This year, the occupied Palestinian territory rose to its 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. 

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.

Gaza is now the deadliest place for civilians and aid workers in the world. More than one hundred thousand Palestinian civilians have been either killed or injured due to Israeli military operations. Every day this number continues to rise.

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 36,000 Palestinians and injuring more than 81,000 others. More than 50% of the identified fatalities are said to be women and children.

The IRC is deeply concerned over reports of multiple mass graves found at Nasser Hospital in Khan Younis and Al-Shifa Hospital in Gaza City following the Israeli military's withdrawal from both sites.

“Some of the deceased were allegedly elderly, women and wounded individuals—with some found with their hands tied and stripped of their clothes,” said IRC vice president of emergencies, Bob Kitchen. “We echo the UN High Commissioner for Human Rights' demand for an immediate and thorough independent investigation into these incidents.”

The IRC is calling for an immediate and permanent 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 Kitchen. “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.
Nearly 1.7 million Palestinians are estimated to be internally displaced. Some families have been displaced several times over.
Photo: Majdi Fathi/NurPhoto via Getty Images

Predictions for 2024

Airstrikes and fighting will continue to have devastating impact on civilians

Israel’s offensive has killed more than 36,000 Palestinians. An estimated 8,000 of the identified fatalities are children 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. 

Despite repeated warnings from humanitarian organisations, Israeli forces launched a ground incursion into eastern Rafah and have taken control of the Palestinian side of the border crossing. Over 9,000 Palestinians have been displaced from Rafah. Aid flow through the Rafah crossing has halted and no aid trucks have entered the area since May 5.

If Rafah meets the same fate as Gaza City and Khan Younis, all parts of Gaza will be destroyed—alongside any hope for hundreds of thousands of people. It is unconscionable to target such a densely populated area.

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 a permanent 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.
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, 3.3 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 625,000 school-aged children have lost access to education, with the majority of schools being used as shelters and almost 90% of schools damaged or destroyed.

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.

Children continue to be cut off from psychosocial support. Before the recent increase in hostilities, over one million children in Gaza needed mental health and psychosocial support. Currently, every child has experienced profoundly distressing events and trauma, characterised by extensive destruction and displacement. At the same time, parents and caregivers are facing severe psychological stress.

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. In addition, the IRC and Nafs have partnered to establish a Mobile Community Center that will enhance the access of marginalised people, mainly children, to their residential areas and provide them with Mental Health and Psychosocial services in the West Bank and Gaza strip. This project aims to provide vital support by offering training, awareness sessions and recreational activities to help nurture the mental well-being of as many violence and war-affected children as possible.

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 healthcare system has collapsed

Across Gaza, hospitals and clinics have been damaged and destroyed. Insecurity Insight recorded almost 800 incidents of violence against, or obstruction of access to, health care in Gaza since the outbreak of violence in October.

Only 16 of Gaza’s 36 hospitals remain partially functional.

“These healthcare facilities are not built for mass casualty,” says Dr. Seema Jilani, paediatrician and member of MAP and IRC's first Emergency Medical Team. "And in fact, no hospital in the world is built for this kind of sustained severity of mass casualty, nor could any be able to sustain it.”

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 travelling to Israel, the West Bank or East Jerusalem for treatment. 

Health needs have been greatly exacerbated by the deterioration of water, sanitation and hygiene (WASH) conditions in Southern Gaza. Some Palestinians are being forced to survive on just 3% of the internationally recognized minimum standard for daily water intake. Meanwhile, the disruption of services has led to growing piles of garbage that are contaminating water sources and causing major health issues and disease outbreaks. 

“Put simply, we are witnessing a catastrophic decline in living standards and health conditions every day,” says IRC country director for the Gaza crisis, Kiryn Lanning. “A permanent ceasefire, release of all hostages, and a major increase in humanitarian aid and fuel are critical to putting an end to this crisis.”

Even with an immediate ceasefire, nearly 12,000 people would 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 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, 32 people, including 28 children, have died of malnutrition and dehydration at hospitals 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 still be halted. A permanent 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. Throughout April, an average of 186 trucks crossed into Gaza per day—about 37% of the pre-conflict aid delivery rates. The closure of the Rafah and Kerem Shalom Crossings is leading to severe shortages of fuel and threatening the continuity of humanitarian interventions.

The delivery of assistance has also been constrained by the displacement and death of humanitarian aid workers. As of May 2024, more than 260 humanitarian aid workers, including over 190 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 permanent ceasefire. We reiterate that sea routes are not a solution to the ongoing humanitarian catastrophe, and cannot deliver the volume or consistency of aid required to meet the dire needs. 

Israel must provide rapid and unimpeded passage of humanitarian relief at speed and scale, through all possible land routes and entry points and within Gaza. Most importantly, an immediate and permanent ceasefire is vital to protect Palestinians from further harm, release the hostages, and allow essential assistance to be provided to people across the whole of Gaza. 

Gaza needs a ceasefire now.

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.

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’s response in Gaza 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. Local partners have been leading the response in Gaza and we are supporting their objectives through financial, technical and operational support.

The IRC and Medical Aid for Palestinians (MAP) have deployed six 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, paediatricians and disaster 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 384 surgeries and 1,243 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 utilising a comprehensive approach that prioritises 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 Gaza 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 and begun delivering mental health and psychosocial service (MHPSS) activities through six mobile community centres—three in Gaza and three in the West Bank. Our partnership with Nafs is expected to deliver support to 5,000 children within the next few months.

We have 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, our three mobile health teams have provided more than 10,000 patient consultations in northern Gaza. The teams have been providing health services in three shelter clusters in northern Gaza since February. In the first week of March alone, these clinics served almost 7,000 patients and we expect to reach more than 30,000 in the following months.

Moreover, we have also begun MHPSS activities for 12,000 women and children and early childhood development (ECD) activities for 6,000 children between 1 and 4 years old in shelters in the north. Juzoor is using a combination of their own and IRC ECD materials and providing children's activity kits to support children affected by the crisis in the occupied Palestinian territory.

In partnership with the Psychosocial Counseling Center for Women (PSCCW), the IRC is addressing the severe challenges facing Palestinian women and children in the West Bank. The partnership focuses on empowering these communities through comprehensive mental health and psychosocial support, supporting 250 women gender-based violence survivors and 470 children to develop resilience against trauma. Additionally, the initiative includes economic empowerment through cash-for-work programs for 40 female graduates, aiming to strengthen economic independence and enhance community well-being.

The 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 has also procured and delivered 46 metric tons of pharmaceuticals and medical supplies which the IRC and our partners are distributing to support health facilities across Gaza. These include paediatric and psychotropic medicines as well as trauma supplies and are based on needs identified and coordinated across health actors working in Gaza.

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 and delivered 46 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 Gaza?

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 40 countries, including places on the 2024 Emergency Watchlist.