Gaza Humanitarian Response Update | 8-21 July 2024

Attachments

Health

Response

  • During the reporting period, 49 Health Cluster partners reached about 350,000 people across the Strip. As of 23 July, there are 13 Emergency Medical Teams (EMTs) supporting the local healthcare workforce, including one in northern Gaza, and there is continued work to expand the bed capacity of hospitals.
  • Following the detection of Vaccine-Derived Poliovirus (VDPV) Type 2 in environmental samples collected from Deir al Balah and Khan Younis, the World Health Organization (WHO) has been working closely with the Ministry of Health in Gaza and partners to initiate response measures, including the deployment of a Polio expert to conduct further assessments and guide the response strategy.
  • The Health Cluster has set up a medical evacuation taskforce to lead the establishment of an effective and reliable medevac process.

Challenges

  • The numerous mass casualty incidents are stretching partners’ capacities to respond to trauma and emergency cases, amid a critical shortage of hospital beds as many hospitals have been put out of service.
  • Hospital generators remain at a breaking point due to overuse, the lack of alternative power generation options and constrained access to spare parts, placing the lives of critically ill and injured patients at risk.
  • The lack of access to clean water, hygiene kits, and sanitation facilities continues to pose major health risks and drive a surge in acute respiratory infections (currently exceeding 990,000 cases), diarrheal illnesses (577,000 cases), acute jaundice syndrome (107,000 cases) and skin infections. These health issues are exacerbated by poor living conditions and overcrowding in Gaza, making it even more challenging for healthcare providers to respond effectively.

Nutrition

Response

  • Partners continue to conduct Mid-Upper Arm Circumference (MUAC) screenings in shelters and healthcare facilities across the Gaza Strip. Since mid-January, 169,101 children aged 6-59 months and 10,355 pregnant and breastfeeding women (PBW) have been screened for malnutrition. Of all screened children, 11,541 have been diagnosed with acute malnutrition and have been receiving treatment in line with the simplified protocols; these include 8,993 children diagnosed with Moderate Acute Malnutrition (MAM), and 2,548 with Severe Acute Malnutrition (SAM). Additionally, 271 PBW have been enrolled in treatment.
  • As of 20 July, 307 service delivery points for blanket supplementary feeding and Infant and Young Child Feeding (IYCF) counselling were available at 296 sites. Since mid-July, nearly 100 metric tons of Lipid-based Nutrient Supplements (LNS-MQ) entered Gaza, allowing partners to resume the Blanket Supplementary Feeding Program (BSFP) at scale.
  • In July, as part of the “Find and Treat” campaign, 624 volunteers have so far been trained in screening, Community Management of Acute Malnutrition (CMAM), and IYCF practices. To date, a total of 438 health workers have been trained in CMAM, including 22 between 8 and 21 July, and 838 community workers have been trained to detect and refer identified cases of acutely malnourished children for treatment.
  • The Management of Acute Malnutrition Technical Working Group has developed a new set of tools for partners to better detect and manage malnutrition cases among infants under six months of age.
  • The Cluster continues to carry out a soft survey, mainly in Khan Younis and Deir al Balah, to acquire a better picture of the general distribution of Breast-milk Substitutes (BMS), such as infant formula and other milks, which is concerning given the associated risks of increased infant morbidity and mortality in emergencies, especially as the water and sanitation situation continues to deteriorate.

Challenges

  • Repeated displacement, insecurity and access constraints continue to hamper the early detection of children and women requiring nutrition services and the scale-up of operational presence to provide needed support. Tents have been set up to conduct malnutrition screenings and provide services, but the lack of privacy renders breastfeeding counselling challenging.
  • Repeated displacement, including among children diagnosed with malnutrition, has made it difficult for partners to monitor and follow up on malnutrition cases and for families to carry supplies for malnutrition prevention and treatment.
  • Insecurity, access constraints, and limited infrastructure hinder the delivery and storage of nutrition supplies like LNS-SQ, Ready-to-Use Therapeutic Food (RUTF), and Ready-to-Use Infant Formula (RUIF).

