UNRWA Situation Report #104 on the situation in the Gaza Strip and the West Bank, including East Jerusalem

Friday, April 26, 2024

All information from 22–24 April 2024, is valid as of 24 April 2024 at 22:30 

Days 199-201 of Hostilities  

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Key Points  

The Gaza Strip 

  • On 23 April, Israeli Security Forces (ISF) announced a new evacuation order in parts of Beit Lahiya, in the North Gaza governorate. OCHA estimate that the area is home to at least 18,300 Palestinians before 7 October and includes three schools, including one UNRWA school, and the Indonesian Hospital, which reportedly hosts internally displaced persons (IDPs). Furthermore, ISF operations continue from air, land and sea continue across the Gaza Strip.
  • On 24 April, UNRWA launched its updated occupied Palestinian territory (oPt) flash appeal.  UNRWA is seeking US$ 1.21 billion to address the unprecedented humanitarian crisis in the Gaza Strip and respond to needs in the West Bank as violence increases. The Agency’s emergency appeal covers its humanitarian response until the end of 2024. It aims to respond to the most urgent needs of 1.7 million Palestinians in the Gaza Strip given the ongoing war, and more than 200,000 Palestine Refugees in the West Bank, including East Jerusalem. 
  • On 24 April Sigrid Kaag the Senior Humanitarian and Reconstruction Coordinator (SHRC) for Gaza briefed the Security Council.  Kaag reiterated that UNRWA is pivotal to providing life-saving humanitarian aid and critical social services to Palestine Refugees.  “As such, UNRWA is irreplaceable and indispensable as a humanitarian lifeline and must be allowed to deliver on its mandate.” She also noted that further steps are needed to enable sustained flow of humanitarian and commercial goods into Gaza in terms of volume, need and reach.
  • Since 7 October, according to OCHA more than two thirds of the population of the Gaza Strip have been placed under evacuation orders.
  • According to the Health Cluster, as of 24 April, Israeli authorities had approved just over half of all medical evacuation requests (5,263 out of 9,817). These limitations span from age restrictions, which have at times prevented essential evacuations of newborn babies, to the requirement for companions to have passports, in a context in which an estimated 30 to 40 per cent of people in Gaza have lost their identification documents during displacement, according to the Protection Cluster. The criteria for selecting patients who may be evacuated remain unclear, with only eight per cent of male patients aged 19 to 60 years approved for evacuation, compared to 74 per cent of women of the same age range.
  • Between 1 and 24 April, 57 per cent (39 out of 69) of humanitarian aid missions to northern Gaza were facilitated by Israeli authorities, 35 per cent (24) were denied or impeded, seven per cent were cancelled (five) due to logistical constraints, and one remains pending as of the time of reporting.  The last time UNRWA was able to deliver food supplies to the area was on 23 January 2024.  UNRWA remains critical in both the northern and southern parts of Gaza, with key distributions of food and non-food items including medicines in UNRWA health and distribution centres and emergency shelters.   
  • Commissioner-General of UNRWA on X highlighted that UNRWA Supplies and Dispatch Tracking Dashboard monitored that on 22 April more than 310 trucks of aid entered into the Gaza Strip via Kerem Shalom and Rafah land crossings.  This is the highest number of trucks since the war began on 7 October.  This increase, whilst welcomed, needs to be sustained, and access to commercial supplies expanded.  So far in April the average number of trucks entering the Gaza Strip via Kerem Shalom and Rafah landing crossings is 192 trucks per day, which is still well below the operational capacity of both border crossings and the minimum target of 500 trucks per day.
  • As of 24 April, the total number of UNRWA colleagues killed since the beginning of hostilities is 180.
  • As of 24 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. 

A child rides a bike among piles of waste in Rafah, Southern Gaza Strip, April 2024. © 2024 UNRWA Photo by Louise Wateridge
A child rides a bike among piles of waste in Rafah, Southern Gaza Strip, April 2024. © 2024 UNRWA Photo by Louise Wateridge

Overall Situation 

The Gaza Strip

  • According to the Ministry of Health in Gaza as of 24 April, at least 34,262 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 77,229 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. 
  • Two incidents have been reported impacting UNRWA installations and IDPs sheltering there. While verification of details and casualty figures remain ongoing, initial reports indicate:
    • On 13 March 2024 (estimated date, to be confirmed), a health centre in northern Gaza was directly hit resulting in damage to the building.
  • On 23 April 2024 (estimated date, to be confirmed), a school in Beit Lahia, north of the Gaza Strip, sustained severe collateral damage as a result of bombardments in the area. 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 at UNRWA premises. 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 24 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.  



  • As of 18 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 18 April, they provided 11,091 medical consultations.
  • UNRWA conducted another 8,732 medical consultations through 351 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 18 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 1,094 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 274 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). Between 3 January and 14 April over 74,296 children were vaccinated against measles, mumps and rubella and other diseases.

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 8 April, UNRWA continued to distribute flour outside of shelters in the southern governorates. To date, a total of 380,224 families (nearly 1.9 million people) have been reached, of whom 276,447 families have received two rounds of flour and another 75,423 families have received three rounds.

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


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 Philippe Lazzarini, UNRWA Commissioner-General

"This war should not become the new norm as we get into another sad milestone: 200 long days of brutality, loss, despair and anxiety. All efforts must be exerted to reach a long overdue ceasefire. Until then, much more support must come to UNRWA to allow us to respond to vast and growing humanitarian needs."

Read the news release: Nearly 2 Million People Depend On Assistance From UNRWA As War In Gaza Enters 200 Days And Violence Increases In The West Bank


Quote from a displaced man in Gaza:

“You have to queue for water. […] You also need to queue for the bathroom. […] Everything is in a queue. In displacement, everything means suffering; […] and everything needs time and fatigue.”





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A child rides a bike among piles of waste in Rafah, Southern Gaza Strip, April 2024. © 2024 UNRWA Photo by Louise Wateridge