Shejaiha was particularly badly affected with thousands of people reportedly fleeing their homes this morning, as heavy bombardment from Israeli tanks and artillery continued. The situation remains tense across all of the five areas of Gaza. Medical authorities at Shifa hospital reported that 300 injured people had already been received at the hospital and confirmed 40 fatalities. Those numbers could increase significantly as it is understood that there may be many more still unable to evacuate from Shejaiha.

Hundreds of civilians, including Palestine refugees, are also crowding in the compound of Shifa Hospital – the main medical facility in the Gaza Strip. The situation could not be more dire for the collapsed health sector in Gaza, with this latest conflict only adding to the burden on overwhelmed doctors and medical staff.

This is the third war in five and a half years endured by the people of Gaza. As with previous conflicts, there is nowhere for women, men and children to escape to. The Strip is densely populated and the seven-year Israeli-imposed blockade means that people’s movement to and from Gaza remains virtually banned. Since July 2013, the operation of Rafah crossing, at the southern end of the Strip, has also been significantly reduced by the Egyptian authorities, citing security concerns.

The escalation of violence is now more acutely affecting UNRWA’s regular operations. All UNRWA installations in Magazi and Bureij refugee camps in the Middle Area are closed because of ongoing security concerns. Two health clinics remain closed and another three had operations disrupted after sustaining damage. A total of 18 UNRWA installations were closed during the reporting period.

At the moment, due to ongoing violence, it continues to be extremely difficult to deliver supplies to Beit Hanoun in the very north of the Gaza Strip, where more than 2,500 people are taking shelter in an UNRWA school. Some efforts have been made to undertake local delivery of goods within this area but access to it has so far been denied by the Israeli authorities.

All UNRWA schools in Gaza City that are in areas considered secure are now being utilized as designated emergency shelters. Whilst some funding has been secured to continue providing vital supplies such as food, water, mattresses and hygiene kits, urgent needs persist.

According to the Protection Cluster, there were at least 54 people killed over night, ten of whom were children – seven boys and three girls. The total death toll since 8 July has reached 368 people, with the Palestinian Ministry of Public Health reporting about 2,295 injured. At least 80 children are amongst the total dead. This number is expected to rise, perhaps considerably, during the course of the day.

• UNRWA is now providing shelter to more than 63,000 beneficiaries in all of the five areas of the Gaza Strip. There are currently 55 UNRWA schools operating as designated emergency shelters, with more expected to open throughout the day. The priority continues to be the provision of food, water, sleeping and hygiene items.
• Over the past 24 hours, food and water rations were distributed to shelters. 7,776 50-piece bread packets and 25,662 tins of tuna provided by WFP, were delivered and distributed to shelters.
• Regular UNRWA operations are affected but continue as security permits. Fifteen of UNRWA’s 21 health clinics remain operational, and regular UNRWA services are available. 9,153 people visited UNRWA health clinics yesterday, including more than 620 children who had regular check-ups and/or immunizations. There were 359 visits to the dentist at UNRWA health clinics and 12 people had appointments with psychosocial counselors.
• Yesterday, 21 sanitation staff worked at Designated Emergency Shelters in Jabalia.
• A total of 9,820 cubic metres of water was made available to refugee families through water wells in 8 camps.

In the past 24 hours, three UNRWA installations were damaged – one school in Rafah, a school in the north of Gaza and a storehouse holding NFIs, also in the north. It is understood that none of the NFIs were lost, but the store was closed after being damaged by airstrikes.