Hostilities in the Gaza Strip and Israel | Flash Update #102

Key points

• Intense Israeli bombardment from air, land, and sea continued across much of the Gaza Strip on 25 January, resulting in further civilian casualties, displacement and destruction. Ground operations and fighting between Israeli forces and Palestinian armed groups were also reported across much of Gaza. Hostilities were particularly intense in Khan Younis, with heavy fighting reported in proximity to Al Aqsa, Nasser, Al Amal and Al Kheir hospitals. There are reports of Palestinians trying to flee to the southern town of Rafah, which is already overcrowded, despite the lack of safe passage. Al Mawasi area in Khan Younis was reportedly under heavy attack.  
• Between the afternoons of 24 and 25 January, according to the Ministry of Health (MoH) in Gaza, 200 Palestinians were reportedly killed, and 370 Palestinians were injured. Between 7 October 2023 and 12:00 on 25 January 2024, at least 25,900 Palestinians were killed in Gaza and 64,110 Palestinians were injured, according to the MoH.  
• Between the afternoons of 24 January and 25 January, no Israeli soldiers were reportedly killed in Gaza. As of 25 January, 217* soldiers have been killed, and 1,250 soldiers have been injured in Gaza, according to the Israeli military. 
• On 24 January, a carpentry workshop inside the Khan Younis Training Centre (KYTC) was struck by shells, causing a fire and resulting in at least 13 Palestinians killed, according to UNRWA.  It is estimated that some 800 IDPs had been sheltering inside the workshop, with 43,000 people registered at the  centre. The area of the KYTC was also struck on 22 January, with six people killed by stray bullets and shrapnel falling outside the centre, as reported by UNRWA.  On 25 January, the World Health Organization (WHO) Director-General, Dr. Tedros Ghebreyesus, reported that UNRWA and WHO helped evacuate 45 patients, 15 in critical condition, from the KYTC to another health facility.  However, due to the intensity of fighting, the team was unable to evacuate all the injured. One patient reportedly died en route. The WHO Director-General called for the protection of all civilians, humanitarians and health workers, while reiterating his appeal for an immediate ceasefire. The Israeli military has announced that it is investigating the circumstances of the strike on the KYTC on 24 January and stated that it was not the result of an aerial or artillery strike from its forces.  
• As of 25 January, according to the WHO, there are 14 partially functional hospitals out of 36 in all of Gaza; seven in the north and seven in the south. ‘Partial functionality’ indicates that a hospital is accessible to people in need of health care; it can admit some new patients and can undertake some level of surgery. In addition, Nasser Hospital in Khan Younis is ‘minimally functioning’, as it is surrounded by the Israeli military and is experiencing intense fighting, and is no longer able to receive patients or supplies.  On 24 January, the MoH in Gaza reported that the Nasser Hospital was besieged, and that no one was able to enter or exit the facility due to ongoing bombardment in the vicinity. Health staff were reported to be digging graves on the hospital grounds due to the large numbers of anticipated fatalities and the need to manage burials. Al Kheir Hospital in Khan Younis, which previously designated as ‘minimally functioning’, and one of only three in the Gaza Strip that provides maternity services is no longer operational, with reports of patients, who had just undergone critical operations, having to flee the facility.   
• On 24 January, the International Committee of the Red Cross (ICRC) stated that for approximately two million people in Gaza, the Nasser Hospital and the European Gaza Hospital (EGH) are the only two referral hospitals that provide advanced surgical and medical emergency services with large bed capacities, which is not sufficient given the number of wounded and sick across Gaza. “The humanitarian imperative to protect Gaza’s health facilities is clear. If these medical facilities – especially Nasser and EGH – cease to function, the world will bear witness to untold thousands of preventable deaths given the size of the population, the current extreme living conditions, a collapsing health system, and the intensity of the fighting. The parties to the conflict and all who have influence upon them must take immediate steps to ensure the hospitals and the people within them are safe; to ensure that health personnel, wounded and sick people, and ambulances can safely access the hospital; and to facilitate the timely re-supply of items necessary to the functioning of the hospitals including medicine, fuel, food and water.” 
• On 25 January, the Palestine Red Crescent Society (PRCS) reported that Israeli forces are continueing to besiege their ambulance headquarters and nearby Al Amal Hospital in Khan Younis, restricting all movement in the area. On 24 January, the entrance of the PRCS headquarters was reportedly struck, killing at least three Palestinians: on 23 January, another Palestiniana was reoportedly killed at the entrance to the hospital due to shelling amid intense fighting around the hospital. The PRCS stated that they have been forced to ask IDPs taking shelter in the compound to donate blood,  as  staff  are unable to access blood banks and treat the wounded.  
• On 25 January, at about 12:30, a group of Palestinians who were waiting at the Al Kuwait roundabout in Gaza city for the arrival of humanitarian relief were reportedly fired upon by the Israeli military, according to the Gaza Ministry of Health. At least 20 Palestinians were reportedly killed, and around 150 others injured, many seriously, with casualties transferred to Al Shifaa and Al Ahli hospitals. The Israeli military has reportedly opened an investigation into the incident.  
• On 24 January, the UN Human Rights Office (OHCHR) in the Occupied Palestinian Territory reported that thousands of civilians were forced to flee to Rafah, which is now hosting more than 50 per cent of Gaza’s population. Strikes have seriously endangered civilians, including those sheltering in health facilities. They stated that: “...the IDF continues to shell areas that it has unilaterally designated as ‘safe’ for evacuation, reinforcing that nowhere in Gaza is safe (for example, the Al Mawasi area in western Khan Younis)…and raises grave alarm of further escalation of the hostilities in Rafah which could have serious implications for over 1.3 million people who are reportedly sheltering in the governorate with the attendant risk that people who are essentially trapped in smaller and smaller areas may be forced out of Gaza.” 
• On 23 January, the Palestinian telecommunications company Paltel announced that services in Gaza were gradually being restored. Initial reports indicate that the phonelines have not been restored to the middle and northern areas, and internet services have not been restored to the entire Gaza Strip since the start of the previous telecommunication blackout on 12 January. The communications shutdown continues 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. 
• On 24 January, UN partners, on the occasion of World Education Day, urged all actors to ensure that barriers to education are addressed, especially through the provision of adequate shelter that facilitates recovery, to enable the right to learn. Further, they stated: “learning has been devastated in the Gaza Strip since the hostilities began in October 2023. Over 625,000 students and 22,564 teachers have been deprived of education and a safe place for over three months, and thousands of learners and education personnel are amongst the more than 25,000 people who have reportedly been killed”. All UNRWA schools in the Gaza Strip have closed–most turned into shelters–, depriving the 300,000 children who attended them of their education. UNRWA reports that at least 340 internally displaced people have been killed while seeking safety in UNRWA shelters. 

