Palestinians were injured by the Israeli Forces and/or Israeli settlers while harvesting olives, and on 19 October six Palestinian farmers were detained by the Israeli Forces while picking olives in Husan, near Bethlehem.

Overall Situation

The Gaza Strip

• As of 22 October 2024, according to the Ministry of Health (MoH) in Gaza as reported by OCHA, at least 42,718 Palestinians have reportedly been killed in Gaza and 100,282 have been reported injured (between 7 October 2023 and 22 October 2024).

Humanitarian Access, Protection of Civilians

• UNRWA is working to verify the details of incidents that reportedly impact UNRWA premises. Further information will be provided once it becomes available.
• During the reporting period, numerous incidents have been reported impacting UNRWA installations, including cases where internally displaced people (IDPs) sheltering there and/or UNRWA staff have been affected. The verification of details and any casualty figures are ongoing:
• On 17 October 2024, the Israeli Forces conducted an airstrike hitting a tent inside an UNRWA school in Jabalia. Twenty-five IDPs were reportedly killed, and initial estimates indicate that 150 others were injured. Further verification of the number of casualties is ongoing.
• On 18 October 2024, Israeli tanks reportedly surrounded three UNRWA schools-turned-shelters with IDPs inside, in north Jabalia camp.
• On 19 October 2024, an UNRWA school west of Gaza City was hit by an Israeli Forces airstrike. Eleven people were reportedly killed, and several others injured. Three classrooms on the southern side of the school were destroyed.
• On 19 October 2024, an Israeli tank shell reportedly hit an UNRWA school in Jabalia camp. A fire broke out and damage was reported to the tents inside the school. Casualties among the IDPs and damage to the school are being verified.
• On 19 October 2024, bombing and heavy shooting were reported in the northern area opposite an UNRWA administrative office in Nuseirat. UNRWA personnel evacuated the building due to the intense military activity nearby. No injuries or damages were reported.
• On 19 October 2024, the Israeli Forces reportedly entered two UNRWA schools in north Jabalia camp and forcefully evacuated the IDPs sheltering inside. Initial reports indicate that the Israeli Forces arrested men and ordered women to head west of Gaza City. Mass detentions of civilians potentially at an UNRWA school in Jabalia camp were reported.
• On 20 October 2024, two bullets were found in the UNRWA area office in Nuseirat. They had reportedly been fired from an Israeli Forces quadcopter. No injuries among the staff and minor damages to the building were reported.
• On 20 October 2024, Israeli Forces reportedly fired tank shells at two UNRWA schools in Jabalia camp. Damage was reported, further verification is ongoing.
• On 21 October 2024, the Israeli Forces reportedly besieged and forcefully evacuated seven UNRWA schools in Jabalia Camp serving as designated emergency shelters. Israeli artillery shells directly struck one of the UNRWA schools while IDPs were evacuating. Seven people were reportedly killed, and several others were injured.
• On 21 October 2024, Israeli Forces artillery reportedly hit a classroom located in the northern building of an UNRWA school in Beit Hanoun. Initial reports indicate three fatalities and several injuries. Verifications are ongoing.
• On 22 October 2024, a UNRWA school-turned-shelter in Beit Lahiya was reportedly forcefully evacuated and then set ablaze by Israeli troops on the ground. Further verification of the incident and of potential casualties are ongoing, noting the lack of access to installations in north Gaza at this time.
• On 23 October 2024, the Israeli Forces reportedly forcefully evacuated IDPs sheltering inside an UNRWA health centre and an UNRWA school in Jabalia towards West Gaza City and the south of the Gaza Strip.
• On 23 October 2024, Israeli Forces Unmanned Aerial Vehicles reportedly opened fire inside an UNRWA school in Beit Hanoun, in an attempt to forcefully evacuate the IDPs. No casualties were reported, only minor damage to the school.
• On 23 October 2024, the Israeli Forces reportedly struck a vehicle in close proximity to an UNRWA school east of Gaza City, resulting in three IDPs injured inside the school. Minor damages to the school were reported. The incident reportedly caused IDPs to further leave the shelter. Casualties outside the school were reported.
• On 23 October 2024, Israeli Forces tanks were reportedly surrounding an UNRWA school in Beit Lahiya, while gunfire and artillery shells were also being fired in the vicinity of the school. Some IDPs were forcibly evacuated in a reportedly panicked manner. An Israeli Forces drone reportedly struck the upper floors of the school, causing several injuries.
• On 24 October 2024, seven IDPs inside a UNRWA school in Al Maghazi Camp reportedly sustained slight injuries as a result of an Israeli Forces strike nearby.
• On 24 October 2024, the Israeli Forces reportedly directly struck an UNRWA school in Jabalia, hitting tents used by IDPs. This resulted in the tents being set ablaze. Injuries among the IDPs inside the school were reported.
• 464* incidents impacting UNRWA premises and the people inside them have been reported since the beginning of the war (some with multiple incidents impacting the same location), including at least74* incidents of military use and/or interference at UNRWA premises. 190* Agency installations have been impacted by munitions or subjected to armed actor interference through these incidents. UNRWA estimates that, in total, at least 563* IDPs sheltering in UNRWA installations have been killed and at least 1,790* injured since the start of the war. UNRWA is verifying the number of casualties caused by these incidents.

