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World: Counting every life: Why mortality evidence can't be optional in humanitarian crises

Country: World Source: ELRHA What if the most powerful indicator in humanitarian response was also the most neglected? When crises unfold, we count displacement, malnutrition, and funding gaps. But months later, one question often remains unanswered - how many people died? That omission matters - because mortality data changes decisions. As the UK Humanitarian Innovation Hub (UKHIH) and Elrha close Phase 2 of our Mortality Estimation in Humanitarian Crises Systems Innovation Partnership, this blog marks the beginning of a series exploring why mortality estimation matters, and how grantees are innovating so the humanitarian system can do it better. Mortality: the metric that changes the conversation Credible and timely mortality figures change conversations and decisions. As Chris Porter from FCDO put it during a 2025 panel discussion: "We often debate malnutrition rates, but deaths stop people in their tracks." Mortality metrics capture crisis severity, scale, and urgency in a way few other indicators can. Mortality data used to be central to humanitarian assessments. Over time, however, it slipped to the margins - seen as too sensitive, too political, too technically complex, or too slow to be useful. The result is a paradox: the metric that best reflects human cost in crises is often missing from decision-making altogether. Why mortality evidence is so hard - and essential Estimating mortality in crises is undeniably challenging. Data is incomplete. Access is constrained. Methods vary. Numbers can be contested or suppressed, particularly in politically charged settings. Different approaches can produce vastly different estimates, eroding trust and confidence. But the cost of not measuring mortality is higher. Without credible mortality evidence the true scale of crises is underestimated; resources are allocated reactively rather than strategically; accountability weakens and advocacy relies on anecdote instead of evidence. Mortality estimation is not just a technical exercise. It is a moral and operational necessity. From reactive funding toward systems change UKHIH-Elrha’s current investments are built on a longer history of mortality-driven action. Funding followed mortality research in Somalia that helped trigger an unusual and early UN intervention in a subsequent developing famine in 2016. That response was not driven by malnutrition figures, but by mortality data. It was rare. And it worked. Recently completed research established that mortality in southern Chad was far higher than humanitarian actors had assumed, with large segments of the affected population missed entirely. This evidence forced uncomfortable reassessments, but also opened pathways to identify deaths that would otherwise have remained uncounted. Those efforts demonstrated what's possible when rigorous methods are applied under pressure. They informed response discussions, shaped advocacy, and challenged assumptions in decision-making. But they also highlight a deeper issue: Mortality estimation has been treated as an emergency add-on rather than a standing capability in crises contexts. UKHIH’s first investment in mortality estimation proved decisive in a politically charged context. Rigorous work helped establish the credibility of mortality estimates from Gaza when official figures were being publicly dismissed. This evidence made it far harder for governments and global institutions to ignore the scale of civilian death, cutting through political pressure and reaffirming the role of independent science. Building on this work, UKHIH launched the Systems Innovation Partnership in 2024 to move beyond isolated projects and towards a durable ecosystem for mortality estimation. One rooted in equitable partnerships, shared infrastructure, and long-term investment, particularly in low- and middle-income countries. What progress looks like in practice UKHIH-Elrha is currently the only dedicated funder focused specifically on mortality estimation in humanitarian crises. Across Phases 1 and 2, we've seen tangible signs of change: Stronger methods, including improved modelling approaches and shared tools and resources like the Somalia Mortality Estimation Data Observatory (S-MED) Deeper learning, through case studies examining how mortality evidence has influenced - or failed to influence - responses in crises More equitable leadership, with LMIC-based partners SIMAD Institute for Global Health (Somalia) and Evidence for Change (Kenya) playing central roles in phases 1 and 2, scaling up partnering in phase 2 with Addis Ababa University, Mekelle University (Ethiopia) and Rebuild Hope for Africa (DRC) among others. Broader dialogue, bringing together researchers, humanitarians, policymakers, and funders to tackle the "last mile" problem of uptake and use Co-funding, for longer-term, strategic investment that builds synergies and amplifies impact across the system with European Commission Humanitarian Aid (ECHO). What this blog series will cover This blog marks the start of a weekly series showcasing the Phase 2 consortia pushing this agenda forward. IMPACT Initiatives are exploring locally led mortality estimation in Somalia, Ethiopia, and the DRC, highlighting what it takes to shift ownership and trust. Johns Hopkins University is focusing on methodological innovation in DRC, alongside practical guidance for local decision-makers on when and how mortality estimates can be generated and used. Save the Children International is developing a governance mechanism among Strategic, Technical and National Stakeholders and building an online platform making guidance, tools, and technical support accessible and equitable across the sector. Together, these consortia address not just how to count deaths, but how to ensure mortality evidence shapes response. Counting deaths to save lives Mortality evidence can't be optional because uncounted deaths represent a failure of accountability, a gap in our understanding, and a missed opportunity to prevent more. When we don’t count deaths, we're not avoiding difficult conversations - we're having them anyway, just without evidence The UKHIH-Elrha partnerships show we can do better. What remains is a choice: to embed mortality estimation as a non-negotiable part of crisis response, or to continue operating in the dark about the very metric that matters most.

