GAZAHUMANITARIAN

SNAPSHOT15 July 2024

Humanitarian non-governmental organizations (NGOs) operating in
Gaza have consistently reported that Israel’s systematic obstruction ofaid and its ongoing attacks on aid operations, including facilities,
personnel and distribution points, have prevented the effective
delivery to people in need. Ever since Israel's defense minister Gallant
declared a complete siege on the Gaza Strip on 9 October 2023, theamount of aid entering the enclave has been insufficient to meet theneeds on the ground. ¹
In early May, Israel launched a long-feared major ground incursion into
Rafah and southern Gaza, resulting in mass forcible displacement,
civilian casualties, and closure and restrictions at main crossings. Thisaction halted medical evacuations and severed humanitarian aid to Gaza.
Over the last weeks, continued Israeli bombardment across Gaza,
including attacks on UN-run schools used as shelters, new so-called“evacuation orders”, attacks on municipal workers and other public
service providers including water and sanitation workers, have further
deteriorated the ability of aid agencies to respond. Palestinians continue
to be squeezed into smaller, overcrowded areas that lack the resources
to support human life.
The Government of Israel's statistics on truck entries and narrative on
access fail to address several vital components necessary for aneffective operational response. Among these, the most significant is theactual delivery of aid to the population in need within Gaza. The mere
entry of trucks into Gaza does not guarantee that the supplies reach theintended recipients due to safety and security reasons. Furthermore,
the reported numbers do not differentiate between types of cargo,
often mixing commercial goods with critical humanitarian aid, which
obscures the real picture of assistance reaching those in crisis.
This document aims to provide a snapshot of the immense obstacles
that impede aid delivery in Gaza, with concrete examples from NGOs on
the ground. It offers a glimpse into the daily challenges faced byhumanitarian workers, made worse by conflict, bombardment andgunfire, and the siege tactics. We aim to complement ongoing reportingfrom UN agencies and civil society groups to paint a picture of theseharsh realities.
¹ In early May, seven agencies released a briefing note outlining the discrepancy between the
Government of Israel's public commitments to improving humanitarian access in Gaza andthe harsh reality on the ground. In late May, eighteen agencies published another press
release, denouncing the cosmetic changes to the rapidly disintegrating access situation andwarning of the humanitarian system's imminent collapse.

DETERIORATION OF ACCESSFOR HUMANITARIAN SUPPLIESINTO GAZA
None of the land crossings into Gaza – the most effective, viable
way to deliver assistance – have been fully functional since
October 2023, while the North of the strip remains effectively
cut off from the South by the Israeli army.

Southern access - Kerem Shalom / Karam
Abu Salem crossing
The situation around the Kerem Shalom/Karam Abu Salem(KS/KAS) crossing has deteriorated significantly since Israel’s
offensive in May, making the crossing unsafe to access fromwithin Gaza and currently not logistically viable. Since early May,
KS/KAS has been designated as the primary crossing forhumanitarian cargo, food, fuel, and other critical supplies and is
described by Israeli authorities as ‘open’ – but in practice only asmall trickle of aid has entered through this crossing andreached people in need for the following reasons:
The area between this crossing and the so-called“humanitarian zone”, where most Palestinians in Gaza reside,
is an active combat zone and has become extremely unsafe
since the onset of the Israeli offensive on Rafah.
The security situation has further deteriorated due to Israeli
attacks on Gaza’s civilian police force, which have hindered
their ability to work due to life safety concerns. This has led
to a breakdown in public order and safety, increasing the
likelihood of looting of humanitarian convoys. The increase inlooting incidents now is a result of 9 months of Israeli
destruction of civilian infrastructure and aid obstruction,squeezing the population into a pressure cooker situation.
When people are pushed to extreme limits, they will dowhatever it takes for the survival of their families.
Lack of visibility and predictability on the situation and
KS/KAS crossing, which is hardly accessible for NGOs and theUN, complicates operations and planning.

Since early May, most organizations have had to discontinue purchasing new goods due to the backlog created by the lack offunctioning entry routes from Egypt to Gaza. There are reportedly over 1,500 UN/NGOs trucks currently waiting in Al Arish in
Egypt to cross into Gaza.
The deteriorating environment has severely impacted humanitarian organizations, including ActionAid (AA), CARE, Médecins duMonde (MDM), Médecins sans Frontières (MSF), Mercy Corps (MC), the Norwegian Refugee Council (NRC), Save theChildren (SC), Première Urgence Internationale (PUI), Plan International, and their ability to operate:

SC has 10 pallets of essential
medical supplies in Al Arish withno ability to move those into
Gaza safely. SC’s last medical
supply shipment was stuck due
to the Rafah closure, resulting insome supplies spoiling. While SC
is exploring northern supply
routes, there remains no feasible
way to transfer these supplies
further South.

