Hostilities in the Gaza Strip and Israel | Flash update #32

Palestinian mother and her newborn baby girl in a school used to shelter displaced people in the Gaza Strip. “There is no bathroom, no water, and no proper care,” she says. ”I have not checked or cleaned the cesarean section stitches yet.” Screenshot from a video by UNICEF


  • The situation of hundreds of thousands of Palestinians in Gaza city and other areas north of Wadi Gaza (hereafter: the north) is increasingly dire. Armed clashes and intense bombardment continue as people struggle to secure the minimum amounts of water and food to survive.
  • As of 7 November, no bakeries were active in the north, due to the lack of fuel, water and wheat flour, as well as the damage sustained by many. Food security partners have been unable to deliver assistance in the north for the past seven days.
  • Attacks continue in close proximity to hospitals in the north that are sheltering tens of thousands of internally displaced persons (IDPs), who are provided with only the most essential services. According to the World Health Organization, hospitals in the north are conducting complex surgeries, including amputations, without anesthesia, due to the lack of medical supplies.
  • Shelters south of Wadi Gaza (hereafter: the south) are unable to accommodate new arrivals as they face severe overcrowding; in one shelter, over 600 IDPs are forced to share one toilet.
  • The daily volume of humanitarian assistance entering from Egypt meets a fraction of people’s needs. Drinking water brought in serves just 4 per cent of Gaza’s residents, while desperately needed fuel remains banned.

Hostilities and casualties (Gaza Strip)

  • On 7 November, armed clashes between Israeli forces and Palestinian armed groups continued in and outside of Gaza city, as well as in the North Gaza governorate. Meanwhile, intense Israeli bombardments from the air, sea, and land continued across the Gaza Strip, while Palestinian armed groups continued launching projectiles toward Israel.
  • Between 6 November (noon) and 7 November (14:00), 548 Palestinians were killed in Gaza, according to the Ministry of Health (MoH) in Gaza. Among the deadliest incidents reported overnight were three simultaneous strikes on residential buildings across east of Rafah, where more than 25 Palestinians were reportedly killed. Another airstrike hit a neighborhood in central Khan Yunis, reportedly resulting in 16 Palestinian fatalities.
  • This brings the reported fatality toll since the start of the hostilities to 10,328, of whom 67 per cent are said to be children and women, according to MoH Gaza. About 2,450 others, including 1,350 children, have been reported missing and may be trapped or dead under the rubble, awaiting rescue or recovery.
  • These reported fatalities include at least 192 medical staff, according to the MoH Gaza. Of them, at least 16 were on duty when killed, according to the World Health Organization (WHO). The fatalities further include 89 UNRWA staff, and 18 Palestinian Civil Defense personnel.
  • The death toll among Israeli soldiers in Gaza remains 30, according to official Israeli sources.
  • See the latest snapshot for more breakdowns.
  • UN Secretary-General António Guterres stated that Israeli ground operations and continued bombardment are hitting civilians, hospitals, refugee camps, mosques, churches and UN facilities, while Hamas and other militants use civilians as human shields and continue to launch rockets indiscriminately towards Israel.

Access and movement (Gaza Strip)

  • On 7 November, the Israeli military continued calling on residents of the north to move southwards. For the fourth consecutive day, it opened a “corridor” along the main traffic artery, Salah Ad Deen Road, for residents to leave the north between 10:00 and 14:00. UN monitors estimate that up to 15,000 people may have passed, three times the figure estimated on 6 November. The majority, including children, elderly people and people with disabilities, arrived on foot with minimal belongings. Some IDPs reported that they had had to cross Israeli checkpoints to reach the area and had witnessed arrests by Israeli forces.
  • The Egyptian border was opened on 7 November for the evacuation of about 600 foreign and dual nationals, and 17 injured people. Some of the latter were transported from northern Gaza in an ambulance convoy led by the International Committee of the Red Cross (ICRC).
  • Additionally, 81 trucks, primarily carrying food, medicines, health supplies, bottled water and hygiene products, crossed from Egypt into Gaza, bringing the number of trucks that have entered Gaza since 21 October to 650. Prior to the start of hostilities, an average of 500 truckloads entered Gaza every working day.
  • The Kerem Shalom crossing with Israel, which prior to the hostilities was the main entry point for goods, remains closed, as does the Israeli pedestrian crossing of Erez.

Displacement (Gaza Strip)

  • About 1.5 million people in Gaza are internally displaced. Of them, nearly 725,000 are sheltering in 149 UNRWA facilities, 122,000 in hospitals, churches, and public buildings, 131,134 in 94 non-UNRWA schools, and the remainder with host families.
  • Overcrowding remains a major concern. More than 557,000 people are sheltering in 92 UNRWA facilities in the south, where shelters are unable to accommodate new arrivals. The Khan Younis Training Centre, the most overcrowded UNRWA facility, hosts more than 22,000 IDPs: the space per person is less than two square metres, while each toilet is shared by at least 600 people.
  • The worsening sanitary conditions, along with the lack of privacy and space, generate health and safety hazards. Thousands of cases of acute respiratory infections, diarrhea and chicken pox have been reported among people taking refuge at UNRWA shelters.
  • An estimated 160,000 IDPs are housed in 57 UNRWA facilities in the north. UNRWA, however, is no longer able to provide services in those areas and does not have accurate information on people’s needs and conditions since the Israeli evacuation order on 12 October.
  • On 7 November, an UNRWA school in Khan Younis was struck, killing one IDP and injuring nine others. This brings the total number of IDPs killed since 7 October to 67, while 549 others have been injured.
  • See the live IDP dashboard for the latest figures and more breakdowns.