One Door, Many Solutions: Saving Lives in Somalia with CERF

Country: Somalia Source: Action Against Hunger Population: 19 million People in Need: 6 million People Facing Hunger: 9.8 million People Helped Last Year: 3,201,516 Our Team: 116 employees Program Start: 1992 In Somalia, birth is never a quiet, private thing. Grandmothers whisper blessings. Neighbors hold your hand. For as long as anyone can remember, mothers have brought babies into the world this way; guided by the women who came before them. That wisdom is real. It matters. But it is not always enough. In Somalia, fewer than one in three mothers give birth with a trained health worker by their side. Too many mothers and babies die from problems that good medical care can prevent. So, how do you keep the wisdom of grandmothers and add the safety of modern medicine? You build a place that families trust. That is exactly what happened at Makkah Hospital in Mogadishu, with support from the United Nations Central Emergency Response Fund (CERF), World Health Organization Somalia, and Action Against Hunger. And that is where two young mothers—strangers to each other—walked through the same door and changed the future of their families. Dahiro was 24 years old. She traveled a long way from her village in Jilib, a small town far from the capital. She had already given birth twice before, both times at home, and both times without a doctor or a nurse. “I always feared hospitals for delivery,” she said, holding her newborn daughter close. “In Jilib, you trust what your grandmother told you.” Dahiro holds her newborn baby at the Makkah Hospital, supported by Action Against Hunger Dahiro was a careful, loving mother. She breastfed her older children because her aunt told her it was the right thing to do. The practice also helped space out her pregnancies in a natural way. She followed the traditions and believed she was doing everything right. “But I didn’t know,” she says quietly, “that I was only doing half the job to protect them.” She had recently realized through conversation with the hospital staff that, while breastfeeding built her babies’ immune systems, they needed vaccines as an additional shield. Her older children, still back in the village, had never been vaccinated because she simply didn’t know they needed to be. Down the hall, 25-year-old Nafisa sat with her children gathered around her. She was a single mother, and life had not been easy. A bad drought pushed her family from their home and into a displacement camp. Nafisa has a consultation at Makkah Hospital, supported by Action Against Hunger. Nafisa first came to Makkah Hospital in June 2025 because her two young children were dangerously thin. They were malnourished and needed special milk and therapeutic food to survive. While the medical team treated her children, they noticed Nafisa was pregnant and signed her up for check-ups right away. In September 2025, she returned to the hospital and delivered her baby safely. But even then, she could not stop worrying. A measles outbreak was spreading near her camp. “I feared my children might get sick from Jadeeco [the Somali word for measles],” she said . Her voice was steady, but her eyes showed fear. The team at Makkah Hospital did not treat Dahiro’s and Nafisa’s appointments as time to address isolated issues. They treated them as an opportunity for holistic care. This is the “one-stop-shop” approach: when a mother walks through the door for any reason—a birth, a sick child, or hunger—the team checks on everything. Every child. Every need. Dahiro is helped by a midwife in the postnatal room in Makkah Hospital, supported by Action Against Hunger. Action Against Hunger and WHO Somalia have built a healthcare system that sees the whole family. When Makkah Hospital brings vaccines, nutrition, and maternal care under one roof, they are turning Somalia’s National Transformation Plan (NTP) – the country’s roadmap for rebuilding and modernizing the country through 2029 – into a reality that mothers can actually feel. One ordinary morning at Makkah Hospital, something small and powerful happened. Dahiro and Nafisa were both in the ward at the same time. Dahiro’s newborn daughter received her very first vaccine. Nafisa’s children got their life-saving shots and were checked to make sure they were growing well. Two families, side by side, stepping into safety at the same time. Nafisa in the Makkah Hospital This is how big goals like Universal Health Coverage and the Sustainable Development Goals (particularly SDG 3: Good Health and Well-Being) stop being words on paper and start becoming real life. Every visit becomes a chance to catch what might otherwise be missed. Dahiro and Nafisa headed home, carrying their children and a new shield of knowledge. “I will go back home with what I know now,” Dahiro says with new confidence. “I will speak to other mothers. My aunts gave me their wisdom, and now I will give other mothers the wisdom I have found here.” She is not rejecting what her grandmother taught her; she is adding to it. Nafisa does not say much as she leaves. She just breathes with relief and holds her children a little tighter, knowing they are finally safe. These two women walked into Makkah Hospital as strangers, each carrying her own fears. They are walking out as proof of what becomes possible when the right support meets a mother’s love. When you give a mother the tools, she protects the family. And family by family, they are rewriting the future of a nation.

DR Congo: Ebola Outbreak 2026: Questions and Answers with Direct Relief’s Dr. Jeffrey Samuel

