UNRWA Situation Report #150 on the situation in the Gaza Strip and the West Bank, including East Jerusalem. All information updated for 26 November – 3 December 2024, valid as of 3 December 2024 at 22:30 [EN/AR]

Highlights

• Food security in Gaza is collapsing, leaving people in a state of sheer desperation. On 29 November, two young girls and a woman were tragically killed in Deir al-Balah as crowds overwhelmed a bakery providing food assistance in a frantic struggle for scarce food supplies.
• As of 1 December, UNRWA paused the delivery of aid through Kerem Shalom/Karem Abu Salem, the main crossing point for humanitarian aid into the Gaza Strip, due to a total breakdown of law and order.
• Last month, 90 per cent of aid trucks – 98 of 109 – were looted at Kerem Shalom/Karem Abu Salem.
• Gaza now has the highest number of child amputees per capita anywhere in the world.
• So far, only 23 per cent of the needs to protect displaced people in the Gaza Strip from rain and cold weather have been met, leaving 945,000 people at risk of exposure this winter.

Key Points

The Gaza Strip

• Strikes by the Israeli Forces continue, with aerial, land and maritime bombardments across the Gaza Strip, resulting in civilian casualties and the destruction of residential buildings and public infrastructure.
• In northern Gaza, since 6 October 2024, the Israeli Forces have been carrying out a ground offensive and continue to impose a tight siege. Intense military operations are ongoing amid a near total lack of humanitarian aid entering the area, in addition to severe communications and internet disruptions. Some parts of the North Gaza governorate have been under a tightened siege for 60 days. Access remains extremely challenging, and partners’ ongoing attempts to deliver aid into these besieged areas continues to be largely prevented, leaving between 65,000 and 75,000 people without access to food, water, electricity or reliable healthcare, as mass casualty incidents continue.
• As of 18 November, the UN and its partners estimated that between 100,000 and 131,000 people had been displaced since 6 October 2024 from North Gaza governorate to Gaza City. The influx has raised the population in the Gaza City governorate from around 250,000, estimated to have been present as of the end of September 2024, to approximately 375,000 people. Between 65,000 and 75,000 people are estimated to remain in North Gaza governorate, accounting for less than 20 per cent of the population there before the intensification of military operations and the siege.
• On 29 November, two young girls and one woman died while queuing among large crowds to get bread at a bakery supported by the World Food Programme (WFP) in Deir al-Balah. WFP highlighted that “the incident unfolded in a moment of desperation as people anxiously tried to get access to scarce food supplies in Gaza.”
• On 1 December, UNRWA Commissioner-General Philippe Lazzarini posted on X (previously known as Twitter) that UNRWA was pausing the delivery of aid through Kerem Shalom/Karem Abu Salem, the main crossing point for humanitarian aid into the Gaza Strip, explaining that “the road out of this crossing has not been safe for months.” The UNRWA Commissioner-General added that the humanitarian operation in Gaza has become “unnecessarily impossible” due to several factors – namely, the ongoing siege, hurdles from Israeli authorities, political decisions to restrict the amount of aid, the lack of safety on aid routes and targeting of local police, which all combined led to a breakdown in law and order.
• The Emergency Telecommunication Cluster led by the WFP highlighted that communications infrastructure in Gaza is heavily impacted by the war, with congested networks, service outages, and damaged towers, adding that limited access to connectivity and secure radio communications is severely hampering the humanitarian response and the safety of humanitarian workers in the field.
• According to the Shelter Cluster, so far only 23 per cent of the needs to protect displaced people in the Gaza Strip from rain and cold weather have been met, leaving 945,000 people at risk of exposure this winter.
• The United Nations Population Fund published a report (“Shattered Lives and Dreams: the toll of the war on Gaza on young people”) highlighting that young people in the Gaza Strip have endured unprecedented trauma, losing family, friends, homes, and access to education. In addition to the physical destruction, the mental health of Gaza’s youth has sharply deteriorated, with many grappling with PTSD, anxiety, and depression.
• Gaza now has the highest number of child amputees per capita anywhere in the world — many losing limbs and undergoing surgeries without even anesthesia.
• According to UNICEF as reported by OCHA, “at the current rate of medical evacuations, it would take seven years to rescue 2,500 children in urgent need of medical evacuation,” and some children have died while waiting for approvals.
