The United Nations Office for the Coordination of Humanitarian Affairs (OCHA) warns that, six months after the ceasefire agreement took effect in the Gaza Strip, the humanitarian response led by the UN and partner aid agencies remains constrained, leaving people in dire conditions. According to OCHA, people across Gaza are still exposed to lethal force and the risk of further casualties, destroyed property, and displacement, which deepens humanitarian needs.
In an update on Thursday, OCHA reiterated that attacks affecting civilians must be investigated and that civilians must be protected.
“Israel, as the occupying power, must protect Palestinians. Perpetrators of violence must be held accountable,” the humanitarian office said.
Other humanitarian organizations operating in Gaza broadly share OCHA’s assessment of the situation, though some express their concerns in more direct and less diplomatic terms.
MSF: Reality in Gaza Remains Catastrophic
On Friday, Médecins Sans Frontières (MSF, Doctors Without Borders) said that Israeli forces continue to systematically violate the ceasefire announced on October 10, 2023, by carrying out daily attacks on the territory, while Israeli authorities continue to deliberately obstruct aid to Gaza.
“Six months on, the ceasefire has failed to end the genocide against Palestinians in Gaza, with Israeli authorities continuing to impose conditions intended to destroy conditions of life,” said Claire San Filippo, emergency manager for MSF.
Although the intensity of the conflict has decreased since the ceasefire was announced, the situation in Gaza remains dire. People are suffering and dying because they can’t access basic necessities, have been forced into desperate living situations, and have limited access to medical care due to the devastated health system.
“Despite the reduction of the intensity of violence, Israeli attacks are continuous and the situation remains catastrophic. People’s needs are massive, yet Israeli authorities have continued to systematically restrict the entry of humanitarian aid,” San Filippo said.
According to Gaza health officials, over the past six months since the October 10 ceasefire, more than 730 people have been killed and more than 1,900 have been injured in Israeli attacks.
MSF reports that, since the ceasefire, its teams have provided over 40,000 dressings for patients with violent trauma wounds, including those from gunshots, explosions, and other weapons.
During that same period, MSF medical teams treated over 15,000 trauma cases in their two field hospitals alone. These cases included both recent injuries and wounds requiring long-term care. At the MSF clinic in Gaza City, more than 18,000 wound dressings were performed, over 60 percent of which were for trauma wounds.
Meanwhile, Palestinians continue to face shortages of clean water, food, electricity, and access to healthcare. The already devastated health system is further deteriorating due to obstructions to aid and Israel’s deregistration of 37 international non-governmental organizations (NGOs) that provide crucial assistance in Gaza.
Since January 1 of this year, Israeli authorities have blocked MSF and dozens of other NGOs from bringing medical and humanitarian supplies into Gaza. At the same time, Israel is preventing most medical evacuations for patients needing specialized care outside Gaza.
According to the World Health Organization (WHO), more than 18,500 people in Gaza, including approximately 4,000 children, are currently in need of medical evacuation.
MSF reports that its health facilities are facing critical shortages of medicine and medical equipment, including gauze, compresses, and sterile supplies. Medications are also in short supply, including insulin for diabetes and other non-communicable diseases.
These shortages impact critical treatments for chronic diseases and increase suffering and strip away the dignity of people in Gaza, the humanitarian organization emphasized.
Approximately 90 percent of Gaza’s population has been forcibly displaced—often multiple times—and many now live in tents or makeshift shelters. There has been little improvement in conditions since the ceasefire, while people's living space in Gaza is shrinking continuously and is constantly framed by violence.
Since the ceasefire began, the territory has effectively been divided by what is referred to as the “yellow line,” a zone under full Israeli military control that covers approximately 58 percent of the territory, leaving Palestinians confined to the remaining 42 percent, much of which is destroyed.
MSF calls on world leaders and governments—including those of the United States, Arab states, the European Union, and its member states—to use all political means to pressure Israeli authorities to protect civilians, restore dignified living conditions, and allow unhindered humanitarian aid into Gaza, as required by international law.
NRC: Civilians in Gaza remain trapped amid attacks
While MSF centers on the medical and operational impact, other organizations highlight the broader humanitarian and political constraints that are shaping the crisis. On Friday, the Norwegian Refugee Council (NRC) stated that the ceasefire has largely remained nominal and meaningful recovery is still out of reach for civilians in Gaza.
“Six months into the ceasefire, civilians in Gaza remain trapped amid attacks on civilians, restricted aid, and an uncertain political process that is now shaping whether recovery will begin or collapse,” said Jan Egeland, NRC Secretary General, in a statement.
“While the ceasefire has formally held, Israeli strikes have continued to kill and injure civilians, destroy homes, and erode any sense of safety.”
Similar to MSF, the NRC chief stressed that humanitarian access remains severely constrained while aid deliveries continue to fall far below agreed-upon levels. Far too few trucks are entering Gaza to meet the population's basic needs.
Egeland added that the entry of goods and the restoration of infrastructure are increasingly tied to political negotiations over Gaza’s future rather than being treated as operational questions.
“Ongoing talks […] have introduced new conditions that link reconstruction, the lifting of restrictions, and the withdrawal of Israeli forces to the disarmament of Hamas. Failure of these negotiations could trigger renewed large-scale hostilities,” he said, noting that civilians are already paying the price of this uncertainty.
Egeland pointed out that NRC teams continue to operate under extreme conditions and have reached nearly one million people with shelter, legal assistance, water, and other essential services.
“Yet the situation on the ground is deteriorating. Families remain in makeshift shelters, exposed to hazards, with limited access to basic goods and rising prices driven by restricted supply,” he added.
War crimes, crimes against humanity, and genocide
Against this backdrop, concerns are mounting among legal experts and humanitarians across the world about the ongoing impunity for crimes perpetrated by Israeli military personnel and government officials, along with the resulting legal consequences.
According to legal experts, the deliberate obstruction of humanitarian assistance is a grave violation of international humanitarian law and amounts to war crimes, crimes against humanity, and in some assessments genocide.
UN commissions, international and Israeli human rights organizations, human rights experts, and leading genocide scholars, have found that Israel's actions in Gaza—including the obstruction of humanitarian aid—not only meet the legal definitions of war crimes and crimes against humanity but also amount to genocide against Gaza's population.
Even though the limited ceasefire has reduced active Israeli attacks, impunity for crimes committed by military personnel and government officials since October 2023 persists, with profound political consequences. Governments around the world, particularly those providing military aid and political support to the Israeli government, have been implicated in these crimes.
Some of the most egregious crimes include using starvation as a method of warfare, denying humanitarian aid, and collectively punishing civilians. They also include indiscriminate attacks targeting civilians, aid workers, and journalists; deliberate attacks on civilian objects and undefended buildings; forced displacement; torture; and enforced disappearances.
Since October 2023, the human toll has been staggering. According to Gaza’s health officials, more than 244,000 Palestinians, primarily civilians, have been killed, injured, or maimed in Israeli military operations. The recorded death toll exceeds 72,300, including over 21,200 identified children, while the total number of injuries surpasses 172,100.
The true number of casualties is believed to be considerably higher. Among those confirmed dead are at least 589 aid workers, 397 UN staff members, 1,700 health care workers, and 259 journalists. Additionally, an estimated 58,000 children in Gaza have lost one or both parents.