Hostilities in the Gaza Strip and Israel | Flash update #33

Water distribution in Deir al Balah. Photo by UNRWA

KEY POINTS

• About 50,000 more people evacuated the north of Gaza to the south through a “corridor” opened by the Israeli military on 8 November. 
• Hundreds of thousands of people remaining north of Wadi Gaza, including IDPs, are facing a dire humanitarian situation and are struggling to secure the minimum amounts of water and food to survive. 
• Due to the lack of fuel to run generators, Al Quds hospital in Gaza city shut down key services on 8 November, and Al Awda hospital, the only provider of maternity services in northern Gaza, warned about an imminent closure. 
• On 7 November, UNRWA and the World Health Organization (WHO) delivered medical supplies and medicines to Shifa hospital in Gaza city.  
• On 8 November, an UNRWA school in Gaza city sheltering thousands of displaced people was hit by an airstrike, resulting in dozens of Palestinians fatalities, according to initial reports. 
• Shelters are unable to accommodate for the overwhelming number of IDPs. In UNRWA shelters, every toilet is shared by 160 people on average. 
• 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 8 November, 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. The north and the south of Gaza have reportedly been disconnected by Israeli ground troops. 
• Between 7 November (14:00) and 8 November (14:00), 241 Palestinians were killed in Gaza, according to the Ministry of Health (MoH) in Gaza. Among the deadliest incidents was an airstrike in Gaza city that reportedly killed 43 members of one extended family. On 7 November, around 15:00, airstrikes reportedly hit two residential buildings in Deir al Balah, killing 23 Palestinians and injuring dozens of others. 
• The fatality toll reported by MoH in Gaza since the start of the hostilities stands at 10,569, of whom 67 per cent are said to be children and women. 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. 
• The reported fatalities since 7 October include at least 192 medical staff, according to the MoH Gaza. Of them, at least 16 were on duty when killed, according to WHO. The fatalities further include 92 UNRWA staff, and 18 Palestinian Civil Defense personnel. 
• As of 8 November, 32 out of the 37 journalists killed since the escalation of hostilities, were Palestinians from Gaza, according to the Committee to Protect Journalists (CPJ). Additionally, they stated that this is the deadliest month for journalists globally since their records began in 1992. 
• On 8 November, three Israeli soldiers were reportedly killed in Gaza, bringing the total number of soldiers killed since the start of ground operations to 33, according to official Israeli sources. 
• See the latest snapshot for more breakdowns.
• On 8 November, the UN High Commissioner for Human Rights, Volker Türk, stated that “parties to the conflict have the obligation to take constant care to spare the civilian population and civilian objects, which remains applicable throughout the attacks. The actions of one party do not absolve the other party of its obligations under international humanitarian law. Attacks against medical facilities, medical personnel and the wounded and sick are prohibited.” 

Access and movement (Gaza Strip)

• On 8 November, the Israeli military continued calling on residents of the north to move southwards. For the fifth 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, which was then extended by one hour, as people were still moving southwards. It is estimated that about 50,000 people evacuated during the day, the largest number since the corridor opened, bringing the estimated figure since 5 November to 72,000.  
• Clashes and shelling on and around the road reportedly continued, endangering evacuees with reports of corpses alongside the road. Most evacuees are moving on foot and Israeli military reportedly forced those evacuees who use vehicles to leave them at the southern edge of Gaza city, at Al Kuwaiti roundabout. The evacuees then walk 4-5 kilometres down the corridor, with an estimated distance of up to 20 kilometres for those traveling farthest. 
• One of the evacuees told OCHA observers: “I’ve come from Gaza city. I’ve come with tens of my family members, sisters, brothers, children, aunts, and cousins. My aunt is old and in a wheelchair. We managed to find transportation to drop us at the Kuwaiti roundabout and had to walk for about two hours. I saw a lot of damage on my way, I saw Israeli tanks and soldiers positioned at the eastern side of the road, near Netzarim, and they did not approach us. I saw a few dead bodies and body parts on the road. We had already been displaced inside one of the schools [in the north] and had to evacuate again due to the intensity of the bombardments. We couldn’t stay any longer.” 
• For unconfirmed reasons, the Rafah Crossing with Egypt did not open for the movement of people on 8 November. 
• A total of 106 trucks, primarily carrying food, medicines, health supplies, bottled water and hygiene products, crossed from Egypt into Gaza on 8 November, bringing the number of trucks that have entered Gaza since 21 October to 756. 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 number of toilets differs from one shelter to another; however, on average, 160 people sheltering in UNRWA schools facilities share a single toilet and there is one shower unit for every 700 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. 
• See the live IDP dashboard for the latest figures and more breakdowns.

