UNRWA Report #193 on Humanitarian Crisis in Gaza, West Bank

Students inside a temporary learning space (TLS) in an UNRWA shelter. © 2025 UNRWA photo

Highlights

The Gaza Strip

• On 19 October, the Israeli authorities accused Hamas of violating the ceasefire, citing reported attacks on their troops in southern Gaza. In response, the Israeli Forces conducted airstrikes across multiple locations in the Gaza Strip. One of the strikes hit an UNRWA school building being used as a shelter, resulting in four fatalities and several persons injured.

• On the same day, the delivery of humanitarian aid into the Gaza Strip was temporarily halted by the Israeli authorities, with closure of all crossings. Later the same day, the Israeli forces announced the renewed enforcement of the ceasefire, including resumption of aid deliveries.

• UNRWA continues to face a ban on bringing humanitarian aid into the Gaza Strip. Meanwhile, pre-positioned outside Gaza, UNRWA has enough food parcels for 1.1 million people, flour for 2.1 million individuals, and shelter supplies for up to 1.3 million people.

• Following the start of the ceasefire, large-scale population movements were recorded by the Site Management Cluster, mainly from southern to northern Gaza. A total of 487,988 displacement movements were recorded between 10 and 18 October.

• UNRWA started to expand its operations in Gaza City. UNRWA staff resumed health services in Salah Ad-Din Medical Point, as well as restarting work in over 20 emergency shelters in Gaza City. In addition, solid waste removal and distribution of water resumed in Gaza City, albeit at reduced capacity.

• Efforts to rehabilitate installations are complicated by the widespread presence of explosive ordnance, which continues to pose life-threatening risks to people across the Gaza Strip. As noted by OCHA, it is urgent to ensure improved access for mine action partners so they can conduct the full spectrum of essential activities, including explosive ordnance clearance, which requires specialized personnel and equipment.

• On 18 October, UNRWA launched the new e-learning school year, aiming to reach 290,000 children across the Gaza Strip through its distance learning programme, a vital pathway to restoring formal education for children.

• The United Nations Environmental Programme (UNEP) recently estimated, based on satellite imagery collected on 8 July 2025, that widespread destruction across the Gaza  Strip has generated more than 61 million tons of debris.

• According to the latest Gaza Protection Cluster Snapshot, the absence of a stable income for displaced families in Gaza is deepening dependency on humanitarian assistance and driving negative coping mechanisms, such as skipping or reducing food portions or sending adolescent boys to unsafe informal labour.

|   The occupied West Bank including East Jerusalem

• With the official start of the annual olive harvest on 9 October, Israeli settler violence towards Palestinian communities has increased, with attacks on olive trees and Palestinians harvesting olives recorded across the West Bank. The Director of UNRWA Affairs for the West Bank Field Office called for the protection of all Palestinians participating in the annual harvest.

• As part of the Gaza ceasefire agreement, Palestinian detainees from the Gaza Strip and the West Bank, including East Jerusalem, were included in the prisoner release conducted on 13 October.

Key Points

The Gaza Strip

Fatalities and Injuries

• Between 7 October 2023 and 15 October 2025, according to the Ministry of Health (MoH) in Gaza, as stated by OCHA, at least 67,938 Palestinians have been reportedly killed in the Gaza Strip and 170,169 have been injured.

• In a statement on 15 October, the UN human rights office (OHCHR) highlighted ongoing risks to civilians in the Gaza Strip, including due to unlawful conduct by Palestinian armed groups, intensification of internal armed clashes, extrajudicial executions, and the killing of civilians around Israeli military redeployment lines.

• UNRWA recorded over 380 workers killed since the war began (309 UNRWA personnel, in addition to 72 persons who were supporting UNRWA activities[2]), as of 19 October 2025.

Health crisis

• UNRWA started to expand its health services and redeploy its medical staff in Gaza City, responding to the needs on the ground. Two UNRWA medical points are currently functioning in Gaza City and providing lifesaving services (including maternal services) to approximately 450 patients per day.

Education crisis

• According to OCHA, Education Cluster partners have begun to scale up non-formal education in temporary learning spaces (TLS) across the Gaza Strip following the ceasefire. These efforts are designed to ensure continuity of learning by providing additional safe areas, as most schools have been damaged or continue to host displaced families.

• UNRWA plans to expand temporary learning spaces (TLSs) in shelters to enable non-formal education in newly accessible areas.

• On Saturday 18 Oct, UNRWA launched the new school year of e-learning, aiming to reach over 290,000 children with distance learning.

Displacement, Site management

• According to the Site Management Cluster, population movements were mainly from south to north and west to east; however, reverse movements were also observed, likely as people checked damaged homes or returned south and west due to limited services in northern and eastern areas, resulting from widespread destruction.

• UNRWA continues monitoring movement of displaced persons and displacement sites, and currently runs over 70 shelters. As of 16 October, over 70,000 forcibly displaced persons were estimated to be living in UNRWA shelters and surrounding areas.

• Currently, 115 UNRWA facilities are located within the Israeli militarized zone/Netzarim Corridor.

