Gaza Humanitarian Response Update | 2-15 September 2024 – occupied Palestinian territory

Period: 2-15 September 2024

The information below is provided every other week by Clusters and select technical working groups operating in the Occupied Palestinian Territory (OPT). For an overview of priority needs and activities by cluster, please see the Flash Appeal.

Health

Response

• During the reporting period, 52 Health Cluster partners were active in Gaza, with 31 reporting on their response activities. As of 15 September, there were 15 emergency medical teams (EMTs) supporting the local health-care workforce, including three in northern Gaza.
• The first round of the emergency polio vaccination campaign successfully took place between 1 and 12 September, with 559,161 children under the age of 10 immunized and 40 health partners involved in the joint vaccination effort.
• On 11 September, the World Health Organization (WHO), with partners and the UAE Ministry of Foreign Affairs, evacuated 97 critically injured and sick patients, along with 155 caretakers, from Gaza to receive specialized treatment in the UAE. The patients comprised 45 children and 52 adults with trauma injuries, cancer, cardiovascular, blood and liver diseases, and a variety of other pathologies.
• During the reporting period, Health Cluster partners conducted three missions to hospitals in northern Gaza to rotate EMTs, conduct assessments, and deliver medical supplies along with 67,000 litres of fuel. One of these missions, on 10 September, was to assess the newly rehabilitated Emergency Department at Al Shifa Hospital.
• So far in 2024, 37 EMTs – deployed in hospitals throughout the Strip – have provided over 1.4 million medical consultations, performed 29,230 surgeries and treated 56,500 patients with noncommunicable diseases. Six field hospitals have been established by health partners and 500 additional beds provided to compensate for the dramatic reduction in hospital bed capacity.

Challenges

• Health partners continue to face major security challenges in accessing medical facilities in northern Gaza.
• Due to obstacles hindering the entry of humanitarian aid, the backlog of health supplies and equipment waiting to enter Gaza continues to grow, while health facilities within the Strip are facing increasingly severe supply shortages. Public health-care facilities in southern Gaza are reporting an over 70 per cent shortage of critical medical items, including consumables, complete blood count (CBC) kits and laboratory equipment.
• The lack of a systematic mechanism for the medical evacuation of critically ill and injured patients out of Gaza results in an ever-growing waiting list, as the clinical conditions of many deteriorates. As of 12 September, out of 14,510 patients for whom medical evacuation has been requested since October 2023, 5,130 (35 per cent) have been evacuated abroad, with only 219 patients allowed to leave Gaza by Israeli authorities since the closure of the Rafah Crossing in May 2024.

Nutrition

Response

• During the reporting period, 38,214 children under the age of five and 15,603 pregnant and breastfeeding women (PBW) received a 30-day allocation of lipid-based nutrient supplements (LNS-MQ) under the Supplementary Feeding Programme, led by the World Food Programme (WFP). This represents a nearly 46 per cent increase compared with the 20,788 children and 9,757 PWB provided with LNS-MQ between 17 and 31 August.
• In the first two weeks of September, almost 30,000 caregivers in Gaza received counselling for breastfeeding and for adapted complementary feeding of children aged six months and older by nutrition partners. As part of its efforts to enhance infant and young child feeding practices, the Nutrition Cluster is currently working with the Sexual and Reproductive Health Technical Working Group (SRHTWG) to scale up early initiation of breastfeeding and support for breastfeeding mothers.
• Since mid-January, 290,961 children aged 6-59 months have been screened for malnutrition, including 54,153 in the northern governorates. A total of 11,131 children were screened in the first two weeks of September. Of all screened children, 19,352 have been diagnosed with acute malnutrition, including 15,175 with moderate acute malnutrition (MAM) and 4,177 with severe acute malnutrition (SAM); of those with SAM, 145 had medical complications. Treatment was provided in four stabilization centres and 102 outpatient programme sites to those identified as malnourished.

Challenges

• Transport and adequate storage of nutrition supplies is challenging because of the limited entry of humanitarian supplies and the loss of access to warehouses due to ongoing hostilities, evacuation orders, access, and logistical constraints. This is particularly challenging where infrastructure and resources are limited and for products such as ready-to-use infant formula, requiring refrigeration.
• Continuous displacement is disrupting distribution, service delivery, and case monitoring, especially among children, and access to nutrition sites. Coordinating nutrition support for newly displaced people arriving at shelters is increasingly complex.