Country: Democratic Republic of the Congo Source: Direct Relief A clinical pharmacist and Direct Relief’s regional director for Africa, Dr. Samuel talks about the current Ebola outbreak, how it's different than past events, and how it can be contained. By Talya Meyers When the first cases of Ebola virus were announced in the Democratic Republic of the Congo this month, Dr. Jeffrey Samuel, traveling in East Africa, read about it on the Direct Relief website. Dr. Samuel, a clinical pharmacist and Direct Relief’s regional director for Africa, was visiting hospital partners in Uganda at the time the country’s first cases were being identified and contained. “We were already engaging with and supporting partners in Uganda through routine medical shipments and other ongoing support,” he explained. “That work was not Ebola-specific, but it reflects the kind of sustained support health systems need before, during, and after an emergency.” Direct Relief also dispatched $2.5 million in emergency medical support to the DRC, the epicenter of the outbreak, to support Ebola containment and treatment. But Dr. Samuel stressed that routine support can’t be disentangled from emergency response. Both are vital to containing an Ebola outbreak or similar public health emergency, and to helping affected communities respond and recover. “Ebola response is about much more than Ebola alone,” he said. “Stronger health systems allow countries to continue delivering essential healthcare services even while responding to an emergency.” Direct Relief: So many people are unfamiliar with Ebola, and it’s frightening. Can you give us some background? How does Ebola spread, what are the symptoms, and how do people stay safe? Jeffrey Samuel: Yeah, absolutely. Ebola is a severe viral disease: It primarily spreads through direct contact with body fluids from someone who is either sick with the disease or has died from it. That includes blood, vomit, diarrhea, urine, saliva, sweat, and other types of bodily fluids like that. It can also spread through contaminated medical equipment, unsafe burial practices, or direct contact with the body of someone who has died from the disease. One important thing I always emphasize with Ebola is that it’s not airborne, like measles or Covid-19. You can’t get Ebola simply by walking past someone. That’s why healthcare workers, the families that take care of these patients, and the people involved in different burial practices are often at the highest risk. Ebola typically starts with non-specific symptoms: stuff like fever, fatigue, muscle aches, headaches, and weakness. It can look like malaria, typhoid and other infectious diseases common in the region, so it’s hard to distinguish at the outset. It’s not until the disease starts to progress that many patients start developing vomiting, diarrhea, and dehydration. Their organs start to fail, and in some cases, patients can experience hemorrhaging in the later stages of illness. The incubation period, which means the time between when a person is exposed to when the symptoms begin, is usually between 2 and 21 days. That’s a very large range, which does not help [with diagnosis and containment] either. Direct Relief: How dangerous is this outbreak? Jeffrey Samuel: Historically, Ebola has been extremely deadly. Fatality rates typically depend on the strain involved, how quickly the outbreak is detected, and the strength of the healthcare system responding to it. Most people are familiar with the Zaire virus, which caused the large Ebola outbreaks from 2014 to 2016 in West Africa. Those outbreaks often had fatality rates around 50 to 70 percent, which is extremely high. The Bundibugyo virus, which is the one that’s causing the current outbreak, has historically had somewhat lower fatality rates – generally around 25 to 50 percent. But that’s still a very serious and potentially fatal disease. Direct Relief: How is Ebola prevented and treated? Jeffrey Samuel: In terms of prevention, the most important measures are early identification of cases, isolation of those suspected cases, infection prevention and control – in other words, good hand hygiene and personal protective equipment – contact tracing of people those patients have been in contact with recently, and safe burial procedures. You need strong community engagement and trust. That’s a big [issue] specifically with this outbreak. There have been reports of Ebola treatment units being attacked and set on fire, which shows how difficult containment becomes when fear, grief, and mistrust are present. Right now, the treatment is supportive care. That includes IV fluids, electrolyte replacement, oxygen support, treatment of secondary infections, management of blood pressure, providing the right nutritional support, and very careful monitoring. These supportive care measures can really improve survival in a massive way. For us at Direct Relief, focusing on supporting these areas is top priority. Direct Relief: Can you talk about the difference between treating the Zaire and Bundibugyo strains? Jeffrey Samuel: Absolutely. The biggest practical difference is that this current outbreak is being caused by the Bundibugyo virus, while the 2014 to 2016 West Africa outbreak was caused by the Zaire Ebola virus. That distinction matters because all of the approved vaccines and monoclonal antibody treatments that were developed over the past decade were specifically designed for the Zaire Ebola virus. But it’s important to remember that during that outbreak, these tools were not widely available. In fact, that outbreak is what accelerated [Ebola] vaccine and therapeutic development globally. Researchers are now working on similar tools for the Bundibugyo virus as well. In the