Day 76: Over 20,000 Palestinians Killed Since October 7th

On 21 December, heavy Israeli bombardments from air, land, and sea, continued across most of the Gaza Strip. Intense ground operations and fighting between Israeli forces and Palestinian armed groups continued, in most areas of Gaza, with the exception of Rafah. The firing of rockets by Palestinian armed groups into Israel continued.

20,000 Palestinians have been killed since the 7th of October. Of them, more than 8,000 are said to be children and more than 6,200 women. The Under-General Secretary stated: “That such a brutal conflict has been allowed to continue and for this long – despite the widespread condemnation, the physical and mental toll and the massive destruction – is an indelible stain on our collective conscience.”

According to the United Nations Office for the Coordination of Humanitarian Affairs:

• On 21 December, at about 20:40, the main telecommunication provider in Gaza announced that its services were gradually returning to the southern and central Gaza. This followed a shut down since 14 December, apart from 18 to 20 December, where there was a partial resumption at about ten per cent capacity in southern Gaza. Humanitarian agencies and first responders have warned that telecommunication blackouts jeopardize the already constrained provision of life-saving assistance. As a result of limited communication throughout the day, this Flash Update provides limited updated information about the humanitarian situation in Gaza over the past 24 hours.
• Between 7 October and 19 December, 19,667 fatalities were reported by the Gaza Ministry of Health (MoH), which has not published updated tolls since then. The Gaza Government Media Office reported on the fatalities as of 21 December, although their methodology is unknown. Taken together, with the noted caveats, these figures amount to about 20,000.
• Between 20 and 21 December, four Israeli soldiers were reportedly killed in Gaza. Since the start of the ground operations, 138 soldiers have been killed in Gaza, and 771 soldiers have been injured.
• The entire population in the Gaza Strip faces an imminent risk of famine, according to the latest estimates from the Integrated Food Security Phase Classification (IPC) global partnership on 21 December. Bombardment, ground operations, and the besiegement of the entire population, coupled with restricted humanitarian access, have resulted in catastrophic levels of acute food insecurity, intensifying the risk of famine each day, according to IPC.
• Should the situation continue, it is predicted that between 8 December 2023 and 7 February 2024, Gaza’s population will be the highest share of people facing high levels of acute food insecurity ever classified by the IPC initiative for any given area or country, since its establishment in 2004. (More details under the food security section).
• On 20 December, Israeli forces raided the Palestine Red Crescent Society’s (PRCS) ambulance centre in Jabalya, north of Gaza, after a two-day siege. Reportedly, staff members and paramedics were arrested and taken to an unknown location. Some 127 people, including 22 injured patients who were being treated by staff, were inside the building. Contact was lost with the operations room and PRCS team in Gaza, due to the telecommunications blackout.
•    On 21 December, The World Health Organization (WHO) stated that northern Gaza had been left without a functional hospital due to the lack of fuel, staff, and supplies. Only nine out of 36 health facilities are partially functional in the whole of Gaza, with no functional hospital in the north. Al Ahli is still treating patients but not admitting new ones, along with Al-Shifa, Al Awda and Al Sahaba hospitals. These hospitals are still sheltering thousands of displaced people
• • Under such conditions, people are unable to avail of hospitals’ services. For example, 42 babies have been born within a school functioning as a shelter in Deir al Balah (Middle Area), according to UNRWA, instead of in health facilities.
  • On 20 December, the International Labour Organization and the Palestinian Central Bureau of Statistics assessed that at least 66 per cent of employment, the equivalent of 192,000 jobs, has been lost in Gaza since the escalation of hostilities on 7 October. The effects of the escalation are also felt in the West Bank, where 32 per cent of employment has been lost, the equivalent of 276,000 jobs, in the same time period, according to the two bodies.
  • On 21 December, 78 trucks carrying supplies and five ambulances entered Gaza through Rafah crossing and 22 trucks entered through Kerem Shalom crossing. This remains well below the daily average of 500 truckloads (including fuel and private sector goods) that entered every working day prior to 7 October.