Food Security

Response

• As of 16 September, 14 bakeries supported by humanitarian partners were operational in the Gaza Strip – one in Khan Younis, seven in Deir al Balah, four in Gaza city and two in Jabalya. Five bakeries in northern Gaza were forced to temporarily close on 14 September and resumed partial functionality on 15 September after receiving a limited amount of fuel to sustain operations for two days. Partners are working to deliver more fuel as soon as possible. Meanwhile, five bakeries in Rafah remain closed due to ongoing hostilities.
• Bread from the 14 bakeries continues to be delivered to kitchens for free distribution along with cooked meals. However, the distribution of free bread cannot currently be scaled up to meet the high demands.
• As of early September, more than 500,000 cooked meals prepared in 155 kitchens were provided daily to families across the Strip, compared with about 450,000 daily meals provided in 130 kitchens in late August. Some kitchens forced to close or relocate in July and August have now resumed operations in their original locations.
• In September, due to continuous supply shortages, partners are providing only one food parcel per family per month in central and southern Gaza, compared with two parcels per family in the north.
• In support of the polio vaccination campaign, partners provided cooked meals and bottled water to hundreds of campaign workers across the Strip. In addition, some food distribution points were also used as vaccination sites to maximize coverage.
• In addition to the distribution of more than 80 metric tons (MT) of gluten-free flour in northern Gaza in late August, during the first half of September, in collaboration with the private sector, partners brought two metric tons of gluten-free flour to southern and central Gaza through the Kerem Shalom Crossing. The distribution is set to take place with Health Cluster partners to people with celiac disease.

Challenges

• Insecurity, damaged roads, the breakdown of law and order, and access limitations have resulted in critical shortages of aid commodities to sustain operations, increasing the risk of spoilage and infestation of stranded food supplies. As a result, partners lack sufficient food stocks to meet requirements and have scaled down distribution, for the second consecutive month.
• According to a recent food security and market analysis by the World food Programme, poor dietary diversity continues to be observed in the Strip with humanitarian assistance remaining the main source of food for households.
• The significant increase in firewood prices is pushing more people into energy poverty, coupled with the limited availability of gas and the ongoing electricity cut off. It is anticipated that the energy crisis will further worsen in upcoming months as the rainy winter season approaches. Protracted shortages of cooking energy continue to force displaced families to cook by burning wood from waste, which hinders proper food preparation and nutrition intake, exacerbates health and protection risks, and causes environmental hazards.
• The extremely limited entry of fresh supplies into northern Gaza for four consecutive months has resulted in a near total absence of protein sources, such as meat and poultry, with only a few types of unaffordable vegetables available, either locally produced or from distributed aid being sold in the market.
• The extremely limited entry of fertilizers and other livestock and crop production inputs is a key obstacle hampering the restoration of local food production in Gaza. A dual-track approach is required to food assistance and emergency livelihood interventions. Agricultural activities, including small-scale gardening that is critical to enhance dietary diversity, remain largely suspended.
• If physical road access, health-care provision, as well as energy, water, sanitation, hygiene, and shelter conditions are further compromised, there is a high risk that the food insecurity and malnutrition situation will worsen beyond the already alarming rates observed.
• More than half of the people in the Gaza Strip are facing difficulties in accessing markets, with the current state of the formal banking system’ exacerbating the issue, according to the recent market monitoring findings by the World Food Programme. There are barely any functional ATMs in the Gaza Strip, compared with 91 before October 2023. Limited cash liquidity and insufficient access to financial services and telecommunications continue to hamper partners’ day-to-day operations and prevents the scale up of CVA.

Logistics

Response

• Since October 2023, and as of 7 September, the Logistics Cluster received from humanitarian partners 39,077 cubic metres of relief items for storage inside Gaza. During the reporting period, the common storage capacity in the Strip was increased by 345 square metres with the opening of the Humanity and Inclusion/Atlas Logistique warehouse in Az Zawida, as part of the common logistics services facilitated by the Logistics Cluster.
• Since December 2023, the Logistics Cluster has consolidated 18,222 cubic metres of humanitarian cargo at its common warehouse in Amman. The Cluster has also equipped the facility with a 40-foot reefer container to accommodate cold chain cargo.
• Since November 2023, and by 7 September, the Cluster facilitated 93 humanitarian convoys into Gaza through the Jordan corridor on behalf of 23 humanitarian partners. The convoys comprised 30,833 metric tonnes of aid (2,185 truckloads).
• As of 2 September, the forecast for the next three months stood at 239,413 metric tons of humanitarian aid, of which 117,743 metric tons through the Egypt corridor, 24,371 metric tons through the Jordan corridor, 62,529 metric tons from the Ashdod port, in Israel, and a 33,618 metric tons cargo which is yet to be allocated to a specific corridor.

