Humanitarian situation in Gaza

On 8 February 2024, the House of Lords will debate the following motion:

Baroness Hussein-Ece (Liberal Democrat) to ask His Majesty’s Government what assessment they have made of the current humanitarian situation in Gaza.

This remains a fast-moving situation and all statistics are correct at the time of publication. For further information on the wider conflict, and fears over the potential for escalation in the region, see section 6 ‘Read More’ at the end of this briefing.

1. Humanitarian impact of the conflict

The continuing crisis in Gaza has had significant humanitarian consequences. In the words of UN Secretary General António Guterres, the hostilities in Gaza and Israel have “created appalling human suffering, physical destruction and collective trauma across Israel and the Occupied Palestinian Territory”.^[1]

Since the armed raid by Hamas forces into Israel on 7 October 2023, and the subsequent large-scale military incursion into Gaza by the Israeli Defence Forces (IDF), according to contested estimates from the Gazan Ministry of Health more than 27,000 Palestinians have lost their lives in Gaza, and a further 66,000 have been injured.^[2] Over 1,200 Israelis have been killed and a further 5,400 reported injured over the same period. More than 130 Israeli hostages are still being held by Hamas or other armed groups who participated in the 7 October 2023 raid. Allegations have also been made that there was a “deliberate, systematic genital mutilation” of female Israeli victims involved in the 7 October 2023 attacks.^[3]

The consequences of the conflict for civilian infrastructure in Gaza have been profound. The UN estimates that 70,000 housing units have been destroyed and 290,000 units damaged—over 60 percent of total housing stock—and 1.7 million people have been displaced, about 75 percent of a total population in the Gaza strip of around 2.3 million.^[4] Many of these people have been displaced multiple times, as families have been forced to move repeatedly in search of safety. Indeed, the UN report that there is “shrinking space to shelter”, noting that mass evacuation orders issued by the Israeli military that began on 1 December 2023 currently cover a total of 158 square kilometres, amounting to 41 percent of the Gaza Strip.^[5] The UN report that this area was home to 1.38 million Palestinians before 7 October 2023 and subsequently it contained 161 shelters hosting an estimated 700,750 internally displaced people (IDPs). The Israeli military has also launched further operations around the southern population centre of Rafah in recent days.^[6]

Only 14 of the 36 hospitals in Gaza are functional and only partially; they face severe shortages of medical staff, fuel and supplies.^[7] The IDF has also conducted controversial raids into hospital premises to target alleged Hamas fighters.^[8]

Since 11 October 2023, 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. The UN notes that the communications and industrial fuel shutdown continues to “significantly hinder” the aid community’s efforts to assess and to adequately respond to the deepening humanitarian crisis.^[9]

There is a significant shortage of food in Gaza. According to the Integrated Food Security Phase Classification (IPC), over 2 million people are at imminent risk of famine. Of these, some 378,000 people are at phase 5 (‘catastrophic’ levels, referring to extreme lack of food, starvation, and exhaustion of coping capacities) and 939,000 people are at phase 4 (emergency levels).^[10] UN human rights officials have pointed out the dangers for particular demographic groups in Gaza:

Currently every single person in Gaza is hungry, a quarter of the population are starving and struggling to find food and drinkable water, and famine is imminent. Pregnant women are not receiving adequate nutrition and healthcare, putting their lives at risk. In addition, all children under five—335,000—are at high risk of severe malnutrition as the risk of famine conditions continues to increase, a whole generation is now in danger of suffering from stunting[.]^[11]

Disease is also spreading in Gaza as conditions continue to deteriorate, including a lack of clean water and inadequate sewage facilities.^[12] The UN report that civilians in Gaza “do not have access to adequate quantity and quality of water and lack hygiene materials, which has consequences on their wellbeing, including physical health”.^[13] They also note that the accumulation of solid waste on the streets, around hospitals, IDP shelters, and various sites remains a priority concern, as “tens of thousands of tons of uncollected public waste are intensifying public health risks”.

