Hostilities in the Gaza Strip and Israel | Flash Update #95

Key points 

• Intense Israeli bombardments from air, land, and sea continued across much of the Gaza Strip on 17 January, resulting in further civilian casualties and destruction. The indiscriminate firing of rockets by Palestinian armed groups from Gaza continued. Ground operations and fighting between Israeli forces and Palestinian armed groups were also reported across much of Gaza. On 17 January, the UN Secretary-General repeated his call for an immediate humanitarian ceasefire in Gaza. 
• Between the afternoons of 16 and 17 January, according to the Ministry of Health (MoH) in Gaza, 163 Palestinians were killed, and another 350 people were injured. Between 7 October 2023 and 12:00 on 17 January 2024, at least 24,448 Palestinians were killed in Gaza and 61,504 Palestinians were injured, according to the MoH.  
• Between 16 January and 17 January, three Israeli soldiers were reportedly killed in Gaza. Since the start of the ground operation, 191 soldiers have been killed, and 1,152 soldiers have been injured in Gaza, according to the Israeli military. 
• As of 17 January, telecommunication services in Gaza have remained shut down for the fifth consecutive day, since 12 January. In light of this, new information is limited in this Flash Update. This is the seventh time that communications have stopped working since 7 October. The blackout of telecommunications prevents people in Gaza from accessing lifesaving information or calling for first responders, and impedes other forms of humanitarian response. 
• As of 15 January, the Deir al Balah water pipeline, with a capacity of close to 17,000 cubic metres of per day, stopped functioning and is in urgent need of repairs. Water, hygiene, and sanitation (WASH) partners have estimated that repairs could take up to four weeks, even if sustained access and the necessary supplies are allowed. Only one of the three water pipelines from Israel into Gaza, located in the south, is currently functioning. 
• Between 16 and 17 January, the Khan Younis area was reportedly under heavy bombardment with intense fighting on the ground, with many casualties reported. Residential buildings, a cemetery (see Hostilities section for more information) and hospitals are among the civilian objects affected by the fighting. 
• On 16 January, at about 18:30, the vicinities of Al Amal Hospital in Khan Younis were struck, and serious damages were caused to the building, leading to panic among patients, medical teams, and internally displaced persons (IDPs). No casualties were reported. On 16 January, at about 22:20 and onwards, continuous artillery shelling struck the vicinity of An Nasser Medical Complex, with some munitions falling inside the compound and no casualties reported. 
• On 17 January, the Jordanian Army quoted in media stated that their field hospital in Khan Younis was heavily damaged and one of its staff members and one patient were injured, amid shelling by Israeli forces in the area. Israeli officials deny this claim and state that Palestinian were firing from within the compound.   
• On 17 January, 98* truckloads with food, medicine and other supplies entered the Gaza Strip through Rafah and Kerem Shalom crossings. Since the opening of Kerem Shalom crossing, almost 22 per cent of aid trucks have come in through that entry point.  
• On 17 January, 11 Palestinians, including two children, were killed in two military operations in the Nablus and Tulkarm governorates, in the West Bank. Nine of the Palestinians, including two children, were killed in airstrikes and the other two people were killed with live ammunition. For more information, see the West Bank section. 

Hostilities and casualties (Gaza Strip) 

The communications shutdown has limited the full reporting of incidents. However, the following are among the deadliest incidents reported between 16 January and 17 January.  

• On 16 January, throughout the day, 23 Palestinians were reportedly killed as about 12 residential squares were struck in many locations in central, west, southeast, and east of Khan Younis. 
• On 16 January, at about 13:40, a woman and her daughter were reportedly killed when a group of Palestinians were struck west of Rafah. 
• On 16 January, in the afternoon, at least 20 bodies of killed Palestinians were reportedly recovered from under the rubble of a destroyed buildings in Al Maghazi and An Nuseirat camp areas.  
• On 16 January, at about 2:35, eight Palestinians, including two girls, were reportedly killed and dozens were injured when a house was struck and destroyed near Al Abrar Mosque, between Al Haboura camp and Yabna camp, in central Rafah. 
• On 16 January, at night, seven Palestinian were reportedly killed when a residential building was struck in An Nasmawi neighbourhood, adjacent to the Nasser Medical Complex, west of Khan Younis. 
• On 17 January, at about 7:00, the vicinity of Tariq bin Ziyad School, west of Khan Younis, was struck. Seven bodies of Palestinian were reportedly recovered after the attack. 

On 17 January, at about 7:00, Israeli forces withdrew from the vicinity of Nasser Hospital, in Khan Younis. Initial reports and video footage show that much of the Al Namsawi cemetery was destroyed and graves empty with some corpses reportedly missing. 

