This year, the occupied Palestinian territories rose to their highest ever position on the IRC’s Emergency Watchlist, as devastating violence is causing a humanitarian emergency that will persist long after the fighting eventually stops. 

Gaza is now the deadliest place for civilians and aid workers in the world.

Palestinians are enduring the brutal consequences of the latest round of hostilities between Israel and Hamas, which is being fought without sufficient regard for the international laws and norms built to protect civilians even in the most dire circumstances.

What is happening in Gaza? 

Israeli forces began airstrikes and ground operations after Hamas and other Palestinian armed groups launched a deadly attack on southern Israel on October 7, 2023, killing 1,200 people and taking over 200 hostages—many of whom remain captive. Israeli military operations have since caused catastrophic destruction and widespread death and displacement throughout Gaza, particularly in the north, killing more than 33,000 Palestinians and injuring more than 75,000 others. Up to 70% of those killed are said to be women and children.

Diplomatic engagement brought about a temporary truce in late November 2023 and the release of some hostages but violence continues. The International Rescue Committee (IRC) is calling for an immediate and sustained ceasefire to protect Palestinians from further harm, enable the release of all hostages, and allow for a step-change in the amount of assistance provided to people across the whole of Gaza.

“The only way for civilians to be protected and for humanitarian assistance to be provided at the necessary scale required is for the conflict to end,” says Bob Kitchen, the IRC’s vice president of emergencies. “The need for a ceasefire becomes more urgent as each hour passes, with more than two million Palestinians facing humanitarian catastrophe.”

The need for a ceasefire becomes more urgent as each hour passes, with more than two million Palestinians facing humanitarian catastrophe.

People assess the destruction cause by Israeli air strikes in Gaza City on October 7, 2023.
Photo: Majdi Fathi/NurPhoto via Getty Images

Predictions for 2024

Airstrikes and fighting will continue to have devastating impacts on civilians

Israel’s offensive has killed more than 33,000 Palestinians. More than 13,500 children are dead and tens of thousands are unaccompanied or separated from their families. More than 1,000 Palestinian children in Gaza were killed in the first 100 days of conflict alone.

Some 1.7 million Palestinians, nearly 75% of the population, are estimated to be internally displaced—with many having been displaced multiple times. They are forced to shelter in schools, hospitals and U.N. facilities without basic supplies or sanitation. 

The civilian population in the Gaza Strip is being squeezed into smaller and smaller areas. Nearly 1.5 million people, which is more than half of Gaza's population, including over 600,000 children, have sought shelter in Rafah governorate. Humanitarian and human rights organizations have repeatedly warned that the planned Israeli ground incursion into Rafah promises to decimate life and life-saving assistance. If Rafah meets the same fate as Gaza City and Khan Younis, all parts of Gaza will be destroyed—alongside any lifeline of hope and survival for hundreds of thousands of Gazans.

The 7-day truce in late November contributed to temporary improvements in humanitarian access and civilian protection. However, since then, widespread bombardment has resumed in Gaza, putting the lives of hundreds of thousands at risk.

The number of Palestinians in need of assistance will continue to grow as violence continues. Only an end to the fighting will offer civilians safety.

Palestinians are pictured hugging and mourning together.
Palestinians mourn after eight members of their family were killed in Israeli airstrikes.
Photo: Mustafa Hassona/Anadolu Agency via Getty Images

People will struggle to recover and rebuild their lives

Even before October 7, almost 80% of Gaza’s population relied on some type of humanitarian assistance. After the destruction of key infrastructure and mass displacement, 3.1 million people across Gaza and the West Bank now require humanitarian assistance.

Many will experience protracted displacement, given that over 60% of Gaza’s housing has reportedly been damaged or destroyed, reinforcing the importance of the rights of Palestinians—most of whom are already refugees—to return to their homes. 

Children will lose years of education. Gaza’s 600,000 school-aged children have lost access to education, with 92% of schools being used as shelters, nearly 30% of schools damaged or destroyed, and staff killed or displaced.

A new acronym, WCNSF—wounded child, no surviving family—has been coined by responders and medical staff due to the number of children who have now lost their entire families. More than 1,000 children have lost either one of both their legs according to UNICEF, all of whom will now require lifelong support.

The IRC is deeply concerned about the escalating mental health and psychological toll on civilians, particularly children, who are grappling with the devastating impacts of war.

The IRC, in partnership with Anera, is actively working to provide essential mental health and psychosocial support to children affected by the crisis in schools being used as shelters in the Rafah, Khan Younis and Deir Al Balah governorates in Gaza.

Palestinians fleeing Israeli attacks take shelter at UNRWA school in Khan Yunis, Gaza.
Palestinians fleeing Israeli attacks take shelter at UNRWA school in Khan Yunis, Gaza.
Photo: Doaa Albaz/Anadolu via Getty Images

Gaza’s health care system has collapsed

Across Gaza, hospitals and clinics have been damaged and destroyed. Insecurity Insight recorded more than 700 incidents of violence against, or obstruction of access to, health care in Gaza since the outbreak of violence in October.