Speaking to the UN Security Council on 31 January 2024, Martin Griffiths, UN under secretary general for humanitarian affairs and emergency relief coordination, summed up the problems currently facing many in Gaza:

We now estimate that some 75 percent of the total population are displaced. Their living conditions are abominable and worsening by the day.

Heavy rains are flooding the makeshift tent camps [set up by refugees and displaced people], forcing children, parents and the elderly to sleep in the mud.

Food insecurity continues to mount.

And clean water is almost completely inaccessible.

With little public health support available, preventable diseases are rife, and will continue to spread.^[14]

Some aid is entering Gaza. Trucks are able to enter via the Rafah and Kerem Shalom crossings, though they are reportedly subject to “excessive delays”.^[15] The United Nations Office for the Coordination of Humanitarian Affairs (UNOCHA) reports the average number of trucks that entered Gaza each day before 7 October 2023 was around 500. Since 7 October 2023, the highest daily average was 173 from 24 to 30 November 2023, during the pause in fighting between Israel and Hamas. The most recent daily total, recorded on 31 January 2024, was 161 trucks.^[16]

The crossings into Gaza are marked on the map below from UNOCHA.

Figure 1. Map showing crossing points into the Gaza Strip

UN officials have described the aid that is entering Gaza as “grossly inadequate”.^[17] They also contend that vulnerable populations in northern and central Gaza are “increasingly beyond reach because of an increasing trend in denied and restricted access”, as well as heightened hostilities in central Gaza.^[18] The UN also notes that threats to the safety of humanitarian personnel and sites are frequent, “impeding the delivery of time-sensitive and life-saving aid and pos[ing] serious risks to those involved in humanitarian efforts”. Martin Griffiths called on more to be done to ensure safety of aid workers, predictable supply and consistent access, and for more crossings to be opened:

First, we need to be able to deliver and distribute supplies safely. This means we need significantly improved security assurances.

Second, we need to establish a predictable flow of supplies.

Finally, we need rapid and unimpeded access.

Humanitarian supplies must be able to enter Gaza via multiple points, from Egypt and Israel. This would help clear bottlenecks and speed up delivery of supplies.

We continue to face the frequent rejection for entry of much needed items into Gaza by Israel, for unclear, inconsistent and often unspecified reasons.

We must also have access to civilians in need across Gaza.

At present, our access to Khan Younis, the Middle Area and North Gaza is largely absent.^[19]

Israel has rejected assertions that it is restricting access to aid, highlighting its decision to open the Kerem Shalom crossing to humanitarian aid from 17 December 2023.^[20] In January 2024, the US administration also announced Israel would allow flour to be shipped via Israel’s Ashdod port.^[21] At the time of writing, the delivery of such aid through Ashdod does not appear to have started. Israeli Prime Minister Benjamin Netanyahu also reportedly agreed to a deal in mid-January 2024 that will see more aid enter Gaza as well as medicines delivered to Israeli hostages being held by Hamas in Gaza.^[22]

The delivery of aid has been further complicated by the crisis which has engulfed the United Nations Reliefs and Works Agency (UNRWA), leading to a suspension in funding. This is discussed in further detail in the section 2 of this briefing.

At the time of writing hopes for a temporary ceasefire deal negotiated by Qatar appear to be rising. According to Qatari officials, Hamas and Israel have agreed to the “substance” of a deal that would result in the remaining civilian hostages held in Gaza being freed in return for a ceasefire lasting 40 days.^[23] However, Hamas is yet to commit itself to the deal, with the Times reporting on 1 February 2024 that no decision had been made on whether it would accept the terms proposed. Still, negotiators reportedly remained hopeful that a deal can be agreed “within weeks”.^[24]

2. Suspension of United Nations Reliefs and Works Agency funding

UNRWA plays a key role in delivering humanitarian assistance into Gaza and across the region. However, according to a dossier compiled by Israeli intelligence forces, significant numbers of individuals working for UNRWA have alleged links or direct affiliations with either Hamas or Islamic Jihad.^[25] Israel alleges that at least 12 of these individuals directly participated in the October 7 attacks. UNRWA has said that it is urgently investigating these allegations and has sacked nine people.