Hostilities and casualties (Gaza Strip)

The following are among the deadliest incidents reported on 24 and 25 January:   

• On 24 January, at about 15:50, five Palestinians, including two children, were reportedly killed and dozens were injured, after residential buildings in Rafah were struck. 
• On 25 January, at about 21:00, at least ten Palestinians, including four children, were reportedly killed and tens of others were injured after a residential square was struck in Nuseirat Refugee Camp, central Gaza.  

Displacement (Gaza Strip)

• According to a statement released by OHCHR on 24 January, the intensification of the operation in Khan Younis raises serious concerns that civilians will be forced to leave their homes and shelters, including those who had previously been displaced from northern Gaza to Khan Younis.  Hundreds of thousands of displaced people are now filling the streets of Khan Younis and Rafah, and are living in makeshift shelters in miserable conditions, with little or no access to food, water, medicines and appropriate shelter, and many are facing the risk of further displacement. 
• As of 22 January, according to UNRWA, there are an estimated 1.7 million IDPs in Gaza. Many of them have been displaced multiple times, as families have been forced to move repeatedly in search of safety. Due to the continued fighting and evacuation orders, some households have moved away from the shelters where they were initially registered. Rafah governorate is the main refuge for those displaced, with over one million people squeezed into an extremely overcrowded space. Following intense Israeli bombardment and fighting in Khan Younis and the central area of the Gaza Strip in recent days, as well as new Israeli military evacuation orders, a significant number of displaced people have moved further south. 
• On 23 January, the Israeli military issued new evacuation orders via social media to Palestinians in a number of city blocks in Khan Younis. The affected area covers some four square kilometres. There are about 88,000 residents in the area, in addition to an estimated 425,000 internally displaced people (IDPs) seeking shelter in 24 schools and other institutions. The affected area includes Nasser Hospital (475 bed capacity), Al Amal Hospital (100 beds) and the Jordanian Hospital (50 beds), representing almost 20 per cent of the remaining partially functioning hospitals across the Gaza Strip. Three health clinics are also located in the affected area. Some 18,000 IDPs are reported to be in the Nasser Hospital, with an unknown number of IDPs seeking shelter in the other health facilities.  On 25 January, the Israeli military reissued the same evacuation orders via social media. 