Challenges

• Severe access and security constraints, compounded by frequent evacuation orders, continue to hamper Logistics Cluster operations at the entry points and throughout the Gaza Strip.
• Following a security incident on 8 September at the Allenby Bridge, all three land crossing points between Jordan and Israel were temporarily closed for a few days by Israeli authorities, further delaying the transport of aid.

Water, Sanitation and Hygiene (WASH)

Response

• Between 2 and 15 September, the Palestinian Water Authority (PWA) and Coastal Municipalities Water Utility (CMWU) reported that the average water supply for safe drinking and domestic purposes was about 116,000 cubic metres per day across the Gaza Strip, or just over a quarter of water supply provided prior to October 2023. This includes 78,600 cubic metres of water produced by municipal and UNRWA water wells.
• Between 1 and 14 September, WASH Cluster partners received a total of 302,533 litres of fuel, or an average of 21,600 litres per day, which represents only 31 per cent of the minimum daily threshold of 70,000 litres required to meet critical WASH needs and ensure the public health. This includes 218,533 litres south of Wadi Gaza and 84,000 in the north.
• Ahead of the rainy season, WASH Cluster partners are rehabilitating wastewater pumping stations in Deir al Balah, removing solid waste and cleaning stormwater channels in Nuseirat, rehabilitating drainage systems, procuring dewatering pumps, identifying flood-prone areas, and developing community engagement messages to raise flood risk awareness.
• The WASH Cluster is conducting water quality testing across the Gaza Strip, with a focus on health-care facilities, water trucks, designated shelters, areas experiencing an upsurge in cases of acute watery or bloody diarrhoea.
• The WASH Cluster produced a guide for partners on the mapping of stormwater basins and flood-prone areas. This is complemented by the WASH winterization response and preparedness plan, which includes proactive measures to mitigate flood risks.

Challenges

• There is an urgent need for generators, submersible pumps, and other critical supplies for water wells and pumping stations. Due to the lack of availability in the local market, these materials must necessarily be sourced from external suppliers.
• The lack of access to soap and other basic hygiene items is severely hindering families’ ability to protect themselves from communicable diseases, especially in overcrowded shelters, and disproportionately affects children, pregnant women, and those with compromised immune systems. Key products like shampoo, detergent, and dishwashing liquid are no longer available; making it impossible for households to maintain cleanliness, prepare food safely, or wash clothes. Health-care facilities are struggling to maintain proper sanitation, increasing the risk of infections for patients and staff.
• A rising number of coordination requests for missions within the Al Mawasi area, where the Israeli authorities ordered Palestinians to take shelter in, are not being facilitated by Israeli authorities. This affects the rehabilitation of WASH infrastructure and the implementation of other WASH interventions. Requests for transporting critical supplies from south of Wadi Gaza to the north are facing similar challenges.
• The flow of water from the main transmission line running from Israel remains at only 80 per cent of capacity, with several critical water facilities lost in recent weeks. Repair operations are urgently required to return to full capacity as soon as possible.

Shelter and Non-Food Items (NFI)

Response

• The Shelter Cluster continues to track the needs of internally displaced persons (IDPs) whose shelters have been damaged by hostilities or flooded in the Deir al Balah and Khan Younis governorates. Where possible, the cluster provides shelter support, including tents, sealing-off kits, and non-food items.
• Between 2 and 15 September, Shelter Cluster partners provided 451 family tents and 219 sealing-off-kits to households in need in southern Gaza, as well as 175 tents and a limited number of sealing-off kits in northern Gaza.

Challenges

• With the rainy season approaching, Shelter Cluster partners are unable to import enough materials to provide sufficient protection from wind, rain, or flooding. With logistical constraints and depleted stocks, few partners have any items to support households with emergency shelter and other essential items.
• Due to the access constraints that allow a rate of about four trucks of Shelter and NFIs entering Gaza per week in August, the Cluster is prioritizing the entry of sealing-off kits over tents into Gaza, as more of these can be transported on a single truck. However, this is the bare minimum and cannot be considered a meaningful response.
• The Israeli authorities are restricting the movement of Shelter Cluster partners between northern and southern Gaza, thereby limiting response agility. This, alongside recurrent displacement, also hinders the ability to assess the shelter needs.