meantime, the public health response principles remain largely the same. It’s really surveillance, monitoring, contact tracing, infection prevention and control, supportive care, and community engagement. Direct Relief: Why did this outbreak take so long to surface? Jeffrey Samuel: One of the biggest challenges is that early symptoms of Ebola look very similar to many other diseases common in the region. A patient with fever, vomiting, fatigue, or diarrhea may initially be suspected of having malaria, cholera, typhoid, or another common illness. In many outbreaks, the alarm bells only begin once healthcare workers become infected, or if there’s a cluster of unexplained deaths that appear, or if the laboratory testing confirms something unusual. This outbreak is also occurring in an incredibly complex environment. The eastern DRC has faced years of conflict, displacement, insecurity, and strain on the healthcare system. Insecurity can delay surveillance teams from reaching the affected areas. It can limit testing capacity, disrupt transport, and make it harder to trace contacts effectively. There are also trust issues that can emerge during outbreaks. In some communities, people may fear isolation centers or avoid seeking care because they worry about stigma or separation from family members. And because the Bundibugyo virus is relatively uncommon compared to the Zaire Ebola virus, it may not have been the first thing clinicians initially suspected when they were seeing these cases. Direct Relief: Is this going to spread much further? What happens if it does? Jeffrey Samuel: Yes, there’s certainly a risk of further regional spread, which is why neighboring countries have implemented stricter border controls, enhanced surveillance, and other preparedness measures. Rwanda, for example, temporarily closed key border crossings with the DRC. And in the U.S., travelers who have recently visited the DRC, Uganda, or South Sudan are being routed through designated airports for enhanced public health screening. The biggest danger is that outbreaks can overwhelm fragile health systems and healthcare facilities. They can reduce routine care access. They can increase infections in healthcare workers, and interrupt normal services like maternal and child health or vaccination programs. Ebola really creates broader humanitarian impacts, and in settings already affected by conflict or displacement, the response becomes even more difficult. A lot of measures have been put in place to try to prevent it from spreading further regionally. But that doesn’t negate the impact that’s happening on the ground right now. Direct Relief: During the West Africa outbreak, Americans were diagnosed with Ebola – it’s happened during this event too – and they had much better survival rates than the West African people who got sick. Why is that? Jeffrey Samuel: It’s important to state clearly that the differences in outcomes were not biological. They were largely about access to care and the strength of the surrounding healthcare system. Patients treated in highly resourced settings like the U.S. often received earlier diagnosis, intensive monitoring around the clock, aggressive fluid and electrolyte replacement. That’s a real key. They also had access to oxygen support, advanced laboratory testing, PPE, and intensive care when needed. [Note: the federal administration has announced that Americans diagnosed with Ebola during this outbreak are being routed to Kenya, not the U.S., for treatment.] In many outbreak settings, especially in places affected by conflict or displacement, it can be much harder to provide that same level of care consistently because the infrastructure and resources are often much more limited. And that can have a real impact on patient outcomes. Honestly, this is one of the broader lessons Ebola keeps exposing globally: Outbreak preparedness and health system strengthening are deeply connected. Direct Relief: Direct Relief has shipped a significant range of medical support, including PPE, cardiovascular drugs, and IV fluids, to the DRC in response to this Ebola outbreak. How did the organization decide what to send, and what role will that support play? Jeffrey Samuel: All these items play a very practical and important role in the outbreak response. PPE helps protect healthcare workers and prevent transmission inside of healthcare facilities. During Ebola outbreaks, protecting healthcare workers is critical because health worker infections can quickly weaken the overall response capacity. IV fluids are absolutely key to supportive care. Ebola patients often experience severe vomiting, diarrhea, dehydration, and electrolyte loss. So a key part of treatment is being able to replace those fluids and electrolytes. Beyond Ebola-specific supplies, essential medicines like cardiovascular drugs, antibiotics, and other critical treatments help keep the broader health system functioning during an outbreak. Ebola response does not pause the rest of healthcare – patients still need care for chronic diseases, infections, pregnancy complications, and other urgent health needs. And our approach is very much partner-driven. We work directly with local partner organizations, hospitals, and in-country ministries of health to understand the actual operational and clinical needs on the ground. We also look at storage capacity, cold chain requirements, logistics, and feasibility for what we send. The strongest responses happen when that emergency support is layered onto resilient local systems. Emergency response plus long-term system strengthening go hand in hand. The goal is to support countries not only in responding to the current outbreak, but also to build stronger systems for whatever comes next.