Food Security

Response

  • As of 20 July, 13 out of 18 bakeries supported by humanitarian partners were operational in the Gaza Strip – four in Gaza city, two in North Gaza and seven in Deir al Balah. Of the four bakeries in Gaza city, two had to temporarily cease operations between 8 and 19 July due to fighting and the lack of fuel. The other five bakeries located in Rafah remain closed due to the ongoing hostilities.
  • In July, about 630,000 cooked meals prepared in 180 kitchens were provided daily by FSS partners to families across the Strip, including about 20,000 meals in northern Gaza and 610,000 meals in central and southern Gaza. In addition, there are joint efforts with the Water, Sanitation and Hygiene Cluster to ensure the provision of safe drinking water to each community kitchen.
  • Since 8 July, FSS partners have been providing cooked meals, fresh fruits and high energy biscuits to people displaced from northern to central and southern Gaza, as part of multi-sectoral response at IDP reception points. FSS is also working with community representatives and Site Management Working Group (SMWG) partners who are tracking displacement to identify households who have been repeatedly displaced and ensure they are included in food assistance programmes.
  • In the first half of July, partners distributed about 36 metric tons of animal feed to more than 350 livestock-keeping households in southern and central Gaza, thereby contributing to the local production of meat and dairy products, which are key to ensure a nutritious diet, especially for children.

Challenges

  • Insecurity, damaged roads, the breakdown of law and order, and access limitations continue to hamper movement along the main humanitarian cargo route between Kerem Shalom Crossing and Khan Younis and Deir al Balah. This has resulted in critical shortages of aid commodities to sustain humanitarian operations, including the operation of community kitchens, in addition to increasing the risk of spoilage and infestation of stranded food supplies due to extremely high temperatures.
  • The passage of fuel and aid supplies from central/southern Gaza to the north continues to be partly impeded. As a result, the six bakeries in northern Gaza (four in Gaza city and two in North Gaza) are receiving only scarce fuel quantities, sufficient to keep them running for a few days at a time. In addition, hot meal production capacity in Gaza and North Gaza governorates has been insufficient to support tens of thousands of newly displaced people.
  • The lack of entry of commercial supplies into northern Gaza for nearly three months has resulted in a near total lack of protein sources such as meat and poultry on the local market, with only a few types of locally produced vegetables available at unaffordable prices.
  • Most distributed food rations contain gluten, negatively affecting hundreds of people with celiac disease and other medical conditions associated with gluten. FSS partners are currently seeking to bring in gluten-free flour.
  • The lack of a constant flow of seeds, fertilizers and other animal and crop production inputs is a key obstacle hampering the restoration of local food production in Gaza. Ongoing military operations in Rafah and eastern Khan Younis, where significant agricultural production was concentrated prior to the war, have resulted in additional damage to greenhouses and forced more people to leave their farms unattended, further destabilizing food systems.
  • Agricultural activities, including small-scale gardening that is critical to enhance dietary diversity, remain suspended. The implications of missing the upcoming agricultural season will likely devastate people’s livelihoods.
  • Shortages of cooking gas have forced displaced households to rely on burning wood and plastic from furniture and waste to cook, hindering proper food preparation as well as exacerbating health risks and environmental hazards.
  • Limited cash liquidity and insufficient access to financial services and telecommunications continue to hamper partners’ day-to-day operations and prevent the scale up of Cash and Voucher assistance to the population.

Water, Sanitation and Hygiene (WASH)

Response

  • Between 8 and 21 July, the Coastal Municipal Water Utility/Palestinian Water Authority (CMWU/PWA) reported that the average water supply for safe drinking and domestic purposes was about 90,000 cubic metres across the Gaza Strip, or about a quarter of water supply prior to the war. Al Muntar water pipeline from Israel to northern Gaza, which had been out of service since 1 July, resumed operations on 20 July after undergoing multiple rounds of maintenance to repair leakages and other damage.
  • In northern Gaza, UNRWA is rehabilitating two water wells, which could provide 200 cubic metres of additional water per day. At present, only four out of seven UNRWA water wells are operational, producing 3,800 cubic metres of water a day.
  • A slight increase in fuel provision during the reporting period was partly redirected to sewage facilities to urgently manage flooding and contamination.
  • In Khan Younis, the first phase of rehabilitating the sewage system is complete, with six pumping stations now restored, and the second phase focusing on network repairs near pumping stations is underway. About 76 kilometres of the network are damaged or clogged, of which two kilometers are already undergoing repairs. UNICEF and CMWU are also working to rehabilitate two pumping stations in western Khan Younis, which are partially damaged.
  • In Deir al Balah, there is ongoing work by the WASH Cluster and CMWU to rehabilitate the wastewater network and system in Az Zawaida and Al Maghazi Refugee Camp. UNICEF and CMWU are also coordinating the cleaning and unclogging of sewage lines in the governorate.

