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    <span class="visually-hidden">United Nations Office for the Coordination of Humanitarian Affairs</span>
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 4. Humanitarian Situation Update #247 | Gaza Strip [EN/AR]


HUMANITARIAN SITUATION UPDATE #247 | GAZA STRIP [EN/AR]

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KEY HIGHLIGHTS

 * Attacks on civilian infrastructure continue, particularly in North Gaza,
   where WHO reports appalling conditions at Kamal Adwan Hospital and where 61
   out of 95 attacks on school buildings since 6 October 2024 took place.
 * Humanitarian organizations are struggling to meet growing shelter needs amid
   recurrent displacement, limited entry of shelter supplies, and skyrocketing
   prices of winterization items on the local market.
 * Women are being heavily affected by the scarcity of diagnostic tests and
   essential medical treatments, often facing delayed or inadequate care.


HUMANITARIAN DEVELOPMENTS

 * Israeli bombardment from the air, land and sea continues to be reported
   across the Gaza Strip, resulting in further civilian casualties,
   displacement, and destruction of civilian infrastructure. In the North Gaza
   governorate, the Israeli military has been carrying out a ground offensive
   since 6 October 2024, with fighting reported between Israeli forces and
   Palestinian armed groups. Israeli forces have continued to impose a tightened
   siege on Beit Lahiya, Beit Hanoun and parts of Jabalya and humanitarian
   assistance has been largely denied for more than 10 weeks (see data below).
   Rocket firing by Palestinian armed groups towards Israel was reported.
 * Between the afternoons of 10 and 17 December, according to the Ministry of
   Health (MoH) in Gaza, 273 Palestinians were killed and 853 were injured.
   Between 7 October 2023 and 17 December 2024, at least 45,059 Palestinians
   were killed and 107,041 were injured, according to MoH in Gaza.
 * Between the afternoons of 10 and 17 December, two Israeli soldiers were
   killed in Gaza, according to the Israeli military. Between 7 October 2023 and
   17 December 2024, according to the Israeli military and official Israeli
   sources cited in the media, more than 1,586 Israelis and foreign nationals
   were killed, the majority on 7 October 2023 and its immediate aftermath. The
   figure includes 386 soldiers killed in Gaza or along the border in Israel
   since the beginning of the ground operation. In addition, 2,488 Israeli
   soldiers were reported injured since the beginning of the ground operation.
   As of 17 December, it is estimated that 100 Israelis and foreign nationals
   remain captive in Gaza, including hostages who have been declared dead and
   whose bodies are withheld in Gaza.
 * Attacks on schools sheltering internally displaced people (IDPs) in Gaza
   continue to be reported, with nine such incidents documented so far in
   December 2024 by the UN Human Rights Office (OHCHR). According to the
   Education Cluster, between 6 October and 15 December 2024, 95 incidents
   involving attacks on school buildings, mostly serving as IDP shelters, were
   documented, including 61 incidents in North Gaza governorate. On 14 and 15
   December alone, four schools were hit, as follows:
   * On 14 December, two schools-turned shelters were reportedly hit in Gaza
     city, resulting in the killing of seven Palestinians, including three
     children, and the injury of tens of others, according to Palestinian Civil
     Defense (PCD).
   * On 15 December, Israeli troops reportedly surrounded and raided Khalil
     Owaidah School sheltering IDPs in 'Izbat Beit Hanun, in North Gaza, where
     it was reported that male IDPs were detained while women and children were
     forced to move southwards. Tens of people were reported killed, but the
     exact circumstances remain unclear. Citing IDP testimonies, PCD reported
     that fatalities included 10-15 people who were incinerated, and the school
     was destroyed.
   * On 15 December, the third floor of an UNRWA school sheltering IDPs in Al
     Mawasi, in Khan Younis, was hit. Within minutes, the emergency department
     of the nearby Nasser Medical Complex was flooded with casualties, most of
     them women and children. Many were severely injured and died on site or en
     route to the hospital, reported international doctors from Medical Aid for
     Palestinians (MAP) operating in the facility as part of a joint Emergency
     Medical Team (EMT) with the International Rescue Committee. An internal
     medicine and emergency care consultant counted at least 18 people dying in
     the emergency department, including 12 children under the age of 12. The
     first patient arrived in the facility was “a three-year-old girl who had
     the left side of her forehead torn open by shrapnel fragments which had
     penetrated her skull,” and who, due to shortages of painkillers and
     anaesthetics, had to be treated “with very little access to medications,”
     added the consultant. A plastic surgeon also noted that his first patient
     was a 12 to 14-year-old boy whose face was entirely burnt, and who had open
     wounds on his chest and on both of his legs.
