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Key Points

More than 613,000 internally displaced people (IDPs) are sheltering in 150 UNRWA facilities across the Gaza Strip. In the last 24 hours another three UNRWA staff members have been killed, bringing the total to 38 staff killed since 7 October. Two have been injured, one of whom is in a critical condition. One school in Rafah, sheltering 4,600 IDPs, sustained severe collateral damage due to a close proximity strike. One IDP was killed and 44 more were injured, including nine children. Fuel is urgently needed to continue the UNRWA lifesaving humanitarian operations. If fuel is not received into Gaza, UNRWA will be forced to significantly reduce and in some cases bring its humanitarian operations across the Gaza Strip to a halt. The coming 24 hours are very critical.

Overall Situation

According to the Ministry of Health in Gaza, 5,791 people have been killed since 7 October, including 2,360 children, 1,292 women, 295 elderly, and 16,298 were injured. This is in addition to the 1,550 reported missing, presumably under the rubble of destroyed buildings, including 870 children. Overall, nearly 1,400 Israelis and foreign nationals have been killed in Israel, according to the Israeli authorities, the vast majority on 7 October (OCHA). In the West Bank, 95 people have been killed and nearly 1,900 injured since 7 October. Overcrowding conditions in UNRWA shelters remain a serious concern, as the current facilities can no longer provide dignified living conditions. Some shelters are currently hosting 10 to 12 times more people than their designed capacity.

Humanitarian Access, Protection of Civilians

The Gaza Strip

Since 7 October, 38 UNRWA colleagues were killed and 20 have been injured, with one in critical condition. At least 41 UNRWA installations have been impacted since 7 October.

UNRWA Response

UNRWA Shelters

The average number of IDPs per shelter has reached 2.7 times capacity, with some shelters reaching 12 times intended occupancy. In the Middle Area, one school is hosting up to 13,300 IDPs, while another facility in Khan Younis is hosting 21,000 persons.
UNRWA continues to distribute assistance in shelters; however current conditions severely constrain access to essential services and represent a health and protection risk for IDPs.

Health

The eight UNRWA health centres that remain operational in the South (out of 22) recorded 4,200 visits on 24 October for refugees and non-refugees. In addition to essential primary healthcare, post-natal and high-risk pregnancy care services resumed on 24 October with 40 displaced women receiving this service. Healthcare support for non-communicable diseases (NCDs) patients continued. Healthcare services were maintained within the UNRWA shelters, with the support of 93 mobile medical units and medical teams, serving around 10,000 cases at shelters. According to initial health assessments from the mobile medical teams there are over 37,500 persons with NCDs, over 4,660 pregnant women and around 390 post-natal cases requiring medical attention among the IDPs. In addition, medical teams are increasingly identifying cases of acute respiratory and diarrhea among children under five years old. UNRWA’s stocks of medicines are critically decreasing with availability for a few more days only. UNRWA primary health centres are running out of fuel, threatening the provision of essential healthcare services.

Psychosocial support

UNRWA has counsellors and social workers in the shelters, who provide psychological first aid and other specialized protection services. Since the beginning of the crisis, UNRWA social workers provided 8,900 people with psychosocial support and social work services. These include cases that are referred for medication and other specialized mental health and psychosocial support interventions.

Protection

UNRWA conducted a Rapid Gender Analysis (RGA) to identify the different impacts of the war on women, man, girls and boys and better understand their different needs and coping strategies. The RGA highlighted the following: There is a shortage of feminine hygiene supplies and very few toilets. This results in increased challenges for females to maintain menstrual hygiene. Overcrowding and limited privacy increase familial tensions (which can increase the risk of GBV) and broader tensions between males. There are critical gaps in access to health services that particularly affect women and adolescent girls, including access to comprehensive emergency obstetric care, newborn care and sexual and reproductive health services.

Water and Sanitation Services (WASH)

Some solid waste collection from the camps and from emergency shelters and transfer to landfills continues in Middle, Khan Younis and Rafah areas with difficulties due to the scarcity of fuel and staff. Water wells in Jabalia, Khan Younis and Rafah are functional with about 11,000 m3 being pumped from nine water wells. Despite the limited availability of fuel, desalination plants continue to operate in the shelters for the provision of potable water. Water trucking operations in shelters in Rafah and Khan Younis also continue; however, the potable water provided is not enough to meet all needs. Maintenance and rehabilitation work at shelters continue on a daily basis. This includes essential repairs and upgrading of shelters to accommodate additional IDPs when possible, as well as the installation of mobile showers and toilet units.