UNRWA Situation Report #105 on the situation in the Gaza Strip and the West Bank, including East Jerusalem – 25-28 April 2024

Days 202-205 of Hostilities

Key Points

The Gaza Strip

• Israeli Security Forces (ISF) operations continue from air, land and sea continue across the Gaza Strip, resulting in further civilian casualties, infrastructure damage and displacement.
• According to WHO[1] the ongoing conflict continues to jeopardize the health system, with challenges to access to health, and delivery of lifesaving supplies. In northern Gaza, only five hospitals remain partially functional, providing limited health care services to the vulnerable population and in the south, only six hospitals are currently operational. Hospitals continue to be overstretched and only partially functional with an estimated average bed occupancy rate of over two and a half times. UNRWA continues to provide health services across the Gaza Strip with eight health centres and over 100 medical points operational.
• Since 7 October, the Education Cluster has been monitoring damage to schools in Gaza. Its latest monitoring exercise indicates that nearly 86 per cent of schools sustained some level of damage. At least 72 per cent of schools in Gaza will either need full reconstruction or major rehabilitation work to be functional again. The Education Cluster assesses that at least 30 per cent of all schools damaged or directly hit were UNRWA schools. Since the beginning of the escalation, the Education Cluster has been receiving several reports, photos and videos, showing that schools are being used for military purposes by ISF including for detention, interrogation and as military bases.​ – April has so far brought in the highest volume of humanitarian and commercial supplies since the opening of land routes into the Gaza Strip on 21 October 2023. From 1 — 27 April, 5,132 trucks (190 trucks per day) have entered via Kerem Shalom and Rafah land crossings into the Gaza Strip, which is already higher than the entirety of March where 4,993 trucks entered (161 trucks per day). While this is welcome, a significant expansion needs to occur to reach pre-conflict levels of 500 trucks a day.
• As of 28 April, the total number of UNRWA colleagues killed since the beginning of hostilities is 182, an increase of two since the last report.

– As of 28 April, up to 1.7 million people (over 75 per cent of the population)* have been displaced across the Gaza Strip, the majority multiple times.*** Families are forced to move repeatedly in search of safety. Following intense Israeli bombardments and fighting in Khan Younis and the Middle Area in recent weeks, a significant number of displaced people have moved further south.

*\This includes 1 million people living in or near emergency shelters or informal shelters. As of 12 October, approximately 160,000 internally displaced persons (IDPs) were recorded in UNRWA shelters in Northern Gaza and Gaza City governorates. UNRWA currently estimates that the population of Northern Gaza and Gaza City governorates is up to 300,000 people. The ability of UNRWA to provide humanitarian support and updated data in these areas has been severely restricted. The ongoing hostilities, evacuation orders issued by ISF, and the constant need for safer locations have resulted in people being displaced multiple times.

**\UNRWA reported on 15 January in Situation Report 64 that up to 1.9 million IDPs were either residing in 154 UNRWA shelters or near these shelters. Due to the continued escalation of fighting and evacuation orders, some households have moved away from the shelters where they were initially registered.

***\There are instances where the same IDPs are registered in multiple shelters due to the fluid movement of populations; hereafter, estimates are used for these shelters. UNRWA plans to conduct a more accurate count of IDPs in shelters, including informal shelters, as soon as the security situation allows.

The West Bank, including East Jerusalem

The West Bank, including East Jerusalem update will shift to once a week, every Monday.

• Between 22 and 28 April, there were at least 158 ISF search and arrest operations recorded across the West Bank, including East Jerusalem — averaging more than 22 operations per day. At least 83 Palestinians, including Palestine Refugees, were detained during this period. This includes three Palestinian children detained from Jalazone refugee camp on 25 April.
• There were five Palestinians killed, including one in Aqbat Jabr refugee camp in the central West Bank on 23 April during an ISF search operation, and one child killed in Ramallah on 25 April.
• In Ramallah, the Israeli authorities issued a demolition order on 25 April on a house belonging to a Palestinian prisoner in Israeli detention. Punitive home demolitions are a form of collective punishment which are illegal under international law.
• Israeli settler violence remained prevalent, with at least 18 incidents involving Israeli settlers reported across the West Bank between 26 and 28 April. In the southern West Bank, armed settlers held Palestinian farmers at gunpoint in Nahhalin area, seized crops in Wadi al-Abyadh and assaulted shepherds in Masafer Yatta. In the north, armed settlers closed the Jenin-Nablus road near Bizzariya and threw stones at Palestinian vehicles. In the Jordan Valley, settlers entered and tore down Palestinian tents.

Overall Situation

The Gaza Strip

• According to the Ministry of Health in Gaza as of 26 April, at least 34,356 Palestinians have been killed in the Gaza Strip since 7 October. About 70 per cent of those killed are reported to be women and children. Another 77,368 Palestinians have been reportedly injured.

