Humanitarian Needs and Response Update | 16–22 April 2024 – OCHA Update

Needs

• Ready-to-use therapeutic food (RUTF) and  preventative nutrition commodities, including high-energy biscuits (HEB), lipid-based nutrient supplements (MQ-LNS), and micronutrient supplements. These supplies are essential for more than 160,000 pregnant and breastfeeding women (PBW) and 346,000 children under the age of five, who are at the greatest risk of malnutrition and preventable mortality, including about 135,000 children under the age of two who are highly vulnerable to acute malnutrition. Overall, 50,400 children under the age of five are estimated to be acutely malnourished.
• Immediate humanitarian access to address increasing acute malnutrition. The rate of malnutrition is particularly high in northern Gaza, where severe wasting is seen in 31 per cent of children under the age of two.
• Continued active identification of nutrition cases to ensure timely detection, referral, and treatment of acutely malnourished children.
• Preventive nutrition interventions, including infant and young child feeding (IYCF) and the provision of age-appropriate supplementary feeding products for people in need.
• Expanded Outpatient Therapeutic Programme (OTP) targeting children with acute malnutrition to ensure greater proximity of nutrition treatment services to affected people.
• Strengthen partners’ capacity to provide nutrition-in-emergency services, including community-based management of acute malnutrition (CMAM) and IYCF practices in emergencies.
• Enhance the mapping of service coverage as well as monitoring and reporting systems to identify gaps and ensure effective coordination and a streamlined nutrition response.

Response

• Cluster partners continue to conduct Mid-Upper Arm Circumference (MUAC) screenings; to date, 51,3679 children aged 6-59 months have been screened, of whom 3,513 have been diagnosed with acute malnutrition, including 2,559 with Moderate Acute Malnutrition (MAM) and 954 with Severe Acute Malnutrition (SAM).
• Since 1 April, 37 children suffering from SAM with medical complications have required inpatient care at three Stabilization Centres (SCs) at Kamal Adwan Hospital, Tall as Sultan Hospital, and the IMC field hospital. Sixty-eight per cent of these admissions were at Kamal Adwan Hospital. WHO has provided supplies and technical support to the SCs while UNICEF has provided RUTF/ nutrition commodities.
• UNICEF has expanded outpatient treatment of acutely malnourished children to 95 OTP sites, providing services in North Gaza (36 sites), Deir al Balah (11 sites), Khan Younis (2 sites), and Rafah (46 sites) through 13 nutrition partners.
• Since 1 April, WFP and seven organizations have distributed 15-day allocations of supplementary food (MQ-LNS) to 9,187 people, including 6,426 children under five and 2,761 PBW, in Deir al Balah, Khan Younis and Rafah.
• Since 1 April, 9,970 caregivers of children under two, including PBW, received sensitization sessions on IYCF practices in emergencies (IYCF-E). Save the Children is supporting efforts to foster IYCF-E practices by setting up 10 mother-baby areas in Rafah, Deir Al-Balah, and Gaza city, together with UNRWA and Juzoor. As part of a wider IYCF programme, Save the Children facilitated a one-hour training in Rafah for Cluster partners on how to provide lifesaving support to infants under six months who have no option for breastmilk feeding; they plan to replicate the training in Arabic in Deir al Balah.
• Nutrition interventions are being provided at 296 sites, including 21 health facilities, 238 formal and informal shelters, and 37 sites in the host communities.

Challenges

• Limited humanitarian access throughout Gaza, particularly in the northern areas, continues to exacerbate the catastrophic levels of food insecurity already faced by people and to prevent the urgent delivery of life-saving nutrition commodities. Compounded by deteriorating health and WASH services, this is resulting in an increasing number of acutely malnourished children.
• Continued displacement undermines the effective provision of nutrition services.
• Protracted hostilities and stress have resulted in an inability of mothers to breastfeed babies.

Needs

• Immediate, uninterrupted, and safe access across Gaza to address catastrophic levels of food insecurity, scale up the delivery of life-saving aid, and ward off famine.
• A continuous supply of fuel and cooking gas to sustain humanitarian operations and keep essential services, such as mills and bakeries, operational.
• Revitalizing agriculture, livestock and fishing activities to restore livelihoods and ensure a sustained supply of nutritious and diversified food.

Response

• During the reporting period, 16 partners were able to provide food assistance across Gaza, including food parcels, hot meals, bread, and flour.
• The distribution of fodder is ongoing in Rafah, with people each receiving a 50-kilogramme sack, sufficient to feed five sheep for five days.
• Fifteen bakeries are currently operational in Rafah (5), Deir al Balah (6) and Gaza city (4), producing around 1.1 million bread parcels. Fuel availability will allow the expansion of the bakery network.
• Since November, 1.9 million people have received flour in southern Gaza, of whom 1.2 million people received a second round and 172,000 people are now receiving a third round.

Challenges

• Humanitarian access throughout Gaza continues to be limited, particularly in the north, hindering the urgent delivery of life-saving food commodities. Failure to provide assistance could exacerbate displacement, increase vulnerability to exploitation, and perpetuate cycles of instability.
•  Distribution efforts in the first half of April continued to face access challenges. In northern Gaza, assistance gaps remain huge, with only about 10 per cent of the population covered. In Deir al Balah and Khan Younis, food assistance reached 45 per cent of the population, while in Rafah, where more than a million people are concentrated, only 40 per cent of the population was reached.
• The limited number of entry points into Gaza and sub-optimal operating hours at crossings and checkpoints continue to constrain the ability to expand supply routes.
• Infrastructural and security hurdles continue to hinder mobility and safe humanitarian access within Gaza, with escorts necessary to safeguard convoys.
• The lack of sufficient fuel for essential services and operations.

Needs

• Maintain critical WASH infrastructure operational through increased provision of fuel and generators, including spare parts and maintenance equipment.
• Collect the accumulated solid waste throughout Gaza and transfer it to landfills.

Response

• Fuel continues to be distributed daily to water and sanitation facilities, albeit in insufficient and inconsistent quantities, including in northern Gaza.
• Maintenance of the two damaged Mekorot water connection points and repair of the downstream transmission lines, is ongoing.
• Emergency water distribution activities continue at scale in Rafah and Deir al Balah.
• With support from UNICEF, a local NGO has installed four portable, solar-powered desalination plants, generating 16 cubic meters of water per day.

Challenges

• Restricted access to sanitary landfills prevents the collection and safe disposal of accumulated solid waste.
• Fuel shortages continue to hinder the effective operation of critical WASH infrastructure.
• Limited access to northern Gaza continues to undermine the delivery of supplies and scaling up of WASH assistance.

Needs

• Access to independent and reliable communication platforms to coordinate emergency response and deliver life-saving aid, amid ongoing communication challenges and intermittent access to telecommunications services.
• Increase mainstreaming of PSEA messages and strengthen knowledge of safeguarding practices.
• Under the new Flash Appeal released on 17 April, the ETC requires US$1.8 million to address urgent and lifesaving communication needs until 31 December 2024.

Response

• Briefed humanitarian partners on 16 April on technical recommendations for licensing and importing Frequency Modulation (FM) broadcasting equipment into Gaza, based on pre-requisites from Israeli authorities.
• Planned deployment of ETC field coordinator to strengthen face-to-face engagements and support partners with technical advice and guidance on telecommunications services.
• For more information on ETC activities, please visit: Palestine: Conflict | Emergency Telecommunications Cluster (ETC) (etcluster.org).

Challenges

• Limited access to electricity, fuel, and telecommunications services.
• The import of telecommunications equipment into Gaza.