  Hostilities and casualties (Gaza Strip)

  • The following are among the deadliest incidents reported on 21 December:
    • At about 19:00, 28 Palestinians, including children and women, were reportedly killed, and tens of others were injured, when two houses and agricultural land sheltering internally displaced persons (IDPs) were struck near the European Hospital, in Khan Yunis.
    • At about 17:10, 13 Palestinians were reportedly killed, and ten others were reportedly injured when a house was struck in Al-Amal neighbourhood, west of Khan Yunis.
  • On 20 December, at about 17:20, Israeli forces reportedly forced Palestinian families out of their homes before setting those structures on fire at An Nazla area in Jabalya city, northern Gaza.
  • On 20 December, the UN Human Rights Office issued a statement on reports of an incident on 19 December between 20:00 and 23:00, whereby Israeli forces reportedly shot and killed at least 11 Palestinian men, and allegedly injured an unconfirmed number of women and children in the Al Awda residential building, also known as the “Annan building,” in Ar Remal neighbourhood, Gaza city. Three related families were sheltering inside this building during the incidents. Initial witness reports circulating through media allege that the men were separated from women and children and were then shot and killed in what may amount to a war crime. The details of this incident are yet to be verified.

  Displacement (Gaza Strip)

  • Areas encompassing about 30 per cent of the Gaza Strip (excluding the orders to evacuate the areas north of Wadi Gaza) have been marked for evacuation on the Israeli military’s online map. Access to this information is impaired by recurrent interruptions in telecommunications and the lack of electricity.
  • Inflow of IDPs to Rafah governorate continued on 20 December. As shelters in Rafah city have exceeded their capacity significantly, most newly arriving IDPs have settled in the streets and in empty spaces across the city. Rafah governorate has become the most densely populated area in the Gaza Strip, with hundreds of thousands of IDPs squeezed into extremely overcrowded spaces and in dire living conditions. Population density is assessed to now exceed 12,000 people per square kilometre, a fourfold increase prior to the escalation. Thousands of people line up before aid distribution centres in need of food, water, shelter, and protection, amid the absence of latrines and adequate water and sanitation facilities in informal displacement sites and makeshift shelters. This situation is compounded by the cold winter and rain over the last week, which have flooded tents and other makeshift shelters.
  • Obtaining an accurate figure of the total number of IDPs remains challenging. According to UNRWA, 1.9 million people in Gaza, or nearly 85 per cent of the population, are estimated to be internally displaced, including people who have been displaced multiple times.
  • Lack of food, basic survival items, and poor hygiene, exacerbate the already dire living conditions, amplify protection and mental health issues, and increase the spread of disease.

  Electricity

  • Since 11 October, the Gaza Strip has been under an electricity blackout, after the Israeli authorities cut off the electricity supply, and fuel reserves for Gaza’s sole power plant were depleted. For more information on electricity supply to the Gaza Strip, please see this  dashboard.

  Health care, including attacks (Gaza Strip)

  • According to WHO, as of 19 December, nine out of Gaza’s 36 hospitals are partially functional, all located in the south. These hospitals are operating at three times their capacity, while facing critical shortages of basic supplies and fuel. According to the MoH in Gaza, occupancy rates are now reaching 206 per cent in inpatient departments and 250 per cent in intensive care units.

  Water, Sanitation and Hygiene

  • On 20 December, UNICEF stated that children in Gaza are not able to access 90 per cent of their normal water use. The impact on children is severe, as they are more susceptible to dehydration, diarrhoea, disease, and malnutrition. Concerns of waterborne diseases such as cholera and chronic diarrhoea are particularly heightened given the lack of safe water, especially following the seasonal rains and flooding. Officials have recorded almost 20 times the monthly average of reported cases of diarrhoea among children under the age of 5, 160,000 cases of acute respiratory infection, and increases in other infectious conditions and illnesses, such as scabies, lice, chicken pox, and skin rashes.
  • On 20 December, the Director General of WHO echoed a concern for the rises in infectious disease stating that “Gaza is already experiencing soaring rates of infectious disease outbreaks. Diarrhoea cases among children aged under 5 are 25 times what they were before the conflict. Such illnesses can be lethal for malnourished children, more so in the absence of functioning health services.”

