UNRWA Situation Report #33 on the situation in the Gaza Strip and the West Bank, including East Jerusalem

Sunday, November 19, 2023

All information is valid as of 18 November 2023 at 22:30 local time 

Day 43 of Hostilities 

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Key Points  

The Gaza Strip 

  • On 18 November, one UNRWA colleague was killed in the North area due to strikes. In total, 104 colleagues have been killed since the beginning of the war. This is the highest number of United Nations aid workers killed in a conflict in the history of the United Nations. 
  • Several incidents impacting UNRWA installations and Internally Displaced People (IDPs) have been recorded by UNRWA in the last 24 hours resulting in the killing and injuring of many IDPs sheltering in the installations. UNRWA is still trying to verify the correct number of casualties.
  • Almost 1.7 million people have been displaced across the Gaza Strip since 7 October.
  • As of 18 November, nearly 884,000 internally displaced persons (IDPs) are now sheltering in 154 UNRWA installations across all five governorates of the Gaza Strip, including in the north.  
  • Nearly 724,000 IDPs are sheltering in 97 facilities in the Middle, Khan Younis and Rafah areas. Nearly 160,000 IDPs were sheltering in 57 UNRWA schools in the northern and Gaza areas as of 12 October 2023, before the evacuation order was issued by Israeli Authorities. UNRWA is not able to access these shelters to assist or protect IDPs and does not have information on their needs and conditions.
  • The entry of fuel critical for the overall humanitarian operations across the Gaza Strip has been largely banned since 7 October when the war began.  
  • On Wednesday, 15 November, the Israeli Authorities allowed the entry of just less than 23,000 litres (half a truck) of fuel for UNRWA to transport trucks of aid arriving via Rafah. This fuel could not to be used for any other humanitarian purposes.
  • On 18 November, the Israeli Authorities authorized the entry of 120,000 litres of fuel that will be used over two days and will only cover half of the daily critical needs. UNRWA has been informed that 120,000 litres of fuel will be delivered every two days.
  • Fuel is also critical for telecommunications networks. Gaza endured a fourth communications blackout on Friday 17 November. As a result, UNRWA was not able to transport trucks of humanitarian assistance arriving via Egypt.


The West Bank, including East Jerusalem

  • On 16 November, an ISF operation was reported in Fara’a refugee camp, north-east of Nablus. There was an exchange of fire between Palestinian and ISF and two Palestinians were reportedly injured, including one with live ammunition. One Palestinian was detained.
  • An UNRWA sanitation labourer was held by ISF while working in the camp and wearing a UN vest, and then released. The UNRWA health centre and schools in the camp opened later.
  • In the evening, an ISF operation was reported in Jenin city and refugee camp. An exchange of fire took place between Palestinians and ISF in the city and in the vicinity of the camp. ISF snipers were reportedly stationed on the top of Palestinian houses, in the city and in the vicinity of the camp, and ISF drones reportedly fired missiles at Palestinian houses.
  • Over 1,600 students in UNRWA four schools in Jenin refugee camp are still unable to safely access school premises due to the bad condition of the roads. Schools continue to operate through blended learning.
  • On 17 November, a Palestinian died from injuries sustained in clashes with ISF during the ISF operation in Jenin refugee camp on 9 November.
  • On 18 November, an ISF drone fired missiles towards the Fatah office in Balata refugee camp, Nablus. Five Palestinians were reported killed and two others were injured. Damages were also reported to infrastructure and other buildings in the camp, including the house behind the targeted building, which housed eight people in two apartments. It has been reported as uninhabitable.
  • On the same morning, ISF launched an operation in the Balata refugee camp, and entered the camp with an armoured bulldozer. ISF further damaged the area where the drone strike occurred earlier in the night, including a house in the market area and a number of neighbouring homes, as well as some shops.
  • On the same day, ISF launched a search and arrest operation in Ein Sultan refugee camp, Jericho. Clashes took place between ISF and Palestinians and several cases of tear gas inhalation were reported.

Woman taking shelter in an UNRWA school in Rafah after heavy rain and flooding, 14 November 2023. ©Ashraf Amra
Woman taking shelter in an UNRWA school in Rafah after heavy rain and flooding, 14 November 2023. ©Ashraf Amra


Overall Situation 

The Gaza Strip

  • According to the Ministry of Health (MoH) in Gaza, as of 10 November over 11,078 people have been killed in the Gaza Strip since 7 October; two thirds of them are reportedly children and women. Due to the collapse in MoH services and communications in the North, casualty data has not been updated for the last five days.
  • Overall, around 1,200 Israelis and foreign nationals have been killed in Israel, according to Israeli Authorities, the vast majority on 7 October (OCHA).