 * Other deadly incidents reported between 10 and 15 December include:
   * On 10 December, at about 23:00, 22 Palestinians were reportedly killed and
     others injured when a three-story building was hit near Kamal Adwan
     Hospital in Beit Lahiya in North Gaza.
   * On 12 December, at about 00:30, seven Palestinians including children and
     women were reportedly killed and others injured when two apartments in a
     residential tower were hit in northwestern Gaza city.
   * On 12 December, on two occasions at about 00:01 and 00:55, 22 Palestinians
     were reportedly killed and others injured when people were hit in Khan
     Younis and Rafah. According to the Government Media Office (GMO),
     fatalities included 15 people tasked with securing the movement of aid
     trucks, raising the number of people killed while securing aid trucks to
     720 so far.
   * On 12 December, at about 02:00, 15 Palestinians including at least one
     woman and seven children were reportedly killed, and several others
     injured, when a house sheltering IDPs was hit in western An Nuseirat
     refugee camp in northern Deir al Balah.
   * On 12 December, at about 20:30, at least 34 Palestinians were reportedly
     killed and 40 others injured, when two residential buildings were hit in
     central An Nuseirat refugee camp, in Deir al Balah, according to PCD.
     According to the UN Children’s Fund (UNICEF), at least eight children were
     among the fatalities (see below). Extensive damage of the residential block
     was also reported.
   * On 14 December, at about 13:45, 12 Palestinians, including at least two
     girls, one woman and the mayor, were reportedly killed and others injured
     when Deir al Balah Municipality in central Deir al Balah was hit.
   * On 15 December, at about 21:05, at least ten Palestinians were reportedly
     killed and others injured when a house was hit in Ash Shuja’iyeh
     neighbourhood in eastern Gaza city.
   * On 15 December, six people were reportedly killed and others injured when a
     PCD centre was hit in An Nuseirat refugee camp, in northern Deir al Balah.
     Fatalities reportedly included a cameraperson and four PCD staff and
     volunteers. The cameraman is among four journalists reported killed in Gaza
     between 11 and 15 December, according to the Committee to Protect
     Journalists (CPJ). As of 17 December, the Palestinian Journalists Syndicate
     reported that 188 journalists and media workers have been killed in Gaza.
 * Between 11 and 17 December, the Director of Kamal Adwan Hospital in North
   Gaza reported near daily attacks on or very close to the facility, which
   currently hospitalizes 60 injured people, with debris and explosions
   shattering doors and windows, causing further damage to water tanks, the
   electricity generators and the oxygen supply network, and igniting a fire on
   the hospital’s third floor on one occasion. Due to ongoing insecurity and the
   lack of ambulances and equipment, medical staff have generally been unable to
   assist people trapped under the rubble in the surrounding areas or have
   themselves been hit. On 12 December, MoH announced that Dr. Saeed Judeh, the
   last orthopaedic doctor in North Gaza, was killed while en route from Kamal
   Adwan to the nearby Al Awda Hospital to treat patients. On the same day,
   according to the World Health Organization (WHO), a nurse was killed while
   travelling to Kamal Adwan. On 14 December, following four denied attempts by
   WHO to urgently deliver life-saving supplies to the hospital, the
   Organization and its partners reached Kamal Adwan, describing conditions in
   the health facility as “appalling”. The team delivered 5,000 litres of fuel,
   food and medicines, and transferred three critical patients and six
   companions to Al-Shifa Hospital in Gaza city. However, WHO’s request to
   re-deploy the Indonesian Emergency Medical Team (EMT) to the hospital
   continued to be denied, despite the need for immediate surgical interventions
   for injured patients. On 16 December, the facility’s Director informed that
   the intensive care department was targeted by snipers, with all windows hit,
   forcing medical staff to treat some of the injured in the corridors. As of 4
   December 2024, WHO had recorded 591 health attacks across the Gaza Strip,
   including 23 since 20 November.