  Food security

  • On 19 December, according to WFP’s Regional Director for the Middle East and North Africa, half of Gaza’s population is starving in a situation of extreme or severe hunger, and 90 per cent of the population regularly go without food for a whole day. Only ten per cent of the food currently required for 2.2 million people has entered Gaza in the last 70 days. On 17 December, media reported people jumping onto aid trucks, attempting to secure food and other supplies.
  • The Inegrated Food Security Phase Classification (IPC), identify 5 Phases of classification for food security: Generally Food Secure (1), Borderline Food Insecure (2), Acute food and Livelihood Crisis (3), Humanitarian Emergency (4) and Famine/Humanitarian Catastrophe (5). The recent estimates from the IPC reveal an unprecedented level of acute food insecurity in the Gaza Strip. Over 90 percent of the population in the Gaza Strip (about 2.08 million people) was estimated to face high levels of acute food insecurity, classified in IPC Phase 3 or above (Crisis or worse). Among these, over 40 percent of the population (939,000 people) were in Emergency (IPC Phase 4) and over 15 percent (378,000 people) were in Catastrophe (IPC Phase 5).
  • Furthermore, in the projected period from the latest IPC findings, spanning from 8 December 2023 to 7 February 2024, the entire population in the Gaza Strip (approximately 2.2 million people) is anticipated to experience severe food insecurity, classified as IPC Phase 3 or higher (Crisis or worse).  The IPC Famine Review Committee has been activated amid evidence exceeding acute food insecurity Phase 5 threshold. Among these, over half a million people are facing catastrophic conditions—IPC Phase 5 (Catastrophe), characterized by households experiencing an extreme lack of food, starvation, and exhaustion of coping capacities.
  • On 20 December, WFP delivered hot meals to 2,000 people in Gaza city communities. These were done in addition to the distribution of food parcels to 2,500 people in Rafah communities.

  Hostilities and casualties (Israel)

  • Over 1,200 Israelis and foreign nationals have been killed in Israel, including 36 children, according to the Israeli authorities, the vast majority on 7 October.
  • During the humanitarian pause (24-30 November), 86 Israeli and 24 foreign national hostages were released. The Israeli authorities estimate that about 129 Israelis and foreign nationals remain captive in Gaza. On 21 December, UN Special Representative of the Secretary-General on Sexual Violence in Conflict, called for the immediate, safe, and unconditional release of remaining hostages.

  ording to the Israeli military.

