UNRWA Report on the Humanitarian Crisis in Gaza, West Bank

A displaced older woman fleeing Gaza City. © 2025 UNRWA photo.

Highlights

|   The Gaza Strip

• Escalating attacks on Gaza City, including on displaced people’s tents, residential buildings and civilian infrastructure, continue to inflict heavy casualties, impede the humanitarian response and contribute to large population displacement.

• Most of UNRWA services in Gaza City have been shut down due to the expansion of the Israeli military operation. Water trucking and other WASH services have been suspended, and the provision of lifesaving primary health care services has been reduced to the minimum.

• Médecins Sans Frontières (MSF) was forced to suspend its lifesaving medical activities in Gaza City on 27 September, due to the rapidly deteriorating security situation and the unacceptable level of risk for staff.

• In southern Gaza, families are squeezed into makeshift tents along the coast, packed into overcrowded schools, or sleeping in the open and amid the rubble. Basic services are stretched beyond capacity.  UNRWA continues expanding its services in the Middle and Southern areas, including by rehabilitating shelters and medical facilities.

• On 25 September, UNRWA Commissioner General called on world leaders convened at the UN General Assembly High Level Week to demand an immediate ceasefire in Gaza and the unconditional release of hostages and “push back against the weaponization of humanitarian assistance”.

   The occupied West Bank including East Jerusalem

• Operation ‘Iron Wall’ has continued for more than nine months, with approximately 32,000 Palestine Refugees from Tulkarm, Nur Shams and Jenin camps in the northern West Bank remaining displaced from their homes.

• The Allenby/King Hussein border crossing was closed following shooting that killed two Israeli Security Forces personnel on 18 September. The bridge has since re-opened on some days for passengers for some hours. The cargo terminal remains closed.  

The Gaza Strip

Fatalities and Injuries

• Between 7 October 2023 and 24 September 2025, according to the Ministry of Health (MoH) in Gaza, as stated by OCHA, at least 65,419 Palestinians have been reportedly killed in Gaza and 167,160 have been injured.

• According to records of the UN Human Rights Office (OHCHR), since the establishment of the Israeli militarized food  distribution system in the Gaza Strip on 27 May and as of 22 September, at least 2,340 people seeking assistance have been killed.

• Since the war began, 543 aid workers have been confirmed killed in Gaza. Among these, UNRWA recorded 370 workers killed since the war began (304 UNRWA personnel, in addition to 66 people who were supporting UNRWA activities[2] ), as of 24 September 2025.

Hunger, malnutrition and famine

• Famine has been confirmed in the Gaza governorate. According to Integrated Food Security (IPC), 100 per cent of the analysed 1.98 million people in Gaza, Deir al-Balah and Khan Younis governorates are currently facing or projected to face crisis or worse levels of food insecurity between 16 August and 30 September 2025.

• UNRWA’s capacity to monitor and address the spread of famine and malnutrition in Gaza City has been further restricted, amid the expansion of the Israeli military operations in the area. During the reporting period, only one medical facility continued to conduct malnutrition screening and treatment in Gaza City, functioning at minimum capacity.

• UNRWA’s latest Mid-Upper Arm Circumference (MUAC)-based findings show that malnutrition has reached 27.9 per cent in Gaza City in the first half of September:  nearly one in three young children is now malnourished. According to UNRWA’s records from 1 – 15 September, the overall prevalence of malnutrition across the Gaza Strip is around 11.9 per cent.

• According to International Rescue Committee (IRC)’s rapid needs assessment, one in three young children went a full day without food in the past 24 hours. According to the IRC, Gaza is now home to the highest number of child amputees per capita worldwide, estimated at up to 4,000 since the war began. Children are reportedly struggling with anxiety, nightmares, sudden aggression, and fear of being left alone, with harmful coping strategies (such as children resorting to begging, looting, or child labor) on the rise.

• OCHA reported that according to MoH in Gaza, as of 19 September, 440 malnutrition-related deaths, including 147 children, were documented since October 2023.

Health crisis

• Only one UNRWA medical point remains functioning in Gaza City and continues providing primary healthcare services, albeit at minimum capacity. The remaining UNRWA health facilities in Gaza City (namely one health centre in Beach Camp and three medical points) were forced to suspend services. Previously, UNRWA medical teams provided services to around 4,000 patients per day in Gaza City.