Two countries, one injury: Obstetric fistula in Nigeria and Somalia

Countries: Nigeria, Somalia Source: Médecins Sans Frontières Obstetric fistula is a devastating yet preventable condition that continues to affect women with limited access to pre- and postnatal care. When Aisha* arrived at Jahun General Hospital in Jigawa state in northern Nigeria she was in deep physical and emotional pain: She had not only lost her child during delivery, but had sustained an injury while giving birth. On the other side of the African continent, Hodan* walked into Bay Regional Hospital in Baidoa, southwestern Somalia, after suffering for eight years from urinary incontinence caused by a difficult delivery. She had been married as a teenager in a village on the rural outskirts of Bur Hakaba. Her first delivery was prolonged and complicated; the baby was delivered with forceps but did not survive. Soon after, Hodan lost control of her bladder, and she was too ashamed to talk about her condition for years. These two women, thousands of miles apart, suffer from the same condition: obstetric fistula. This condition develops when the soft tissue between the birth canal and bladder or rectum is damaged through prolonged, obstructed labor without timely access to emergency obstetric care, creating a permanent opening through which urine or stool leaks continuously. Many of the women who reach us have lived with this condition for years before they even knew what it was. Fistula care is not only about surgery. It is about listening, counseling, and helping women rebuild their confidence. At Jahun General Hospital and at Bay Regional Hospital, teams from Doctors Without Borders/Médecins Sans Frontières (MSF) and the respective state ministries of health provide reconstructive surgery, psychological support, and rehabilitation to women living with obstetric fistula. Risk factors for obstetric fistula The risk for fistula is highest where women marry and give birth young; where childhood malnutrition is widespread; where female genital mutilation is common; and where health systems cannot guarantee an emergency cesarean section in time. In Nigeria and Somalia, these factors overlap. So do insecurity, displacement, and long distances that many women must travel to reach a functioning health facility. Beyond physical injury — which can cause chronic pain, recurring infections, and an increased risk of kidney damage — women living with fistula often face stigma, exclusion from work and community life, and even, in many cases, divorce. How MSF cares for patients with obstetric fistula The 55-bed fistula ward at the Jahun General Hospital is, by design, more than a surgical facility. Care is free. Women stay between two and three months. Each patient may need one or more reconstructive surgeries, supported by physiotherapy, mental health care, and nutrition. “Most of the women who reach us have already given birth somewhere else or tried to — often at home, and often after several days of labor,” says Dr. Raphael Kananga, MSF medical coordinator in Nigeria. “By the time they arrive at our hospital, they have already sustained an injury, often with additional infections and complications. Surgical repair is possible, but this should have been prevented from happening in the first place.” Since the project opened in 2008, the teams have performed more than 6,000 fistula surgeries in Jahun. In 2025, 295 women were admitted and 224 had reconstructive surgery. From January to March 2026, 64 more women had already been admitted to the facility, with 48 already receiving surgical care. Most of the women who reach us have already given birth somewhere else or tried to — often at home, and often after several days of labor. By the time they arrive at our hospital, they have already sustained an injury, often with additional infections and complications. Aisha has already had two surgeries and is preparing for a third. “At first, I thought I would never be cured,” she says. “Then I came here and saw other women with the same condition. I realized I was not alone.” In southwestern Somalia, the fistula unit at Bay Regional Hospital offers free surgical repair, pre- and post-operative care, counseling, and nutrition support. Since opening in 2025, 38 women have been treated. Across the country, several thousand more women are estimated to need this care but are unable to access it. Dr. Idris Suleiman Abubakar, fistula surgeon at Jahun General Hospital Courage to come forward The most terrible thing about obstetric fistula is that women suffer it when they bring another life into this world. Here you have a woman trying to bring another life, and at the end, she suffers, she often loses the child, and she is left with this condition. We have seen women in our practice [struggle with their mental health] because of this condition. It is something even the woman herself is ashamed of. So it takes courage, and a great deal of self-confidence, for her to come forward at all. Imagine a woman who has lost all hope of ever living a normal life again, and through the work you do, she is returned to what she thought she would never reach again. That is when you see real happiness in another person. And that gives me joy. That is what keeps taking me back. ... From there, I understood why I am drawn back to fistula work. If we really want to tackle obstetric fistula, every pregnant woman must deliver in a properly equipped facility, with personnel trained in midwifery. Without that, even women who reach a health facility will continue to develop fistulas — because the skilled care needed to prevent them is not actually there. Barriers to accessing fistula care "Many of the women who reach us have lived with this condition for years before they even knew what it was, or that anything could be done about it,” says Frida Athanassiadis, MSF medical coordinator in Somalia. “Fistula care is not only about surgery. It is about listening, counseling, and helping women rebuild their confidence.” Hodan lived with the condition for eight years before a relative told her about the new service in Baidoa. “For a long time, I did not know there was a name for what was wrong with me. I did not know there was treatment,” she says. At first, I thought I would never be cured. Then I came here and saw other women with the same condition. I realized I was not alone. Jahun is the only facility with the capacity to provide vesicovaginal fistula reconstructive surgical services in Jigawa state. In Somalia, the fistula unit at Bay Regional Hospital in Baidoa is the only facility in Southwest state and one of the few facilities in the country able to offer specialized repair. The limited number of services, combined with insecurity, displacement, poverty, and long travel distances, means this care remains beyond reach for most women who need it. How to prevent obstetric fistula Fistula is completely preventable. What stops fistula from occurring in the first place is clear: prenatal care that identifies risks early, trained midwives within reach of the women they serve, a functional referral pathway, and access to emergency cesarean section before prolonged labor causes tissue damage. There is an urgent need for sustained investment in maternal and newborn care in both Somalia and Nigeria. Prenatal services, skilled birth attendants, timely emergency obstetric care, and specialized repair must be available for women who need it. * Names changed for privacy