*Since the start of the war, latest figures are continuously under review as UNRWA gains access to locations that were previously inaccessible and as further verification occur. Total summary figures will be published once further verification has been conducted, noting that these numbers are subject to change once verifications have been conducted.

UNRWA Response

The Gaza Strip

Health

• According to the Health Cluster, UNRWA remains one of the largest health actors operating in the Gaza Strip, contributing to over half of the people reached with health services since 7 October 2023. Between 7 October 2023 and 29 September 2024, UNRWA provided over 5.87 million medical consultations across the Gaza Strip. In addition to medical consultations, UNRWA (in partnership with and support from other UN agencies, including UNICEF and WHO) continues to provide vaccines. Over 193,000 children have been provided routine immunisation vaccines between the start of 2024 until 22 September 2024. In addition to that, around 560,000 children across the Gaza Strip have been vaccinated against polio during the first round of the vaccination campaign in September.
• The second round of the polio vaccination campaign took place in southern Gaza between 19-22 October. Since 14 October, UNRWA, WHO, UNICEF, and partners vaccinated over 440,000 children against polio and provided nearly 358,000 children with Vitamin A doses in Gaza middle and southern areas.
• However, the third phase of the polio vaccination campaign, set to begin on 23 October in norther Gaza, had to be postponed due to escalating violence, intense bombardment, mass displacement orders and lack of assured humanitarian pauses. This final phase of the campaign aimed to vaccinate 119,279 children across northern Gaza.
• As of 21 October, seven out of 272 UNRWA health centres were operational in Gaza. Health services were also provided by 81 mobile medical teams working in 46 medical points inside and outside IDP shelters in the middle area, Khan Younis, Mawasi and Gaza. UNRWA health facilities provide primary health care, including outpatient services, non-communicable disease (NCD) care, medications, vaccinations, antenatal and postnatal health care, laboratory services, dental services, physiotherapy and dressings for the injured. The number of operational health facilities changes constantly based on demand, access and security.
• As of 21 October, 1,078 UNRWA health staff continued to work in health centres, temporary clinics and medical points across the Gaza Strip, providing 15,710 medical consultations on that day.
• UNRWA continued to provide mental health and psychosocial support (MHPSS) services in the middle and Khan Younis areas, with teams of psychiatrists and supervisors to assist special cases referred from UNRWA health centres and shelters. On 21 October, UNRWA teams responded to 451 cases in health centres and at medical points through individual consultations, awareness sessions and to address cases of gender-based violence (GBV).
• On 21 October, UNRWA medical teams provided care for 400 post-natal and pregnant women at high risk.
• On 21 October, UNRWA teams provided oral health services in dental stations and mobile dental clinics, reaching 690 patients, including referred cases from remote dental consultations.
• On 21 October, 288 patients received physiotherapy rehabilitation services in health centres and medical points.
• Stocks of medicines in UNRWA health facilities are low and at least 56 items will run out by November. UNRWA laboratory services are now limited to four tests out of nearly 35 that were provided before 7 October 2023 due to zero stock of most laboratory supplies. All laboratory equipment requires maintenance or replacement.