 * On 11 December, the Humanitarian Coordinator (HC) for the Occupied
   Palestinian Territory, Muhannad Hadi, concluded a two-day visit to the Gaza
   Strip, where he met with displaced people and youth groups and witnessed
   first-hand the decimation of Gaza’s health sector. On 10 December, the HC
   visited a medical point operated by a network of local NGOs in An Nuseirat
   refugee camp, in Deir al Balah. Due to security concerns, the facility was
   temporarily evacuated five times, three of them in November 2024. It handles
   an average of 3,000 consultations per month, a quarter of which relate to
   infectious diseases. Urinary tract infections are prevalent among pregnant
   women due to the lack of clean water, amid shortages of microbiology tests to
   identify the types of bacteria. Other diagnostic procedures for women are
   completely unavailable, resulting in late diagnoses of cancer and invasive
   procedures as hysterectomies having to be performed instead of being able to
   treat conditions like uterine bleeding. The facility also suffers from severe
   shortages of medical supplies, including analgesics and Infection Prevention
   and Control (IPC) material, and medications are sufficient for only five per
   cent of the 80-100 patients visiting the medical point daily. The HC also
   visited the Nasser Medical Complex in Khan Younis, which had 655 admitted
   patients, with paediatric bed occupancy being at 250 per cent. All heart
   surgeries have been halted due to the lack of supplies for cardiac
   catheterization, and only other life-saving activities are being performed,
   while chemotherapy and other procedures have stopped. On 11 December, the HC
   visited the Al Aqsa Hospital in Deir al Balah, where he heard from hospital
   staff and management – as well as patients – about the struggles the heath
   system is facing. Speaking to journalists from Al Aqsa, the HC paid tribute
   to the medical teams who continue their work amid catastrophic conditions.
 * More than 160 children, or an average of four children every day, have
   reportedly been killed in Gaza since the beginning of November 2024, stressed
   UNICEF’s Executive Director, Catherine RusselI, in a statement condemning the
   latest attack on An Nuseirat camp on 12 December (see above). Reiterating
   that there is no safe space in Gaza and that children lack everything, from
   food to safe water, medical supplies and warm clothes, the UN official added:
   “The world cannot look away when so many children are exposed to daily
   bloodshed, hunger, disease, and cold.” A recently released study based on
   data collected in June 2024 by the Community Training Centre for Crisis
   Management in Gaza, with support from the Dutch Relief Alliance and the War
   Child Alliance, reveals that 96 per cent of children in the surveyed
   households, where at least one child is injured, disabled, unaccompanied or
   separated from parents, felt that their death was imminent while 49 per cent
   expressed a desire to die. The study also found that 92 per cent of children
   were not accepting reality, 83 per cent experienced severe fear and 73 per
   cent exhibited aggressive behaviour, with many more showing signs of
   withdrawal and anxiety, alongside a pervasive sense of hopelessness.
 * Between 11 and 14 December, four evacuation orders were announced by the
   Israeli military, affecting at least 69,000 people in parts of Gaza city,
   North Gaza, Deir Al Balah and Khan Younis for which several evacuation orders
   had already been issued. The first order covered approximately 3.2 square
   kilometres in Deir al Balah and affected an estimated 10,000 people,
   including about 5,200 people residing across nine displacement sites. The
   second order covered about 1.8 square kilometres in Gaza city, affected at
   least 20,000 people, including IDPs in one UNRWA shelter, and resulted in the
   temporary closure of one UN-supported bakery and the suspension of water,
   sanitation and nutrition services. The area affected by this order includes
   the Patients Friends Association Hospital and three other health facilities.
   The first two orders triggered limited displacement according to reports by
   humanitarian partners. The third evacuation order covered about 5.5 square
   kilometres in both Gaza city and parts of North Gaza, including ten IDP
   sites, two health facilities, two distribution centres and 24 water trucking
   points, and affected an estimated 35,000 people. The displacement of about
   250 families (~1,250 people) from this area southward, particularly toward As
   Sabra neighbourhood in Gaza city, was reported. The last evacuation order
   covered about 4.3 square kilometres in Deir al Balah and Khan Younis,
   affecting approximately 4,000 people, and resulting in the reported
   displacement of 450 families (~2,250 people). Since October 2023, about 80.5
   per cent of the Gaza Strip’s territory has been placed under evacuation
   orders that remain active, excluding orders that were subsequently rescinded.