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. 
• Since 19 November, limited fuel amounts have entered the Gaza Strip from Rafah. However, since these are insufficient, hospitals, water facilities and other critical facilities are still only operating at limited capacity. A Rapid Disaster Needs Assessment team has identified about 570 kilometres of electricity feeder lines that have been damaged as of 12 January. This represents some 57 per cent of feeder lines, with damage expected to have increased further since then. Fuel is urgently needed for the Gaza Electricity Distribution Company (GEDCO) teams to conduct damage assessments and field repairs. 

Health care, including attacks (Gaza Strip)

• According to WHO, health care in Gaza remains extremely fragile. The seven partially functional 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 seven partially functional hospitals in the south are operating at three times their capacity, while facing critical shortages of basic supplies and fuel, with hospitals in Khan Younis at risk of closure due to intense hostilities and the issuance of evacuation orders in adjacent areas. Over 90 health facilities and over 80 ambulances have been impacted since the escalation of hostilities. Other factors include power supply disruptions and fuel shortages. According to the MoH in Gaza, occupancy rates are reaching 206 per cent in inpatient departments and 250 per cent in intensive care units. 

Water, Sanitation and Hygiene (WASH)

• A UNOSAT satellite imagery analysis released in mid-January shows that 87 per cent of WASH facilities in Gaza governorate were either destroyed or sustained some level of damage. Similarly, 82 per cent of WASH facilities in northern Gaza, 54 per cent in Deir al Balah, 46 per cent in Khan Younis and some eight per cent in Rafah governorates are either destroyed or sustained varying levels of damage. With the intensifying conflict in Deir al Balah and especially Khan Younis since 22 January, it is likely that the remaining frail infrastructure is at risk of further damage and destruction. At the same time, the absence of visible damage to WASH infrastructure does not guarantee functionality. Other enabling tools, such as generators, fuel, and pumps are imperative for the functionality of water and sanitation infrastructure. 
• The availability of water for drinking and domestic use in Gaza is shrinking. According to WASH humanitarian partners, water availability through the municipal wells is presently at 21,200 cubic metres a day, which is a tenth of their production capacity of 255,000 cubic metres a day prior to the escalation of hostilities. Water from these wells is known to be substandard given it is brackish (salty), whereas water from the Israeli-operated lines yielded the optimal safe drinking water prior to the hostilities. At present, only one of the three Israeli lines – the Bani Sa’id point – is functional, yielding 22,000 cubic metres a day, which is less than half of what would have been available if all lines were working. 
• Furthermore, water availability through the short-term desalination plants presently stands at 1,600 cubic metres per day, which is 7 per cent of the pre-crisis capacity of 22,000 cubic metres per day. Due to import restrictions on critical items, water testing kits and chlorine to treat the water across Gaza are presently unavailable. Furthermore, the amalgamation of solid waste and fecal waste, exacerbated by rains and floods, is giving rise to severe health and environmental threats. With WHO already reporting 158,000 cases of diarrhea, the inability to perform water chlorination to kill bacteria is exacerbating the already concerning situation. At present, Health and WASH partners have developed an Acute Watery Diarrhea preparedness and response plan. Barriers to the import of critical items must be removed to enable adequate response. 

Food Insecurity

• Since the beginning of the month and as of 22 January, the World Food Programme (WFP) reported having reached nearly 930,000 affected people with in-kind and general food assistance across the Gaza Strip, including more than 560,000 IDPs in makeshift camps, UNRWA shelters and IDPs with host families, with food parcels. In addition, WFP distributed canned meat, biscuits, and wheat flour to 13,250 people in the northern governorates of Gaza. Starting in January, WFP resumed subsidized bread distribution, reaching over 560,000 people in Gaza and distributed hot meals to 102,762 people.
• Humanitarian partners report that, as of 17 January, only 15 bakeries were operational across the Gaza Strip; six in Rafah and nine in Deir al Balah. No bakeries are functioning north of Wadi Gaza. WFP has been supporting eight of the functional bakeries (six in Rafah and two in Deir al Balah), by providing wheat flour, salt, yeast and sugar. Through this initiative, about 250,000 people were able to purchase bread at a subsidized price. Before 7 October, a total of 97 bakeries were operative overall in the Gaza Strip, in particular: 25 in Deir al Balah, 20 in Khan Younis, 19 in Rafah, 8 in northern Gaza and 25 in Gaza city. 

