UNRWA Situation Report #134 on the situation in the Gaza Strip and the West Bank, including East Jerusalem

6 September 2024

All information from 3 – 5 September 2024, valid as of 5 September 2024 at 22:30

Days 334-336 of Hostilities

Key Points  

The Gaza Strip

• Ongoing strikes by Israeli Security Forces (ISF) continue, with aerial, land and maritime bombardments across the Gaza Strip, resulting in civilian casualties, displacement and the destruction of residential structures and public infrastructure.
• On 3 September ACAPS released a thematic report on the impact of the conflict on mental health and psychosocial support needs in Gaza.  The report highlighted that since October 2023, the 2.1 million Palestinians living in Gaza have witnessed or experienced an unprecedented number of violent and traumatic events, including direct violence, repeated displacement, and the loss of loved ones, homes, and belongings. Such experiences have increased anxiety, depression, and other mental health and psychosocial problems. Extensive destruction of the healthcare system prevents even basic treatment of these conditions in the immediate and long term.
• Humanitarian pauses across specific areas of the Gaza Strip have enabled the first round of the emergency polio vaccination campaign.  Between 1 – 3 September, nearly 187,000 children were reached, according to World Health Organisation and the Health Cluster.  The Polio vaccination campaign will be done in phases, focusing on one zone at a time – starting in the middle area, shifting to the south, and finally to the northern governorates. Vaccination coverage in the first phase exceeded the initial estimated target of 157, 000 children, due to population movement towards central Gaza, and expanded coverage in areas outside the humanitarian pause zone.  To ensure no child is missed in this area, polio vaccination will continue at four large health facilities in the middle area of Gaza over the next few days. Vaccine doses have been supplied to these sites to meet additional needs.
• Both Food Security and Nutrition Clusters continue to experience access challenges; in August more than 1 million people did not receive any food rations in southern and central Gaza.  Continuous displacement is disrupting access to nutrition sites and distribution cycles, hindering the humanitarian partners’ ability to maintain consistent service delivery.
• According to the UN, at least 1.9 million people (or nine in ten people) across the Gaza Strip are internally displaced, including people who have been repeatedly displaced (some, up to 10 times or more).
• Several challenges stand in the way of collecting much needed humanitarian supplies from the Karem Abu Salem (Kerem Shalom) crossing point in southern Gaza. These include deteriorating law and order, war and insecurity, damaged infrastructure, fuel shortages and access restrictions.  According to OCHA, between 1 and 31 August 2024, an average of only 69 humanitarian trucks entered the Gaza Strip per day. This is well below the pre-crisis average of 500 trucks per working day. According to the Food Security Cluster, Nutrition Cluster, Health Cluster and Shelter Cluster, persistent challenges in bringing aid into Gaza are causing significant shortages in critical humanitarian goods such as medicines, food, and nutrition supplies.
• As of 4 September, the total number of UNRWA team members killed since 7 October is 213.
• The latest information on supplies entering Gaza can be accessed through the below link:
  Gaza Supplies and Dispatch Tracking | UNRWA

The West Bank, including East Jerusalem

The West Bank, including East Jerusalem update is now once a week.

• According to OCHA, between 7 October 2023 and 2 September 2024, 652 Palestinians have been killed in the West Bank, including East Jerusalem. Separately, UNICEF confirmed that over 150 children have been killed in the West Bank, including East Jerusalem, during the period, 7 October 2023 to 22 July 2024.

UNRWA teams vaccinate children in Khan Younis as the polio vaccination campaign moves to Gaza southern areas, Khan Younis, Southern Gaza Strip, 5 September 2024. © 2024 UNRWA Photo

Overall Situation

The Gaza Strip

• According to the Ministry of Health in Gaza, and as reported by OCHA, between 7 October 2023 and 4 September 2024, at least 40,861 Palestinians were reported killed and 94,224 injured.