Challenges

  • The lack of generators and alternative energy sources, combined with the shortage of fuel and spare parts to operate existing generators, continue to severely hamper water production and sewage pumping, exposing the population to major health risks across the Gaza Strip. For example, there is currently a lack of fuel and spare parts to address reported sewage flooding between Az Zawaida and An Nuseirat Refugee Camp, particularly around As Sawalha pumping station.
  • WASH response actors cannot keep up with the high number of requests to remove sludge from septic tanks and cesspools and flooded sewage from streets due to a lack of vacuum trucks. The private sector is also struggling to meet demand.
  • The depletion of chlorine reserves, which are being consumed at double the rate prior to the war, requires the urgent import of new chlorine supplies to facilitate water purification.

Shelter and Non-Food Items (NFI)

Response

  • Between 8 and 21 July, and notwithstanding minimal resources, Shelter Cluster partners provided NFIs to 950 families who were displaced within northern Gaza, following the issuance of evacuation orders by Israeli military. Also in northern Gaza, partners provided 200 tents to a new IDP site in Beit Lahya, and preparations are ongoing to dispatch additional NFIs. In Deir al Balah, NGO partners provided shelter materials and NFIs to about 100 families who were recently displaced from northern Gaza.
  • The Shelter Cluster continues to track destinations and needs of new IDPs in Deir al Balah and Khan Younis governorates and provide, where possible, shelter support (e.g. tents, NFIs, sealing off kits).

Challenges

  • Partners remain unable to implement a meaningful Shelter response due to the severe lack of shelter materials and NFIs in Gaza.
  • Restrictions by the Israeli authorities on the transport of shelter materials between northern and southern Gaza means that partners cannot cover needs as they arise.
  • Recurrent displacement and limited access to many locations continue to hinder the ability of Shelter and NFI actors to carry out assessments and develop a comprehensive understanding of needs.

Protection

Response

  • Protection teams continue to identify and respond to the exponentially increasing protection risks and needs of displaced people in Khan Younis and Deir al Balah, by conducting visits to shelters and IDP sites, undertaking focus group discussions and key informant interviews with IDPs, monitoring aid distribution, and ensuring follow up on previously identified vulnerable cases.
  • Protection teams continue to track the release of Palestinians who were arbitrarily detained from Gaza and provide them with emergency assistance, including medical care and support to reunite with their families.
  • Child Protection partners continue to follow up on child protection cases and strengthen case management. Jointly with the Education Cluster, they also continue to identify child friendly spaces at informal displacement sites. During the reporting period, partners provided Psychosocial Support (PSS) for 800 children in northern Gaza and referred 15 cases of unaccompanied children or children with disability for support. With UNRWA support, a total of 4,784 children received clothes through distribution stores in Khan Younis and Deir al Balah. Overall, child protection partners have to date reached 682,000 children and 126,000 caregivers (see the Child Protection online dashboard).
  • The Protection Cluster continues to provide Psychological First Aid (PFA), identification and referral training to non-protection professionals. The training targets first-line service providers from other sectors to enable them to provide PFA, identify protection cases, and refer them to protection experts for further assistance.
  • During the reporting period, with support from the United Nations Population Fund (UNFPA) and UN Women, Gender-Based Violence (GBV) sheltering services were restored in southern Gaza, with two partners available to provide sheltering for high-risk GBV cases. To date, GBV partners have provided services to 12,000 displaced women and girls, established six mobile safe spaces in Deir al Balah and Khan Younis, and distributed over 80,000 hygiene and Menstrual Hygiene Management (MHM) kits, and sanitary pads, to the most vulnerable women and girls. GBV partners also continue to advocate for the entry into Gaza of additional hygiene supplies for women and girls to address shortages. Twenty GBV service providers have received PSS through care-for-carer sessions.
  • While efforts continue to deploy additional Explosive Ordnance Disposal (EOD) officers to Gaza, EOD-related activities had to be placed on hold following the evacuation order issued by the Israeli forces in eastern Khan Younis. The United Nations Mine Action Service (UNMAS) has been prioritizing emergency support to respond to requests related to medial access routes. Four Explosive Threat Assessments (ETA) were conducted, and three inter-agency convoys were escorted during the reporting period. Raising awareness messages on risks of explosive ordnance continue to be disseminated, including through in-person sessions in Nuseirat, Deir al Balah, Khan Younis, and Gaza; digital campaigns using SMS, radio and social media; awareness-raising sessions for humanitarians; distribution of materials, and Training of Trainers (ToT) sessions for local partners.