Displacement (Gaza Strip)

• On 17 January, UNRWA Commissioner-General, Philippe Lazzarini, stated: “In the south, around Rafah, makeshift structures of plastic sheeting have mushroomed everywhere, including on the streets, with people trying to protect themselves from the cold and rain. Each one of these flimsy shelters can be home to over 20 people. Rafah is so congested that one can barely drive a car amid the sea of people… In Deir al Balah, in the Middle Area… I heard stories of women foregoing food and water to avoid having to use the unsanitary toilets. Skin diseases and headlice are rife with those affected stigmatized. People were struggling for food and medicine during the day, feeling cold and damp during the night… There is very little information about the north of the Gaza Strip, as access to the area remains highly restricted.” 
• As of 11 January, according to UNRWA, 1.9 million people, or nearly 85 per cent of Gaza’s population, were estimated to be internally displaced, including many who have been displaced multiple times, as families are forced to move repeatedly in search of safety. Nearly 1.4 million IDPs are sheltering in 154 UNRWA facilities across all five governorates, including 160,000 in the north and Gaza city; facilities far are exceeding their intended capacity. A total of 1.78 million IDPs are receiving assistance from UNRWA. Rafah governorate is the main refuge for those displaced, with over one million people squeezed into an extremely overcrowded space, following the intensification of hostilities in Khan Younis and Deir al Balah and the Israeli military’s evacuation orders. Obtaining an accurate figure of the total number of IDPs remains challenging. 

Electricity

• Since 11 October 2023, the Gaza Strip has been under an electricity blackout, after the Israeli authorities cut off the electricity supply, and fuel reserves for Gaza’s sole power plant were depleted. The communications and industrial fuel shutdown continue to significantly hinder the aid community’s efforts to assess the full extent of needs in Gaza and to adequately respond to the deepening humanitarian crisis. For more information on electricity supply to the Gaza Strip, please see this dashboard

Humanitarian Access (Gaza Strip-Northern Gaza) 

• In the first two weeks of January, humanitarian agencies planned 29 missions to deliver lifesaving supplies to areas to the north of Wadi Gaza. Only 7 of the 29 (24 per cent) were accomplished, either fully or partially. The remainder of the missions were denied access by the Israeli authorities. Two additional missions, originally coordinated with the Israeli authorities, could not be completed due to the non-viability of allocated routes or excessive delays at checkpoints, which did not allow the missions to succeed during the safe operating windows.  
• The denials of humanitarian missions’ access to areas north of Wadi Gaza over the first half of January spiked compared with the previous months; in October and December, only 14 per cent (6 out of 43) of missions planned to the north were denied, while the remaining 86 per cent (37 out of 43 missions) were facilitated. These denials prevent a scale-up in humanitarian assistance and add significant cost to the overall response. Additionally, planned missions that are denied access to areas north of Wadi Gaza represent opportunities missed for alternative missions that could be undertaken to other areas of the Gaza Strip. The capacity of humanitarian agencies to operate safely and effectively also remains heavily compromised by the long-term restrictions applied by the Israeli authorities on the import of critical humanitarian equipment into Gaza. 

Health care, including attacks (Gaza Strip)

• Initial reports on 17 January indicate that a missile reportedly struck the UNRWA health clinic in Ad Daraj, in Gaza city. Further details on the impact of the projectile are yet to be established. 
• According to WHO, only 15 out of Gaza’s 36 hospitals are functional, albeit partially: nine in the south and six in the north. In Deir al Balah and Khan Younis, three hospitals – Al Aqsa, Nasser, and Gaza European – are at risk of closure due to the issuance of evacuation orders in adjacent areas and the ongoing conduct of hostilities nearby. Hospitals in the north have been offering limited maternity, trauma, and emergency care services. However, they face challenges such as a shortage of medical staff, including specialized surgeons, neurosurgeons, and intensive care staff, as well as a lack of medical supplies, and have an urgent need for fuel, food, and drinking water. The nine partially functional hospitals in the south are operating at three times their capacity, while facing critical shortages of basic supplies and fuel. According to the MoH in Gaza, occupancy rates are reaching 206 per cent in inpatient departments and 250 per cent in intensive care units. 
• On 17 January, WHO Health Emergency Officer, Sean Casey, said: “We are working on mobilizing additional field hospitals, additional healthcare workers to backfill some of the people who have been displaced, the health workers who themselves are fearing for their lives and to meet the significantly increased burden of care that is created by injuries related to the hostilities and to the atrocious living conditions that people are under now. To summarize what I’ve seen: a rapid deterioration of the health system alongside a rapidly increasing level of humanitarian need and diminishing level of humanitarian access, particularly the areas north of Rafah. Every movement presents risks and logistical challenges.” 