• The entire population in the Gaza Strip faces an imminent risk of famine, according to the latest estimates from the Integrated Food Security Phase Classification (IPC) global partnership on 21 December. Bombardment, ground operations, and the besiegement of the entire population, coupled with restricted humanitarian access, have resulted in catastrophic levels of acute food insecurity, intensifying the risk of famine each day, according to IPC.
• Should the situation continue, it is precited that between 8 December 2023 and 7 February 2024, Gaza’s population will be the highest share of people facing high levels of acute food insecurity ever classified by the IPC initiative for any given area or country, since its establishment in 2004. (More details under the food security section).
• On 20 December, Israeli forces raided the Palestine Red Crescent Society’s (PRCS) ambulance centre in Jabalya, north of Gaza, after a two-day siege. Reportedly, staff members and paramedics were arrested and taken to an unknown location. Some 127 people, including 22 injured patients who were being treated by staff, were inside the building. Contact was lost with the operations room and PRCS team in Gaza, due to the telecommunications blackout.
• On 21 December, The World Health Organization (WHO) stated that northern Gaza had been left without a functional hospital due to the lack of fuel, staff, and supplies. Only nine out of 36 health facilities are partially functional in the whole of Gaza, with no functional hospital in the north. Al Ahli is still treating patients but not admitting new ones, along with Al-Shifa, Al Awda and Al Sahaba hospitals. These hospitals are still sheltering thousands of displaced people
• Under such conditions, people are unable to avail of hospitals’ services. For example, 42 babies have been born within a school functioning as a shelter in Deir al Balah (Middle Area), according to UNRWA, instead of in health facilities.
• On 20 December, the International Labour Organization and the Palestinian Central Bureau of Statistics assessed that at least 66 per cent of employment, the equivalent of 192,000 jobs, has been lost in Gaza since the escalation of hostilities on 7 October. The effects of the escalation are also felt in the West Bank, where 32 per cent of employment has been lost, the equivalent of 276,000 jobs, in the same time period, according to the two bodies.
• On 21 December, 78 trucks carrying supplies and five ambulances entered Gaza through Rafah crossing and 22 trucks entered through Kerem Shalom crossing. This remains well below the daily average of 500 truckloads (including fuel and private sector goods) that entered every working day prior to 7 October.

Hostilities and casualties (Gaza Strip)

• The following are among the deadliest incidents reported on 21 December:
  • At about 19:00, 28 Palestinians, including children and women, were reportedly killed, and tens of others were injured, when two houses and agricultural land sheltering internally displaced persons (IDPs) were struck near the European Hospital, in Khan Yunis.
  • At about 17:10, 13 Palestinians were reportedly killed, and ten others were reportedly injured when a house was struck in Al-Amal neighbourhood, west of Khan Yunis.
• On 20 December, at about 17:20, Israeli forces reportedly forced Palestinian families out of their homes before setting those structures on fire at An Nazla area in Jabalya city, northern Gaza.
• On 20 December, the UN Human Rights Office issued a statement on reports of an incident on 19 December between 20:00 and 23:00, whereby Israeli forces reportedly shot and killed at least 11 Palestinian men, and allegedly injured an unconfirmed number of women and children in the Al Awda residential building, also known as the “Annan building,” in Ar Remal neighbourhood, Gaza city. Three related families were sheltering inside this building during the incidents. Initial witness reports circulating through media allege that the men were separated from women and children and were then shot and killed in what may amount to a war crime. The details of this incident are yet to be verified.

Displacement (Gaza Strip)

• Areas encompassing about 30 per cent of the Gaza Strip (excluding the orders to evacuate the areas north of Wadi Gaza) have been marked for evacuation on the Israeli military’s online map. Access to this information is impaired by recurrent interruptions in telecommunications and the lack of electricity.
• Inflow of IDPs to Rafah governorate continued on 20 December. As shelters in Rafah city have exceeded their capacity significantly, most newly arriving IDPs have settled in the streets and in empty spaces across the city. Rafah governorate has become the most densely populated area in the Gaza Strip, with hundreds of thousands of IDPs squeezed into extremely overcrowded spaces and in dire living conditions. Population density is assessed to now exceed 12,000 people per square kilometre, a fourfold increase prior to the escalation. Thousands of people line up before aid distribution centres in need of food, water, shelter, and protection, amid the absence of latrines and adequate water and sanitation facilities in informal displacement sites and makeshift shelters. This situation is compounded by the cold winter and rain over the last week, which have flooded tents and other makeshift shelters.
• Obtaining an accurate figure of the total number of IDPs remains challenging. According to UNRWA, 1.9 million people in Gaza, or nearly 85 per cent of the population, are estimated to be internally displaced, including people who have been displaced multiple times.
• Lack of food, basic survival items, and poor hygiene, exacerbate the already dire living conditions, amplify protection and mental health issues, and increase the spread of disease.