The West Bank

  • According to OCHA, since 7 October, 198 Palestinians, including 52 children, have been killed by ISF and eight, including one child, by Israeli settlers


Humanitarian Access, Protection of Civilians 

The Gaza Strip

  • On 18 November, one UNRWA colleague was killed in the North area due to strikes. In total, 104 colleagues were killed since the beginning of the war.
  • Due to strikes nearby, two UNRWA schools were impacted in Khan Younis. In one school, which is sheltering over 7,600 IDPs, one person was killed and four people, including one child, were injured. In another school, which is sheltering over 5,100 IDPs, one person was injured.
  • UNRWA received reports that one UNRWA school in Gaza City was directly struck. Initial media reports and witness statements suggest that many people were killed and injured. According to witnesses, between 3,000-4,000 IDPs were sheltering at the school at the time.
  • UNRWA received reports that one UNRWA school in Jabalia, in the North Area, was also directly impacted when classrooms on the 2nd and 3rd floors were hit. At least 24 individuals were reported killed in the strike, and it is possible that the number killed may be far higher. It is not possible to estimate the number injured at this time.
  • According to witnesses, up to 7,000 IDPs were sheltering at the school at the time. This is the second time this school has been hit, as on 4 November, it was already hit resulting in 12 killed and 54 injured (according to Ministry of Health figures).
  • UNRWA also received reports that ISF tanks entered another school in Gaza and used it for their military operations.
  • At least 778 IDPs sheltering in UNRWA premises have been reportedly injured and at least 176 were reported killed since 7 October. The number of killed and injured IDPs is an estimate and it is likely to be higher as UNRWA is still trying to verify casualties from incidents impacting its installations in the North Gaza and Gaza governorates.
  • As of 18 November, UNRWA was able to verify that 85 incidents[1] have impacted 67 UNRWA installations since the beginning of the war. Of these, 17 installations were directly hit and 45 were impacted by collateral damage. Based on information available at the time of reporting, there have been five incursions into UNRWA installations since the beginning of the war.
  • Over 50 per cent of the impacted installations are south of Wadi Gaza.
  • In total, 104 UNRWA colleagues have been killed since the beginning of the hostilities. This is the highest number of United Nations aid workers killed in a conflict in the history of the United Nations. At least half have been killed south of Wadi Gaza.

[1] Number of incidents impacting UNRWA installations, which includes counting multiple incidents involving the same installation as individual events. 


UNRWA Response  

The Gaza Strip  

UNRWA Shelters 

  • The number of displaced people continues to increase. UNRWA shelters in the Middle and Southern areas are severely overcrowded and are unable to accommodate new arrivals.
  • The installations accommodate far more people than their intended capacity. They are not designed to host such a large number of people and do not have adequate facilities to provide safe and dignified living conditions. The over-crowding is leading to significant spread of diseases, including acute respiratory illness and diarrhea, raises environmental and health issues and limits the Agency’s ability to provide services.
  • People inside shelters do not have enough food and basic survival items. Hygiene levels are poor and mental health issues increase.
  • On average, there is one shower unit for every 700 people in UNRWA shelters. 
  • The number of toilets differs from one shelter to another. In general, there are 30 to 50 toilets in a school (including those for persons with disabilities). On average, 150 people sheltering in UNRWA schools share a single toilet



  • On 15 and 16 November, nine (out of 22) UNRWA health centres were still operational in the middle and southern areas, recording 15,974 patient visits, including Palestine Refugees and non-refugees. 
  • Most of these health centres are unable to use online registration systems for patients due to network breakdown. Patient information is therefore mostly registered on paper, making data collection and reporting more challenging.
  • Midwives are providing care for post-natal and high-risk pregnant women at the nine operational health centres. There are an estimated 50,000 pregnant women in Gaza, with more than 180 giving birth every day. A total of 483 post-natal and high-risk pregnancy cases were attended to at the health centres on 15 and 16 November.
  • On 15 and 16 November, 1,289 children were vaccinated at seven health centres according to the national vaccination programme.
  • On the same day, emergency dental services (bleeding- swellings- trauma and extraction) were provided to 533 cases at seven health centres.
  • UNRWA continued to provide health care to IDPs at shelters through 124 medical teams deployed to the shelters. 331 health workers attended a total of 20,082 cases on 15 and 16 November.
  • Only through further rationing of fuel reserves and through solar energy has UNRWA been able to operate the health centres. Soon UNRWA operations will entirely depend on solar energy which is designed to cater for minimal operations. Functionality of the solar energy is not guaranteed as any malfunction and/or battery failure will bring all operations to a halt. 


Relief and Social Services/Psychosocial support

  • UNRWA has counsellors and social workers in the shelters to provide psychosocial first aid and other specialized protection services. Since 7 October, over 44,830 individuals (nearly 61 per cent of whom are females) received psychosocial support including family support and recreational activities.
  • In coordination with the organization “Humanity & Inclusion”, UNRWA provided specialized support, including dignity kits and assistive devices, to 3,830 persons with disabilities, injured, children and elderly.


Water, Sanitation, Hygiene (WASH)

  • UNRWA was able to continue the provision of reduced water and sanitation services. The production of water wells decreased to 7,000 cubic metres (from an average of 10,000 cubic metres).
  • The distribution of potable water stopped in Rafah due to lack of fuel for the water tankers but continued in Khan Younis and Middle areas thanks to the desalination plant which remained operational.  Distribution of domestic water to the shelters continued at a minimum level.
  • A number of public water wells in the south of Wadi Gaza stopped working. However, UNRWA is unable to confirm precise figures due to the communication breakdowns.
  • Solid waste collection from the camps and from emergency shelters and transfer to landfills continues in the Middle, Khan Younis and Rafah areas. 


Quote from UNRWA staff

“Just getting into one of the shelters makes you burst into tears. Children looking for food and water & standing in queues for over six hours just to get a piece of bread or a bottle of water. People are literally sleeping on streets here in Khan Younis as thousands keep escaping from the North. Markets are totally empty except for a few vegetables. This misery has to stop, or people are going to die of hunger and diseases.”



ENDs -  

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UNRWA Situation Report #33 on the situation in the Gaza Strip and the West Bank, including East Jerusalem