Only 12 of Gaza’s 36 hospitals remain partially functional.

“No hospitals in Gaza are fully functioning any longer,” says Dr. Seema Jilani, senior health technical advisor for emergencies. “IRC staff and partners in Gaza continue to witness devastation in the health facilities that are left.

The health services that remain are completely overwhelmed and lack health care personnel, which has impacted operations. Health care professionals are continuing to work with minimal rest and scarce resources.

Meanwhile, ongoing border closures prevent patients from traveling to Israel, the West Bank or East Jerusalem for treatment. On top of this, a lack of fuel for water desalination has left 95% of Gaza’s population without access to safe water, increasing the risk of diseases like cholera.

“Projections suggest that the spread of cholera, measles, polio, and meningococcal meningitis pose a mortal threat,” adds Dr. Jilani. “There have been 8,000 reported cases of Hepatitis A, a vaccine-preventable and usually limited illness. However, without timely health care, it can result in liver failure, complications, and even death.”

Without an immediate ceasefire, nearly 12,000 people could lose their lives in Gaza as a result of disease. Nearly 90,000 could die of secondary health impacts alone should the conflict escalate further.

Is Gaza facing a famine?

Almost all of Gaza's population has been without access to essential food, clean water and healthcare for six months, pushing the population to the brink of famine. The Integrated Food Security Phase Classification (IPC) acute food insecurity analysis conducted in December 2023 warned of a risk that famine may occur by the end of May 2024 if an immediate cessation of hostilities and sustained access for the provision of essential supplies and services to the population did not take place.

The entire population in the Gaza Strip is facing high levels of acute food insecurity classified in IPC Phases 3, 4 or 5. This includes half of the population (about 1.11 million) experiencing catastrophic food insecurity (IPC Phase 5, Catastrophe). At catastrophic levels, households face an extreme lack of food and are unable to meet other basic needs, even after full employment of coping strategies. 

 To date, there have been 28 reported deaths of children, along with a number of adult deaths, due to starvation and dehydration in Gaza.

International humanitarian law prohibits the starvation of civilians as a method of warfare, while the Rome Statute of the International Criminal Court provides that intentionally starving civilians by “depriving them of objects indispensable to their survival, including willfully impeding relief supplies” is a war crime. 

“Seeing the numbers of people facing imminent famine in Gaza is shocking and unprecedented. Children are starving due to an entirely man-made and preventable crisis,” explains Sam Duerden, IRC team lead for occupied Palestinian territory. 

If escalation continues, a report from the London School of Hygiene and Tropical Medicine and the Johns Hopkins Center for Humanitarian Health projects that almost half of all children (46%) in Gaza aged 6 months to 5 years, approximately 140,000 young children—could suffer from acute malnutrition by August. This would be a 15-fold increase from the pre-war prevalence of acute malnutrition, which stood at just 3% before October 7. If this projection becomes reality, Gaza could have one of the highest rates of acute malnutrition in the world.

Famine can be halted still. A ceasefire must be implemented immediately, and Israel must end its arbitrary denial of food, water, fuel and essential medicines. All parties must allow and facilitate rapid and unimpeded passage of humanitarian relief from all possible land routes and entry points and within Gaza. All hostages must be released.

A mother in Palestine pours water into bottles for her children.
Palestinians are on the brink of Famine. A ceasefire is needed to ensure the critical delivery of humanitarian assistance.
Photo: Abed Rahim Khatib/Anadolu via Getty Images

Access restrictions will compound humanitarian needs

Israel severely restricted the amount of aid entering Gaza after October 7. Before the war, 500 truckloads of aid entered Gaza daily—with needs increased, a huge uplift in aid is required, but far less is actually arriving.

Within the first six weeks of 2024, the Israeli military denied access to more than 50% of aid missions planned for north of Wadi Gaza and 25% for areas south of Wadi Gaza. Almost 5,000 humanitarian aid trucks entered Gaza in March—about one-third of the rates of pre-conflict aid delivery.

The delivery of assistance has also been constrained by the displacement and death of humanitarian aid workers. As of April 2024, more than 200 humanitarian aid workers, including over 170 U.N. staff, have been killed—making Gaza the most dangerous place for aid workers in the world.

As the humanitarian situation in Gaza continues to reach new lows daily, world leaders—including President Biden—must use all available influence to push for an immediate and sustained ceasefire. Airdrops—or a new port that could take weeks to construct—are not a solution. 

Gaza needs a ceasefire now.

Gaza’s recovery after the fighting ends will depend on whether, and how intensely, Israel maintains its policy of preventing basic goods and services from entering Gaza.

