This year, the occupied Palestinian territory rose to its highest ever position on the Watchlist, as devastating violence is causing a humanitarian emergency that will persist long after the fighting eventually stops. 

Gaza enters 2024 as the deadliest place for civilians in the world. Residents 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 ground incursion and rocket barrage on southern Israel on October 7, 2023, killing 1,200 people and taking over 200 hostages. Israeli operations have since caused severe destruction and widespread death and displacement throughout Gaza, particularly in the north, killing over 26,000 people. Diplomatic engagement brought about a temporary truce in late November 2023 and the release of some hostages but violence continues.

Gaza is now the deadliest place for civilians in the world.

“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 impact on civilians

Israel’s offensive has killed over 26,000 Palestinians. Over 10,000 were children. Some 1.7 million Palestinians, nearly 80% 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 7-day truce 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.

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 7 October, 80% of Gaza’s population were reliant on humanitarian assistance. In 2024, after the destruction of key infrastructure and mass displacement, all 2.2 million people living in Gaza will need humanitarian aid. 

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 likely lose years of education, with schools damaged and staff killed or displaced, while a sustained mental health response will be required to address the high levels of psychological stress and trauma.

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 is on the verge of collapse

Across Gaza, hospitals and clinics have been damaged and destroyed. Insecurity Insight recorded almost 600 incidents of violence against, or obstruction of access to, healthcare in Gaza since the outbreak of violence in October.

Hostilities and Israeli restrictions on allowing fuel to enter Gaza have left the hospitals that remain, particularly in the north, unable to function. Without an end to the fighting and sustained humanitarian support, it will continue to be extremely difficult for people to access medical care. 

Meanwhile, ongoing border closures will 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.

An Integrated Food Security Phase Classification (IPC) food security analysis shows that 100% of Gazans are at imminent risk of famine, further driving medical needs.

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 will be required, but far less is actually arriving. 

Aid delivery has been further constrained by the damage to roads, lack of fuel, and the displacement and death of humanitarian aid workers. As of January 2024, more than 150 U.N. staff have been killed - making Gaza the most dangerous place for aid workers in the world. Nearly all aid workers have been displaced. As long as fighting persists, these constraints will continue.

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 7 October, violence between security forces, settlers and Palestinians has increased significantly, resulting in more than 370 Palestinians being killed, including 94 children, and 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 Palestinian girl walks with her father after the Friday prayer in Gaza on August 4, 2023
A Palestinian girl walks with her father after the Friday prayer in Gaza on August 4, 2023.
Photo: MOHAMMED ABED/AFP via Getty Images

 How is the IRC responding?

The IRC is closely monitoring and assessing the situation in the occupied Palestinian territory (oPt). The IRC deployed an emergency medical team, in partnership with Medical Aid for Palestinians (MAP), to the Al Aqsa hospital in Gaza’s Middle Area. Unfortunately, the emergency medical team has been forced to withdraw and cease activities due to increasing Israeli military activity in the area. 

In addition, the IRC has procured 27.5 metric tons of pharmaceuticals and medical supplies and is working to distribute supplies to hospitals and clinics in Gaza. We are currently working on procuring a second shipment that will specifically address the needs identified by the Ministry of Health and our valued partners, focusing on pediatric and psychotropic medicines.

The IRC is also supporting partners to deliver food, medical supplies and pharmaceuticals, and to provide critical services in emergency shelters including healthcare, psychosocial support and cash assistance for people to meet their basic needs.

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. 

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.