As of 12 July, three trucks
containing
predominantly
essential medical items havebeen waiting in Egypt to enter
Gaza through the KS/KAS
crossing since 14 June. The
MSF-supported Nasser Medical
Complex in Khan Younis isfacing critical shortages of
medical supplies.

On 7 July, CARE successfully
delivered a truckload of baby
kits into Gaza for the first timesince May, after being stalled at
the KS/KAS crossing for aroundthree weeks. Several additional
trucks equipped with baby andhygiene kits remain in Cairo,
held back from dispatch to Gaza
due to the substantial backlogs.

PUI has procured bedding
sets and personal care items
sufficient to fill 50 trucks
since early May, which havestill not been allowed tocross into Gaza. Since theexpanded
incursion
intoRafah on 6 May, PUI has only
managed to bring two trucksof aid into the enclave.

One AA truck entered throughKS/KAS in June and the content
was fully distributed. However,a total of 20 truckloads are still
stuck in Egypt containing 1800
dignity kits and 1580 hygienekits. Efforts to coordinate forentry have been ongoing for atleast 2 months.

MdM had planned to dispatchprimary healthcare supplies forthree of its Primary Health Care
Centers in the Middle Area ofGaza, as well as sexual andreproductive health, prenatal,and postnatal supplies intended
to support up to 5,000 women,
girls, and newborns. The
closure of Rafah crossing andongoing restrictions at KS/KAS
have blocked these shipments.

MC trucks containing 660 foodkits and 886 hygiene kits havebeen stuck in Egypt waiting tocross into KS/KAS since 12
June. Trucks containing 464
hygiene kits and 370 food kitsthat were facilitated incollaboration
with
Plan
International Egypt to enter
Gaza via KS/KAS on 14 June
have yet to be uplifted due toaccess and security constraints.
A further 1,000 sealing off kits
and 1,000 bedding sets havebeen procured in Egypt but are
unable to enter Gaza due to theaccess issues at KS/KAS.

900 pallets of NRC’s sheltermaterials, non-food items, andhygiene products are currently
scattered at various points
around the KS/KAS crossing;
NRC has not managed toreceive new supplies to its
warehouse in the Middle Area
since 3 May. 16 trucks filledwith NRC items such as hygienekits, kitchen sets, sleeping bags,
tarpaulins, and water filtersthat have been rejected byIsraeliauthorities
have
accumulatedin
Al-Arish
warehouse since December,incurring demurrage fees.

Southern access - Rafah crossing
In early May 2024, Israeli forces seized and subsequently closed the Rafah crossing. It was reportedly found to be destroyed
shortly thereafter. This brought the movement of aid from Egypt into Gaza through Rafah to a complete halt.

Since Israel's Rafah offensive in early May, Humanity & Inclusion / Handicap International (HI) has had a temporary halt intransporting goods into Gaza. After spending several months establishing new supply chains from Egypt into Gaza through the Rafah
crossing, the closure of the crossing has brought HI’s supply chain to a standstill. Just before Israel's offensive, HI had sent hygienekits to Gaza; however, these supplies were lost in the ensuing chaos and remain untraceable. Currently, HI still has 456 pallets ofcritical supplies stuck in Jordan, Egypt, and France, including prosthetics and orthotics, assistive devices for people with disabilities
and injuries, wound dressing kits, hygiene and dignity kits, and clothing, all unable to be delivered to Gaza.

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Northern access - Erez and Western Erez/Zikim/As-Siafa
In early May, Israel announced the opening of two crossings in the North.
However, on 9 May, Erez/Beit Hanoun crossing closed again for UN andNGO humanitarian trucks. In practice, Western Erez/Zikim/As-Siafa
crossing is logistically hardly viable, and inadequate to cover the needsof people in the Northern area, where 20% of households are classified

in Catastrophe (IPC Phase 5) and 45% in Emergency(IPC Phase 4) for food insecurity.
Furthermore, humanitarian aid entering throughnorthern crossings has to first travel through the
Jordan corridor from Amman, a route with many
challenges. Vandalism by Israeli settlers, thenecessity to cross-load goods from one truck toanother at each crossing, lack of organizationaloversight whilst unloading at Western Erez/Zikim/AsSiafa, and extended X-ray scanning have resulted insignificant delays in aid delivery. Moreover, not all
humanitarian actors can utilize the Jordan corridor as
aid must be customs-cleared, requiring organizations
to be registered in Israel.
For these reasons, as well as logisticalchallenges induced by the closure andbacklog at southern crossings causedby the Israeli military operation, it
took Oxfam five weeks to transport
just 1,600 ju
food parcels through Western
Erez/Zikim/As-Siafa crossing point. In reality, it
should take no more than 6 hours to drive goods from
Jordan to Gaza and not more than 3 days maximum toprocess the entire delivery. Delays in the heat areespecially critical for perishable food items, greatly
increasing the risk of spoilage during transit.