Escalating violence in the occupied West Bank will drive humanitarian needs

Throughout 2023, tensions also rose in the West Bank and East Jerusalem. Since October 7, violence between security forces, settlers and Palestinians has increased significantly. Some 418 Palestinians in the West Bank and East Jerusalem have been killed, including 106 children, and more than 5,700 others have been arrested—including more than 2,000 who are being held without a charge or trial. 

The ongoing conflict has also spurred a notable increase in displacements within the West Bank linked to settler violence and the destruction of homes during Israeli military operations. Movement restrictions due to newly created checkpoints and roadblocks have also limited the availability of essential goods and medicines, as well as children’s access to education.

A young girl, wearing a yellow jacket, and her mother walk through the remnants of a Gaza neighborhood, destroyed by the war.
Displaced Palestinians walk through their destroyed neighborhood in Gaza during a temporary ceasefire to check on their homes and collect any items that remain intact.
Photo: Ashraf Amra/Anadolu via Getty Images

 How is the IRC responding?

The IRC is closely monitoring and assessing the situation in the occupied Palestinian territory (oPt). Local partners have been leading the response in Gaza and we are supporting their objectives through financial, technical and operational support. Partner-led activities contribute to the IRC's emergency outcomes in health, basic needs, education and safety.

The IRC and Medical Aid for Palestinians (MAP) have deployed five successive Emergency Medical Teams to provide emergency and life-saving medical care, including direct medical care at hospitals, and the distribution of medical supplies and pharmaceuticals. The team, composed of trauma doctors, surgeons, pediatricians and water and sanitation experts, are offering surge and relief support to hospitals and providing life-saving medical care to injured Palestinians. To date, our EMTs have delivered at least 175 surgeries and 552 consultations, including minor procedures and critical care.

In partnership with Anera, the IRC is working to provide essential mental health and psychosocial support to Palestinian children. We are utilizing a comprehensive approach that prioritizes the needs of children between the ages of 4 and 18, to implement therapeutic activities including play, art therapy and life skills training. Our activities are designed to empower children to cope with their experiences, express themselves creatively, and develop essential life skills for the future, thereby promoting healing, resilience, and emotional wellbeing. By fostering a safe and supportive environment, we aim to mitigate the long-term impact of the crisis in Palestine and have started providing psychosocial support services for 9,000 children between 4 and 11 years old and informal literacy and numeracy sessions for 1,200 children, targeting people sheltering in schools.

The IRC has also partnered with Nafs to establish a Mobile Community Center (MCC) that will enhance the access of marginalized people, mainly children, to their residential areas and provide them with Mental Health and Psychosocial services in the West Bank and Gaza strip. Our partnership with Nafs is expected to reach 5,000 children in the next few months.

The IRC has also procured or released 49 metric tons of pharmaceuticals and medical supplies which the IRC and our partners are distributing to support health facilities across Gaza. These include pediatric and psychotropic medicines as well as trauma supplies and are based on needs identified and coordinated across health actors working in Gaza.

We have also partnered with Palestinian NGO, Juzoor for Health and Social Development, to address the health and mental health needs of those displaced and to provide access to basic services for children and families. Together, we are providing critical services, including health services, psychosocial support and cash assistance, in more than 20 shelters throughout Gaza. We expect to reach more than 30,000 Palestinians through our partnership with Juzoor in the coming months.

The International Rescue Committee (IRC) and Welfare Association (Taawon) partnered to combat the severe hunger affecting displaced families in Rafah, southern Gaza, where over one million people have been displaced and have sought refuge in what is considered Gaza’s last haven. Together, we delivered fresh food parcels to approximately 3,500 families between January and February 2024.

The IRC’s response in oPt draws on our global experience and expertise in emergency response, as well as our longstanding presence in the region. In 2022, IRC teams across Syria, Lebanon, Jordan, Iraq, Yemen and Libya helped 6.3 million people.

The IRC plans to scale its programming in Gaza as soon as a ceasefire is in place. The IRC will aim to work directly and through partners to provide nutrition, water, sanitation and hygiene, healthcare, and protection particularly focused on separated children.

A truckload of medical supplies, marked with the MAP logo, en route to be distributed in Gaza.
Medical supplies procured by the International Rescue Committee (IRC) arrive in Gaza. The IRC procured 49 metric tons of pharmaceuticals and other medical supplies. The supplies are distributed to hospitals and clinics to support critical health and medical services.
Photo: IRC

How can I help people in Palestine?

The IRC is working with partners to deliver critical emergency aid to families in Gaza and conflict zones around the world. Donate now to support our critical work. We are on the frontlines providing critical aid to crisis-affected people in more than 50 countries, including places on the 2024 Emergency Watchlist.

Urge Congress to call for a ceasefire.

Read more about the top 10 crises the world can’t ignore in 2024 and learn more about the IRC's 2024 Emergency Watchlist.