7 things you need to know about the humanitarian situation in Gaza

Gaza family

21 December 2023


Over two months of relentless bombing have turned life for people in Gaza into “hell on earth”. Displacement, hunger, lack of medical care and clean water, and the onset of winter are stretching the coping abilities of children and their families to the absolute limit.

A staggering 1.9 million people have been displaced and lack water, food, and medicine. So does everyone else in the enclave. At least 18,800 have been killed - the Ministry of Health has been unable to update the death toll for the past few days, and many bodies that remain trapped under the rubble are not counted. Approximately 51,000 people are reported injured and thousands more are still missing.

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We have gathered seven facts to help you better understand what this war means for the Palestinians in Gaza.


Gaza Children Camp

Palestinian children stand in a makeshift camp for displaced people in Rafah city, near the Egyptian border in southern Gaza. © Grayscale Media/CARE

In times of war, it is often children and mothers who are most affected by the fighting. The hostilities in the Gaza Strip have an especially catastrophic impact on children and have killed an average of over 110 children every day since 7 October. In total, more than 7,700 children have reportedly been killed, 40% of reported fatalities. In this conflict, more children have been killed than in all major global conflicts combined in 2022.


Gaza Family Camp

Shahin family from the al-Shati refugee camp in Gaza City, fled to the southern Gaza Strip after their home was destroyed by an Israeli airstrike, leaving them homeless. They constructed a tent from plastic sheets in a makeshift camp in the town of Tal al-Sultan, situated near the Egyptian border city of Rafah.© Grayscale Media/CARE

1.9 million people, nearly 85% of the population, have been displaced since 7 October, ordered to move, desperate to escape the violence and destruction and find the basic necessities to survive. Most of them had to flee multiple times, like Alaa and her children.

“We lived in four different places since the war started. Ever since I first saw my children’s little faces, I’ve wanted nothing else than to keep them safe and healthy. Now, in the blink of an eye, the only thing I can tell them is to run faster.”

Most people have no home to go back to as around 60% of all houses in Gaza are estimated to have been either damaged or destroyed. Our colleague Saaed, CARE Gaza’s Emergency Coordinator, was able to speak to a friend during the seven-day truce in late November who could check on his home in Gaza City. “He told me that our house is completely destroyed due to airstrikes. It makes me very sad to hear that the place where we raised a family for so many years has been reduced to nothing. All our assets are lost.

Almost 1.3 million Palestinians now live in just 155 UNRWA shelters. Shelters in middle and southern Gaza, the area the vast majority of people fled to ahead of advancing military operations, are, on average, hosting more than four times their capacity. Overcrowded shelters lack privacy or means to retain dignity and increase the risk of gender-based violence and sexual exploitation and abuse against women and girls. Others have found refuge with family, often sharing small rooms with 30 or more people. Increasingly, families are also setting up tents in open areas, while many others have lost so much and have no more means: they are forced to sleep on the street.

Since the end of the truce, the levels of bombardment are worse than ever.

“We were told to leave our homes because the area will be hit by airstrikes. But we don’t know where else to go; there is nowhere we can go,”

Very few areas in Gaza are untouched by the fighting, available spaces are shrinking every minute, and those spaces lack the food, water, shelter, and sanitation needed for survival. Nowhere in Gaza is safe, or even livable.


Gaza Mother and Daughter Displaced

A Palestinian child holds books and toys as she tries to rescue her belongings from the rubble of her destroyed house in Khan Yunis in the southern Gaza Strip.© Grayscale Media/CARE

Almost half of the 2.3 million people in the Gaza Strip are under the age of 18. In the current war, none of these children can receive any education at school, with many forced to use school buildings as a shelter. Additionally, 70% of all school buildings, 342 in total, have been damaged in the fighting, including those sheltering children and their families. Therefore, children mourn dead parents and siblings and collect firewood to keep warm instead of playing or going to school. “Education is a forgotten dream for children terrified this day might be their last,” says Aaron Brent, CARE’s Acting Country Director for the West Bank and Gaza. “Psychological trauma has reached unprecedented highs. Mothers are telling us their children have stopped speaking or eating because of what they have seen and lived through. Others are crying and screaming with every loud sound they hear.