Map: Office of Coordination of Humanitarian Affairs (OCHA), 10 July 2024

Aid entering does not match the needs
Already prior to October 2023, the Israeli blockade restricted
the entry of trucks into Gaza to roughly 500 trucks per
working day, resulting in around 10,000 - 11,500 trucks
entering each month to meet the bare humanitarian minimumin times of stability. Over the last nine months, humanitarianneeds have sharply increased, requiring far more aid than in
the past to support the population’s survival.
The Israeli Coordination of Government Activities in the Territories
body (COGAT) states that a total of 41,234 trucks have entered Gaza
from 7 October 2023 to 9 July 2024. This is significantly higher thanthe UN’s figures of humanitarian trucks entering Gaza. While it isunclear and unverifiable how COGAT’s figures are calculated, there isan apparent prioritization of commercial goods over humanitarian
supplies, despite the sky-high prices in the markets. Colleagues on
the ground report that the most affordable foods available are
sweets/fizzy drinks. Fruits and vegetables are hard to find, and areoften too expensive for people to afford. Access to a nutritious diet isparticularly critical for children as well as pregnant and lactating
mothers given long-term implications for child development.
Moreover, prior to October, approximately 11,000 trucks entered
Gaza each month, totaling at least 99,000 over nine months. As such,even according to COGAT’s own numbers, only 40% of Gaza’s
minimum needs during periods of stability are met (41,234 out of
99,000). Most importantly, COGAT’s numbers of trucks andhumanitarian access narrative ignore several components key to aneffective operational response, including whether
humanitarian aid is reaching populations in need within
Gaza.
Counting trucks is a false metric for evaluating
humanitarian access in the Gaza Strip. Instead,humanitarian access should be gauged by the
reduction in human suffering and the availability ofsufficient supplies to provide assistance to the
population. This is not the situation in Gaza, where aidorganizations are reporting critical shortages ofurgently needed items.

MdM and its teams are facing shortages of
medical supplies. Drug supplies are severely
limited, with several types completely
banned frombanned
entering Gaza, including anesthetics forsurgeries and strong painkillers. Additionally, essential
drugs for non-communicable diseases, particularly
those for type 1 diabetes, are missing. There is also acurrent shortage of creams for skin diseases. Recently,
there has been a notable lack of antibiotics, especiallythose safe for pregnant and lactating women.

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INSIDE GAZA: ACCESS WITHOUTSECURITY IS NOT ACCESS
Even when humanitarian staff and goods are within Gaza, their
movement to reach those in need is severely restricted. NGOs reportnumerous obstacles including checkpoint delays, constantbombardment, fuel shortages, impassable roads and UXOs, as well as
ongoing military operations. Humanitarian operations are confined to anincreasingly smaller so-called “humanitarian zone” which has neverproven to be safe, as demonstrated by the 13 July attack on Al-Mawasi,
reportedly killing at least 90 civilians and wounding 300.
According to the UN, of the 115 humanitarian missions planned fornorthern Gaza in June, only 53 (46%) were facilitated by Israeli
authorities. Additionally, 41 missions (35.7%) faced impediments, 11(9.6%) were outright denied access, and 10 (8.7%) were canceled due tologistical, operational, or security concerns. Movement between Gaza's
North and South is also particularly challenging due to the checkpoints
and holding points along the Israeli military's Netzarim corridor, which
segments the enclave, compounded by persistent fighting and insecurity,
including the following:

Picture: © CARE. The few aid trucks that do enter Gaza face the risk oflooting and must be equipped with protective cages around windows
and lights due to the increasing desperation of the local population
facing starvation and death.

Several NGOs reported that their teams are required to notify the Israeli authorities of their movements even within
designated “humanitarian zones” and must wait for acknowledgement before proceeding. The stated intended purpose of
these so-called "humanitarian zones" is to ensure safe and free movement; the necessity for such notifications illustrates
that no place in Gaza is safe.

One NGO described severe mobility challenges during the short journey from Deir al Balah to Gaza City. Departing at 8AM,
teams faced multiple stops, requiring Israeli approvals, extensive security screenings, and prolonged waits, turning a brief
trip into a day-long ordeal. Palestinian aid workers are subjected to additional risks as they must exit the vehicle for checks,
whereas non-Palestinian staff are screened via cameras or drones.