The West Bank, including East Jerusalem

• According to OCHA, between 7 October 2023– 24 April 2024, 469 Palestinians, including at least 112 children, have been killed in the West Bank, including East Jerusalem.

Humanitarian Access, Protection of Civilians

The Gaza Strip

• UNRWA is working to verify the details of incidents reportedly affecting UNRWA premises. Further information will be provided once it becomes available.
• On 28 April 2024, UNRWA conducted a joint mission with the UN Mine Action Service (UNMAS) to assess six UNRWA installations in Khan Younis, including the Khan Younis Training Centre, a health centre, two schools, a sanitation office and a water well. The assessment was aimed at identifying any potential threats posed by explosive remnants of war (ERW) and/or unexploded ordnance (UXO) and to verify the information that these premises had been impacted by armed conflict incidents.
• According to the assessment, all six installations were impacted by armed conflict incidents resulting in damage to the buildings, ranging from minor to severe damage and destruction of the premises. Additionally, UXO was found in the Khan Younis Training Centre and was promptly signaled and cordoned off by UNMAS experts. To mitigate the threats posed by ERW and UXO, UNRWA teams are conducting awareness raising sessions among staff and IDPs on explosive ordnance risk education.
• No new armed conflict incidents involving UNRWA installations have been reported for the period 25 – 28 April 2024.
• The number of reported incidents impacting our installations therefore remains the same as per last update:
• 362* 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 50 incidents of military use and/or interference. 165 different UNRWA installations have been impacted.
• UNRWA estimates that in total at least 428* IDPs sheltering in UNRWA shelters have been killed and at least a further 1,430* injured since the start of the war. UNRWA is still verifying the number of casualties caused by incidents that impacted its installations, and notes that these figures do not include some reported casualties where the number of injuries could not be determined.

*numbers are subject to change once further verifications have been conducted.

UNRWA Response

The Gaza Strip

UNRWA Shelters

• As of 28 April, nearly **1.7 million **displaced people are now sheltering across emergency shelters (UNRWA and public shelters), informal sites or in the vicinity of UNRWA shelters and distribution sites and within host communities.

Health

• As of 22 April, eight (out of 24[1]) UNRWA health centres were operational. Of those, one is in the north, two are in the Middle Area, two in Khan Younis and three in Rafah. These health centres provide primary health care services, including outpatient services, non-communicable disease care, medication, vaccination, antenatal and postnatal health care and dressing for injured patients.
• On 13 March, UNRWA opened a temporary health centre to provide health services for the people in al-Mawasi, west of Khan Younis.
• Nearly 820 healthcare staff continue to work in operational health centres. On 22 April, they provided 11,599 medical consultations.
• UNRWA conducted another 8,472 medical consultations through 364 staff at the shelters, including at the newly established medical points in al-Mawasi area to serve an influx of displaced persons from Khan Younis. The total registered population in al-Mawasi is currently 403,447 displaced people.
• As of 22 April, 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 862 cases. UNRWA teams responded to cases in health centres and in medical points through individual consultations, awareness sessions and support for cases of gender-based violence. UNRWA teams provided medical care for 345 post-natal and pregnant women at high risk.
• In early January, UNRWA received vaccines from UNICEF for its health centres. Eleven different types of vaccines were received (refrigerated and freezer storage). On 22 April over 783 children were vaccinated against measles, mumps and rubella, hepatitis, tuberculosis and other diseases.

[1] Pre-conflict UNRWA had 22 health centres, following the conflict an additional 2 temporary health centres are operational in the Mawasi area.

Psychosocial support (PSS)

• UNRWA counsellors continue to provide live-saving psychosocial support in Gaza, including psychosocial first aid, individual and group counselling, fatigue management sessions, recreational activities, Explosive Ordnance Risk Education (EORE) as well as protection cash assistance targeting children, youth and adults.
• Since the onset of the conflict, it is estimated that 590,000 IDPs, including over 320,000 children, have benefited from a total of 167,559 PSS sessions/activities. During the period 9 — 19 April 2024, a total of 20,361 IDPs, including 13,399 children, received these services. Specifically, counsellors addressed 850 individual cases and provided 644 group awareness sessions benefiting 5,543 adults. Additionally, they conducted 515 recreational activities engaging 11,431 children. Counsellors also provided 119 EORE sessions to 1,487 adults and 1,740 children and contributed to supporting 160 protection cases.

** Food Security**

• As of 29 April, UNRWA continued to distribute flour outside of shelters in the southern governorates. To date, a total of 380,225 families (nearly 1.9 million people) have been reached, of whom 322,060 families have received two rounds of flour and another 189,182 families have received three rounds.

Water, Sanitation and Hygiene (WASH)

Due to the security situation, in combination with challenges to internet connectivity, we have been unable to provide any additional updates since Sitrep 67.

Quote from Louise Wateridge, UNRWA Communications Officer in Gaza:

“Buildings are skeletons. It’s haunting. Any home still standing has entire walls missing — you can see into previous lives, frozen in time. ”

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