World: Aid in Danger Bi-Monthly News Brief (29 April - 12 May 2026)

Countries: World, Democratic Republic of the Congo, Haiti, Lebanon, Libya, occupied Palestinian territory, South Sudan, Sudan, Ukraine Source: Insecurity Insight Please refer to the attached file. Aid in Danger incidents affecting aid agencies and their staff and impact on programmes Incidents of threats and violence affecting aid workers, aid delivery and aid impact supporting aid agencies in risk mitigation and safety and security measures when implementing programmes. The incidents reported are not a complete nor a representative list of all events that affected the provision of aid delivery. Insecurity Insight continues to update data and figures may change. Updated data includes new and historic reports identified in open-sources and verified security incidents submitted by Aid in Danger partner agencies. Africa Democratic Republic of the Congo 01 May 2026: In Mwenga territory, South Kivu province, an INGO team travelling between Mwenga, Kamituga and Kitutu on a humanitarian and medical needs assessment mission was reportedly stopped at a checkpoint by Wazalendo, despite prior coordination with authorities and health actors. Wazalendo members disagreed about the team’s identity and whether to let them proceed, causing them to open fire on each other, with the INGO team caught in the crossfire. The team were unharmed and continued their mission to Mwenga. Source: Actualité 03 May 2026: In Kalimoto rural locality, Lwindi chiefdom, Mwenga territory, South Kivu province, an INGO convoy travelling to Mwenga, Kamituga and Kitutu to assess humanitarian needs was reportedly attacked and robbed by Wazalendo militiamen during a humanitarian mission. Source: Actualité Sudan 02 May 2026: In Nyala city, South Darfur state, buildings near the offices of humanitarian organisations were damaged, and at least five people were injured, after a drone attack from an unidentified perpetrator**. Source:** UN News 04 May 2026: In Khartoum city and state, at an airport vital to humanitarian access, a drone from an unidentified perpetrator was shot down, leading to flights being cancelled. Source: UN News South Sudan 29 April 2026: In Walgak town, Akobo county of Jonglei state, food distributions were disrupted by renewed clashes in the area by South Sudan People's Defence Forces (SSPDF), and opposition groups, including the Sudan People’s Liberation Army in Opposition (SPLA-IO). Source: OCHA, Humanitarian Access Snapshot As reported 12 May 2026: In an undisclosed location, the RSF-controlled Tasis Alliance coalition government stipulated that international humanitarian organisations must register with it and open their headquarters in Nyala within 30 days, to operate under its control or else lose the ability to carry out any further activities in the RSF-controlled areas. The SAF rejected the proposal. Source: Ayin Network 12 May 2026: In Dilling city, South Kordofan, an unspecified number of volunteers and humanitarian workers preparing food for displaced people were killed or injured when alleged RSF and SPLM–North artillery shelling hit the vicinity of a market and bus station. Source: Sudan Doctors Network Europe Ukraine 30 April 2026: In Dnipro city and raion, Dnipropetrovsk oblast, a vaccination bus of the Dnipropetrovsk Regional Center for Disease Control and Prevention, donated by the WHO, was destroyed while on its way to provide vaccination services by a Russian aerial strike. Sources: Public Health Centre of Ukraine and UN News 04 May 2026: In Dnipropetrovsk oblast, a humanitarian vehicle was damaged by a Russian forces strike. Sources: UN News 12 May 2026: In Dnipropetrovsk oblast, a WFP truck traveling in a convoy alongside two WFP armoured passenger vehicles, carrying a total of seven staff members, was struck by a Russian drone strike after successfully offloading food commodities in Zoriane and Slovianka villages. The truck driver was injured and taken to hospital. While immobilised, the truck was hit again multiple times by separate drones. All vehicles were clearly marked as UN WFP vehicles. Source: United Nations Middle East and North Africa Lebanon As reported on 12 May 2026: In Nabatieh city, district and governorate, two Lebanese Civil Defence paramedics were killed by a sequential Israeli drone strike whilst responding to a man who was killed after an Israeli drone hit his rickshaw near the Civil Defence centre. Sources: CBC, Middle East Eye and Quds News Network Libya On 11 May 2026: In international waters approximately 55 nautical miles north of Libya, the Sea-Watch 5 NGO vessel was fired at approximately 16 times by the Libyan coast guard after rescuing around 90 people. They gave no warnings prior to the shots and threatened to take the boat and the crew back to Libya. Source: EU Observer Occupied Palestinian Territory As reported 05 May 2026: In an undisclosed location, humanitarian facilities came under fire by unidentified perpetrators in two separate incidents. Source: UN News As reported 05 May 2026: In an undisclosed location, a UN warehouse was struck by an Israeli airstrike. Source: UN News As reported 05 May 2026: In an undisclosed location, relief vehicles were damaged when an unidentified perpetrator threw stones. Source: UN News Gaza Strip 29 April 2026: In international waters, about 1,111 km from Gaza, the Global Sumud Flotilla carrying food and supplies from Barcelona to Gaza was intercepted by Israeli naval forces at around 2100, using speedboats to encircle the humanitarian convoy and military lasers and weapons to subdue activists on board. Overnight and into the morning of 30 April, Israeli forces seized at least 15 of the 58 vessels and reportedly disabled the engines of several boats and abandoned them, leaving hundreds of people stranded. Source: Quds News Network 12 May 2026: In Beit Lahia city, North Gaza governorate, the area near an MSF team struck by two shells from an Israeli tank, injuring at least 12 people. The impact occurred around 400m from Al Tayeb Clinic. Source: MSF East Africa The Americas Haiti 10 May 2026: In Cité Soleil and Croix-des-Bouquets, West department, a security guard at an MSF hospital was injured by gunfire during armed clashes involving multiple unidentified armed groups. More than 40 people with gunshot wounds were treated there and over 800 displaced people sought refuge around the hospital. MSF suspended operations and evacuated its hospital following the violence. Source: MSF

Somalia: SWALIM Quarterly Newsletter (Jan - March 2026)

Country: Somalia Source: Food and Agriculture Organization of the United Nations Please refer to the attached file. Key highlights include: Strengthened drought and flood early warning through CDI analyses, climate updates, river monitoring products, and the Gu 2026 Seasonal Climate Outlook. Capacity-building initiatives on impact-based flood forecasting, anticipatory action, early warning systems, and land and crop suitability assessment. Updated river breakage assessments along the Juba and Shabelle rivers to support flood preparedness and risk reduction. Progress on Somalia’s Land Cover Reference System, Prosopis mapping, and strategic borehole monitoring. Insights from the Gu 2026 National Climate Outlook Forum, which emphasized that the season should be treated as a stabilization window rather than a full recovery season.

"I am reclaiming my health, my dignity, and my life": Women healing from obstetric fistula in Yemen [EN/AR]