Oxfam’s trucks have been limited to delivering goods through the West Erez/Zikim/As-Siafa
crossing in Northern Gaza. This region has been heavily impacted by continuous Israeli bombings,
destroying infrastructure and forcing many, including Oxfam's local partners, to flee to lessperilous areas. The lack of fuel has further impeded their ability to distribute aid effectively. As aresult, simply transporting goods from the crossing to people in need has become a challenge.

Navigating the Gaza Strip has become increasingly difficult due to escalating fuel shortages
since the Israeli ground incursion in Rafah. Prior to October, a liter of gas cost around 7
shekels (less than 2 USD), whereas it has now skyrocketed to between 200 and 220 shekels(nearly 60 USD). This fuel crisis has drastically hindered mobility, affecting essential
operations. Lacking fuel, DanChurchAid and Norwegian Church Aid (DCA-NCA) teams have had
to rely on donkey carts or walk extensive distances to complete their tasks.
Following DCA-NCA's needs assessments, the organizations planned to implement critical
WASH interventions in Al Mawasi area in Khan Younis. However, as Israeli military operations
approached these areas, the organizations were forced to limit their assistance to only the
Middle Area. This is just one of many instances where organizations have had to cancel,
postpone, or relocate their operations, preventing them from responding on the basis of needs.

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HUMANITARIAN ACTION UNDER ATTACK
Despite attempts to use voluntary humanitarian notification and deconfliction systems with the Israeli forces, our premises,
infrastructure, and personnel have repeatedly come under attack, disrupting aid efforts and endangering lives. Over 500
healthcare workers and 274 aid workers have been killed in the last nine months. These workers should be protected and nevertargeted, and their killing reduces already limited staff capacity. Survivors face constant danger, sheltering from bombs, andstruggling to find food, hindering their work. Many NGOs have suspended sending additional staff into Gaza, despite urgent needs
for rotation and reinforcement.

Since the start of the war, MSF staff andpatients have had to leave 14 healthstructures and have endured 26 violent
incidents, which includes airstrikes
damaging hospitals, tanks firing atagreed deconflicted shelters, groundoffensives into medical centres, andconvoys fired on. The last MSF healthfacility in North Gaza has been forced totemporarily close after Israeli forces
issued a so-called evacuation order forareas of Gaza City on 8 July.

In May, a medical point supported by MdM
within an UNRWA school sheltering
displaced persons in North Gaza wasdestroyed by Israeli forces during athree-week Israeli military offensive on
Jabalya refugee camp. It was one of 6
UNRWA schools that were besieged, set
on fire and destroyed by Israeli forces.
The severity of the military operation in
Jabalya led to significant devastation,
temporarily halted critical health services
for multiple days before resuming inanother location.

In June, Israeli forces bombed the homeof an HI staff member in Nuseirat Camp,killing her and her entire family.
Around the same time, Israeli forces also
destroyed a warehouse in Rafah
managed by Atlas Logistique, one of HI’s
operational units, destroying with itnearly 200 pallets of life-saving aid
belonging to different organizations.

LEGAL OBLIGATIONS AND WAYS FORWARD
Under Article 55 of the IV Geneva Convention, the occupying power is obligated to ensure that the humanitarianneeds of the occupied population are met. This includes facilitating humanitarian aid and creating conditions thatenable the provision of supplies. In this case, Israel as the occupying power has the duty to ensure that aid is not
only allowed into Gaza but also delivered safely to those in need.
Humanitarian organizations are crucial in providing support but cannot do so without safe delivery procedures and an
enabling environment - a responsibility beyond our remit. The facilitation of aid must be principled, safe, secure, andunimpeded across all areas of Gaza. The protection of humanitarians is meant to be guaranteed under International
Humanitarian Law (IHL). The responsibility for upholding this protection rests with the parties to the conflict. Third
States must also respect their own legal obligations to urgently act to enforce respect for IHL in the Gaza Strip.

Our presence in Gaza is solely due to the unwavering commitment of our colleagues on the grounddespite great risks to their own lives. Our continued presence should not be mistaken for a sign ofsomething worthy of being called “access” - it is despite its very absence. The risks our colleagues
are exposed to each moment are unacceptable. Today, the issue is not just a "shrinking"humanitarian space; there is hardly any space left to operate at all.
The undersigned NGOs continue to call for an immediate and lasting ceasefire and maintain it is the
only way to provide humanitarian assistance and protect and save lives in Gaza.
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