UNRWA Situation Report #188 on the Humanitarian Crisis in the Gaza Strip and the occupied West Bank, including East Jerusalem

Fatalities and Injuries

• Between 7 October 2023 and 10 September 2025, according to the Ministry of Health (MoH) in Gaza, as stated by OCHA, at least 64,656 Palestinians have been reportedly killed in Gaza and 163,503 have been injured. OCHA reported the Gaza MoH recorded that, of the 60,199 reported killed as of 31 July, 27,605 were men, 9,735 women, 18,430 children, and 4,429 elderly.
• According to records of the UN Human Rights Office (OHCHR), since the establishment of the Israeli militarized aid distribution system in the Gaza Strip on 27 May and as of 9 September, at least 2,256 people seeking food aid  have been killed. This includes 1,172 near militarized supply sites and 1,084 along convoy supply routes. Younger men and older boys continue to comprise the vast majority of deaths and injuries, with most casualties reportedly the result of live fire.

Hunger, malnutrition and famine

• Famine (Integrated Food Security Phase Classification (IPC) Phase 5) has been confirmed in Gaza governorate. According to IPC, 100 per cent of the analysed 1.98 million people in Gaza, Deir Balah and Khan Younis governorates are currently facing and projected to face crisis or worse levels of food insecurity between 16 August and 30 September 2025.
• On 7 September, the Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator issued a statement saying that “There is a narrow window – until the end of September – to prevent famine from spreading to Deir al Balah and Khan Younis. That window is now closing fast.” The statement advocated to “Let humanitarian aid in (…). Protect civilians. Implement the International Court of Justice’s provisional measures. Release the hostages. Free arbitrarily detained Palestinians. Ceasefire.”
• The lack of dietary diversity in Gaza compromises nutritional intake, increasing the risk of acute malnutrition and related health complications, particularly among children. According to the Nutrition Cluster, as reported by OCHA, all children under five years old in Gaza, or about 320,000 children (of whom 290,000 are between six months and five years of age) are at risk of becoming acutely malnourished. With most food items essential for dietary diversity either non-existent or prohibitively expensive, malnutrition cases among children continue to be identified.
• UNRWA’s latest Mid-Upper Arm Circumference (MUAC)-based findings show that malnutrition has reached 28.5 per cent in Gaza City, as of mid-August meaning nearly one in three young children is now malnourished. According to UNRWA’s records, the overall prevalence of malnutrition across the Gaza Strip around 14.5 per cent.
• OCHA reported that according to MoH in Gaza, as of 10 September, 404 malnutrition-related deaths, including 141 children, were documented since October 2023. Updated data breakdowns published by MoH on 27 August indicate that of the total, four malnutrition-related deaths were documented in 2023, 49 deaths in 2024, and 260 between January and 27 August 2025.

Health crisis

• The displacement order for Gaza City is threatening humanitarian operations carried out by UNRWA and humanitarian partners to serve nearly 1 million Palestinian residents. According to the Health and Nutrition clusters, some health partners have suspended activities at primary health care centres, while 12 out of 49 outpatient therapeutic sites have halted services amid ongoing airstrikes in Gaza City. According to WHO, about half of all functional hospitals are in Gaza City; this includes 36 per cent of all hospital beds and 50 per cent of Intensive Care Unit (ICU) beds across the Strip.
• The health response in Gaza continues to face severe operational challenges, including extensive damage to health facilities, killing of medical workers, obstacles to safe movements within the Gaza Strip, and restrictions on the entry of medical supplies and critical fuel. This is forcing the few remaining hospitals to ration resources and/or suspend critical services.
• Shortages of medicines, fuel and basic infection control materials are having devastating consequences for patient care. Non-communicable disease patients, including those with diabetes, hypertension and heart disease, are increasingly unable to access their prescribed treatment due to depleted stocks, which will have serious repercussions on their health.
• WHO reported that ongoing attacks and resource shortages have severely weakened the health system – damaging or destroying 94 per cent of hospitals, overwhelming remaining partially functional ones, and disrupting essential health service delivery. Hospitals are overwhelmed by mass casualty incidents, with an average of eight incidents per day. Al-Shifa and Al-Ahli hospitals, in Gaza City, are operating at nearly 300 per cent  over capacity, with a constant influx of complex trauma injuries. Every hospital is overrun.
• UNFPA warns that the health system is collapsing and could lose half of its remaining capacity if hostilities continue; UNFPA added that four hospitals providing obstetric and newborn care and 23 primary healthcare centres and medical points delivering outpatient sexual and reproductive health services in Gaza City are at imminent risk of shutdown. Facilities in the south are already operating above capacity and cannot absorb the growing influx of patients from the north.
• OCHA reported that acute watery diarrhoea remains one of the most reported health conditions, accounting for 37 per cent of total reported morbidity. Shortages and restrictions in the entry of chlorination supplies, including chlorine tablets, continue to undermine household-level water treatment and system-level disinfection (wells, trucking, desalination), directly compromising drinking water safety and contributing to the continuing surge in diarrheal infections. In addition, UNRWA recorded that the numbers of suspected Guillain-Barré syndrome (GBS) cases have also increased to 107 with 10 associated deaths reported, since the last reporting period. Fifty-eight per cent of the cases were reported from Khan Younis area.

