Crisis in Palestine: UNFPA Palestine Situation Report, Issue #7 (01 March to 01 April 2024)

06 April 2024

Situation Overview

In Gaza, the scale of devastation is unprecedented, with approximately 1.7 million people displaced and entire communities obliterated. The specter of starvation looms, particularly in the north where around 200,000 people are trapped, with famine expected between now and May. According to the Ministry of Health in Gaza, 32,623 Palestinians have been killed, with over 7,000 missing or buried under rubble, and 75,092 injured. The urgent need for humanitarian aid in Gaza cannot be overstated, as the region grapples with a crisis of unprecedented proportions.

The looming ground operation in Rafah poses a grave threat to 1.5 million Palestinians, including tens of thousands of pregnant women, new mothers and newborns. Today, Rafah is unrecognizable due to congestion, with people sleeping in the streets and makeshift shelters. Any attack would exacerbate suffering and hinder aid delivery, imperiling the safety of hundreds of thousands of desperate, traumatized people fleeing bombardment with nowhere else to go.

The siege enforced on Gaza by Israel, including closed crossings and and lack of essential resources like water and electricity, have been critical factors contributing to the unfolding humanitarian catastrophe. Humanitarian organizations are facing numerous challenges including security risks and access constraints especially for aid missions to northern Gaza. Ensuring aid reaches Gaza at the necessary scale demands access to all entry points, particularly via land routes. Aid delivery by air and sea is not a substitute for land routes, which are faster, more cost-effective, and easier to monitor. Air drops pose significant challenges, including high costs, lack of monitoring, and potential danger. Ultimately, these methods cannot adequately address Gaza’s health and food insecurity.

Famine is imminent in Gaza as the recent IPC assessment reveals that half of its population, 1.1 million people, faces catastrophic food insecurity. Among the 677,000 on the brink of famine are an estimated 15,000 pregnant women, heightening the risks for both mothers and newborns. Children’s acute malnutrition rates have doubled since January, with one in three under two suffering from malnutrition. Tragically, 27 children in the north of Gaza have already died due to malnutrition. Israel’s restrictions on aid, displacement, and infrastructure destruction exacerbate the crisis. 95% of pregnant and breastfeeding women have insufficient micronutrient intake, further elevating risks.

The assault on healthcare facilities in Gaza has been relentless, with over 400 attacks, predominantly airstrikes and raids, causing extensive damage to hospitals and clinics while claiming the lives of healthcare workers. Currently, only 10 out of 36 hospitals and 20 out of 80 primary healthcare facilities are functional, operating at limited capacity and overwhelmed with patients, grappling with critical shortages of fuel, medicines, supplies, and medical staff.

155,000 pregnant women and new mothers, along with their newborns, face dire circumstances, contending with severe shortages of food, water, and medical care. Tragically, newborns are falling victim to dangerously low birth weights, worsened by the lack of nutrition, clean water, and neonatal health services. The situation is exacerbated by the shutdown of all but three maternity hospitals, with Al-Helal Al-Emirati Maternity Hospital in Rafah overwhelmed by demand and struggling to cope with acute shortages of essential supplies and medications. Medical professionals are forced to make agonizing decisions as they endeavor to provide care under increasingly challenging conditions. Hospitals are discharging women shortly after childbirth, and cesareans are on the rise due to fear and uncertainty. Simultaneously, there is a surge in premature births and low birth weights due to multiple factors including stress, early labor/birth, and malnutrition. Urgent action is vital to ensure the survival and well-being of mothers and newborns in Gaza, where approximately 180 deliveries take place daily

Doctors have said they are no longer seeing normal-sized children, newborn babies dying simply because their birth weight is just too low. Mothers should wrap their arms around their children. These children should not be wrapped in body bags.” -Dominic Allen, UNFPA Representative after visiting maternity hospitals in Gaza

According to a rapid assessment by WASH Cluster partners, Gaza’s 690,000 menstruating women and adolescent girls face urgent challenges due to a critical shortage of sanitary products and access to water and wash facilities. Many resort to using rags as pads are unavailable, while clean water for hygiene is scarce. Close to three-quarters of these women and girls lack privacy for washing, with a similar number having no access to clean water. The assessment reveals grim statistics: only one toilet for every 341 people, with 80% non-functional in displacement sites; less than a quarter offering safe and private latrine access; one shower available for every 1,292 persons in the only 39% of sites with showers; and sanitary pads inaccessible to over two-thirds of women and girls, rising to nearly 90% in makeshift shelters. Furthermore, only half of displacement sites have separate showers for genders, majority without adequate lighting.

“I use clean pieces of cotton from my children›s clothes because there are no pads, and we can’t afford the high prices in the market. Then I wash them and reuse them when I have access to water and soap. Currently, there are no clothes, water, or soap available. We are forced to throw them away or bury them.” -Sara, 28 year-old woman from Gaza

Since early October, an estimated 37 mothers are killed daily, leaving families devastated and children vulnerable. Close to one million women and girls are forcibly displaced, facing exacerbated protection risks in overcrowded shelters lacking basic necessities and privacy. Gender-based violence (GBV) is rampant, with internally displaced women expressing acute vulnerability due to loss of protection amidst the increasing presence of Israeli Forces and separation from family support networks. This fear is compounded by the total breakdown in law and order, stemming from desperation and scarcity. GBV prevention and response services have collapsed, with safe houses forced to close and the GBV Sub-Cluster unable to provide comprehensive support due to displacement and destruction.

“It was a very intense discussion – listening directly to women in makeshift tents on the sand, with the sound of bombs in the distance – to understand their needs. When I asked the women, ’What’s your one message to the world?’ they unanimously answered, ’Dignity’ especially after the ceasefire.” -Dominic Allen, UNFPA Representative after a field visit to Mawasi IDP camps in Rafah

The situation in the West Bank has reached its worst point in decades, with hundreds killed and thousands injured, including children. Movement restrictions persist, hindering access to vital health and social services, ambulance movement, and humanitarian aid delivery. Approximately 73,000 women are pregnant, with 8,100 expected to give birth in the next month alone. Since October 7, 2023, a staggering total of 1,620 Palestinians, including 710 children, have been displaced across the West Bank, including East Jerusalem, due to the demolition