• OCHA reported that water supply in the Gaza Strip continues to be limited and dependent on fuel supplies. Overall, gross water production reported by the Palestinian Water Authority (PWA) and the Coastal Municipalities Water Utility (CMWU) has dropped by nine per cent in November, from an average of 96,394 to 87,358 cubic metres per day, and there is a high percentage of losses through the network due to damaged networks. Over the course of November, critical fuel shortages have resulted in a 43 per cent decrease in water production by groundwater wells, from 61,000 to about 35,000 cubic metres per day, while fuel deliveries to operate water and sanitation facilities in North Gaza governorate have remained blocked since 1 October 2024.
• According to OCHA, on 3 December, the Palestinian Water Authority stated that damage to Gaza's water sector has exceeded 80 per cent, affecting wells, pumping stations, desalination plants, distribution networks and sewage treatment plants.
• On 2 December, the Israeli military issued an evacuation order affecting about three square kilometres in northern Khan Younis governorate and parts of Deir al-Balah, which were previously placed under evacuation on four occasions between December 2023 and August 2024.
• According to OCHA, as of 3 December, around 80 per cent of the Gaza Strip is under active Israeli-issued evacuation orders.
• According to the UN, at least 1.9 million people – or about 90 per cent of the population – across the Gaza Strip are displaced. Many have been displaced repeatedly, some 10 times or more.
• As of 3 December 2024, around 380,000 displaced people are registered sheltering across over 100 UNRWA school buildings in the Gaza Strip*.
• On 25 November 2024, the Israeli authorities issued an evacuation order for the areas of Beit Lahiya and Jabalia. Forty-three UNRWA installations are located within the area affected by the Israeli Forces’ evacuation zone. Overall, since the start of the Israeli Forces’ ongoing operation in the North of the Gaza Strip, the Israeli authorities have issued evacuation orders impacting 54 UNRWA installations critical to providing humanitarian assistance to displaced people in the North. Some of these facilities serve as emergency shelters.
• Between 7 October 2023 and 3 December 2024, according to the Ministry of Health (MoH) in Gaza as stated by OCHA, at least 44,502 Palestinians have reportedly been killed in Gaza and 105,454 have been injured.
• 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, the MoH further reported. Additionally, as of 7 October 2024, the MoH noted that 35,055 children had lost one or both parents over the past year.
• As of 2 December, the total number of UNRWA team members killed since 7 October 2023 is 251.
• According to OCHA, as of 22 November, 2024 has become the deadliest year on record for humanitarian personnel with 281 personnel killed globally. The war in Gaza is driving up the numbers. Many humanitarian personnel were killed in the line of duty while providing humanitarian assistance. Most of them were UNRWA staff members.
• Several challenges continue to stand in the way of collecting much needed humanitarian supplies from the Kerem Shalom/Karem Abu Salem crossing point in southern Gaza. These include deteriorating law and order, war and insecurity, damaged infrastructure, fuel shortages and access restrictions.
• According to OCHA, between 1 and 30 November, 1,935 humanitarian trucks were permitted to enter the Gaza Strip. This represents a daily average of only 65 humanitarian trucks, well below the pre-war average of 500 trucks per working day.
• OCHA reported that, of the 578 humanitarian movements coordinated with Israeli authorities across Gaza from 1 to 30 November 2024, 204 were denied access, 93 impeded, 44 cancelled due to logistical and security challenges and only 237 facilitated.
• Out of the 132 aid movements needed to pass through the Israeli military-controlled Al Rashid or Salah Ad Din checkpoints to reach areas north of Wadi Gaza between 1 and 30 November, 56 were denied, 32 were impeded, ten had to be cancelled and 34 were facilitated.
• Between 1 and 30 November, the UN attempted to reach besieged areas in North Gaza 53 times, 48 of which were outright denied. Five were initially approved, but then severely impeded on the ground. On 1 December, WFP was able to send 200 food parcels with a humanitarian mission – led by the World Health Organization (WHO) – to Kamal Adwan hospital in Beit Lahiya.
• OCHA reported that coordinated aid missions to areas in Rafah governorate, which has been under an ongoing Israeli military operation since early May, have faced similar challenges, with 30 out of 36 coordinated requests submitted to Israeli authorities denied, one impeded, one cancelled, and only four facilitated. This excludes 81 coordinated movements to Kerem Shalom/Karem Abu Salem crossing, of which two were denied, 14 impeded, 11 cancelled and 53 facilitated.
• The latest information on supplies entering Gaza can be accessed through the link below:

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 31 October 2024, 736 Palestinians have been killed in the West Bank, including East Jerusalem, of those, 430 Palestinians were killed since the beginning of 2024.
• Between 25 November and 1 December, six Palestinians were killed and at least nine were injured in the West Bank, including East Jerusalem. Of these, four were killed during an exchange of fire during a search operation by Israeli Forces in Sir, south of Jenin, in the morning of 1 December. A Palestinian involved in an alleged attack on Israeli settlers and Israeli Forces near Ariel settlement on 29 November was shot dead at the scene. On 30 November, a Palestinian reportedly died in Sur Bahir during a pursuit by Israeli Forces.
• On 27 November, a large-scale operation by Israeli Forces started in El Far’a camp and Tubas city in the northern West Bank, lasting nearly 11 hours and resulting in extensive destruction of infrastructure including roads and sewerage networks. At least three Palestinians were injured and four detained during the operation.

Overall situation

The Gaza Strip

• Between 7 October 2023 and 3 December 2024, according to the MoH in Gaza as stated by OCHA, at least 44,502 Palestinians reportedly have been killed in the Gaza Strip while 105,454 have been reported injured.

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, four new incidents has been reported impacting UNRWA installations and displaced people sheltering there, including UNRWA personnel:
  • On 1 December, two stray bullets, reportedly fired by the Israeli Forces, struck the second floor of an UNRWA area operations office, west of Rafah. No injuries were reported.
  • On 28 November, a displaced person sustained a moderate injury to her jaw while she was inside a classroom of an UNRWA school in Nuseirat, reportedly due to the impact of Israeli Forces’ shelling nearby.
  • On 28 November, shrapnel reportedly penetrated an educational tent at an UNRWA school in Nuseirat due to shelling close to the location. No injuries or damage were reported.
  • On 26 November, the Israeli Forces reportedly directly struck with one missile the yard of an UNRWA school in Nuseirat. Damage was reported.

* Since the start of the war in October 2023, the latest casualty figures are continuously under review as UNRWA gets access to locations that were previously inaccessible and as further verifications occur. The summary figures will be published/updated as information becomes available, noting that these numbers are subject to change once verifications are concluded.