Humanitarian Access

• On 22 January, WHO and partners completed a high-risk mission to resupply fuel to the Shifa Hospital in northern Gaza, where hundreds of thousands of people remain cut off from aid. According to WHO, functionality has improved since their last visit ten days previously. There are 120 health and care workers, and 300 patients. The hospital conducts between five and ten surgeries daily, mainly trauma cases that require immediate care. Essential services such as basic laboratory and radiological facilities remain operational, along with emergency care, a surgical unit, post-operative care, and a dialysis unit. There are plans to reopen a 9-bed Intensive Care Unit over the coming days. A significant decrease in the number of displaced people sheltering in the hospital, from 40,000 to 10,000, was also observed.  
• The capacity of humanitarian agencies to operate safely and effectively anywhere in Gaza remains heavily compromised by recurrent denials of access to the north, restrictions on the import of critical equipment, and the intensity of hostilities, among other factors. For more information, see the Humanitarian Access Snapshot.  

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.  
• 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. 

Violence and casualties (West Bank)

• On 25 January, Israeli forces shot and killed a Palestinian man, aged 27, in Bir al Basha village in Jenin. Israeli forces raided the village and surrounded the man’s house, alleging that he and another person were wanted. The forces shot and killed one of them, who reportedly shot at the forces, and arrested the other man.  
• Since 7 October 2023 and as of 25 January 2024, 361 Palestinians have been killed, including 92 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 these 361 fatalities, 351 were killed by Israeli forces, eight by Israeli settlers and two by either Israeli forces or settlers. 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. So far in 2024 (as of 25 January), 52 Palestinians, including at least 11 children, have been killed. 
• Since 7 October 2023 and as of 25 January 2024, five Israelis, including four members of Israeli forces, have been killed in Palestinian-perpetrated attacks in the West Bank, including East Jerusalem. In addition, 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 25 January 2024, 4,354 Palestinians, including 657 children, have been injured in the West Bank, including East Jerusalem. Of them, 4,219 have been injured by Israeli forces, 114 by settlers and 21 by either Israeli forces or settlers. Of the total injuries, 54 per cent were reported in the context of search-and-arrest and other operations, 34 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 25 January 2024, OCHA has recorded 457 Israeli settler attacks against Palestinians, resulting in Palestinian casualties (45 incidents), damage to Palestinian-owned property (356 incidents), or both casualties and damage to property (56 incidents). This reflects a daily average of four incidents. 
• 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)

• Since 7 October 2023 and as of 25 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 displacement 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).  
• Since 7 October 2023 and as of 25 January 2024, 495 Palestinians, including 246 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 22 homes have been demolished and 105 Palestinians, including 45 children, displaced due to punitive demolitions from 7 October 2023 and as of 25 January 2024. The numbers exceed those reported in the first nine months of 2023, during which 16 homes were punitively demolished and 78 people displaced.  
• Since 7 October 2023 and as of 25 January 2024, 743 Palestinians, including 311 children, have been displaced, following the destruction of 116 homes during other operations carried out by Israeli forces across the West Bank. About 95 per cent of the displacement was reported in the refugee camps of Jenin, Nur Shams and Tulkarm. This represents 82 per cent of all displacement reported due to the destruction of homes during Israeli military operations since January 2023 (908 people).  

Funding

• As of 25 January, Member States have disbursed $698.6 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 58 per cent of the $1.2 billion requested.  
• Private donations are collected through the Humanitarian Fund. A private foundation in Australia has donated $2.2 million. Since 7 October, the Humanitarian Fund has disbursed about $55 million.  

HUMANITARIAN NEEDS AND RESPONSES: 14-21 January

Health

Needs

• According to WHO, only 16 of Gaza’s 36 hospitals are partially functional - nine in the south and seven 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