Operational implications and humanitarian response

• Around 12,000 Palestinian UNRWA personnel in Gaza continue to provide services and assistance to an entire population in need. In the occupied West Bank including East Jerusalem, UNRWA continues to play a central role with over 4,000 UNRWA Palestinian staff providing education, health, and other services to Palestine Refugees.

• All UNRWA international staff are prevented from entering the occupied Palestinian territory (the Gaza Strip and the West Bank, including East Jerusalem). This follows the passage of two laws by Israel’s parliament (the Knesset) on 28 October 2024[3]that prohibit UNRWA’s operations in what Israel defines as “Israeli territory” and bar any contact between Israeli officials with UNRWA. The Israeli authorities have not granted the Agency’s international staff visas or permits to enter the occupied Palestinian territory, including Gaza, since the end of January 2025.

• The UN Commission of Inquiry concluded in its report on 16 September that Israel obstructed trusted aid agencies (including UNRWA) from bringing in essential and life-saving aid, for the purposes of bringing about the “physical destruction of the Palestinians in Gaza through unliveable conditions of life in the Gaza Strip.”

The occupied West Bank, including East Jerusalem

• According to OCHA, between 7 October 2023 and 10 October 2025, 1,002 Palestinians – among them at least 212 children – were killed in the occupied West Bank, including East Jerusalem. Of those, 196 Palestinians, including at least 39 children, were killed since the beginning of this year alone.

o On 8 October, one Palestinian was killed and three more injured in Deir Jarir village, northeast of Ramallah, when Israeli settlers forcibly entered the village and opened fire at residents.

o With the official start of the annual olive harvest on 9 October, Israeli settler violence towards Palestinian communities has continued unabated, with attacks on olive trees and Palestinians harvesting olives recorded across the West Bank. The Director of UNRWA Affairs for the West Bank Field Office called for the protection of all Palestinians participating in the olive harvest.

o During an early morning operation on 9 October, Israeli forces forcibly entered the UNRWA El Far’a Health Centre in the northern West Bank, breaking down a main door and searching the premises. This marked the third unauthorised entry into the El Far’a Health Centre since October 2023.

o In the northern West Bank, operation ‘Iron Wall’ has continued since 21 January 2025. In Jenin city, one Palestinian was shot dead by Israeli forces on the evening of 10 October. The following day, two Palestinians were temporarily detained by Israeli forces after attempting to reach their homes inside Nur Shams Camp to retrieve belongings.

o As part of the Gaza ceasefire agreement, Palestinian detainees from Gaza and the West Bank, including East Jerusalem, were included in the prisoner release conducted on 13 October. Families of prisoners to be released were reportedly warned by Israeli forces against celebrating the event.

Gaza humanitarian overview and response

Between 7 October 2023 and 15 October 2025, according to the MoH in Gaza, as stated by OCHA, at least 67,938 Palestinians have been reportedly killed in Gaza and 170,169 have been injured.

1.1. Humanitarian access, armed conflict-related incidents

• UNRWA is verifying details of incidents that reportedly impacted the Agency’s personnel, premises and assets. Additional information will be provided once it becomes available*.

• From 8 to 14 October, several armed-conflict-related incidents have reportedly impacted UNRWA installations and/or personnel.

o On 9 October, the northern side of an UNRWA school and the gate of an UNRWA health centre in Nuseirat were reportedly struck by Israeli forces shooting in the area. No casualties among UNRWA staff members were reported, while minor damage was reported.

o Following an initial assessment after the announcement of the ceasefire, it was observed on 13 October that the UNRWA Water Pump at Beach Camp sustained significant damage, reportedly from an airstrike by Israeli forces.

o On 13 October, an UNRWA staff member was reportedly injured due to a stray bullet from an undetermined source in Maghazi Camp in the Middle Area.

As of 14 October 2025, 936* incidents impacting UNRWA premises and the people inside them have been reported since the beginning of the war. 312* (or nearly all) UNRWA installations have been impacted by armed conflict-related incidents since the beginning of the war, with some installations impacted multiple times. UNRWA estimates that, in total, at least 845* persons sheltering in UNRWA buildings have been reported killed and at least 2,563* injured since the start of current hostilities. UNRWA continues to verify and update the number of casualties caused by these incidents. A total of 115 UNRWA facilities are located within the Israeli Forces’ militarized zone/Netzarim Corridor.

*Since the start of the war in October 2023, the latest casualty figures are continuously under review as UNRWA gains access to locations that were previously inaccessible and as further verifications occur. The summary figures will be published/updated as information becomes available, noting that these numbers are subject to change once verifications are concluded.

1.2.   UNRWA response

Health and Nutrition

• UNRWA has provided about 15 million health consultations since the start of the war. This includes 10.2 million medical consultations provided by UNRWA doctors (as mentioned in previous situation reports) and another 5 million delivered by nurses and other health staff, for vaccination, health checks, and counselling.

• To date, only four health centres[4]and three additional UNRWA-rented facilities used as temporary health centres have remained operational in the Gaza Strip. In addition, as of 12 October, UNRWA provides primary health services through 86 mobile medical teams working in 30 health points inside and outside shelters in the Middle Area, Khan Younis, Al Mawasi and Gaza City[5] .

