Key Highlights

• One of four food aid missions to areas that require coordination in Gaza were facilitated by Israeli authorities in March.
• The World Health Organization reports that following the destruction of Al Shifa Hospital, northern Gaza has been left without any CT scanning capabilities, significantly reduced laboratory capacity, and only one source for medical oxygen production.
• Following repeated requests, Israeli authorities have made several commitments to facilitate the increase of humanitarian assistance to people in need.
• On World Health Day, the Palestinian Central Bureau of Statistics emphasized the challenges facing over half a million women of reproductive age and some 350,000 people suffering from chronic illnesses in Gaza.

Gaza Strip Updates

• Israeli bombardment from the air, land, and sea continues to be reported across much of the Gaza Strip, resulting in further civilian casualties, displacement, and destruction of houses and other civilian infrastructure. On 7 April, the Israeli military reportedly withdrew most of its ground forces from the southern Gaza Strip, leaving one brigade stationed in the newly established military corridor south of Gaza city.
• On 6 April, Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, Martin Griffiths, described the passing six months of war in Gaza as a “betrayal of humanity,” warning that “we face the unconscionable prospect of further escalation in Gaza, where no one is safe and there is nowhere safe to go. An already fragile aid operation continues to be undermined by bombardments, insecurity and denials of access.” On 7 April, the Secretary-General of the International Federation of the Red Cross and Red Crescent Societies, Jagan Chapagain, stated: “The current humanitarian situation for the civilians in Gaza is beyond catastrophic. Millions of lives are at risk of hunger. An urgent and unhindered flow of humanitarian aid must be ensured to reach those in need. Not tomorrow, but now.”
• Between the afternoons of 6 April and 8 April, according to the Ministry of Health (MoH) in Gaza, 116 Palestinians were killed, and 183 Palestinians were injured, including 32 killed and 47 injured in the past 24 hours. Between 7 October 2023 and the afternoon of 8 April 2024, at least 33,207 Palestinians were killed in Gaza and 75,933 Palestinians were injured, according to MoH in Gaza. According to the Government Media Office in Gaza, fatalities include some 14,500 children and 9,560 women.
• The following are among the deadly incidents reported between 4 and 7 April:
  • On 4 April, at about 15:00, three Palestinians were reportedly killed when a building northeast of Beit Hanun was hit. Later a Palestinian paramedic was reportedly killed, and three others injured, in an airstrike, while trying to evacuate the wounded.
  • On 4 April, at about 22:30, an unconfirmed number of casualties was reported when a residential square in Al Maghazi Camp was hit.
  • On 5 April, at about 10:00, three Palestinians were reportedly killed and others injured when a house in western An Nuseirat Refugee Camp was hit.
  • On 7 April, at about 9:30, four Palestinians were reportedly killed when a group of people was struck in Az Zahra city, north of An Nuseirat Refugee Camp.
  • On 7 April, at about 11:00, four Palestinians were reportedly killed when a residential building in Ash Shuja’iyyeh area in Gaza city was hit.
• Between the afternoons of 5 and 8 April, four Israeli soldiers were reported killed in Gaza. As of 8 April, 259 soldiers have been killed and 1,559 soldiers have been injured in Gaza since the beginning of the ground operation, according to the Israeli military. In addition, over 1,200 Israelis and foreign nationals, including 33 children, have been killed in Israel, the vast majority on 7 October. On 7 April, the Israeli military retrieved the body of an Israeli hostage from Khan Younis. As of 8 April, Israeli authorities estimate that 133 Israelis and foreign nationals remain captive in Gaza, including fatalities whose bodies are withheld.
• On 6 April, the World Health Organization (WHO) announced the findings of a UN mission to Al Shifa Hospital in Gaza city on 5 April, stating that the basic right to health is “utterly out of reach for the civilians of Gaza” and “the ability of WHO and partners to help is constantly disrupted and impeded.” The UN mission, which was jointly carried out by WHO, OCHA, Mine Action Service (UNMAS), and the Department for Safety and Security (UNDSS), assessed the extent of destruction at Al Shifa Hospital following a two-week Israeli military operation, siege, and heavy fighting between the Israeli military and Palestinian armed groups between 18 March and 1 April. Following six attempts to reach the hospital that were either denied, delayed or impeded by Israeli authorities, WHO reported that the scale of devastation has left what was once the largest and most important referral hospital in Gaza completely non-functional, with substantial efforts needed to clear unexploded ordnance, assess the potential for making the facility safe and accessible, and evaluate the functionality of vital equipment such as ventilators and CT scanners. Most hospital buildings, including the emergency department, the surgical and maternity ward buildings, and the neonatal intensive care department were extensively damaged or burnt, along with most of the equipment, beds, incubators, the oxygen plant, and other assets. As a result, according to WHO, northern Gaza has been left without any CT scanning capabilities, significantly reduced laboratory capacity, and only one source for medical oxygen production at Kamal Adwan Hospital, “severely compromising effective diagnosis, which will increase avoidable deaths.” In addition, WHO staff witnessed numerous shallow graves and many partially buried dead bodies in the hospital’s compound, which had a “pungent smell of decomposing bodies.” Describing the scene, OCHA staff observed that “Shifa has literally become a graveyard. There are bodies still in this courtyard… We should be scaling up our response. Instead, we are being obstructed. We’re stuck at checkpoints waiting. We’re picking up bodies from the side of the road. This madness needs to stop.”