 * On 8 December, OCHA conducted an assessment in East Khan Younis, visiting two
   of the neighbourhoods with the highest number of households - Ma’an, which
   hosts approximately 6,700 families (36,000 people), and parts of Bani Suhaila
   east of the Salah Al Din Road, where 9,200 families (45,000 people) are
   presently sheltering. The aim was to identify key needs in these communities
   after the multiple evacuation orders issued by the Israeli forces in East
   Khan Younis between May and October 2024 were revoked in parts of the area on
   11 November, prompting the return of many families and the arrival of new
   IDPs from Rafah. The key findings are as follows:
   * In both locations, people are residing in or near severely damaged or
     completely destroyed homes, with many having erected makeshift shelters on
     the ruins, which are precarious and at risk of collapse as the winter and
     rainy season begins.
   * Access to domestic and drinking water is particularly scarce in Ma’an, with
     the community relying on low-pressure branches from the Mekorot supply
     line, which provide insufficient water to meet needs. Moreover, only a few
     private filling points, with small tanks of two to five cubic metres, are
     available.
   * Sanitation and hygiene conditions are critical, with many in Ma’an relying
     on pit latrines. In Bani Suhaila, the sewage system has been destroyed,
     with sewage pools observed on the streets and the community highlighting
     the pressing need for rodent control.
   * Due to the widespread destruction of infrastructure, people from both
     communities must travel two and a half kilometres to reach the closest
     market in Khan Younis city, and four kilometres to visit the nearest
     partially functional hospital, the Nasser Medical Complex, with access
     being challenging. Although medical points are available within closer
     reach, they only offer consultations and do not provide any medications.
   * The lack of food assistance is one of the most critical concerns. In Ma’an,
     the community reported that no food aid distribution has occurred since
     they returned, nor have any malnutrition screenings been conducted or
     nutrition supplements provided. In Bani Suhaila, only a charity community
     kitchen provides hot meals twice a week, but quantities are scarce, and
     some individuals go entire days without eating.
   * Information access is a key obstacle in Bani Suhaila, with internet
     coverage being scant and the radio being the primary means of information.
     The community reported not being aware of the eligibility criteria and
     registration system for flour distribution by the UN World Food Programme
     (WFP).
   * In both communities, there is a pressing need for winterization assistance
     to protect makeshift shelters and tents from the harsh winter conditions,
     with women in Bani Suhaila also stressing the urgency to support children,
     prioritizing the provision of clothes, diapers, and baby milk.
 * Humanitarian organizations are struggling to meet growing shelter needs due
   to the recurrent displacement of Palestinians within Gaza, which itself is
   triggered by new evacuation orders issued by the Israeli military, flooding
   that has already caused shelter damage, and bombardment affecting collective
   displacement sites. Moreover, according to the Shelter Cluster, the limited
   entry of shelter materials into the Gaza Strip has meant that only 285,000
   people could be assisted between September and late November 2024 while at
   least 945,000 others now require urgent winterization support to protect them
   from the rain and cold weather. Waiting outside Gaza are 58,000 sealing-off
   kits and over 36,000 tarpaulins that have already been procured to cover the
   needs of about 400,000 people, but these would need two months to be brought
   in at the current rate of 10 shelter trucks entering Gaza per week.
   Meanwhile, partners from the Site Management Working Group (SMWG) continue to
   support committees at 75 displacement sites with financial, technical and
   in-kind support for maintenance and repairs, but such assistance remains
   limited due to the prohibitively high prices of common winterization items,
   such as shovels, plastic ropes and cement bags, on the local market. There is
   also a lack of blankets and warm clothes, disproportionately affecting
   children in makeshift tents, many of which had been provided by aid agencies
   over the past year but have become unusable due to wear and tear. The lack of
   adequate shelter is compounding the already massive health needs, highlights
   WHO. While infectious diseases already spiked during the last winter season,
   as malnutrition rates continue to climb, such diseases are expected to have
   more severe consequences this winter, particularly for children. Between
   January and 17 November 2024, WHO recorded 1,210,306 cases of acute
   respiratory infections, 574,813 cases of acute watery diarrhoea and 114,367
   cases of acute jaundice syndrome.