The charges have provoked a concerned response from the international community. Several nations and long-term donors to UNRWA, including the UK, US, Germany, Italy, Austria and Japan, have suspended payments to the agency whilst these investigations are underway. This has led to significant fears over the ability of UNRWA to deliver urgently needed aid. A UNRWA spokesperson has said that if funding is not resumed the agency will not be able to continue its operations beyond the end of February.

Top donors to UNRWA are set out in the graphic below.

Figure 2. Top donors to UNRWA, aid pledged in 2022 ($mn)

Speaking on 29 January 2024, UK minister Andrew Mitchell noted both UNRWA’s contribution and the UK’s concern over the allegations:

[UNRWA] is critical to delivering humanitarian assistance into Gaza and across the region. It plays a stabilising role at a time when we need focus on de-escalating tensions. The UK is a long-standing donor to UNRWA, as are our closest partners, notably the United States. Since 7 October, we have allocated a further £16mn to it as part of our response to the crisis. UNRWA’s 13,000 staff in Gaza continue their working at great personal risk in the most dangerous circumstances: 152 UNRWA staff members have lost their lives.

The UK is however appalled by allegations that any agency staff were involved in the 7 October atrocities. We welcome the swift action that UNRWA has taken to terminate contracts while it launches an immediate investigation. We and several partners are temporarily pausing future funding until we have reviewed these investigations. We continue to fund vital aid delivery through multiple other partners, including other UN agencies and international and British non-governmental organisations.^[26]

The Times of Israel report that a senior Israeli official has confirmed that Jerusalem supports the decision made by some countries to suspend their funding and stressed that every UNRWA staffer “involved in terror activity must be held accountable”.^[27] Israeli Prime Minister Benjamin Netanyahu has also called UNRWA “perforated with Hamas” amid long-standing Israeli criticism of the agency.^[28] However, the same official quoted above, speaking on condition of anonymity, has also suggested that the Israeli government does not support the immediate discontinuation of UNRWA, saying:

If UNRWA ceases operating on the ground, this could cause a humanitarian catastrophe that would force Israel to halt its fighting against Hamas. This would not be in Israel’s interest and it would not be in the interest of Israel’s allies either.^[29]

In his statement to the Security Council on 31 January 2024, Martin Griffiths said he was “appalled” that some UNRWA employees were allegedly involved in the attack in Israel on 7 October 2023, adding that these were allegations that had to be addressed. However, he also contended that UNRWA’s work providing support to three-quarters of Gaza’s residents “should not be jeopardized by the alleged actions of a few individuals”:

To put it bluntly and simply: Our humanitarian response for the Occupied Palestinian Territory is dependent on UNRWA being adequately funded and operational.

UNRWA is playing an indispensable role in terms of distribution, warehousing, logistics and human resources, with 3,000 staff responding to the current crisis.

Decisions to withhold funds from UNRWA must be revoked.^[30]

3. UK’s diplomatic and aid response to the crisis

3.1 Supply of aid funding and support

For 2023/24, the UK has committed £87mn in aid to the Occupied Palestinian Territories.^[31] This includes £60mn announced in October/November 2023. A total of £16mn was provided to UNRWA before funding was suspended. Additional commitments have also been announced by the United States ($121mn) and the European Union (€103mn).^[32] Germany, France, Canada and Japan have also pledged bilateral aid.

The UK government states no aid is provided to Hamas, who are designated a terrorist organisation by the UK government and are subject to UK sanctions.^[33] The UK has also not provided direct aid to the Palestinian Authority since 2021, though some technical assistance is provided through commercial organisations. In addition, the UK government also states all UK aid to the West Bank and the Gaza Strip “undergoes rigorous oversight”.^[34] This includes field visits, annual audits, due diligence assessments, and mapping of downstream partners of the funding. In every year from 2014 to 2022, at least half of UK aid to the West Bank and Gaza Strip has been delivered through the UNRWA, rather than through local authorities or civil society groups.