• Between 6 and 12 October, UNRWA medical teams provided 5,225 consultations for post-natal and pregnant women at high risk, 3,627 dental and oral health consultations in fixed and mobile clinics, and 2,264 physiotherapy rehabilitation services sessions in health centres and medical points. A total of 5,390 lab tests were conducted in UNRWA health centres and medical points.

• Between 6 and 12 October, an average of 1,134 UNRWA health personnel per day worked in UNRWA health facilities across the Gaza Strip, providing 81,501 medical consultations in total.

Mental Health and Psychosocial Support (MHPSS)

• According to Gaza Community Mental Health Programme (GCMHP), a recently published research study reported 79.3 per cent and 84.5 per cent moderate or higher levels of anxiety and depression, respectively. The rate of post-traumatic stress disorder with symptoms was 67.8 per cent, and 63.1 per cent suffered from significant symptoms of all three accompanying disorders. Additionally, a high frequency of migration was closely associated with the presence of one, two, or three disorders, compared to the absence of any disorders.

• UNRWA remains one of the largest providers of emergency learning and PSS services across the Gaza Strip.

• With the support of 236 school counsellors and over 300 assistant counsellors, the Agency has conducted 330,558 critical PSS sessions for approximately 730,000 displaced persons, including more than half a million children since the beginning of the war. Between 6 and 12 October 2025, a total of 9,172 displaced persons accessed these services.

• Between 7 October 2023 and 19 October 2025, UNRWA’s social work team provided services to 240,725 displaced persons, including psychological first aid, PSS services, family and individual activities, as well as case management. During the same reporting period, services were provided to 2,793 survivors of gender-based violence (GBV) and 5,409 children, including 2,245 unaccompanied children. The team supported 28,901 persons with disabilities with PSS; 8,276 of these individuals received assistive devices and rehabilitation services. Awareness sessions on GBV, child protection, disability and special needs, as well as managing social and psychological stressors, were conducted for 147,445 displaced persons.

• UNRWA heath teams, including 49 psychiatrists, psychosocial counsellors and supervisors, continued to provide mental health and psychosocial support (MHPSS) services in Gaza City, the middle and Khan Younis areas, assisting special cases referred from UNRWA health centres and shelters. From 6 to 12 October, UNRWA teams responded to 3,266 cases in health centres and at health points through individual consultations, psychological first aid, awareness sessions and to address cases of GBV.

Learning

• UNRWA has been providing learning services in the Gaza Strip in Temporary Learning Spaces (TLSs) and through its distance learning initiative.

• To date, more than 59,000 children, over half of them girls, have benefited from learning and recreational activities delivered in 456 TLSs, established across 67 UNRWA schools-turned-shelters since August 2024.

• Between September and October, UNRWA was able to quickly re-open 38 new TLSs in Khan Younis, more than doubling the number of children reached through in-person learning compared to August levels. Between 6 and 12 October, a total of 12,559 children (5,148 boys & 7,411 girls including 174 children with disabilities) benefited from TLS-based learning activities in 166 active TLSs.

Food Security

• Since 7 October 2023 and until the start of the previous ceasefire (19 January 2025), UNRWA reached over 388,000 families (nearly 1.9 million people) with two rounds of flour; at least 374,000 of those families have received three rounds. During the ceasefire, UNRWA reached over 2 million people with critical food assistance.

• UNRWA ran out of food at the end of April. The Agency has not been allowed to bring in any humanitarian assistance including food since 2 March 2025.

Water, Sanitation and Hygiene (WASH)

• Since October 2023, UNRWA has carried out emergency WASH activities across the Gaza Strip, at UNRWA shelters and informal displacement areas. Activities include operating and maintaining water wells and desalination systems and supplying water with water trucks. In addition, UNRWA continues to maintain hygiene in its shelters and sites through cleaning supplies, community-based solid waste management, water tanks disinfection campaigns and pest control.

• In 2025, UNRWA water provision and solid waste collection have reached around 1.4 million people (to date).

• As of 11 October, UNRWA teams returned to serve the displaced population in Gaza City with lifesaving WASH services, including solid waste removal, water trucking, and water wells rehabilitation.

• Between 1 and 15 October, UNRWA distributed around 20,000 cubic metres of domestic and potable water in different areas of the Gaza Strip, reaching around 250,000 IDPs.

• Between 1 and 15 October, UNRWA teams collected 2,500 tons of solid waste inside UNRWA shelters and surrounding areas across the Gaza Strip. Seventy cleaning campaigns were conducted inside its areas of responsibility, benefiting over 200,000 displaced persons. UNRWA teams also conducted over 500 hygiene promotion sessions over the same period.

(UNRWA is the United Nations Relief and Works Agency for Palestine Refugees in the Near East. The United Nations General Assembly established UNRWA in 1949 with a mandate to provide humanitarian assistance and protection to registered Palestine refugees in the Agency’s area of operations pending a just and lasting solution to their plight.)