 * Extreme insecurity in Gaza continues to negatively impact aid operations. On
   11 December, a 70-truck convoy entering through the Kerem Shalom crossing was
   violently attacked by looters, leading to the loss of nearly all food and aid
   supplies. On the same day, a WFP convoy leaving the Kissufim crossing also
   came under fire, with four out of five trucks violently looted. “Attacks
   undermining humanitarian operations are unacceptable. They threaten the
   survival of those in desperate need of assistance,” noted the HC on 13
   December. Emphasizing that “attacks on humanitarian operations can be
   avoided,” the HC reported that earlier in the week, “through an Israeli
   agreement for us to use the Philadelphi corridor, a joint UN convoy delivered
   urgently needed food, reaching nearly 200,000 people in southern and central
   Gaza.” In a statement on this important delivery, UNRWA highlighted that it
   “showcased how coordinated efforts can overcome logistical and operational
   barriers,” and added that the “the solidarity of the community was
   instrumental to the success of this mission, as members provided a more
   secure passage that allowed aid to reach families facing critical food
   shortages.”
 * Between 1 and 16 December, out of 339 planned aid movements across the Gaza
   Strip requiring coordination with Israeli authorities, 30 per cent (102) were
   facilitated, 42 per cent (141) were denied, 18 per cent (62) were impeded,
   and ten per cent (34) were cancelled due to logistical and security
   challenges. These included 96 aid movements that needed to pass through the
   Israeli military-controlled checkpoints on Al Rashid or Salah Ad Din roads to
   reach areas north of Wadi Gaza (including both North Gaza and Gaza
   governorates), of which only 17 per cent (16) were facilitated by the Israeli
   authorities, 43 per cent (41) were denied, 26 per cent (25) were impeded, and
   15 per cent (14) were cancelled. Aid missions to the North Gaza governorate
   were particularly disrupted, especially those seeking to reach Jabalya, Beit
   Lahiya and Beit Hanoun. Between 1 and 16 December, the UN attempted to reach
   these besieged areas 40 times, of which 38 attempts were denied and two were
   impeded. The first impeded mission took place on 1 December, deploying an EMT
   to the Kamal Adwan Hospital and evacuating patients following long delays.
   The second impeded mission took place on 11 December, when a UN team led by
   the Deputy Humanitarian Coordinator visited the Kamal Adwan and Indonesian
   hospitals but was not facilitated to reach areas in Jabaliya and Beit Lahiya
   where communities remain. Coordinated aid missions to areas in Rafah
   governorate, where there has been an ongoing Israeli military operation since
   early May, have faced similar challenges. All 20 coordinated requests
   submitted to the Israeli authorities to access Rafah governorate between 1
   and 16 December were outright denied. This excludes 47 coordinated movements
   to Kerem Shalom crossing, of which 70 per cent (33) were facilitated, 19 per
   cent (nine) were impeded, four per cent (two) were denied, and six per cent
   (three) were cancelled.
 * On 13 December, UNOSAT published an updated preliminary analysis of
   structural damage and destruction in the Gaza Strip, based on satellite
   imagery collected on 1 December 2024. The assessment shows that 170,812
   structures, or 69 per cent of the total throughout the Strip, have either
   been damaged or destroyed, up from 66 per cent identified in the 6 September
   analysis. The governorates of North Gaza and Rafah have experienced the
   highest rise in damage, with 3,138 new structures damaged in North Gaza and
   3,054 in Rafah. Within North Gaza, Jabalya municipality had the highest
   number of newly damaged structures (1,339 structures) and the fourth largest
   number of damaged structures (14,470) among all municipalities, following
   Gaza, Rafah and Khan Younis cities.