• In March, access restrictions and denials of movement by Israeli authorities have continued to hamper the delivery of life-saving assistance, according to a recent OCHA report. Access into Gaza is characterized by “lengthy inspection processes, fuel shortages resulting from Israeli restrictions, and restrictions on the movement of trucks, convoys, and vetted drivers…and congestion at the Kerem Shalom crossing,” while the entry of humanitarian assistance and commercial goods directly into northern Gaza, where 70 per cent of the population is projected to be at risk of famine between mid-March and mid-July 2024, remains extremely limited. Within Gaza, only 26 per cent of planned food missions to high-risk areas requiring coordination with Israeli authorities were facilitated, 51 per cent were either denied or impeded, and 23 per cent were postponed or withdrawn due to security concerns or operational constraints. For movement between southern and northern Gaza, Israeli authorities facilitated less than half of planned aid missions in March and humanitarian actors could only utilize one route, with a limited use so far of the Fence Road on Gaza’s eastern border. Overall, the report underscores that the constrained ability of humanitarian organizations to address humanitarian needs in Gaza has “generated a volatile, insecure, and non-permissive operational environment,” amid intense aerial bombardment, military ground operations, unexploded ordnance contamination, infrastructural damage, and widespread insecurity.
• According to WHO, between mid-October and the end of March, over half of its missions in Gaza have been denied, delayed, impeded, or postponed. On 5 April, a mission bound for Al Awda and Kamal Adwan hospitals in northern Gaza was aborted due to safety considerations, following delays and the detention of a supply truck driver for more than an hour, which did not allow for the completion of the mission before nighttime. The mission aimed to deliver medical supplies and fuel, deploy emergency medical teams, and facilitate the referral of critical patients. On 4 April, WHO and its partners were able to deliver medical supplies for about 1,000 patients and one pallet of canned food to As Sahaba Hospital in Gaza city. Medical supplies for about 1,000 patients were also provided to Al Ahli Hospital, and one patient with complex lower limb injuries, along with a companion, was evacuated to a field hospital in Rafah. Reiterating WHO’s appeal for a ceasefire, WHO Director-General, Tedros Adhanom Ghebreyesus, said: “With shrinking health access, hospitals in the north are overwhelmed, and more medical supplies and food to serve the hundreds of patients are needed. We again call for sustained and safe passage for humanitarian aid.”
• On 6 April, the Humanitarian Coordinator ad interim for the occupied Palestinian territory, Jamie McGoldrick, announced that, following repeated requests by the humanitarian community, Israeli authorities have made several commitments to facilitate the ability of humanitarian actors to scale-up assistance in Gaza. This includes: the temporary re-opening of Erez crossing to allow for the direct entry of assistance into northern Gaza from Ashdod port; expansion of operating hours and scanning capacity at Kerem Shalom and Nitsana crossings; increasing the number of trucks entering through the Jordan corridor via Allenby Bridge from 25 to at least 50 a day; and approval to resume the operation of the water pipeline in northern Gaza. Moreover, the Humanitarian Coordinator reported that Israel has committed to establish a “better functioning coordination cell… that links humanitarian actors directly with the IDF Southern Command.” Israeli authorities have given further assurances that approvals will be given to activate 20 bakeries in northern Gaza. A timeframe for these measures remains pending.
• In a press release on the occasion of World Health Day, the Palestinian Central Bureau of Statistics (PCBS) stressed that the 10 hospitals still partially functioning in Gaza are operating at 359 per cent of their capacity, struggling to cope with the constant inflow of injured patients. Meanwhile, some 350,000 people suffering from chronic diseases are unable to access vital medicines, supplies, and services. PCBS also underlined the impact that the critical shortage of clean water, sanitation and hygiene supplies is having on over 540,000 women of reproductive age in Gaza, and the serious risks being faced by pregnant women and new mothers with no access to reproductive health services and postnatal care. On 2 April, the International Rescue Committee (IRC) indicated that at least 183 women are giving birth in Gaza every day, most without access to midwives, doctors, or healthcare facilities. Credible reports remain of women undergoing Caesarean-sections without anaesthesia. Furthermore, due to displacement, shock and malnutrition, pregnant women are experiencing premature labour and miscarriage, with health organizations having reported a threefold increase in miscarriage rates since the onset of the conflict, according to IRC.