Psychosocial Support and Learning

• UNRWA remains the largest provider of emergency learning and psychosocial support (PSS) across the Gaza Strip. Around 660,000 children continue to be out of school since the beginning of the war. On 1 August 2024, UNRWA began to roll out its first phase response of “Back to Learning” with a focus on mental health activities. This is taking place in up to 45 UNRWA schools-turned-shelters3 by expanding ongoing PSS activities, focusing on arts, music and sports and raising awareness on the risks of explosive ordnance, with the support of nearly 7504 school counsellors and up to 500 teachers. UNRWA continues to provide lifesaving PSS services in Gaza, including psychological first aid (PFA), individual and group counselling, fatigue management sessions, recreational activities, Explosive Ordnance Risk Education (EORE) and protection cash assistance, reaching children, youth and adults.
• Since the onset of the conflict and up to 24 October, around 720,000 IDPs, including over 510,000 children, have benefited from 265,302 PSS sessions/activities. Between 17 and 24 October, a total of 15,383 IDPs have accessed these services.
• Following the roll out of the UNRWA “Back to Learning” programme in UNRWA shelters, more than 11,500 children, 56 per cent of whom are girls, have benefited from this initiative. Between 17 and 24 October, 12,604 children (5,689 boys, 6,915 girls, including 364 children with disabilities) participated in a variety of “Back to Learning” activities, including basic literacy and numeracy sessions, PSS sessions, and recreational activities such as arts, music and sports. The activities were conducted daily across 77 temporary learning spaces in 38 shelters, for an average of seven hours per day.
• Between 7 October 2023 and 20 October 2024, UNRWA’s social work team has provided services to 187,644 IDPs, including psychological first aid, psychosocial support services, family and individual activities, as well as case management. These interventions aim to address family issues and strengthen relationships.
• During the same reporting period, protection services were provided to 1,537 survivors of gender-based violence (GBV) and 2,671 children, including 1,499 unaccompanied children, covering reunification, safe sheltering, medication, dignity kits and non-food items (NFIs) through referrals. The team also supported 20,046 persons with disabilities with PSS; 7,752 of these individuals received assistive devices and rehabilitation services. Awareness sessions on GBV, child protection, disability and special needs, as well as managing social and psychological stressors were conducted for 118,916 IDPs.

Food Security

• From 7 October 2023 to 3 October 2024, a total of 380,236 families (nearly 1.9 million people) have been reached with two rounds of flour; 366,944 of those families have received three rounds.
• UNRWA continues to distribute food parcels in the southern governorates. These include5 flour, rice, chickpeas, lentils, cheese, hummus and canned fish, and are designed to cover approximately 90 per cent of daily calorific needs per quarter. To date, nearly 1.15 million people have been reached, of whom nearly 215,000 people have received two rounds of food parcels since the war started.
• In addition to the distribution of UNRWA food parcels, the Agency distributes food parcels on behalf of other UN organisations, reaching around 1.4 million people.

Water, Sanitation and Hygiene (WASH)

• Since October 2023, UNRWA has carried out emergency WASH activities across the Gaza Strip. Main activities include the operation and continued maintenance of water wells, desalination systems and water through water trucking and bottled water. In addition, UNRWA continues to distribute hygiene kits and maintain hygiene in UNRWA shelters and sites through providing cleaning supplies, community-based solid waste management and pest control.
• UNRWA continues to be one of the largest WASH actors in the Gaza Strip. Since the beginning of the war, the Agency has maintained and rehabilitated eight wells, reaching over 600,000 IDPs with access to water. In September 2024, UNRWA was able to provide over 70,000 m3 of domestic water. In Jabalia, UNRWA rehabilitated a well which supports over 20,000 IDPs. With the available fleet for sanitation, UNRWA continues to provide a solid waste collection and transfer service in the Khan Younis, middle area and Gaza areas. In September, more than 6,000 tons of waste were collected from camps and emergency shelters. In addition to waste management and collection, over 400 manholes have been cleaned in preparation for winter along with other winterization activities including the removal of debris in the streets and support for flood-prone areas.

[1] Some of the information is reported during the reporting period but does not necessarily correspond to the reporting period.

[2] Pre-conflict, UNRWA had 22 health centres. Following the onset of the conflict, an additional five temporary health centres were established for a total of 27.

[3] Initially reaching 45 UNRWA schools/shelters, "Back to Learning" will gradually expand to 94 schools in future phases.

[4] 176 school counsellors and 566 assistant counsellors.

[5] The composition of the food parcel may change based on food item availability.

Tweet from Philippe Lazzarini, UNRWA Commissioner-General:

“In northern Gaza, people are just waiting to die. They feel deserted, hopeless and alone. They live from one hour to the next, fearing death at every second. […] On behalf of our staff in northern Gaza, I am calling for an immediate truce, even if for few hours, to enable safe humanitarian passage for families who wish to leave the area and reach safer places. This is the bare minimum to save the lives of civilians who have nothing to do with this conflict.”

ENDS-

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