Challenges

  • Insecurity, the disruption of aid flows, the breakdown of law and order, and the denial of entry of critical items continue to hinder the Protection Response. Denied items include mine action supplies, sanitary pads, dignity and MHM kits for women and girls, recreational materials for children, as well as assistive devices for persons with disabilities. Delays in securing the entry of hygiene and dignity kits have resulted in a severe shortage of personal care materials, rendering women and girls more vulnerable to disease and violence.
  • The closure of the Rafah Crossing continues to impede the entry/exit of international aid workers.
  • The limited availability of supplies on the local market has led to soaring prices, further hindering the ability to prioritize the most vulnerable.
  • Cash shortages are hindering the use of Cash and Voucher Assistance (CVA) by some recipients; this is negatively affecting living conditions, increasing the risk of exposure to violence or exploitation for women and girls, and hindering the ability of partners to pay local service providers and staff salaries.
  • Logistic and security constraints continue to hamper the creation of safe spaces for confidential GBV case management activities, such as safe houses/shelters for high-risk cases, case management response, and the implementation of alternative care options for unaccompanied children. The limited availability of safe shelter options exposes IDPs, especially the most vulnerable, to heightened protection risks. Furthermore, intense heat and soaring temperatures are exacerbating living and working conditions in tents and makeshift shelters.
  • Frequent interruptions of internet and communications services and damage to key infrastructure continue to curtail mobility and operations.
  • The abrupt interruption in the entry of fuel has nearly halted the implementation of mine action and other protection activities, as well as monitoring and coordination by the Cluster.
  • Administrative hurdles, such as registration of organizational entities and delayed provision of visas, continue to prevent the scale up of mine action work.
  • Lack of funding continues to limit the deployment of additional EOD experts and Explosive Ordnance Risk Education and Conflict Preparedness and Protection (EORE-CPP) teams to meet the soaring needs.

Education

Response

  • During the reporting period, nine additional community-led education initiatives began in North Gaza, Gaza and Deir al Balah governorates, bringing the total number of such initiatives since October 2023 to 68. The Cluster has linked 35 of these initiatives with partners who are supporting the expansion of services. Moreover, 14 new partner-supported Temporary Learning Spaces (TLS) have been set up to enhance access to informal learning opportunities for school-aged children who have been deprived of formal education since October 2023.
  • Since October 2023, 32 partners have reached more than 350,059 students and teachers with PSS, emergency learning, recreational supplies and activities, and awareness sessions (source: Education Cluster 5W dashboard).

Challenges

  • Evacuation orders continue to pose significant challenges to the expansion of the Education response. Some TLSs had to be evacuated, and it has been challenging to find alternative spaces in new areas of displacement. Moreover, ongoing displacement has increased parents’ safety concerns and reduced children’s participation in activities at established TLSs.
  • The denial or limited entry of education supplies into Gaza and their shortage on the local market continue to hamper the implementation of the Education response, including the ability of volunteer teachers to actively engage children in learning and other recreational activities aimed at addressing the traumatic events they have experienced.
  • Critically low funding levels, with only 35 per cent of the required funds received, continue to hinder the scale up of the Education Cluster response.

Multi-purpose Cash Assistance (MPCA)

Response

  • Between 8 and 21 July, more than 11,127 households in Gaza received emergency MPCA, either first payments or top-ups in the case of vulnerable groups, including persons with disabilities (PwD) and nursing mothers. Overall, between 7 October 2023 and 21 July 2024, 197,407 households (1,362,156 individuals) received at least one MPCA payment. The current MPCA transfer value is ILS 1,000 (around US$275).
  • Since 7 October, 145,913 households (979,427 individuals) have cashed out their assistance. Cash out operations remain concentrated in governorates south of Wadi Gaza.
  • The use of “e-wallets” for digital transactions and purchases continues to expand among humanitarian Cash actors and the first Post-Distribution Monitoring (PDM) survey of e-wallet payments indicates a redemption rate of up to 80 per cent. The Cash Working Group (CWG) has developed a paper on the use of mobile money and e-wallet modalities in Gaza, which can be accessed here.