• According to the Health Cluster, between 1 and 23 September, 16 medical points and 11 primary health centres were forced to suspend or shut down services in Gaza City. At the same time, the situation at the remaining eight hospitals and one field hospital in the city is critical. Those health points are overwhelmed by the influx of casualties resulting from strikes, in addition to providing medical care for non-trauma patients.

• UNRWA continues meanwhile to expand its services in the South to respond to increasing needs of displaced families from Gaza City. During the reporting period, nine medical points have been rehabilitated in Khan Younis, in addition to the Japanese Health Centre, more than doubling the number of operational health facilities in the area.

Education crisis

• While the school year in the occupied Palestinian territory (oPt) officially started in early September, the Education Cluster reports that in-person, formal education remains on hold in the Gaza Strip, with 660,000 children in Gaza deprived of such education for the third consecutive year due to the ongoing war.

• UNRWA Commissioner General, speaking at the UNGA Side-Event “Call to Action for Palestinian Children in the West Bank and Gaza”, noted that “Every day, for nearly two years, the equivalent of a classroom full of children has been killed” and that survivors “have lost nearly four of the last five academic years due to conflict, COVID-19, and displacement”, warning of the risk of irreversible learning losses.  

• Education in Gaza is limited to distance learning programmes, amid severe challenges due to ongoing hostilities, displacement and regular disruptions to telecommunications and internet services. UNRWA continues to contribute to distance learning programmes with an estimated 290,000 students reached through three cycles. Registration for the new cycle of distance learning opened during the reporting period, with ongoing preparation for the start of the new cycle in early October.

Displacement, Site management

• OCHA reported that over 82 per cent of the Gaza Strip remains within the Israeli-militarized zone, under displacement orders, or where these overlap, as of 24 September 2025.

• The Site Management Cluster (SMC) recorded that between 20 and 23 September, Israeli military operations have continued to intensify in Gaza City, prompting people to leave the city, heading  primarily Southwards to Deir al-Balah and Khan Younis.

• Since 18 March when the ceasefire collapsed, over 1.1 million people have been reported displaced across the Gaza Strip, SMC reported.

• During the reporting period, a displacement order remained in place for the entire Gaza City affecting 67 UNRWA facilities in the area.

• UNRWA continues monitoring movement of displaced persons and displacement sites. At the time of writing, over 60,000 forcibly displaced persons are estimated to be living in UNRWA shelters and the surrounding areas, with UNRWA running around 59 shelters. As of 24 September, 10 UNRWA shelters were hosting over 10,000 IDPs in Gaza City[3] .

• At least 197 UNRWA installations – or over half of all UNRWA installations in the Gaza Strip – are located within the Israeli-militarized zone, under displacement orders, or where these overlap.

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 banned 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[4] , that prohibit UNRWA’s operations in what Israeli 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 Gaza for  eight months now (as of end of January 2025).

• The UN Commission of Inquiry concluded in its report from 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 22 September 2025, 996 Palestinians – among them at least 212 children – were killed in the occupied West Bank, including East Jerusalem. Of those, 190 Palestinians, including at least 39 children, were killed since the beginning of this year alone.

o Operation ‘Iron Wall’ has continued for more than nine months now, with some 32,000 Palestine Refugees from Tulkarm, Nur Shams and Jenin camps in the northern West Bank unable to return to their homes. The UN Commission of Inquiry report, from  23 September,  mentions that the Israeli  Forces  operations in these northern refugee camps “have significantly altered the geographical landscape through the destruction of buildings and infrastructure” amounting to collective punishment.

o On 18 September, a Jordanian national opened fire at the Allenby/King Hussein border crossing between Israel and Jordan, killing two Israeli Security personnel. In the immediate aftermath of the attack, the crossing was shut down, along with main checkpoints in the Jericho and Jordan Valley area. The crossing was reopened on 22 September for passenger movement on some days while it remains closed for cargo including humanitarian shipments.  

o On 18 September, the Israeli Forces surrounded a house in Surda, north of Ramallah, using live ammunition and grenades and detaining a Palestinian.

o On 20 September, the Israeli Forces conducted an operation in Ya’bad town, in Jenin governorate, closing the main entrances to the village with earth mounds. Another operation on 24 September closed more roads and an UNRWA school remained closed for the day.

o On 23 September, and Israeli Forces operation took place in Fawwar Camp (south) with snipers deployed to a building near the UNRWA Girls’ schools. UNRWA schools and the health centre were closed for the day. The Israeli Forces withdrew from the camp in the early evening hours.