Site Management Working Group (SMWG)

Response

• During the reporting period, SMWG partners monitored 52 sites hosting an estimated total of 165,000 people in the Khan Younis, Deir al Balah, and the northern governorates. They shared the findings with other clusters on 5 and 12 September, to direct their response where gaps had been identified.
• On 12 September, the SMWG finalized a preliminary analysis aimed at mapping sites which may face flooding during the approaching winter season. A total of 38 makeshift and 13 scattered sites are deemed likely to experience flooding with varying degrees of intensity. The group is set to develop a rapid assessment tool and expand the preliminary analysis to sites on the coast.
• On 15 September, the SMWG briefed the Flood Task Force in Gaza on its analysis of areas that had been subject to flooding between 2020 and 2024.

Challenges

• SMWG partners lack the human resources required to carry out field verifications at numerous IDP sites.
• Mass evacuation orders issued by the Israeli military and the rapid pace of developments, generating constant population movement, hinder the implementation of an effective site management response.

Protection

Response

• Service providers continue supporting people facing or at risk of Gender-Based Violence (GBV), including by providing Cash and Voucher Assistance (CVA) to at-risk women and girls. In August, 1,855 women benefited from such services; figures for the reporting period are not yet available.
• Meanwhile, child protection partners provided psycho-social support (PSS) to 189,916 children and 97,149 caregivers, and explosive ordnance risk education (EORE) to 60,227 people. More information on child protection activities can be found here.
• Partners are carrying out critical mental health activities for children with a small quantity of PSS materials that have entered Gaza following months of denial by Israeli authorities.
• The International Rescue Committee (IRC) delivered a five-day training to 15 child protection and GBV case managers. Participants acquired skills to further train their respective colleagues on how to respond to the needs of children exposed to extreme risks.
• Partners continue to use SMS, radio, and social media, to disseminate messages on explosive ordnance risk education and conflict preparedness and protection (EORE-CPP). The EORE-CPP capacity has increased with ten international partners, through seven national partners, currently delivering in-person EORE-CPP sessions across all of Gaza’s governorates. During the reporting period, partners completed nine explosive hazard assessments (EHA) at humanitarian sites and five EHAs of routes in support of inter-agency missions.
• UNRWA’s protection teams continue to identify and respond to protection risks and the needs of displaced people in Khan Younis and Deir al Balah, including Al Mawasi. They are visiting shelters and IDP sites, providing awareness sessions on EORE, GBV and the prevention of sexual exploitation and abuse (PSEA), undertaking focus group discussions and key informant interviews with IDPs, monitoring aid distribution, and following up on previously identified vulnerable cases. With the Education Cluster, protection monitors also continue to closely monitor learning activities in shelters to ensure that the safety, dignity, and wellbeing of children are prioritised, and any protection issue or concern is timely addressed.

Challenges

• Insecurity, the disruption of aid flows, the breakdown of law and order, and the denial and restriction on entry of critical items continue to hinder the Protection response. Items the importation of which has been denied by the Israeli authorities include sanitary pads, dignity, and menstrual hygiene management kits (MHM) for women and girls, recreational materials for children and assistive devices for persons with disabilities. Minimum standard explosive ordnance disposal (EOD) equipment and EORE materials are also prevented entry by Israeli authorities into Gaza, thereby limiting the capacity of the Mine Action response.
• The PSS needs remain vast, and it is critical that more kits be approved for entry into the Strip.
• Shortage of tents affects the ability to expand group-based psycho-social support and provide safe spaces or temporary accommodation for unaccompanied children. The limited availability of supplies on the local market, including MHM and dignity kits, has disproportionate impact on women and girls, who are at risk of GBV, and increases their vulnerability to diseases.
• Lack of funding and impeded access by Israeli authorities for specialized personnel and equipment for the clearance and disposal of deep-buried bombs (DBB) hamper people’s protection from explosive remnants of war (ERW) and the safe and sustainable delivery of humanitarian aid. Mine Action stresses the need to obtain meaningful data from the Israeli authorities regarding the geographical location of ERW and hazardous areas.
• The ongoing power cut off and limited access to communications services, coupled with fuel shortages and damage to key infrastructure, continue to curtail mobility. Repeated evacuations, ensuing displacements and limited access to areas affected by hostilities, including in northern Gaza, continue to constrain community outreach, referral pathways, and protection activities including proper case management for GBV and child protection.
• Cash shortages continue to hinder the use of CVA by some recipients, negatively impacting living conditions, increasing the risk of exposure to violence or exploitation for women and girls, and undermining the ability of partners to pay local service providers and staff salaries. Meanwhile, the price of most basic commodities available in local markets has more than quadrupled.

