UNRWA Situation Report #109 on the situation in the Gaza Strip and the West Bank, including East Jerusalem

Friday, May 24, 2024

All information from 20-22 May 2024, is valid as of 22 May 2024 at 22:30 

Days 227-229 of Hostilities  

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Key Points  

  • Reports continue of ongoing strikes by Israeli Forces, encompassing aerial, land and maritime bombardment across the Gaza Strip. These attacks result in civilian casualties, displacement and the destruction of residential structures and essential civilian infrastructure. The Israeli ground offensive continues to expand, particularly in the southern regions of Gaza City and eastern Rafah, notably around the Karem Abu Salem (Kerem Shalom) and Rafah Crossings. 
  • Humanitarian operations in Gaza continue to face severe humanitarian access restrictions, including the ongoing closure of key crossings, denials of planned missions and delays in movements imposed by Israeli authorities. According to OCHA, between 1 and 20 May, 183 humanitarian aid missions in Gaza were coordinated with the Israeli authorities. Of the 51 missions to northern Gaza, only 37 per cent were facilitated by the Israeli authorities, and the remaining missions were either denied access, impeded (these may be aborted or accomplished, albeit partially, despite the impediment), or cancelled.  For missions in southern Gaza, among the 132 missions, only half were facilitated by the Israeli authorities and the remaining half 50 per cent were either denied access, impeded, or cancelled.  
  • Families that have been already displaced several times are on the move again due to military operations and Israeli evacuation orders. As of 19 May 2024, the estimated number of people displaced from Rafah is nearly 815,000 people since 6 May, with a further 100,000 people displaced in northern Gaza. Most UNRWA shelters in Rafah have been vacated, with internally displaced people moving to Khan Younis and Deir Al Balah.  Overall displacement numbers correlate with the UNRWA registration figures in the new locations: for example, nearly 150,000 people have registered for essential services for UNRWA in Khan Younis alone in the last ten days. 
  • As a result of the ongoing military operation in eastern Rafah the UNRWA distribution centre and WFP warehouse, both in Rafah, remain inaccessible.
  • The current Israeli military operation in Rafah is directly impacting the ability of aid agencies to bring critical humanitarian supplies into Gaza as well as the ability to rotate critical humanitarian staff.  From 1 – 20 May, according to OCHA, 14 missions which were heading to Kerem Shalom to collect aid supplies encountered delays due to traffic congestions blocking the road and delayed clearance by Israeli authorities, resulting in six missions being aborted. During this reporting period (20- 22 May), the border crossings were only open for one day and only 39 trucks entered the Gaza Strip via Kerem Shalom and Rafah land crossings.  Since 6 – 20 May only 143 trucks have entered the Gaza strip via Karem Abu Salem. 

For latest updates on trucks please check:   

Gaza Supplies and Dispatch Tracking | UNRWA

  • According to WHO and the Health Cluster, evacuation orders and ongoing military operations in proximity of health facilities are further disrupting healthcare service provision. In Rafah, a hospital, a field hospital, and four primary health centres, and 21 medical points located within the zone were ordered to be evacuated in May.  As of 18 May, in the entirety of the Gaza Strip only 15 out of 36 hospitals (41 per cent) remain partially functional, and 33 out of 93 primary health care facilities (35 per cent) are functional.  UNRWA remains the largest health service provider in Gaza, with 7 primary health care clinics and over 100 medical points across the Gaza Strip still operational.  According to the health cluster, UNRWA provides an average of 160,000 people a week with health services eincluding child healthcare, primary healthcare, mental health, which equates to over 50 per cent of all people reached with health services. 
  • As of 22 May, the total number of UNRWA colleagues killed since the beginning of hostilities is 191, an increase of two.

The West Bank, including East Jerusalem

The West Bank, including East Jerusalem update will shift to once a week, every Monday. 

People seeking shelter in Deir al-Balah, Middle Areas, Gaza Strip. May 2024. © 2024 UNRWA Photo by Ashraf Amra
People seeking shelter in Deir al-Balah, Middle Areas, Gaza Strip. May 2024. © 2024 UNRWA Photo by Ashraf Amra

Overall Situation 

The Gaza Strip

  • According to the Ministry of Health in Gaza as of 22 May, at least 35,709 Palestinians have been reportedly killed in the Gaza Strip since 7 October. Another 79,990 Palestinians have been reportedly injured. 