Humanitarian Access, Protection of Civilians 

The Gaza Strip

• UNRWA is working to verify the details of incidents that reportedly impact UNRWA premises. Further information will be provided once it becomes available.
• During the reporting period, no incidents impacting UNRWA installations and internally displaced people (IDPs) sheltering there was reported. The verification of details and any casualty figures are ongoing.
• 464* incidents impacting UNRWA premises and the people inside them have been reported since the beginning of the war (some with multiple incidents impacting the same location), including at least 74* incidents of military use and/or interference at UNRWA premises. 190* Agency installations have been impacted by munitions or subjected to armed actor interference through these incidents. UNRWA estimates that, in total, at least 563* IDPs sheltering in UNRWA installations have been killed and at least 1,790* injured since the start of the war. UNRWA is verifying the number of casualties caused by these incidents.

*Since the start of the war, latest figures are continuously under review as UNRWA gains access to locations that were previously inaccessible and as further verification occur. Total summary figures will be published once further verification has been conducted, noting that these numbers are subject to change once verifications have been conducted. 

UNRWA Response  

The Gaza Strip  

Health

• UNRWA, as part of the national polio campaign, has provided health training to 440 nurses and 440 registrars. In addition, disseminating health messages about the vaccines has started at health facilities and medical points.
• As of 31 August, 80 medical points and 10 (out of 27[1]) UNRWA health centres were operational. The health facilities provide primary health care, including outpatient services, non-communicable disease care, medications, vaccinations, antenatal and postnatal health care and dressings for the injured. The number of operational health facilities fluctuates constantly based on demand, access and security.
• On 31 August, almost 1,100 UNRWA health staff continued to work in health centres and medical points across the Gaza Strip, providing 14,900 medical consultations on that day.
• On 31 August, UNRWA provided mental health and psychosocial support (MHPSS) services in the Middle and Khan Younis areas with teams of psychiatrists and supervisors to assist special cases referred from health centres and shelters. UNRWA teams responded to 489 cases in health centres and at medical points through individual consultations, awareness sessions and to address cases of gender-based violence (GBV).
• On 31 August, medical teams provided medical care for 471 post-natal and pregnant women at high risk.
• According to the Health Cluster, UNRWA remains one of the largest health actors operating in the Gaza Strip, contributing to over half of the people reached with health services since 7 October 2023. Between 7 October 2023 and 18 August 2024, UNRWA provided over 5.2 million medical consultations across the Gaza Strip. In addition, the Agency (in partnership with and support from other UN agencies, including UNICEF and WHO) continues to provide vaccines, with over 130,000 children vaccinated against different childhood diseases since the start of 2024 through mid-July.

Psychosocial support

• With the support of over 500 counsellors, UNRWA continues to provide lifesaving psychosocial support (PSS) services in Gaza, including psychosocial first aid, individual and group counselling, fatigue management sessions, recreational activities, Explosive Ordnance Risk Education (EORE) and protection cash assistance, reaching children, youth and adults.
• More than 600,000 children have been out of school since the beginning of the war.  On 1 August 2024, UNRWA began to roll out its first phase response of ‘back to learning’ with a focus on mental health activities. This is taking place in up to 45 UNRWA schools now turned shelters[2] by expanding ongoing psychosocial support activities, focusing on arts, music and sports and raising awareness on the risks of explosive ordnance.  UNRWA remains the largest provider of Education in Emergencies across the Gaza Strip. Prior to its first phase response across 45 UNRWA schools, a specialized training was held from 29 to 31 July to help teachers in Gaza cope with stress and enhance their capacity to provide activities to children. The training involved 998 teachers from all areas and equipped them with self-care skills, psychosocial support techniques and knowledge on preventing harm caused by the remnants of war. The training was conducted by counsellors and assistant counsellors and supervised by mental health specialists.
• Since the onset of the conflict, around 700,000 IDPs, including over 450,000 children, have benefited from a total of 246,188 PSS sessions/activities. Between 6 and 18 August, a total of 14,816 IDPs, including 9,713 children benefited from these services. During the same period UNRWA counsellors provided 404 individual consultations and 168 group awareness sessions for caregivers. Additionally, UNRWA extended 453 recreational activities for children and 368 explosive ordinance risk education (EORE) sessions for adults and children.
• Since the onset of the conflict, UNRWA’s social work team has provided services to 163,612[3] IDPs, including psychological first aid, PSS, family and individual interventions, as well as case management. These efforts aim to address family issues and strengthen relationships. Furthermore, protection services were provided to 1,353 GBV survivors and 2,101 children, including 1,130 unaccompanied children, covering reunification, safe sheltering, medication, dignity kits and non-food items through referrals. The team also supported 18,330 persons with disabilities with PSS; 7,445 of these individuals received assistive devices and rehabilitation services. Awareness sessions on GBV, child protection, disability and special needs, and managing social and psychological stressors were conducted for 109,655 IDPs.

