There are multiple humanitarian, medical, economic, and industrial effects of the 2008–2009 Gaza War which started with the Israeli air strikes on 27 December 2008 and ended on 18 January with a cease-fire implemented unilaterally by Israel, and later the same day by Hamas and other Palestinian factions.
The cease-fire followed twenty-two days of bombardment by land, sea and air which left over 1,300 Palestinians dead and over 5,000 injured, and the death of 13 Israelis. The United Nations Development Programme warned that there will be long-term consequences of the attacks on Gaza because the livelihoods and assets of tens of thousands of Gaza civilians had been affected.
Gaza humanitarian crisis
The United Nations Office for the Coordination of Humanitarian Affairs states that the Gaza strip humanitarian crisis is significant and should not be understated. The UN stated in 2009 that the situation in the Gaza Strip was a "human dignity crisis," entailing "a massive destruction of livelihoods and a significant deterioration of infrastructure and basic services." Fear and panic were widespread, with 80 percent of the population unable to support themselves and dependent on humanitarian assistance. The International Red Cross said the situation was "intolerable" and a "full blown humanitarian crisis."
On 3 January, prior to the IDF ground operation, Israel's foreign minister Tzipi Livni stated that Israel had taken care to protect the civilian population of Gaza, and that it had kept the humanitarian situation "completely as it should be", maintaining Israel's earlier stance. The head of the Arab League, Amr Moussa, criticised Livni for the statement and further criticised the Security Council for not responding faster to the crisis. On subsequent reports, the UN stated that "only an immediate cease-fire will be able to address the large-scale humanitarian and protection crisis that faces the people of Gaza."
Shelter
Protection and displacement
The UN described the situation as a "critical protection crisis". The entire civilian population in the Gaza strip remains vulnerable, the UN reported, with no safe haven, no bomb shelters and with closed borders, making it one of the rare conflicts where civilians have no place to flee. There is a sense of "panic, fear and distress" throughout the whole strip. Civilians have implemented a self-imposed curfew since no public warning systems or effective shelters exist. People have been evacuating their homes and staying in streets for long hours exposed to further danger, or staying with relatives. Civilians face insecurities while re-stocking basic food items, water and cooking gas. Children, 56% of the population, have no outlets and they remain "dangerously exposed" to the fighting around them.
The Palestinian Red Crescent estimates that thousands of homes have been damaged and it became "increasingly difficult" for their residents to stay in them due to the cold weather. The UNRWA has prepared its schools to act as temporary shelters for displaced persons. As reported by both the Save the Children Alliance and the Al Mezan Center, prior to the IDF ground operation on 3 January, more than 13,000 people (2000 families) have been displaced in the strip. The majority of those families seek shelter with relatives while others are staying at the temporary emergency shelters provided by the UNRWA. As of the thirteenth of day the Israeli military operation, 21,200 displaced Palestinian people were staying at these shelters. By the third week of the attacks, this number has increased by 14,300 refugees, reaching 35,520 Palestinians staying under the UNRWA shelters. In the same period, Al Mezan Center also estimated that a total of 80,000-90,000 Palestinians have been displaced, including up to 50,000 children. As the numbers of displaced refugees constantly increased the UNRWA had to open new emergency shelters throughout the Gaza strip. The shelters were overcrowded and were sheltering double their originally planned capacities.
By 18 January, the number of Palestinians seeking the UNRWA shelters has peaked to around 51,000 displaced people, with only basic level of support due to the unprecedented number of refugees. After the unilateral lull, displaced persons began moving from the emergency centers. As of 23 January, UNRWA was still operating 15 emergency centers while aiming to close those shelters as soon as possible so that they can reopen the schools. As of 9 February, three non-school UNRWA shelters remain open, hosting 388 displaced people. Thousands of Gazans remain homeless.
After the end of the Israeli operation and moving from the emergency shelters, many Palestinians (preliminary assessments shows 10,991 displaced households, or 71,657 people) have been homeless and remain with host families due to the extensive attacks. The host families are overstretched and face shortages of food, non-food items, water and electricity. Priority needs for those families include kitchen sets, hygiene kits, blankets, mattresses and plastic sheeting.
One year after the ceasefire approximately 20,000 people remained displaced.