The West Bank, including East Jerusalem

  • According to OCHA, between 7 October 2023– 22 May 2024, 489 Palestinians, including at least 117 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.  Six incidents have been reported, some of which occurred earlier impacting UNRWA installations and internally displaced people (IDPs) sheltering there but only became available during this reporting period. While verification of details and casualty figures remain ongoing, initial reports indicate:

• On 17 May 2024, UNRWA received the information that 2 adjacent UNRWA offices for sanitation office and maintenance in Jabalia (north of Gaza) were completely destroyed by air strikes and subsequently bulldozed by Israeli forces troops.

• On 19 May 2024, a displaced child was reportedly killed by shrapnel that fell inside a classroom of a school in Jabalia as a result of a strike on a nearby building.   The body of the child was reportedly buried inside the school.

• On 19 May 2024, according to information received by UNRWA from media sources, the Israeli Security Forces (ISF) issued evacuation orders to an UNRWA school and other non-UNRWA schools sheltering IDPs in Jabalia camp, ordering IDPs to leave the school.

• On 22 May 2024, the tents of the IDPs inside a school in Jabalia were reportedly set on fire by the Israeli forces, resulting in several casualties among the IDPs.

• On 22 May 2024, according to information received by UNRWA through media sources, an unconfirmed number of IDPs were killed and others were injured when a school in Jabalia was besieged by Israeli forces tanks and floor of the school was struck by tank shells.

• 388* 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 54 incidents of military use and/or interference at UNRWA premises. 174 different UNRWA installations have been impacted. 

• UNRWA estimates that in total at least 450* IDPs sheltering in UNRWA shelters have been killed and at least a further 1,472* 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 health centres in the last 12 days have not received any medical supplies due to Rafah and Kerem Shalom crossing closure/disruptions.  This affects the stock of medicines, mainly general items such as antibiotics for children and anti-epileptic drugs. Certain laboratory and dental items and vaccines are out of stock. 
  • As of 21 May, 107 medical points and seven (out of 24[1]) UNRWA health centres were operational. These health centres provide primary health care, including outpatient services, non-communicable disease care, medications, vaccination, antenatal and postnatal health care and dressing for injured patients. 
  • On 11 May, four medical points in the North area were closed due to the security situation, UNRWA continued to adapt to the fluid situation and set up an additional medical point in Gaza City on 16 May.  On 21 May, an additional medical point was open in al-Mawasi (Khan Younis) due to increased demand for health services. 
  • Nearly 665 healthcare staff continue to work in operational health centres. On 21 May, they provided 8,468 medical consultations.
  • UNRWA conducted another 6,411 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.
  • As of 21 May, 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 895 cases. UNRWA teams responded to cases in health centres and medical points through individual consultations, awareness sessions and support for cases of gender-based violence. UNRWA teams provided medical care for 350 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). From January – 12 May nearly 100,000 children were vaccinated against measles, mumps and rubella, hepatitis, tuberculosis and other diseases in UNRWA health centres.

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


Psychosocial support (PSS)

  • With the support of more than 300 counsellors, UNRWA continues to provide life-saving psychosocial support services in Gaza, including psychosocial first aid, individual and group counselling, fatigue management sessions, recreational activities, Explosive Ordnance Risk Education (EORE) as well as protection case assistance. targeting children , youth and adults.
  • Since the onset of the conflict, it is estimated that 650,000 IDPs including over 400,000 children have benefited from a total of 205,746 PSS sessions/activities. During the period from 17 - 23 May 2024, a total of 40,701  IDPs ,including 28,704 children, benefited from these services. Specifically, counsellors addressed 1,696 individual consultations and provided 506 group awareness sessions benefiting 5,222 adults .Additionally, they conducted 981 recreational activities engaging 19,019 children. Counsellors also provided 716 EORE sessions to 6,775 adults and 713 sessions to  9,685 children .

 Food Security

  • As of 22 May, UNRWA continued to distribute flour outside of shelters in the southern governorates. To date, a total of 380,225 families (nearly 1.9 million people) have been reached, of whom 337,468 families have received two rounds of flour and another 237,162 families have received three rounds.

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 Abdel-Rahman, 14-year-old boy displaced in Gaza:

"I hope the world can support us, so that we can bring Gaza back to life again.  I and all the people in tents can return to live in our homes and walk in our streets to make Gaza beautiful again."




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People seeking shelter in Deir al-Balah, Middle Areas, Gaza Strip. May 2024. © 2024 UNRWA Photo by Ashraf Amra