Food Security

• To date, a total of 380,236 families (nearly 1.9 million people) have been reached with two rounds of flour; 353,354 of those families have received three rounds.
• UNRWA continues to distribute food parcels in the southern governorates. These include[4] flour, rice, chickpeas, lentils, cheese, hummus and fish, and are designed to cover approximately 90 per cent of daily calorific needs per quarter. To date, nearly 1.15 million people have been reached, of whom, nearly 215,000 people have received two rounds of food parcels since the war started.
• In addition to the distribution of UNRWA food parcels, the Agency distributes food parcels on behalf of other UN organizations, reaching around 1.4 million people.

Water, Sanitation and Hygiene (WASH) 

• Since October 2023, UNRWA has provided emergency WASH activities across the Gaza Strip. Main activities include the operation and continued maintenance of water wells, desalination systems and the direct provision of water through water trucking and the distribution of bottled water. In addition, UNRWA continues to distribute hygiene kits and maintain hygiene in UNRWA shelters and sites through the provision of cleaning supplies, community based solid waste management, and pest control.
• UNRWA continues to be one of the largest WASH actors in the Gaza Strip. Since the beginning of the war, the Agency has maintained and rehabilitated eight wells, reaching over 600,000 IDPs with access to water. Between June and August, UNRWA reached 50,000 IDPs with hygiene kits.
• Between 1-15 August, three water wells in Jabalia and Khan Younis were rehabilitated and made operational, and water was distributed across 101 emergency shelters, reaching nearly half a million people. In addition, UNRWA distributed chlorine tablets to over 110 shelters to prevent water contamination and improve water quality. Another 43,000 IDPs were reached with hygiene kits, including soap, in addition to 1,320 jerry cans and 432 buckets.  Over 200,000 IDPs benefited from cleaning campaigns in different areas. Many more hygiene supplies are needed.
• Throughout the Gaza Strip, hundreds of thousands of tons of solid waste are piling up in streets, between tents in displaced tented areas, and next to the rubble in back alleys. The collapse of solid waste management since the war began is worsening the public health crisis. Between 1 and 22 August, a total of 7,000 tons of solid waste was collected by UNRWA and transferred to temporary dumping sites.

[1]Pre-conflict, UNRWA had 22 health centres. Following the onset of the conflict, an additional five temporary health centres were established.

[2]Initially reaching 45 schools/shelters, ‘back to learning’ will gradually expand to 94 schools in future phases.

[3] Results from 7 October – 1 September.

[4] Note the composition of the food parcel may change based on food item availability.

Quote from Louise Wateridge, UNRWA Spokesperson in Gaza:

“The reality is that these vaccinations are happening in the middle of a war zone, while many other diseases, such as Hepatitis A, are spreading. […] So while we’re doing everything we can to vaccinate for one disease, the inhumane conditions that are causing and spreading these diseases continue.”