Hostilities and casualties (Israel) 

• Over 1,200 Israelis and foreign nationals have been killed in Israel, including 36 children, according to the Israeli authorities, the vast majority on 7 October. 
• As of noon on 15 January, the Israeli authorities estimated that about 136 Israelis and foreign nationals remained captive in Gaza. During the humanitarian pause (24-30 November), 86 Israeli and 24 foreign national hostages were released. 
• On 15 January, the Secretary-General reiterated his call for the release of all hostages: “I once again demand the immediate and unconditional release of all hostages. In the interim, they must be treated humanely and allowed to receive visits and assistance from the International Committee of the Red Cross. The accounts of sexual violence committed by Hamas and others on October 7th must be rigorously investigated and prosecuted. Nothing can justify the deliberate killing, injuring, and kidnapping of civilians – or the launching of rockets towards civilian targets.” 

Violence and casualties (West Bank)

• On 17 January, Israeli forces killed six Palestinians, including two children, in an airstrike that they carried out while operating in Tulkarm Refugee Camp. In the early morning, Israeli forces raided the camp, where clashes erupted between Israeli forces and Palestinians, including an exchange of gunfire and the use of explosive devices by the latter was reported. Subsequently, an Israeli airstrike targeted a group of Palestinians, killing four, including two children. During the operation, seven Palestinians, including two PCRS paramedics, and one Israeli soldier had been injured. An ambulance was severely damaged by shrapnel and two Palestine Red Crescent Society (PRCS) paramedics were detained by Israeli forces. Israeli forces bulldozed several roads inside and the camp, surrounded the hospitals in Tulkarm city and obstructed the movement of medical crews. During the raid, Israeli forces opened fire at a vehicle, killing one Palestinian and injuring another. An additional Palestinian was shot with live ammunition and was later pronounced dead. 
• On 17 January, Israeli forces killed five Palestinian in an airstrike on a vehicle near the entrance of Balata Refugee Camp, Nablus city. Four of the bodies are being withheld by Israeli forces. The fifth body was incinerated by the airstrike. Israeli forces reportedly prevented PRCS ambulances from accessing the location and opened fire at them. According to the Israeli authorities, a vehicle that carried Palestinians accused of conducting attacks against Israelis was targeted. Two hours before the airstrike, Israeli forces conducted an operation in Balata Refugee Camp, in which they raided a number of Palestinian homes. Clashes between Israeli forces and Palestinians also erupted during the operation, including the throwing of pipe bombs by the latter.  
• Since 7 October 2023 and as of 17 January 2024, 355 Palestinians have been killed, including 90 children, across the West Bank, including East Jerusalem. Additionally, two Palestinians from the West Bank were killed while carrying out an attack in Israel on 30 November. Of the fatalities in the West Bank (355), 346 were killed by Israeli forces, eight by Israeli settlers and one by either Israeli forces or settlers. So far in 2024 (as of 17 January), 46 Palestinians, including nine children, have been killed. The number of Palestinians killed in the West Bank, including East Jerusalem, in 2023 (507) marks the highest number of Palestinians killed in the West Bank since OCHA started recording casualties in 2005. 
• Since 7 October 2023 and as of 17 January 2024, five Israelis, including four members of Israeli forces, have been killed in Palestinian attacks in the West Bank, including East Jerusalem. Four Israelis were killed in an attack carried out by Palestinians from the West Bank in West Jerusalem (one of the four was killed by Israeli forces who misidentified him) on 30 November 2023. Another Israeli woman was killed in another attack perpetrated by Palestinians in Israel on 15 January 2024. The number of Israelis killed in the West Bank and Israel in 2023 in attacks perpetrated by Palestinians from the West Bank (36) was the highest since OCHA started recording casualties in 2005. 
• Since 7 October 2023 and as of 17 January 2024, 4,234 Palestinians, including 643 children, have been injured in the West Bank, including East Jerusalem. Of them, 4,104 have been injured by Israeli forces, 109 by settlers and 21 by either Israeli forces or settlers. Of the total injuries, 53 per cent were reported in the context of search-and-arrest and other operations, 35 per cent in demonstrations and 8 per cent during settler attacks against Palestinians. Some 33 per cent of those injuries have been caused by live ammunition, compared with 9 per cent in the first nine months of 2023. 

Settler Violence

• Since 7 October 2023 and as of 17 January 2024, OCHA recorded 431 Israeli settler attacks against Palestinians, resulting in Palestinian casualties (41 incidents), damage to Palestinian-owned property (337 incidents), or both casualties and damage to property (53 incidents). This reflects a daily average of four incidents since 7 October 2023 until 17 January 2024. 
• One-third of the settler attacks against Palestinians after 7 October 2023 have involved firearms, including shootings and threats of shootings. In nearly half of all recorded incidents after 7 October, Israeli forces were either accompanying or reported to be supporting the attackers. 
• In 2023, 1,229 incidents involving Israeli settlers in the West Bank, including East Jerusalem (with or without Israeli forces), resulted in Palestinian casualties, property damage or both. Some 913 of these incidents resulted in damage, 163 resulted in casualties and 153 resulted in both. This is the highest number of settler attacks against Palestinians in any given year since OCHA started recording incidents involving settlers in 2006. 