  • Gaza remains under a full electricity blackout since 11 October, following Israel’s halt of its power and fuel supply, which triggered the shutdown of Gaza’s sole power plant.
  • The entry of fuel, which is desperately needed to operate electricity generators to run life-saving equipment, remains banned by the Israeli authorities.

Health care, including attacks (Gaza Strip)

  • On 7 November, a convoy of five UNRWA and WHO trucks, escorted by two vehicles of the ICRC, on their way to deliver lifesaving medical supplies to the Shifa and Al Quds hospitals in Gaza city, came under fire. Two trucks were damaged, and one of the drivers was injured. The convoy ultimately reached Shifa hospital, where it delivered the medical supplies. The head of the ICRC delegation in Gaza stated that “ensuring that vital assistance can reach medical facilities is a legal obligation under international humanitarian law.”
  • On 7 November, areas in close proximity to the Indonesian and Kamal Odwan hospitals (both in North Gaza governorate) were struck, killing people and damaging buildings and equipment.
  • For the second consecutive day, on 7 November, the Israeli military ordered the evacuation of the Rantisi hospital in Gaza city, claiming that armed groups were using its premises and surroundings. This hospital is the only pediatric facility in northern Gaza, and it also accommodates about 6,000 IDPs. According to the MoH in Gaza, its evacuation would jeopardize the lives of 15 children on life support, 38 children undergoing kidney dialysis, 10 children relying on artificial respiratory devices, and others who are injured.
  • According to WHO, due to the lack of medical supplies, hospitals in the north are conducting complex surgeries, including amputations, without anesthesia.
  • Since 3 November, the main electricity generators at Shifa and the Indonesian Hospital have reportedly not operated due to the lack of fuel. Both facilities operate secondary, smaller generators, which provide electricity primarily to the Intensive Care Units, emergency rooms, and operating theatres.
  • Since the start of hostilities, 14 out of 35 hospitals with inpatient capacities have stopped functioning and 46 (64 per cent) of all primary care facilities across Gaza have shut down due to damage or lack of fuel. Overall, WHO recorded 110 attacks on health affecting 39 health care facilities (including 22 hospitals damaged) and 36 ambulances.

Water and sanitation (Gaza Strip)

  • On 6 November, UNRWA and UNICEF distributed limited amounts of fuel to 120 municipal water wells across the Gaza Strip, including in the north, enough for the wells to operate for about two days. The water extracted is brackish and therefore meant only for non-drinking domestic uses. The fuel had been stored in Gaza since before the start of hostilities.
  • In the north, neither the water desalination plant nor the Israeli pipeline is operational. Municipal staff are struggling to access some of the water wells producing brackish water. For the past week, partners specializing in water, sanitation and hygiene (WASH) have been unable to distribute bottled water among IDPs accommodated in shelters in the north.
  • In the south, one of the two desalination plants is operational, alongside two pipelines supplying water from Israel, providing a limited number households connected to the network with driking water for a few hours per day.
  • The current water aid entering from Egypt in bottles and jerry cans is addressing only 4 per cent of the residents’ water needs per day, based on an allocation of three litres per person per day for all purposes, including cooking and hygiene. Water assistance is being primarily distributed in the south, where over 700,000 people have sought refuge in shelters.

Food security

  • As of 7 November, no bakeries were active in the north, due to the lack of fuel, water and wheat flour, as well as the damage sustained by many. During the day, many people desperately looking for food broke into the last three bakeries with remaining stocks of wheat flour and took about 38 metric tons. Currently, wheat flour is reportedly no longer available in the market throughout the north.
  • Food security partners have been unable to deliver assistance in the north during the past seven days. Reports by IDPs indicate that no food is provided in the shelters and people are merely surviving with limited assistance by local NGOs and community-based organizations, alongside reliance on negative coping mechanisms, such as eating food with limited nutritional value or unfit for human consumption.
  • Access to bread in the south is also challenging. The only operative mill in Gaza remains unable to grind wheat due to a lack of electricity and fuel. Eleven bakeries have been hit and destroyed since 7 October. Only one of the bakeries contracted by the World Food Programme (WFP), along with eight other bakeries in the south, intermittently provides bread to shelters, depending on the availability of flour and fuel. People queue for long hours in bakeries, where they are exposed to airstrikes.
  • WFP and its partners report that some essential food items such as rice, pulses, and vegetable oil are nearly depleted in the market. Other items, including wheat flour, dairy products, eggs, and mineral water, have disappeared from the shelves in shops across Gaza over the past two days. Despite limited stock at the wholesale level, these items cannot reach retailers due to extensive damage, security issues, and the lack of fuel.
  • While about 9,000 tons of wheat grain are stored in mills in Gaza, a significant portion of it cannot be used, due to massive destruction, security concerns, and shortages of fuel and electricity.
  • Food supplies entering from Egypt include mainly ready-to-eat food (canned tuna and date bars) and are primarily distributed to IDPs and host families in the south, with only flour being provided to bakeries.
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