Challenges

  • A liquidity shortage, driven by the inability of banks to transfer money between branches, has negatively affected multiple facets of humanitarian operations, including: payments to locally recruited staff and service providers; the payment of essential operational expenses such as utility and communication bills; procurement activities; and the safety and security of NGOs.
  • Lack of connectivity and available agents, especially in northern Gaza, continue to limit the ability of some households to cash out received assistance. Furthermore, poor electricity supply and limited connectivity compromise the ability of financial service providers to make cash accessible to MPCA recipients. About 7,034 payments have so far been cancelled after not being cashed out for months.
  • Informal markets are the primary source of accessing goods, which complicates efforts to track distributions and gather market data.
  • Assistance falls short of needs due to price volatility and the collapse of formal markets, especially in northern Gaza.

Emergency Telecommunications (ETC)

Response

  • On 10 July, the ETC team participated in an inter-agency assessment in Al Bureij and Maghazi refugee camps in Deir al Balah to identify telecommunications, internet connectivity, and power solution needs.
  • The ETC is engaging with key stakeholders to ensure the availability of fuel and equipment to keep telecommunications services operational.
  • During the reporting period, the ETC coordinated the first steps of importing 33 Track-24 devices (satellite-based staff tracking devices), which are intended for the use of five UN agencies operating in Gaza. The ETC is following up on the coordinating the import of the remaining 65 devices.
  • The ETC Cluster also continues to advocate for the need to import more ICT and telecommunications equipment into Gaza to set up common communications services. For more information on ETC activities, please visit: Conflict | Emergency Telecommunications Cluster (ETC) (etcluster.org).

Challenges

  • Due to escalating hostilities, increased restrictions on the movement of commodities, damaged infrastructure and lack of fuel and spare parts, local Mobile Network Operators and Internet Service Providers in the Gaza Strip are experiencing network outages and are unable to conduct the necessary repairs. Current conditions are also rendering it difficult to maintain the functionality of the remaining network and have resulted in the loss of connectivity in Rafah.
  • The availability of telecommunications equipment is severely limited, hampering the delivery of ETC services. Much equipment has been damaged or destroyed and the import of new equipment has been lengthy and challenging. Only 20 satellite phones, 30 VHF digital radios, four VHF repeaters and four solar power solutions have been coordinated for importation into Gaza with Israeli authorities since 7 October 2023.
  • Increasing insecurity, displacement, and relocation of staff from Rafah to Deir al Balah have rendered it difficult to deploy shared ETC communications services or provide face-to-face technical support for humanitarian responders.
  • The lack of funding has limited the ETC Cluster’s capacity to address immediate communications needs for humanitarian responders in Gaza. Thus far, less than 32 per cent of requested funding (US$1.8 million) by the Cluster under the updated OPT Flash Appeal has been received.

Logistics Cluster

Response

  • As of 21 July, the Logistics Cluster consolidated 14,361 cubic metres of humanitarian cargo at its common warehouse in Amman. The 5,000 square metre facility aims at supporting humanitarian partners’ aid delivery operations via the Jordan corridor.
  • Between 8 and 21 July, six direct convoys with a total of 139 trucks were dispatched with food, shelter and WASH items. Since November 2023, the Logistics Cluster has facilitated a total of 70 humanitarian convoys through this corridor, with 1,713 trucks carrying 23,371 cubic metres of aid dispatched into Gaza on behalf of 22 organisations. All convoy information is available on the interactive dashboard.
  • In Gaza, storage services are available in a warehouse in Deir Al Balah with a capacity of 1,700 square metres.
  • The Logistics Cluster team is working with partners to centralise loading from a single location, to enhance the efficiency of handling operations.

Challenges

  • Access and security constraints continue to severely hamper Logistics Cluster’s efforts to collect partners’ cargo at Kerem Shalom Crossing.
  • Current capacity limitations at Erez West Crossing are limiting the ability of partners to scale-up aid delivery via the Jordan Corridor.
  • As of 21 July, over a thousand UN and international NGO trucks are backed up in Al Arish ready to be dispatched into Gaza, due to the backlog at Kerem Shalom Crossing, which disproportionately affects temperature-sensitive cargo. This figure only includes UN and INGO trucks and does not account for bilateral donations handled by the Egyptian Red Crescent (ERC).