Gaza Humanitarian overview and response

Between 7 October 2023 and 24 September 2025, according to the MoH in Gaza, as stated by OCHA, at least 65,419 Palestinians have been reportedly killed in Gaza and 167,160 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 17 to 23 September, several armed-conflict-related incidents have reportedly impacted UNRWA installations and/or personnel.

o On 20 September 2025, an UNRWA staff member was reportedly injured due to strike near Al-Quds Open University northwest of Gaza City.

o On 20 September 2025, the rooftop of an UNRWA school at Beach Camp was reportedly directly struck. Minor damage to the rooftop and no casualties among UNRWA personnel were reported.

As of 23 September 2025, 927* 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.

*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

• Between 7 October 2023 and 21 September 2025, UNRWA provided nearly 10 million primary health care consultations across the Gaza Strip, remaining one of the largest primary healthcare providers.

• In addition to health consultations, UNRWA (in partnership with and supported by other UN agencies, including UNICEF and WHO) continued to vaccinate children. Over 300,000 routine vaccines have been given to children since January 2024.

• To date, only four out of 22 UNRWA health centres and two additional UNRWA-rented facilities used as temporary health centres were operational in the Gaza Strip. In addition, as of 21 September, UNRWA provides primary health services through 92 mobile medical teams working in 30 health points inside and outside shelters in the Middle Area, Khan Younis, Al Mawasi, Gaza City[5].

• Nutritional assessment was conducted in health centres and health points for children under the age of five years. From 1 to 15 September, 430 children were recorded as malnourished out of 3,609 children screened.

• Between 15 and 21 September, UNRWA medical teams provided 4,896 consultations for post-natal and pregnant women at high risk, 2,955 dental and oral health consultations in fixed and mobile clinics, and 1,822 physiotherapy rehabilitation services sessions in health centres and medical points. A total of 4,156 lab tests were conducted in UNRWA health centres and medical points.

• Between 15 and 21 September, an average of 1,012 UNRWA health personnel per day worked in UNRWA health facilities across the Gaza Strip, providing 73,971 medical consultations in total.

Mental Health and Psychosocial Support (MHPSS)

• 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 328,147 critical PSS sessions for approximately 730,000 displaced persons, including more than half a million children. Between 1 to 7 September 2025, a total of 16,640 displaced persons accessed these services.

• Between 7 October 2023 and 15 September 2025, UNRWA’s social work team provided services to 237,736 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 2,750 survivors of gender-based violence (GBV) and 5,248 children, including 2,230 unaccompanied children. The team supported 27,921 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 14,6497 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 15 to 21 September, UNRWA teams responded to 2,417 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 455 TLSs, established across 66 UNRWA schools-turned-shelters since August 2024.

• Between 1 and 7 September 2025, a total of 4,631 children (1,927 boys, 2,704 girls) benefited from TLS-based learning activities in 132 active TLSs.

Food Security

• Since 7 October 2023 and until the start of the 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 for over six months now (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 and bottled water. In addition, UNRWA continues to maintain hygiene in its shelters and sites through cleaning supplies, community-based solid waste management, and pest control.

• In 2025, UNRWA water provision and solid waste collection have reached around 1.7 million people (to date).

• Over the reporting period, UNRWA had to suspend all WASH activities outside of the Designated Emergency Shelters in Gaza City, including water trucking, solid waste removal and the maintenance of the UNRWA main well in the North. The WASH cluster suspended all solid waste activities in Gaza City during the reporting period.

• Between 1 and 15 September, UNRWA distributed around 35,000 cubic metres of domestic and potable water in different areas, reaching around 370,000 IDPs.

• Between 1 and 15 September, UNRWA teams conducted 60 pest control campaigns across the Gaza Strip, and 116 cleaning campaigns inside its shelters, benefiting over 80,000 displaced persons. UNRWA teams also conducted disinfection campaigns for 55 cubic meters of water tanks benefiting over 60,000 IDPs. - UNRWA