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 24 November 2024, UNRWA provided over 6.6 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 to children. Over 218,000 children received routine immunisation vaccines from the start of 2024 until 24 November 2024. In addition, around 560,000 children across the Gaza Strip have been vaccinated against polio during the first round of the vaccination campaign in September. During the second round of the polio vaccination campaign, which took place between October and November, reaching 94 per cent of the intended population, UNRWA, WHO, UNICEF and partners vaccinated a total of 556,774 children under 10 across the Gaza Strip, and provided 448,425 children between the ages of two and 10 with Vitamin A supplements.
• As of 1 December, seven out of 27[2] UNRWA health centres were operational in Gaza. Health services were also provided by 94 mobile medical teams working in 55 medical points inside and outside shelters in the middle area, Khan Younis, Mawasi and Gaza. UNRWA health facilities provide primary health care, including outpatient services, non-communicable disease care, medications, vaccination, 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 1 December, 1,163 UNRWA health staff continued to work in health centres, temporary clinics and medical points across the Gaza Strip, providing 16,648 medical consultations on that day.
• UNRWA continued to provide mental health and psychosocial support 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 1 December, UNRWA teams responded to 559 cases in health centres and at medical points through individual consultations, awareness sessions and to address cases of gender-based violence (GBV).
• On 1 December, UNRWA medical teams provided care for 490 post-natal and pregnant women at high risk.
• On 1 December, UNRWA teams provided dental and oral health services in dental stations and mobile dental clinics, reaching 781 patients, including referred cases from remote dental consultations.
• On 1 December, 284 patients received physiotherapy rehabilitation services in health centres and medical points.
• Stocks of medicines in UNRWA health facilities are low and at least 59 items will run out within a month. UNRWA laboratory services are now limited to three tests out of nearly 35 that were available before 7 October 2023. This is due to limited availability of stocks of most laboratory supplies. 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 are out of school due to the war. On 1 August 2024, UNRWA began 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-shelters[3] 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 750[4] school counsellors and hundreds of teachers. UNRWA continues to provide lifesaving PSS services in Gaza, including psychological first aid, individual and group counselling, fatigue management sessions, recreational activities, Explosive Ordnance Risk Education and protection cash assistance, reaching children, youth and adults.
• Since the onset of the conflict and up to 2 December, around 730,000 displaced people, including over 520,000 children, have benefited from 272,779 PSS sessions and activities. Between 26 November and 2 December, a total of 17,816 displaced people accessed these services.
• More than 18,000 children, over half of them girls, have benefited from UNRWA’s “Back to Learning” programme so far. Between 26 November and 2 December, 17,604 children (8,069 boys, 9,535 girls, including 427 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 86 temporary learning spaces in 40 shelters, for an average of seven hours per day. This is thanks to 953 UNRWA teachers, with support from counsellors, aiming to address the psychosocial needs of children and adolescents.
• Between 7 October 2023 and 2 December 2024, UNRWA’s social work team has provided services to 192,560* displaced people, including psychological first aid, psychosocial support services, family and individual activities, as well as case management. During the same reporting period, protection services were provided to 1,621 survivors of GBV and 3,639* children, including 2,385 unaccompanied children, covering reunification, safe sheltering, medication, dignity kits and non-food items through referrals. The team also supported 20,786 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 128,320 displaced people.
• Between 10 and 23 November 2024, UNRWA’s protection teams conducted seven observation missions in shelters and sites for displaced people across Khan Younis and Deir al-Balah, including Al Mawasi, undertook seven focus group discussions, and seven key informant interviews. They also continued to monitor aid distribution and follow up on vulnerable cases. The teams monitored learning activities in UNRWA shelters and delivered British Broadcasting Corporation Lifeline podcast activities to 1,233 children. They also followed up on urgent water, sanitation and hygiene interventions in UNRWA shelters, and conducted awareness raising sessions on explosive ordnance, GBV and prevention of sexual exploitation and abuse (PSEA).

* Due to further verification, figures have decreased compared to those reported in the previous situation report (#149).

Food Security

• From 7 October 2023 to 2 December 2024, a total of 388,054 families (nearly 1.9 million people) have been reached with two rounds of flour; 374,909 of those families have received three rounds.
• UNRWA continues to distribute food parcels wherever possible. These include[5] rice, chickpeas, lentils, oil, salt, sugar, milk powder, hummus and canned fish, and are designed to cover approximately 90 per cent of daily calorific needs per quarter. To date, over 1.46 million people have been reached, of whom 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 over 1.4 million people.

Water, Sanitation and Hygiene (WASH)

• Since October 2023, UNRWA has carried out emergency WASH activities across the Gaza Strip. The main activities include operating and maintaining water wells and desalination systems and supplying water with water trucks and bottled water. In addition, UNRWA continues to distribute hygiene kits and maintain hygiene in UNRWA shelters and sites by 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, providing over 600,000 displaced people with access to water. Over the past two weeks, around 28,000 cubic metres of water were distributed across the Gaza Strip. However, UNRWA water wells in Jabalia are still not operational due to damage caused by the intense military operations in the area and the Israeli-imposed siege.
• Winterization efforts are ongoing in Khan Younis, the middle area, and Gaza City, with over 353 manholes cleaned, and 40 cleaning campaigns completed during the reporting period. Pest and rodent control measures were completed. UNRWA distributed over 3000 litres of cleaning liquids for shelters across the Gaza Strip.
• UNRWA continues to provide a solid waste collection and transfer service in the Khan Younis, the middle area and Gaza City areas. Over the past two weeks, more than 2,100 tons of solid waste have been collected and transported to the temporary dumping sites. However, no solid waste activities could take place in the northern areas due to ongoing military operations.

[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:

“The responsibility of protection of aid workers and supplies is with the State of Israel as the occupying power. They must ensure aid flows into Gaza safely and must refrain from attacks on humanitarian workers. I call once again for a ceasefire that would also secure the delivery of safe and uninterrupted aid to people in need.”

ENDS-