Even before the current war, 15 years of blockade and conflict had horrific consequences for the psychological well-being of children in Gaza. Now, CARE and other humanitarian organizations fear an entire generation of children’s lives are dictated by fear, distress, and mourning.


Gaza Camp

Hundreds of displaced Palestinians have erected makeshift shelters out of wooden two-by-fours and nylon tarps in Rafah city, near the border with Egypt. © Grayscale Media/CARE

60% of Gaza has been flattened to the ground. Homes, hospitals, schools, and other critical infrastructure such as water networks, sanitation facilities, and grain mills are destroyed or damaged. Only eight out of 36 hospitals and medical facilities are partly operational, and at least 286 health workers have been killed. For over two months, the Gaza Strip has been cut off from all electricity, and fuel reserves for its only power plant were depleted. “Our team has spoken to doctors who must perform C-sections without anaesthesia and see mothers who lose their babies right after giving birth because there is no power to run incubators that could keep them alive,” said Hiba Tibi, CARE’s Acting Deputy Regional Director for the Middle East and North Africa.

Tens of thousands of wounded people and 180 mothers giving birth every day are left without safe medical or delivery assistance. The few hospitals that are still running have 2,5 times more people in intensive care units than their capacity. Hospitals are also sheltering thousands of displaced people.


Gaza Camp Water

Palestinian children are queuing to get drinkable water in a makeshift camp in Rafah city, near the border with Egypt.© Grayscale Media/CARE

Missiles and airstrikes are not the only killers in Gaza. Malnutrition, cold, and lack of clean water and hygiene, all caused by the siege, are a deadly combination. CARE is already seeing a significant spread of disease infecting and killing those who have survived the bombing and airstrikes. Many people are forced to drink unsafe water. Dehydration and waterborne diseases are a growing threat, especially among those living in makeshift tents in the open. In such dire conditions, more people could die from disease than the bombings. Diarrhoea, chicken pox, and scabies are on the rise, especially endangering the health of small children without medicine and amid horrific sanitation conditions. With cold nights and heavy rains drenching clothes and mattresses, hypothermia becomes a deadly threat for the youngest.

“Lack of medical care, hygiene, and high levels of malnutrition while living in overcrowded shelters are a poisonous mix, and we fear the numbers of women and children dying of otherwise preventable and treatable diseases will rise,” said Hiba Tibi.


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UNRWA school in Khan Younis, southern Gaza Southern Gaza, 15 October 2023. CARE staff distribute water bottles to people displaced by the conflict amid a very severe shortage of drinking water. © Grayscale Media/CARE

According to the World Food Programme, there is a high risk of famine and cases of dehydration and malnutrition are increasing rapidly. The situation has further deteriorated since the truce ended with thousands more people needing to flee to areas that don’t have enough food and water for survival. Up to half of all displaced people report going to sleep hungry, and 44 percent report “very severe hunger levels.” Our colleague Salwa told us she and her family are surviving on canned food, and have queued hours to buy cooking gas. Food prices are skyrocketing, and families cannot afford to buy fresh produce on the market if it is available at all.


Gaza destruction

Destroyed houses are seen in the al-Rimal neighborhood of Gaza City, following several airstrikes. © Grayscale Media/CARE

Prior to 7 October, around 500 truckloads entered Gaza every day – a combination of aid and commercial traffic. Over the past days, only a few dozen trucks per day have been permitted to enter the enclave, and with such extreme humanitarian needs, more support is needed than ever. Lack of fuel, communication blackouts, and constant bombing and airstrikes make aid delivery difficult to impossible for those in need. More than 135 aid workers have been killed since October 7th.

Only an immediate and sustained ceasefire will allow humanitarian agencies to start addressing this unprecedented catastrophe and save the countless lives that are at risk.

Main image: Raed, a resident of the al-Shati refugee camp in Gaza City, fled to the southern Gaza Strip with his family after their home was destroyed by an Israeli airstrike, leaving them homeless. © Grayscale Media/CARE

How you can help

As soon as it is safe to do so, CARE will respond to the urgent needs of those affected by the conflict in Gaza and the region, in particular women and girls. Your donation could help save lives.

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