In his statement to Parliament on 29 January 2024, Andrew Mitchell provided further details on UK aid activity, citing the recent visits of the foreign secretary, Lord Cameron of Chipping Norton, to the region (which are further discussed in section 3.2 of this briefing):

In Israel, the foreign secretary pressed for changes to allow unhindered humanitarian access, such as opening more crossing points for longer and permitting deliveries via Ashdod port. He announced work with Qatar to get more aid into Gaza, with our joint consignment containing 17 tonnes of family-sized tents being flown last Thursday. Earlier this month, Royal Fleet Auxiliary Lyme Bay delivered 87 tonnes of aid into Port Said. Crucially, we are supporting the United Nations World Food Programme to deliver a new humanitarian land corridor from Jordan into Gaza, which has already delivered over 1,000 tonnes of aid into Gaza. We know the desperate plight of civilians caught up in this and the suffering they are going through, and we will continue to do all we can with our partners to save lives.^[35]

3.2 UK diplomatic efforts including potential for recognition of Palestinian statehood

The UK has continued to call for an immediate pause in the conflict to allow further aid to enter Gaza and to facilitate the release of hostages, and for progress to be made towards a “sustainable ceasefire”.^[36] As mentioned above, the Foreign Secretary recently visited the region, meeting with various parties, including leaders in Israel and the Occupied Palestinian Territories, as part of efforts to build a ‘Contact Group’ between the US, UK, key EU, Gulf and Arab countries and Turkey. The UK says the purpose of such a forum would be to help secure a pause in the fighting and then use it to “build momentum towards a lasting solution”.^[37]

The foreign secretary has also indicated that the UK is considering bringing forward recognition of Palestinian statehood as one means through which a lasting end to the crisis could be found.^[38] Lord Cameron said that Palestinians needed “a political horizon so that they can see that there is going to be irreversible progress to a two-state solution”. He added that the UK would work with international allies to examine how a Palestinian state would function:

We should be starting to set out what a Palestinian state would look like—what it would comprise, how it would work.

As that happens, we, with allies, will look at the issue of recognising a Palestinian state, including at the United Nations. This could be one of the things that helps to make this process irreversible.^[39]

In an article published in the Mail on Sunday on 28 January 2024, the foreign secretary also said that Hamas must leave Gaza as part of this path to statehood:

We have to see the key Hamas leaders leave Gaza. Israel has permitted safe passage for terrorists in the past—and the people responsible for October 7 have to go.

We have to see the instruments of terrorism still in Gaza being dismantled. In the carnage of the past 100-plus days of conflict, it often goes unreported that Hamas rocket attacks against Israel have continued. And Hamas still wants to launch terrorist atrocities again. It must be put beyond doubt that this cannot happen.

These steps would give Israel some of the reassurance it needs to end its military campaign. But the Palestinian people need reassurance too.

We must give the people of the West Bank and Gaza the political perspective of a credible route to a Palestinian state and a new future. And it needs to be irreversible. This is not entirely in our gift. But Britain and our partners can help by confirming our commitment to a sovereign, viable Palestinian state, and our vision for its composition. And, crucially, we must state our clear intention to grant it recognition, including at the United Nations.

The Palestinian leadership must help as well, by forming a new government which can immediately start to deliver.^[40]

In his statement to the House of Commons, Andrew Mitchell set out further detail on how the UK saw the path to a resolution of the conflict, including wider concerns such as post-conflict reconstruction in Gaza:

The government’s end goal is clear: Israelis should be able to live without fear of Hamas terrorism, and Gazans should be able to rebuild their lives.