Country: Yemen Source: United Nations Population Fund Please refer to the attached file. ADEN, Yemen - "I lived in silence, hiding my pain from others, enduring my own gaze before enduring theirs," recalls Safiy, 28 years from Bajil District in Al Hudaydah Governorate. For five years, Safiy carried a pain she could neither understand nor explain. After severe complications during childbirth at a hospital in Bajil, she began experiencing faecal leakage—a condition that would force her to withdraw from from daily life. Amina, 20 years, from Aden Governorate too, faced her own silent battle. Married at fifteen and pregnant nine months later, she had no access to antenatal care in her remote village. When labour came, it lasted three agonizing days with only a traditional birth attendant by her side. By the time she reached a hospital, her baby had died. An emergency cesarean section saved her life, but left her with an obstetric fistula—a devastating childbirth injury that would isolate her for a year and a half. Safiy and Amina's stories reflect a harsh reality facing thousands of women across Yemen. Global estimates reveal that Yemen has the highest prevalence of obstetric fistula in the Arab States region—113 cases per 100,000 women as of 2020, compared to 86 per 100,000 across Arab States and 36 per 100,000 in Asia and the Pacific. Obstetric fistula—a hole between the birth canal and bladder or rectum caused by prolonged, obstructed labour without timely medical intervention—is both preventable and treatable. Yet in Yemen, a perfect storm of factors has made it a persistent crisis: early marriage and adolescent pregnancy, critically low rates of skilled birth attendance, and a healthcare system devastated by over a decade of conflict. When Systems Collapse, Women Pay the Price The conflict and humanitarian crisis have pushed Yemen's healthcare system to the brink. An estimated 19.4 million people lack access to basic healthcare, including reproductive health services. Nearly half of all health facilities remain fully or partially functional, and only one in five of them provide maternal and newborn care. Almost half of all childbirths occur outside a health facility. Nearly a quarter of pregnant women do not receive antenatal care, while only 3 in five women give birth with skilled assistance. For women like Safiy and Amina, the barriers to treatment are formidable: limited functional facilities with operating theatres and specialized fistula care, financial and transportation obstacles, weak referral systems in remote areas, and a severe shortage of trained fistula surgeons. Most devastating is the social stigma—the isolation and psychological trauma that discourage women from seeking care at all. A Lifeline in Darkness Safiy decided not to surrender. After being examined at a health facility in Al Huban, she was referred to a UNFPA-supported fistula treatment centre at Al Sadaqa Hospital in Aden. "When the doctor told me about my condition, she said treatment was possible," Safiy remembers. "Those words alone gave me back my breath." She underwent surgery successfully at no cost, and received financial support to cover the transportation. "I could not believe the pain that had accompanied me for five years could come to an end," she says. "Today, I am recovering step by step. I am reclaiming my health, my dignity, and my life." Amina's path to healing followed a similar trajectory. When she learned about the fistula treatment centre she contacted the coordinator and traveled to Al Sadaqa Hospital. After successful surgery, her recovery began. "The hospital not only treated my condition but restored my dignity and renewed my confidence in life," Amina says. "They gave me the chance for a new beginning.” Building Back Better UNFPA supports two dedicated obstetric fistula treatment centers in Yemen—at Al Sadaqa Hospital in Aden and Al Thawra Hospital in Sana'a—providing surgical repair, training midwives, supporting safe childbirth practices, and ensuring women with complications can access skilled care. Since 2023, nearly 300 obstetric fistula repair surgeries have been successfully completed at these two centres. Through partnerships with Ministry of Public Health and local organizations like Deem for Development Organization, UNFPA is working to strengthen referral systems, expand access to emergency obstetric care, and address the root causes that result in obstetric fistula. But the need far outweighs current capacity with steep funding cuts threating the suspension of UNFPA’s support to these two centres "Yes, my story is full of pain, but it is also full of hope,” recalls Safiy. On the International Day to End Obstetric Fistula, that hope needs to transform into action. Obstetric fistula is preventable and treatable; ending it is within our reach.