Education

Response

• During the reporting period, approximately 40 new Temporary Learning Spaces (TLSs) have been established, benefiting around 6,500 students. These spaces provide children with access to quality services, including educational opportunities focused on developing core skills in literacy and numeracy. Additionally, partners continue to deliver Mental Health and Psychosocial Support, as well as structured recreational activities, to help children recover and strengthen their resilience amid ongoing hostilities.
• Given the challenges in providing in-person classes, the Ministry of Education (MoE) in Ramallah has updated its portal to facilitate remote access to educational resources. Although this solution currently benefits only 20,000 of the more than 650,000 students expected to enrol in Gaza, it remains the sole option available to continue formal education in these circumstances. The Education Cluster is supporting the initiative by circulating the online links to students across the Gaza Strip. Discussions are also ongoing with the Emergency Telecommunications Cluster (ETC) to enhance Internet access in some spaces to improve access to the MoE portal.

Challenges

• The continued targeting of schools is fuelling fear among parents, children, and teachers. During the reporting period, eight instances of strikes impacting schools in northern and southern Gaza have been reported. This is limiting the scale-up of learning activities, especially in northern Gaza, where to-date, UNRWA has not re-opened any of its schools-turned-shelters to commence learning initiatives that are already being implemented in Deir al Balah and Khan Younis.
• Children in Gaza risk missing their second consecutive academic year if conditions do not improve. The ongoing hostilities severely restrict access to in-person learning spaces, and the persistent blockade on educational supplies hampers scaling-up the response. Additionally, the use of UNRWA and other schools as shelters for displaced populations further limits the availability of facilities for educational purposes.

Emergency Telecommunications (ETC)

Response

• A second batch of 78 “Track24” satellite-based devices, which are intended for use by UN agencies in Gaza, is being dispatched. The ETC Cluster and WFP are liaising with Israeli authorities to secure a pre-clearance to expedite customs clearance upon arrival. The first batch of 25 “Track24” devices had been delivered to Jerusalem on 21 August.
• On 2 September, the ETC received Israeli approval for 20 Garmin inReach Messenger devices intended for partners in Gaza. The procurement of these devices, which allow two-way messaging and location-sharing in areas without cellular coverage, is ongoing.
• The ETC is finalizing its 2025 Response Plan, requiring an estimated budget of approximately US$2.5 million. The plan focuses on enhancing shared security communications and internet connectivity for humanitarian responders in Gaza.
• The ETC Cluster continues to advocate for the need to import more telecommunications equipment into Gaza to set up common communications services. More information on ETC activities can be accessed here.

Challenges

• Due to increased restrictions on the movement of commodities, damaged infrastructure and lack of fuel and spare parts, local Mobile Network Operators and Internet Service Providers in the Gaza Strip are experiencing network outages and are unable to conduct the necessary repairs. Current conditions also continue to render it difficult to maintain the functionality of the remaining network and have resulted in the loss of connectivity in Rafah.
• The availability of telecommunications equipment is severely limited, hampering the delivery of ETC services. A significant amount of equipment has been damaged or destroyed, and the import of new equipment is lengthy and challenging. Only 20 satellite phones, 20 Garmin inReach Messenger devices, 30 VHF digital radios, four VHF repeaters and four solar power solutions have been coordinated for import into Gaza with Israeli authorities since 7 October 2023.
• Increasing insecurity, displacement, and relocation of staff from Rafah to Deir al Balah have rendered it difficult to deploy shared ETC communications services or provide face-to-face technical support for humanitarian responders.
• The lack of funding has limited the ETC Cluster’s capacity to address immediate communications needs for humanitarian responders in Gaza. Thus far, only 38.1 per cent of funding requested by the Cluster (US$1.8 million) under the updated OPT Flash Appeal has been received.

Protection against sexual exploitation and abuse (PSEA) remains a cross-cutting priority for all clusters. Aid distribution must be delivered with dignity and respect. Any wrongdoing can be reported through SAWA toll-free number 164. SAWA will assist and provide services free of charge and with the utmost confidentiality.