Electricity

• Since 11 October, the Gaza Strip has been under an electricity blackout, after the Israeli authorities cut off the electricity supply, and fuel reserves for Gaza’s sole power plant were depleted. For more information on electricity supply to the Gaza Strip, please see this  dashboard.

Health care, including attacks (Gaza Strip)

• According to WHO, as of 19 December, nine out of Gaza’s 36 hospitals are partially functional, all located in the south. These hospitals are operating at three times their capacity, while facing critical shortages of basic supplies and fuel. According to the MoH in Gaza, occupancy rates are now reaching 206 per cent in inpatient departments and 250 per cent in intensive care units.

Water, Sanitation and Hygiene

• On 20 December, UNICEF stated that children in Gaza are not able to access 90 per cent of their normal water use. The impact on children is severe, as they are more susceptible to dehydration, diarrhoea, disease, and malnutrition. Concerns of waterborne diseases such as cholera and chronic diarrhoea are particularly heightened given the lack of safe water, especially following the seasonal rains and flooding. Officials have recorded almost 20 times the monthly average of reported cases of diarrhoea among children under the age of 5, 160,000 cases of acute respiratory infection, and increases in other infectious conditions and illnesses, such as scabies, lice, chicken pox, and skin rashes.
• On 20 December, the Director General of WHO echoed a concern for the rises in infectious disease stating that “Gaza is already experiencing soaring rates of infectious disease outbreaks. Diarrhoea cases among children aged under 5 are 25 times what they were before the conflict. Such illnesses can be lethal for malnourished children, more so in the absence of functioning health services.”

Food security

• On 19 December, according to WFP’s Regional Director for the Middle East and North Africa, half of Gaza’s population is starving in a situation of extreme or severe hunger, and 90 per cent of the population regularly go without food for a whole day. Only ten per cent of the food currently required for 2.2 million people has entered Gaza in the last 70 days. On 17 December, media reported people jumping onto aid trucks, attempting to secure food and other supplies.
• The Inegrated Food Security Phase Classification (IPC), identify 5 Phases of classification for food security: Generally Food Secure (1), Borderline Food Insecure (2), Acute food and Livelihood Crisis (3), Humanitarian Emergency (4) and Famine/Humanitarian Catastrophe (5). The recent estimates from the IPC reveal an unprecedented level of acute food insecurity in the Gaza Strip. Over 90 percent of the population in the Gaza Strip (about 2.08 million people) was estimated to face high levels of acute food insecurity, classified in IPC Phase 3 or above (Crisis or worse). Among these, over 40 percent of the population (939,000 people) were in Emergency (IPC Phase 4) and over 15 percent (378,000 people) were in Catastrophe (IPC Phase 5).
• Furthermore, in the projected period from the latest IPC findings, spanning from 8 December 2023 to 7 February 2024, the entire population in the Gaza Strip (approximately 2.2 million people) is anticipated to experience severe food insecurity, classified as IPC Phase 3 or higher (Crisis or worse).  The IPC Famine Review Committee has been activated amid evidence exceeding acute food insecurity Phase 5 threshold. Among these, over half a million people are facing catastrophic conditions—IPC Phase 5 (Catastrophe), characterized by households experiencing an extreme lack of food, starvation, and exhaustion of coping capacities.
• On 20 December, WFP delivered hot meals to 2,000 people in Gaza city communities. These were done in addition to the distribution of food parcels to 2,500 people in Rafah communities.

Hostilities and casualties (Israel)

• Over 1,200 Israelis and foreign nationals have been killed in Israel, including 36 children, according to the Israeli authorities, the vast majority on 7 October.
• During the humanitarian pause (24-30 November), 86 Israeli and 24 foreign national hostages were released. The Israeli authorities estimate that about 129 Israelis and foreign nationals remain captive in Gaza. On 21 December, UN Special Representative of the Secretary-General on Sexual Violence in Conflict, called for the immediate, safe, and unconditional release of remaining hostages.