 * According to a new assessment by the Education Cluster, which relies on
   satellite imagery collected on 1 December 2024, nearly 88 per cent of school
   buildings in the Gaza Strip (496 out of 564) have been directly hit or
   damaged and are currently estimated to require either full reconstruction or
   major rehabilitation work to be functional again. Fifty-five per cent of
   these schools (275) are government schools, a third (161) are UNRWA schools,
   and 12 per cent (57) are private schools. The increase is mainly attributed
   to an increase in the number of directly hit schools, particularly in North
   Gaza governorate where 11 out of 18 schools newly classified as “directly
   hit” over the past three months are located. Moreover, according to the
   assessment, most directly hit schools are in areas that were subject to
   evacuation orders by the Israeli military. Prior to the war, “direct hit” or
   “damaged” schools served about 542,959 students and had more than 20,320
   teachers, which represented, respectively, about 88 and 87 per cent of the
   total student population and teaching staff in the Gaza Strip. In addition,
   41 schools are now assessed as “likely damaged,” where at least one damaged
   site has been identified within 30 to 70 meters of school buildings,
   indicating the possibility that these school structures may have sustained
   moderate damage.
 * Given the ubiquitous threat of unexploded ordnance hidden under the rubble,
   the Mine Action Area of Responsibility (AoR) under the Protection Cluster
   continues to raise awareness about the risks posed by explosive remnants of
   war. The Mine Advisory Group (MAG), jointly with Save Youth Future Society,
   has deployed 20 risk education teams across Gaza: five in Gaza city, eight in
   Deir al Balah and seven in Khan Younis. The teams deliver risk education
   sessions and emergency briefings in communities and on the streets, including
   interactive sessions tailored for children whose “natural curiosity puts them
   at higher risk of injury, as explosive items can often appear to be a
   tempting toy,” explains MAG. Furthermore, Mine Action AoR partners continue
   to conduct explosive hazard assessments at humanitarian sites, including
   schools and camps sheltering IDPs, health centres and UN facilities, with 36
   such assessments conducted by the UN Mine Action Service (UNMAS) in November
   and 283 conducted in total since October 2023. In support of debris
   management efforts, assessments also target sites with extensive debris
   contamination, coupled with risk education sessions for construction workers,
   to ensure that future clearance efforts can be safely carried out.


FUNDING

 * On 11 December 2024, the UN and humanitarian partners launched a Flash Appeal
   for nearly US$4.07 billion to address the humanitarian needs of three million
   out of 3.3 million people identified as requiring assistance in Gaza and the
   West Bank, including East Jerusalem, in 2025. Nearly 90 per cent of those
   funds are for the humanitarian response in Gaza, with just over 10 per cent
   for the West Bank. The $4.07 billion ask is much less than what is actually
   needed to mount a full-scale humanitarian response, which would require $6.6
   billion. However, the Flash Appeal reflects the expectation that aid
   organizations will continue to face unacceptable constraints on their
   operations in 2025. This will severely limit the amount of assistance that
   humanitarians are able to provide, which in turn will only increase the
   suffering that Palestinians are enduring. The appeal stresses that, to be
   able to implement the full scale of what is urgently needed, Israel must take
   immediate and effective measures to ensure the essential needs of civilians
   are met. This includes lifting all impediments to aid and fully facilitating
   humanitarian operations, including the distribution of essential goods to
   Palestinians in need.
 * As of 17 December, Member States have disbursed about $2.52 billion out of
   the $3.42 billion (73 per cent) requested to meet the most critical needs of
   2.3 million* people in Gaza and 800,000 people in the West Bank, including
   East Jerusalem, between January and December 2024. For funding analysis,
   please see the Flash Appeal Financial Tracking dashboard. (*2.3 million
   reflects the projected population of the Gaza Strip upon issuance of the
   Flash Appeal in April 2024. As of July 2024, the UN estimates that about 2.1
   million people remain in the Gaza Strip, and this updated number is now used
   for programmatic purposes.)
 * During November, the oPt Humanitarian Fund (oPt HF) managed 124 ongoing
   projects, totalling $91.7 million. These projects aimed to address urgent
   needs in the Gaza Strip (89 per cent) and the West Bank (11 per cent) and are
   strategically focused on education, food security, health, protection,
   emergency shelter and non-food items, water, sanitation and hygiene (WASH),
   coordination and support services, multi-purpose cash assistance and
   nutrition. Of these projects, 70 are being implemented by international
   non-governmental organizations (INGOs), 40 by national NGOs and 14 by UN
   agencies. Notably, 50 out of the 84 projects conducted by INGOs or the UN are
   being implemented in collaboration with national NGOs. Monthly updates,
   annual reports, and a list of all funded projects per year, are available on
   the oPt Humanitarian Fund webpage, under the financing section.

17 December 2024


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