Funding

• The Flash Appeal for the occupied Palestinian territory (oPt), which requests US$1.23 billion to meet the critical needs of 2.7 million people across the oPt (2.2 million in the Gaza Strip and 500,000 in the West Bank, including East Jerusalem), was extended through the end of March 2024. As of 7 April, Member States have disbursed nearly $1.27 billion for the updated Flash Appeal (103 per cent); this includes about $649 million out of $629 million (103 per cent) requested for October-December 2023 and about $623 million out of $600 million (104 per cent) requested for January-March 2024. For funding analysis, please see the Flash Appeal Financial Tracking dashboard. The Humanitarian Country Team plans to launch an updated flash appeal through the end of 2024 on 17 April, taking into account continued access constraints and security challenges.
• In March, the oPt Humanitarian Fund (oPt HF) had a total of 118 ongoing projects, for a total of $72.5 million, addressing urgent needs in the Gaza Strip (85 per cent) and West Bank (15 per cent). Projects focus on the areas of education, food security, health, protection, emergency shelter and non-food items, water, sanitation and hygiene, coordination and support services, multi-purpose cash assistance and nutrition. Of these, 75 projects are being implemented by international NGOs, 28 projects by national NGOs and 15 projects by UN agencies. Of the 90 projects implemented by INGOs or the UN, 51 are being implemented in partnership with NNGOs. Since 7 October, the oPt HF has mobilized a total of $88 million from Member States and private donors, designated for programmes throughout Gaza. For a summary of the oPt HF activities and challenges in March 2024, please follow this link. Private donations are collected directly through the Humanitarian Fund.
• The oPt HF is temporarily supporting the procurement of diesel fuel for humanitarian partners to avert a critical gap that might have stalled life-saving operations, and humanitarian actors are currently devising a longer-term mechanism. This followed the expiration on 31 March of a donor-funded project that provided subsidized fuel to humanitarian actors and critical private sector entities in Gaza. Moreover, in light of the updated Flash Appeal, the HF has additionally allocated $20 million to bolster selected ongoing HF-funded projects in Gaza to enhance the operational capacity of humanitarian partners as well as ensure the continuity and expansion of essential services amid escalating challenges. The HF is also developing an upcoming reserve allocation to bolster the capacity of national NGOs in the central areas of the Gaza Strip and Khan Younis, taking into account anticipated complexities in aid delivery, to ensure a more robust and effective humanitarian response. In the West Bank, the oPt HF has launched a repositioning funding allocation for $5 million for key partners to enhance system readiness and responsiveness to sudden-onset emergencies