• According to OCHA, between 7 October 2023 and 16 September 2024, 689 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 July 2024.

Overall Situation

The Gaza Strip

According to the Ministry of Health in Gaza, and as reported by OCHA, between 7 October 2023 and 18 September 2024, at least 41,272 Palestinians were reported killed and 95,551 injured.

Humanitarian Access, Protection of Civilians

The Gaza Strip

Health

• As of 17 September, 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 17 September, 1,133 UNRWA health staff continued to work in health centers and medical points across the Gaza Strip, providing 15,532 medical consultations on that day.
• On 17 September, 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 UNRWA health centers and shelters. UNRWA teams responded to 505 cases in health centers and at medical points through individual consultations and awareness sessions and to address cases of gender-based violence (GBV).
• On 17 September, medical teams provided medical care for 387 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 9 September 2024, UNRWA provided over 5.47 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 from the start of 2024 through mid-July.

Psychosocial Support and Learning

• UNRWA remains the largest provider of emergency learning and psychosocial support (PSS) across the Gaza Strip.  More than 659,000 children continue to be 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, with the support of nearly 750 [3] school counselors and up to 500 teachers. UNRWA continues to provide lifesaving psychosocial support services in Gaza, including psychosocial first aid, individual and group counseling, fatigue management sessions, recreational activities, Explosive Ordnance Risk Education (EORE), and protection cash assistance, reaching children, youth, and adults.
• Since the onset of the conflict in 2023, as of 15 September 2024, around 700,000 IDPs, including over 470,000 children, have benefited from a total of 253,648 PSS sessions/activities. Between 5-11 September, a total of 11,320 IDPs have accessed these services.
• Following the rollout of UNRWA’s “Back to Learning” program in UNRWA shelters, more than 8,500 children, 60 percent of whom are girls, have benefited from this response. Between 5 – 11 September, 8,320 children (3,317 boys, 5,003 girls, including 168 children with disabilities) participated in a variety of “Back to Learning” activities, including basic literacy and numeracy sessions, PSS sessions, and recreational activities such as arts, music, and sports.
• Since the onset of the war, UNRWA’s social work team has provided services to 172,369 [4] IDPs, including psychological first aid, PSS, family and individual activities, as well as case management. These efforts aim to address family issues and strengthen relationships. Protection services were provided to 1,388 GBV survivors and 2,125 children, including 1,150 unaccompanied children, covering reunification, safe sheltering, medication, dignity kits, and non-food items through referrals. The team also supported 18,833 persons with disabilities with PSS; 7,637 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 113,367 IDPs.

Food Security

• To date, a total of 380,236 families (nearly 1.9 million people) have been reached with two rounds of flour; 358,762 of those families have received three rounds.
• UNRWA continues to distribute food parcels in the southern governorates. These include [5] flour, rice, chickpeas, lentils, cheese, hummus, and canned fish, and are designed to cover approximately 90 percent of daily calorific needs per quarter. To date, nearly 1.15 million people have been reached, of whom nearly 215,000 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 carried out 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 15 August and September, UNRWA distributed over 80 cubic meters of water across 105 emergency shelters, reaching an estimated 480,000 people. During the first week of September, UNRWA distributed chlorine tablets to over 16 emergency shelters to prevent water contamination and improve water quality. Cleaning campaigns and hygiene promotion awareness sessions were held inside to coincide with the Polio vaccination campaigns. It is estimated that over 200,000 IDPs benefited from cleaning campaigns. Outside the emergency shelters, UNRWA continues to provide services, including water well services, to over 700,000 people scattered in informal settlements in Mawasi Khan Younis.
• Throughout the Gaza Strip, hundreds of thousands of tons of solid waste are piling up on the streets, between tents of displaced civilians, and next to the rubble in back alleys. The collapse of solid waste management since 7 October 2023 is worsening the public health crisis. Between 23 August and 5 September 2024, UNRWA collected a total of 2,000 tons of solid waste and transferred that to temporary dumping sites in the middle and southern areas.

• [1]Pre-conflict, UNRWA had 22 health centers. Following the onset of the conflict, an additional five temporary health centers were established.
• [2]Initially reaching 45 UNRWA schools/shelters, ‘Back to Learning’ will gradually expand to 94 schools in future phases.
• [3] 176 school counselors and 566 assistant counselors.
• [4] Results from 7 October 2023 – 15 September 2024.
• [5] Note the composition of the food parcel may change based on food item availability.