Displacement (West Bank) 

• From 7 October 2023 and as of 17 January 2024, at least 198 Palestinian households comprising 1,208 people, including 586 children, have been displaced amid settler violence and access restrictions. The displaced households are from at least 15 herding/Bedouin communities. More than half of the displacements occurred on 12, 15, and 28 October, affecting seven communities. The displacement toll since 7 October 2023, represents 78 per cent of all displacement reported due to settler violence and access restrictions since 1 January 2023 (1,539 people, including 756 children).  
• From 7 October 2023 and as of 17 January 2024, 460 Palestinians, including 227 children, have been displaced, following the demolition of their homes, due to lack of Israeli-issued building permits in Area C and East Jerusalem, which are almost impossible to obtain. 
• A total of 19 homes have been demolished and 95 Palestinians, including 42 children, displaced due to punitive demolitions from 7 October 2023 and as of 17 January 2024. The numbers exceed those reported in the first nine months of the same year, during which 16 homes were punitively demolished and 78 people displaced.  
• From 7 October 2023 and as of 17 January 2024, 602 Palestinians, including 263 children, have been displaced, following the destruction of 94 homes during other operations carried out by Israeli forces across the West Bank. About 94 per cent of the displacement was reported in the refugee camps of Jenin, and in Nur Shams and Tulkarm, both in Tulkarm. This represents 65 per cent of all displacement reported due to the destruction of homes during Israeli military operations since January 2023 (908 people).  

Funding

• As of 16 January, Member States have disbursed $689.8 million against the updated Flash Appeal launched by the UN and its partners to implement its response plan in support of 2.2 million people in the Gaza Strip and 500,000 people in the West Bank. This constitutes 57 per cent of the $1.2 billion requested. Private donations are collected through the Humanitarian Fund. 

HUMANITARIAN NEEDS AND RESPONSES: 7-14 January

Health 

Needs: 

• According to WHO, only 15 of Gaza’s 36 hospitals are partially functional - nine in the south and six in the north.  
• According to the MoH in Gaza, there is a shortage of available hospital beds, as occupancy rates in these hospitals are reaching 206 per cent in inpatient departments and 250 per cent in intensive care units. 
• Food, drinking water, fuel, medical supplies, and support to health workers through rotations and additional personnel, are urgently needed in healthcare facilities across Gaza.  
• During missions to Shifa, Al Helou, Al Aqsa and Nasser hospitals to deliver supplies, fuel, and conduct assessments on 13 January, the WHO team observed the following: 
• A drastic decrease in the number of health personnel in some of the hospitals.  
• Only 12 medical doctors are still working at the Al Aqsa hospital, which is about 10 per cent of the staff who operated before the start of the hostilities. 
• The maternity unit at Al-Aqsa Hospital is not operating and is referring all pregnant women to Al Awda Hospital, which is further away, putting patients at risks during the additional travel time, due to ongoing hostilities. 
• Poor living conditions in shelters have resulted in a rise in water-borne diseases 

Response: 

• Eleven Emergency Medical Teams (EMTs) are present in Gaza Strip and have been providing support to hospitals across the Strip. 
• Health and WASH partners are finalizing an inter-cluster outbreak preparedness and response plan; and are mapping out formal and informal shelters which are without access to primary healthcare services, to identify partners to cover the gaps. 

Challenges and Gaps: 

• The security situation, access, transport, and deconfliction remain extremely challenging, especially hospitals in the northern governorates.  
• Partners’ operations continue to be adversely affected by the displacement of staff and also telecommunication challenges. 
• There is an urgent need to conduct assessments on the outbreak of communicable diseases, such Hepatitis A, to identify the most affected groups, hotspot locations and other key epidemiological information. This is essential to tailor a proper response plan to address identified cases and prevent the spread of disease. 

WASH 

Needs: 

• Flooding is being reported across different parts of the Gaza Strip due to winter weather, extensive infrastructure damage and destruction and the clogging of sewage systems and wastewater.  
• Rainwater lagoons have been contaminated by wastewater and several lagoons are at risk of flooding if the rainfall intensifies. This poses a serious environmental and public health concern.  
• WHO reported an increase in Hepatitis A cases in the Middle Area and Rafah governorates, with the current water and sanitation conditions proving a high risk for further spread. 
• To manage water supply and waste-management alone, 22 generators have been requested. These items are pending entry into Gaza.  
• Only one of the three water pipelines from Israel is currently functioning. The Middle Area water pipeline, with a production capacity of close to 17,000 cubic metres of water per day, needs repairs. It is estimated that repairs would take up to four weeks, even given sustained access and necessary supplies.  
• Only two of the remaining three main low-cap