Buildings destruction
Aid agencies have reported that Gaza "looks like earthquake zone": widespread destruction of houses, infrastructure, roads, greenhouses, cemeteries, mosques and schools are reported in Jabalia, Tal Al Hawa, Beit Hanoun, and Beit Lahia in the northern Gaza Strip. According to the ICRC, "a number of areas, including parts of Beit Lahia looked like the aftermath of a strong earthquake". Meanwhile, Al Mezan Center field workers reported that "entire urban blocks have disappeared" in North Gaza and eastern of Gaza City. The International Red Cross reports that in Jabalia alone, between one and two thousand households are now living in the rubble of their houses. John Holmes, the Under-Secretary General of the United Nations, in his statement to the Security Council, reports that he saw an entire industrial and residential area in East Jabalia which had been "systematically bulldozed", an area of at least one square kilometer and that one of the best schools in Gaza is reduced to rubble 2,000 refugee families had their shelters totally destroyed. UNRWA was ready to provide cash assistance and shelter repair for those families, but has been unable to deliver this assistance to beneficiaries due to a shortage of liquidity and construction material in the Gaza Strip.
An initial survey conducted by the UNDP estimates that 14,000 homes, 68 government buildings, and 31 non-governmental organization offices (NGOs) were either totally or partially damaged. As a result, an estimated 600,000 tonnes of concrete rubble will need to be removed. Since 2007, construction material have not permitted entry into Gaza, adversely affecting UN projects, in particular UNRWA and UNDP which were forced to suspend more than $100 million in construction projects due to lack of materials. Another UNDP rapid damage assessment of 170 out of the 407 government and private schools in the Gaza strip found that ten schools were severely damaged, and that 160 government and ten private schools were partially damaged during the Israeli military operation. Eight kindergartens were severely damaged and 60 were partially damaged. The UN humanitarian office stated that repairing such schools remains an urgent priority. Ten UNICEF tents were brought to Gaza to be used as learning spaces in the most damage-stricken areas. The Israeli Coordinator of Government Activities in the Territories has confirmed that there is as yet no intention to revise the policy prohibiting clearance of reconstruction materials which would enable aid agencies in Gaza to transition to rehabilitation and reconstruction.
A satellite-based damage assessment of the Gaza Strip by the United Nations revealed 2,692 destroyed and severely damaged buildings, 220 impact craters on roads and bridges with an estimated length of of paved and unpaved roads damaged, 714 impact craters on open ground or cultivated land with an estimated land area of , 187 greenhouses completely destroyed or severely damaged with an estimated area of , and of demolished zones targeted by IDF bulldozers, tanks and phosphorus shelling.
Vandalization of Gazan homes by the Israeli defense forces has been reported: plastic bottles of urine and closed bags of excrement were left. There were also houses where excrement was smeared on the walls or in dry piles in corners. In many cases, Haaretz reports, smells indicates that soldiers had urinated on piles of clothing or inside a washing machine. In all the houses, the report continues, the toilets were overflowing and clogged, and there was "filth all around". The Associated Press reported that several homes had graffiti in Hebrew scribbled on the walls including "Death to the Arabs", "The eternal people have no fear", "Long live Jewish people" and other markings. On other incidents, an Israeli commander has reported that he has ordered his soldiers not to deface property and reprimanded anyone who did.
Health
Medical facilities and equipment
Weakened by the eighteen-month Blockade of the Gaza Strip, as of 31 December the central drug store reported that 105 drugs and 255 medical supplies of the essential drug and supplies list are still unavailable, and approximately 20 percent of the ambulances were grounded due to lack of spare parts. Ambulances are experiencing difficulties in reaching the injured because of continuous fire. Hospitals reporting severe gas shortages expect total depletion in the coming days. As a result of shortages, the WFP distributed canned meat and high energy biscuits. The World Health Organization reported that at least 1,000 medical machines were out of order, with shortage of equipment and spare parts. Sources from the Gaza Health Ministry reported that the situation on 2 January, while extremely precarious, has stabilized after the arrival of medical supplies.
From 4 January, all of Gaza City hospitals were without main electricity, depending on back-up generators that were close to collapse. From 4 to 5 January, UNRWA was forced to shut down 19 health centers due to hostilities in the area, and Ministry of Health closed down generators at ambulance stations, vaccine stores, labs and warehouses due to the lack of fuel to run the generators until more was delivered. There existed an urgent need for strong pain killers, body gas, bed sheets for wrapping the dead, and for neuro-, vascular-, orthopedic- and open heart surgeons. Collateral damage to hospitals like broken glass was not being repaired. The Palestinian Red Cross was unable to respond to many calls due to the military operations. Only urgent cases and surgery is being carried out in hospitals and all out-patient clinics have been closed. Only three out of the 56 primary health care clinics are open; 70% of the chronic disease patients regularly attending those centers had to interrupt their treatment due to the security situation. Chronically ill patients who were accessing care outside of the Gaza strip prior to the conflict urgently needed to resume their treatment. Because of the Israeli closure of the Gaza strip, which has lasted more than a year and a half, hospitals are run down and much of the equipment is unreliable and in need for repair. The UN labeled the importance of spare parts for medical equipment as a priority.