[…]

The British government have identified five vital steps for that to happen: a political horizon that provides a credible and irreversible pathway towards a two-state solution; forming a new Palestinian government for the west bank and Gaza, accompanied by an international support package; removing Hamas’s capacity to launch attacks against Israel; the release of all Israeli hostages; and key Hamas leaders agreeing to leave Gaza. All those things are intricately linked, and we cannot secure one without all the others. There are also many other elements to consider, such as Arab-Israeli normalisation, security guarantees, and financing the rebuilding of Gaza, but we need to generate momentum now towards a permanent peace. That is why pushing for a pause now is so important, and why we need a Contact Group meeting, bringing together the key players as soon as possible.^[41]

In further comments in Parliament, Andrew Mitchell has stated that the UK government is clear that “bilateral recognition alone cannot end the occupation”, and that “Britain will recognise a Palestinian state at a time when it best serves the objective of peace”.^[42]

The United States has also indicated that it could recognise a Palestinian state after the war in Gaza, according to reports suggesting the State Department is considering a shift in policy.^[43]

4. Response from Israeli government on Palestinian statehood

The current Israeli administration has repeatedly rejected the idea of Palestinian statehood. In a televised press conference in January 2024, Israeli Prime Minister Benjamin Netanyahu said that the two-state solution for peace between Israelis and Palestinians was something he was fundamentally opposed to.^[44] Arguing that “all territory we evacuate, we get terror, terrible terror against us”, he said that it was a “vital condition” that in any future agreement—or in the absence of one—Israel must maintain “security control” of all territory west of the Jordan River. In other words, Israel, the West Bank and Gaza. He also said that he had made this position clear to Israel’s international allies.

On 5 January 2024, the Israeli defence minister, Yoav Gallant, outlined proposals for the future governance of Gaza once the war was over.^[45] The so-called ‘four corner’ or ‘four pillar’ plan would provide for the following:

• Israel will maintain security control over the territory, including the right to re-enter any parts of Gaza it has withdrawn from
• a multinational, US-sanctioned force ‘will run the territory’s day-to-day bureaucracy and facilitate its rehabilitation’
• Egypt and Israel will monitor and control Gaza’s southern border crossing
• Gaza’s existing non-Hamas-affiliated Palestinian infrastructure and civilian bureaucracy will remain in place^[46]

Amid reports of tension between Mr Gallant and Mr Netanyahu, however, it is not clear whether this plan has been endorsed by the Israeli government. Indeed, amongst signs of domestic division, other ministers have also published their own visions for Gaza’s future.^[47]

Writing for the Royal United Services Institute, Rob Geist Pinfold contends that Prime Minister Netanyahu is trying to resist pressure from the Biden administration to commit to a solution on Gaza’s future and also keep his coalition allies onside:

Gallant’s outing of this long-simmering internal conflict has realised Netanyahu’s greatest fear. Netanyahu has repeatedly resisted the significant and growing pressure from the Biden administration to publish a post-war plan precisely because he knows that doing so would only harm his own overarching objective which extends above and beyond any of Israel’s war aims: maintaining his hold on power as Israel’s longest-serving prime minister.

Backing Gallant’s plan would doom Netanyahu’s coalition by alienating the far-right allies on whom he is reliant for his political survival. But endorsing their vision for a post-war Gaza would precipitate a public spat with the Biden administration. This is exactly why the US has pressured Netanyahu to make his stance clear. Its support for Israel’s war is conditional, and it will not back a post-war vision that ends in expulsions, annexations or occupations. Losing this lifeline of superpower support would at best curtail the Israel Defence Forces’ operational freedom, and at worst force Israel to withdraw from Gaza before meeting its objectives.^[48]

5. Other notable developments

5.1 South African case at the International Court of Justice

South Africa has brought a case at the International Court of Justice (ICJ) alleging that Israel is guilty of acts of genocide in Gaza. On 26 January 2024, the court issued a decision on provisional measures, which included that it had the legal right to proceed with the genocide case.^[49]

The court had been asked to order Israel to immediately halt operations in Gaza, which the court declined to do. However, the ICJ did instruct Israel to prevent its military from committing acts which might be considered genocidal, to prevent and punish incitement to genocide, and to enable humanitarian assistance to the people of Gaza.^[50] The court also ordered Israel to preserve evidence relating to allegations of genocide and to report to the court on progress within one month. It has also ordered the immediate release of all hostages, and reminded all parties to the conflict that they are bound by international humanitarian law.