Education crisis

• While the school year in the occupied Palestinian territory (oPt) began on 8 September, the Education Cluster reports that in-person, formal education remains on hold in the Gaza Strip, with 660,000 children in Gaza have been deprived of education for the third consecutive year due to the ongoing war. Formal education in Gaza is limited to distance learning programmes managed by UNRWA and Ministry of Education and Higher Education (MoE), with an estimated 370,000 students currently enrolled while facing severe challenges due to ongoing hostilities, displacement, and severe disruptions to telecommunications and internet services.
• According to the Education Cluster, as reported by OCHA, since 7 October 2023 and as of 10 July 2025, 97 per cent of school buildings in the Gaza Strip have sustained some level of damage, the majority (92 per cent) requiring clearance of explosive contamination and either full reconstruction or major rehabilitation to be functional again.

Displacement, Site management

• OCHA reported that over 82 per cent of the Gaza Strip remains within the Israeli-militarized zone, under displacement orders, or where these overlap, as of 10 September 2025.
• The Site Management Cluster (SMC) recorded that between 7 and 10 September, military operations have continued to intensify in Gaza City, the origin of 63 per cent of recorded displacement movements, prompting people to flee the city, going primarily Southwards to Deir Al Balah and Khan Younis.
• Since 18 March when the ceasefire collapsed, up to 902,743 people have been reported displaced across the Gaza Strip, SMC reported.
• The SMC notes that the average living space in displacement sites is only 0.5 square metres per person, which is far below the Sphere Standard of 3.5 square metres. Even when families find space, they often lack tents or shelter items, as tented areas continue to be bombed. For those considering moving, the related costs alone are a major deterrent.
• During the reporting period, on 9 September, one new displacement order was issued by Israeli Forces impacting the entire Gaza City and 67 UNRWA facilities located there.
• Through its site managers and frontline staff, UNRWA continues monitoring movement of displaced persons, as well as sites of displacement. At the time of writing, over 94,000 forcibly displaced persons are estimated to be living in UNRWA shelters and the surrounding areas, with UNRWA running some 60 shelters.
• At least 197 UNRWA installations – or over half of all UNRWA installations in the Gaza Strip – are located within the Israeli-militarized zone, under displacement orders, or where these overlap.

Operational implications and humanitarian response

• UNRWA remains one of the largest providers of emergency learning and PSS services across the Gaza Strip.
• With the support of 236 school counsellors and over 300 assistant counsellors, the Agency has conducted 323,761 critical PSS sessions for approximately 730,000 displaced persons, including more than half a million children. Between 18 to 24 August 2025, a total of 8,077 displaced persons accessed these services.
• Between 7 October 2023 and 8 September 2025, UNRWA’s social work team provided services to 236,592 displaced persons, including psychological first aid, PSS services, family and individual activities, as well as case management. During the same reporting period, services were provided to over 2,800 survivors of gender-based violence (GBV) and 5,193 children, including 2,214 unaccompanied children. The team supported 27,442 persons with disabilities with PSS; 8,276 of these individuals received assistive devices and rehabilitation services. Awareness sessions on GBV, child protection, disability and special needs, as well as managing social and psychological stressors, were conducted for 145,895 displaced persons.
• UNRWA continued to provide mental health and psychosocial support (MHPSS) services in Gaza City, the middle and Khan Younis areas, through the support of health teams including 49 among psychiatrists, psychosocial counsellors and supervisors, assisting special cases referred from UNRWA health centres and shelters. From 1 to 7 September, UNRWA teams responded to 2,109 cases in health centres and at medical points through individual consultations, psychological first aid, awareness sessions and to address cases of gender-based violence (GBV).

Learning

• UNRWA has been providing learning services in Gaza in Temporary Learning Spaces (TLSs) and through its distance learning initiative.
• To date, more than 59,000 children, over half of them girls, have benefited from learning and recreational activities delivered in TLSs, established across  UNRWA schools-turned-shelters.
• Between 18 and 24 August 2025, a total of 4,595 children (1,973 boys, 2,622 girls, including 54 children with disabilities) benefited from TLS-based learning activities in 128 active TLSs. UNRWA has completed the second cycle of its Distance Learning Programme in Gaza from 19 April to 26 July 2025. Access to online learning remains very challenging to provide children with regular learning opportunities given cuts in telecommunications and electricity.

Food Security 

• Since 7 October 2023 and until the start of the ceasefire (19 January 2025), UNRWA reached over 388,000 families (nearly 1.9 million people) with two rounds of flour; at least 374,000 of those families have received three rounds.
• Up until the start of the ceasefire (16 January 2025), UNRWA reached at least 1.7 million people with food parcels. Of those, at least 215,000 people received two rounds of food parcels since the war started. These include[3] rice, lentils, beans, oil, salt, sugar, milk powder, hummus, halawa, yeast, and canned fish, and are designed to meet the needs of a family of five for two weeks.
• In addition to the distribution of UNRWA food parcels, the Agency has distributed food parcels on behalf of other UN organisations, having reached over 1.4 million people before the start of the ceasefire.
• During the ceasefire (mid January-mid March 2025), UNRWA reached over 2 million people with critical food assistance. UNRWA ran out of flour and food parcels at the end of April and was forced to halt food distributions. Between 1 March and 19 April 2025, UNRWA distributed nearly 270,000 bags of flour, reaching an estimated 88,000 families – or over 700,000 people. Since the ceasefire collapsed and until 8 April, only around 15,500 families (or an estimated 77,500 people) have received UNRWA food parcels. UNRWA ran out of food at the end of April. The Agency has not been allowed to bring in any humanitarian assistance including food for over six months now (since 2 March 2025).

Water, Sanitation and Hygiene (WASH)