Electricity

• 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 8 November, Al Quds Hospital in Gaza city announced that its main generator had been shut down, and a smaller generator is being used instead to reduce fuel consumption. As a result, the surgical ward, oxygen generation plant and MRI ward, have had to shut down. The hospital will provide two hours of electricity a day for IDPs taking shelter in its facilities. The hospital has been isolated from neighbouring areas and is facing a severe shortage of food, baby formula, medicine and disposables.  
• On 8 November, areas in close proximity to the Al Quds hospital were struck, injuring patients and IDPs, and damaging buildings, according to the Palestine Red Crescent Society (PRCS). Medical teams were unable to reach the hospital or leave to retrieve injured people.  
• On 8 November, Al Awda Hospital indicated that its fuel stock will be exhausted within 30 hours. This hospital provides emergency services and specialized surgeries, and it is the only provider of maternity services in the northern Gaza Strip.  
• According to the Director of Surgery at Shifa Hospital in Gaza city, patients who have undergone surgery are at a high risk of infection due to the unhygienic conditions and lack of equipment. In some cases, wounds have been covered by white flies and their larva, risking tissue damage, bacterial infection, and septicemia. 
• On 7 November, UNRWA facilitated the delivery of the WHO’s much needed emergency medical supplies and medicines to Shifa hospital in Gaza city, north of the Gaza Strip. This is only the second delivery of lifesaving supplies to the hospital since the escalation of hostilities and the total siege of Gaza began.  
• WHO warned on 8 November of the risk of the rapid spread of infectious diseases and bacterial infections due to the water shortage and related consumption of contaminated water. Since mid-October, over 33,500 cases of diarrhea have been reported, of whom more than half were among children under five; by contrast, the monthly average of diarrhea cases in the latter group in 2021 and 2022 stood at 2,000.  

Water and sanitation (Gaza Strip)

• About half of the 120 municipal water wells across the Gaza Strip, which resumed operations on 6 November after receiving fuel from UNRWA and UNICEF, shut down on 8 November, and the rest are expected to do so on 9 November as fuel is exhausted. The water extracted from these wells is brackish and meant only for non-drinking domestic uses.  
• 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. While the situation remains largely unclear due to the hostilities and lack of access, there are serious concerns about dehydration and waterborne diseases following water consumption from unsafe sources.  
• In the south, the two desalination plants are currently operating at about 15 per cent of their capacity and supplying drinking water to IDP shelters through trucking. Two pipelines from Israel connected to the Deir al Balah and Khan Younis are also providing households connected to the network with driking water for a few hours per day.  
• UNRWA has been providing about 1.5 litres of potable water and 3-4 litres of non-potable water per person per day in all shelters in the south. In the largest shelter located in Khan Younis (over 21,700 IDPs), UNRWA in partnership with UNICEF, installed a desalination plant, which turns brackish water extracted from wells, into potable water. 
• Water entering from Egypt in bottles and jerry cans is only addressing 4 per cent of residents’ water needs per day, based on an allocation of three litres per person per day for all purposes, including cooking and hygiene; well below the minimum emergency standards. Water assistance is being primarily distributed in the south, where over 700,000 people have sought refuge in shelters. 
• Anecdotal reports indicate that people hosted or living near the sea, are reaching the beaches to bath and wash clothes in the sea, as well as carrying seawater to their homes and shelters for domestic consumption. This practice may carry various negative health ramifications. Even before the hostilities, seawater in most Gaza beaches was highly polluted, a situation that was exacerbated by the shutdown of all wastewater treatment and dumping of raw sewage to the sea.      

Food security

• As of 8 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. On 7 November, many people desperately looking for food reportedly 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 eight 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. There are indications of negative coping mechanisms due to food scarcity, including skipping or reducing meals and using unsafe and unhealthy methods for making fire. People are reportedly resorting to unconventional eating, such as combinations of raw onion and uncooked eggplant. 
• 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 front of 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.