South Africa has said that it was prompted to lodge a case at the ICJ because it felt obliged “to prevent genocide from occurring”.^[51] A statement from the office of South African President Cyril Ramaphosa said:

South Africa is gravely concerned with the plight of civilians caught in the present Israeli attacks on the Gaza Strip due to the indiscriminate use of force and forcible removal of inhabitants.

Furthermore, there are ongoing reports of international crimes, such as crimes against humanity and war crimes, being committed as well as reports that acts meeting the threshold of genocide or related crimes […] have been and may still be committed in the context of the ongoing massacres in Gaza.

Our opposition to the ongoing slaughter of the people of Gaza has driven us as a country to approach the ICJ. As a people who once tasted the bitter fruits of dispossession, discrimination, racism and state-sponsored violence, we are clear that we will stand on the right side of history.^[52]

Israel has been deeply critical of the decision to bring the case. In remarks published on 26 January 2024, Prime Minister Benjamin Netanyahu said:

Israel’s commitment to international law is unwavering. Equally unwavering is our sacred commitment to continue to defend our country and defend our people.

Like every country, Israel has an inherent right to defend itself.

The vile attempt to deny Israel this fundamental right is blatant discrimination against the Jewish state, and it was justly rejected.

The charge of genocide [levelled] against Israel is not only false, it’s outrageous, and decent people everywhere should reject it.^[53]

Commenting on the case, UK minister Andrew Mitchell said that the UK believed that “Israel has the right to defend itself against Hamas, and we do not believe that Israel’s actions in Gaza can be described as a genocide”.^[54] He added that many of the measures the ICJ called for, such as increased aid, were also points the UK government had been pressing for. He said that “Britain continues to engage closely with the Israeli government on the conduct of their military campaign in Gaza”, including that Israel “must take greater care to avoid harming civilians and civilian infrastructure”.^[55]

5.2 Settler violence in the West Bank

Recent months have also seen an escalation in the levels of violence between Israeli settlers and Palestinians in the Occupied West Bank. The UK was a signatory to a joint statement with other international partners issued on 15 December 2023 which expressed “grave concern about the record number of attacks by extremist settlers against Palestinians in the West Bank”.^[56] The statement added:

This rise in extremist settler violence committed against Palestinians is unacceptable. Israel, as the occupying power, must protect the Palestinian civilian population in the West Bank. Those responsible for the violence must be brought to justice. Israel’s failure to protect Palestinians and prosecute extremist settlers has led to an environment of near complete impunity in which settler violence has reached unprecedented levels. This undermines security in the West Bank and the region and threatens prospects for a lasting peace.^[57]

The continuation of the violence has seen US President Joe Biden issue an executive order on 2 February 2024 giving the US government the power to sanction any foreign nationals who attack, intimidate or seize the property of Palestinians.^[58] Under those powers, the US has implemented sanctions on four Israeli settlers accused of attacking Palestinians in the Occupied West Bank. Commenting on the decision in a letter to the US Congress, President Biden said that violence in the West Bank had reached “intolerable levels”:

The situation in the West Bank—in particular high levels of extremist settler violence, forced displacement of people and villages, and property destruction—has reached intolerable levels and constitutes a serious threat to the peace, security and stability [of the region].^[59]

In response, a statement from Prime Minister Benjamin Netanyahu’s office said “Israel takes action against all law-breakers everywhere, and therefore there is no need for unusual measures on the issue”.^[60]

6. Read more

• House of Commons Library, ‘2023/24 Israel-Hamas conflict: UK and international response’, 5 January 2024; ‘UK and international response to Houthis in the Red Sea 2024’, 29 January 2024; and ‘UK aid to the West Bank and Gaza Strip: FAQs’, 2 February 2024
• US Congressional Research Service, ‘The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA): Overview and the US funding pause,’ 2 February 2024; and ‘Israel and Hamas conflict in brief: Overview, US policy, and options for Congress’, 11 January 2024
• United Nations Office for the Coordination of Humanitarian Affairs, ‘Occupied Palestinian Territory’, accessed 4 February 2024
• BBC News, ‘What are routes out of this ‘dangerous moment’ in Middle East?’, 3 February 2024

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