The Israel-Hamas War: The Humanitarian Crisis in Gaza

On October 7, the Palestinian militant group Hamas launched a massive surprise assault on southern Israel, the deadliest single attack on Israelis in history. Israel’s subsequent declaration of war against Hamas has further worsened an already dire situation in the Gaza Strip, where more than two million Palestinians live. As the violence escalates, some injured civilians and foreign nationals in Gaza have been able to leave the territory during short “humanitarian pauses,” but international appeals for a full cease-fire are persisting as the war’s death toll mounts.

How bad is the humanitarian situation in Gaza?

Gaza, a small territory of about 139 square miles (360 square kilometers), or roughly the size of the city of Detroit, was already experiencing a severe humanitarian crisis before the current hostilities broke out. As a result of a sixteen-year blockade by Israel, about 95 percent of the population cannot access clean water, while more than half of all Gazans depend on international assistance for basic services. Additionally, some 80 percent of Gaza’s residents are considered refugees under international law, and Palestinians overall compose the largest stateless community in the world.

Since Hamas’s attack, the situation in Gaza has become a “catastrophe,” UN Secretary-General António Guterres said. According to the Hamas-controlled Gaza health ministry, as of November 10, Israel’s retaliation has killed at least 11,070 people, two-thirds of them women and children, while some 2,650 others have been reported missing. These figures could not be independently verified, but outside sources have also put the death numbers in the thousands. At least forty journalists and media workers have also been killed, as well as more than one hundred UN employees. Hamas’s assault killed around 1,200 Israelis, around 70 percent of them civilians. 

Israel has imposed a complete siege of the territory, cutting off electricity and water, and supplies of food and medicine are dwindling fast. Without fuel, meanwhile, Gaza’s only power station has gone dark. The lack of electricity has shut down desalination and waste-water treatment plants, further compromising access to safe drinking water. Israeli air strikes have destroyed neighborhoods, schools, and mosques, though the Israeli military has said that it is only targeting weapons storage centers and infrastructure used or occupied by Hamas militants. However, Israeli air strikes targeting residential buildings and medical facilities have resulted in numerous civilian casualties.

By the second week of November, Gaza’s health system was reported to have collapsed, with hospitals running low on rationed fuel reserves and medical supplies. Northern Gaza’s two major hospitals have already greatly exceeded capacity, and hospitals in the south are also overflowing. Beginning in November, Israeli strikes have targeted al-Shifa Hospital, the largest and best-equipped hospital in Gaza. Israeli officials claim Hamas has a command center beneath the facility. Meanwhile, a dispute between Israel and health authorities in Gaza over a potential fuel delivery has delayed fuel from reaching the hospital, from which thousands of people have fled. Israel’s energy minister said on October 12 that electricity, fuel, and water would not be provided to Gaza until all hostages—totaling roughly 240 people—held by Hamas are freed.

What are the refuge options for Palestinians in Gaza?

On October 13, Israel ordered more than one million people living in northern Gaza to evacuate to the south within twenty-four hours, ahead of an expected ground invasion targeting Hamas. The United Nations called on Israel to rescind the order, saying it would be “impossible” to achieve without “devastating humanitarian consequences.” As of November 10, more than 1.6 million people, or over half of Gaza’s population, had been displaced.

Gazans’ options for refuge are limited. Israel has closed its two border crossings with Gaza as part of its blockade. Egypt, which shares the Rafah border crossing with Gaza and already hosts more than 350,000 refugees and asylum seekers [PDF], is the only viable outlet left. Though the Egyptian government was initially reluctant to open the crossing, it has since done so to allow aid trucks carrying water, food, and medical supplies to enter Gaza. (However, UN officials say the daily quota for deliveries is only a fraction of what is required to meet Gaza’s urgent needs.) Some foreign nationals and injured civilians have also been allowed to flee Gaza via the border crossing, which has temporarily closed several times due to Israeli strikes.

With food, fuel, and water supplies rapidly dwindling, the United States is working with the United Nations and other international aid organizations to create “safe zones” [PDF] within Gaza where civilians can receive urgent humanitarian aid.

How are humanitarian aid organizations responding?

In November, the United Nations launched an updated $481 million flash appeal to address the needs of people in Gaza and the West Bank. In Gaza, the UN Children’s Fund (UNICEF) and UN Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) are helping to provide essential goods and services, such as medical supplies, fuel, and emergency assistance. Several other major organizations, including the International Red Cross and Red Crescent Movement—which comprises the Palestine Red Crescent Society—and Doctors Without Borders, are also supplying humanitarian aid to those affected by the conflict. As the fighting continues, international calls for humanitarian pauses have grown, including from countries in the European Union and the Group of Seven (G7), while members of the Arab League have pushed for a complete cease-fire.

Recommended Resources

This article by CFR Senior Fellow David J. Scheffer explains humanitarian law in the context of the Israel-Hamas war.

At this CFR media briefing, panelists discuss international law and the humanitarian crisis in Gaza.

The Center for Preventive Action tracks the Israeli-Palestinian conflict.

CFR’s World101 library explores the history behind the Israeli-Palestinian conflict.

Will Merrow created the graphic for this In Brief.