oPt: Humanitarian Situation Report | 25 May 2026

Country: occupied Palestinian territory Source: UN Office for the Coordination of Humanitarian Affairs Please refer to the attached file. Highlights In just one week, more than 50 attacks by settlers across the West Bank resulted in casualties or property damage, including arson attacks that damaged a mosque, homes, farmland and vehicles. OCHA has documented an average of six such attacks per day in 2026. Concerns over the risk of forced displacement of hundreds of Palestinians in eastern Jerusalem governorate intensified after the Israeli Finance Minister called for the rapid implementation of long-standing demolition orders against Khan al Ahmar. In Gaza, humanitarian partners have launched a pest-control campaign in over 1,700 locations, while warning that their efforts are limited by shortages and restrictions. Only half of all aid trucks from Egypt could offload at the Israeli-controlled Kerem Shalom Crossing in the first 18 days of May, based on data tracked by the Logistics Cluster. Overview The Occupied Palestinian Territory remains heavily fragmented; with people not allowed to move between the Gaza Strip and the West Bank, and movement within each of those areas further restricted by military divisions, physical barriers, and closed zones. Combined with ongoing violence, which keeps claiming civilian lives, these conditions are further deepening people’s humanitarian needs while making it both difficult and unsafe for them to access support. This past week saw new waves of displacement before previous ones had even ended, as attacks and threats once again forced people from their homes or shelters. For humanitarian partners, getting staff and the whole range of critical supplies to where they are needed remains extremely difficult. West Bank Across the West Bank, including East Jerusalem, escalating settler violence, Israeli forces’ operations, demolitions, displacement, and movement restrictions are increasingly heightening protection risks and disrupting Palestinians’ access to essential services. Hundreds of Palestinians living in Area C of eastern Jerusalem governorate are at risk of forced displacement, with concerns intensifying after the Israeli Finance Minister instructed Israeli authorities to rapidly implement long-standing demolition orders against Khan al Ahmar. Bedouin community leaders reported high levels of fear and uncertainty among residents following the announcement. Khan al Ahmar is among 18 Bedouin and herding communities, comprising about 4,000 people, directly affected by the E1 settlement plan between East Jerusalem and Ma’ale Adumim settlement. Humanitarian partners have long warned that the E1 settlement plan would further fragment the West Bank, sever East Jerusalem from the rest of the Occupied Palestinian Territory, heighten the risk of forced displacement of Bedouin communities, and have severe humanitarian consequences for Palestinians across the West Bank. Since 2009, OCHA has documented the demolition of about 550 structures in the 18 communities for lacking Israeli-issued building permits, which are difficult for Palestinians to obtain, including 175 donor-funded structures provided as humanitarian assistance. According to the Shelter Cluster, between 1 January and 30 April, partners reached over 9,300 households, comprising more than 40,300 people, across the West Bank with shelter assistance, targeting displaced families and others affected by conflict-related damage, escalating settler violence, the increasing risk of forcible displacement of entire communities, and deteriorating shelter conditions. Assistance included shelter repairs and rehabilitation; support to displaced families in meeting basic shelter needs; installation of protective measures such as fences, doors, and window mesh; cash assistance for rental support; and the provision of tents, plastic sheeting, bedding kits, kitchen sets, and clothing vouchers. To help Palestinian communities cope with displacement shocks and heightened insecurity, community-based psychosocial support remains the primary intervention modality, complemented by recreational and structured support activities as well as parenting sessions. On average every week, child protection partners provide mental health and psychosocial support (MHPSS) to approximately 1,600 children, including about 80 children with disabilities, and more than 670 caregivers. Partners additionally reach a weekly average of about 380 children and 100 caregivers through awareness raising sessions, including explosive ordnance risk education. Over the past week, cash assistance as well as clothing and other in-kind assistance was provided to about 60 children and 12 caregivers to help address urgent needs and reduce exposure to negative coping mechanisms, while 35 children received case management support, including specialized referrals. Casualties and Escalating Settler Violence Between 12 and 18 May (the reporting period in this section), Israeli forces and settlers killed five Palestinians, including one child, while nearly 60 Palestinians, including six children, were injured across the West Bank, including East Jerusalem. More than half of the injuries occurred during settler attacks, while the remainder were mainly recorded in the context of Israeli forces’ search operations and other raids. During the same period, OCHA documented more than 50 Israeli settler attacks against Palestinians that resulted in casualties, property damage, or both, bringing the number of such attacks documented since the beginning of 2026 to over 870 across more than 220 communities – an average of six attacks per day. Israeli forces shot and killed two Palestinian men while they were reportedly attempting to cross the Barrier. On 12 May, Israeli forces opened fire toward two Palestinians attempting to scale the Barrier near Dahiyat al Bareed, in Jerusalem governorate, killing a Palestinian man from Deir Qaddis village (Ramallah governorate) and injuring another. On 17 May, Israeli forces shot a Palestinian man near the Barrier in Beit Ula village, in Hebron governorate, under similar circumstances. He succumbed to his wounds the following day. Since 7 October 2023, when Israeli authorities revoked or suspended most permits issued to Palestinians to access East Jerusalem and Israel for work and other purposes, and as of 11 May, OCHA has documented the killing of 19 Palestinians and the injury of over 290 others who were reportedly attempting to cross the Barrier. On 14 May, Israeli forces shot and killed a Palestinian child in Al Lubban ash Sharqiya village, in Nablus governorate and withheld his body. In a statement, the Israeli military said that soldiers had opened fire toward Palestinians near Road 60 after stones were thrown at Israeli vehicles traveling on the road. Elsewhere in the northern West Bank, on 16 May, Israeli forces shot and killed a Palestinian man at the entrance to Jenin Camp, which has remained a closed military zone since January 2025, reportedly while he was attempting to enter. In a large-scale attack across Sinjil, Jiljiliya and Abwein villages in Ramallah governorate on 13 May, Israeli forces and settlers shot and killed one Palestinian and injured 10 Palestinians. According to local sources and video footage, dozens of Israeli settlers raided the western area of Sinjil and nearby areas in Jiljiliya and Abwein villages, stealing Palestinian-owned livestock and other property. When residents attempted to retrieve stolen flocks, Israeli forces and settlers fired live ammunition, rubber bullets and tear gas canisters. In a statement, the Israeli military said forces had entered the area following reports that Palestinians had stolen sheep from a settlement outpost, and that troops responded with crowd-control measures and live fire after stones were thrown at them while exiting the village. Subsequently, on 16 May, 22 Palestinian Bedouin families, comprising 137 people including 81 children, in the area were forcibly displaced from the area following recurrent settler attacks and intimidation. The families had previously been displaced from three other communities in 2023 due to settler violence. The reporting period saw a concerning escalation in arson attacks targeting Palestinian property, especially in Ramallah and Hebron governorate, including incidents involving anti-Palestinian graffiti. In one incident, Israeli settlers set fire to a mosque in Jibiya village in Ramallah governorate. In Al Mughayyir and Burqa villages, also in Ramallah governorate, settlers set fire to agricultural land, burning olive trees and cultivated areas, with one fire spreading across about 10 dunums due to strong winds. In Wadi ar Rakhim community near Susiya, in southern Hebron governorate, Israeli settlers threw flammable materials toward a Palestinian home, setting fire to an external kitchen, damaging a parked vehicle, and causing damage to parts of the house. In addition to the arson attacks, Israeli settlers carried out multiple assaults on Palestinian homes and infrastructure across Ramallah, Nablus, Salfit and Hebron governorates. These included physical assaults against Palestinians, attacks on homes while families, including children, were inside, damage to water and electricity infrastructure, theft and vandalism of agricultural property, and the destruction of olive trees and fencing. In one incident in Hebron governorate on 17 May, a large group of settlers reportedly physically assaulted four Palestinians and damaged residential structures and personal property in Umm ad Daraj community near Sa’ir village. In Ramallah governorate, settlers from a recently established outpost near Ein ‘Arik village reportedly raided homes, physically assaulted four Palestinians, vandalized water tanks and construction materials, and seized electric cables. A Palestinian-owned car torched in Jibiya village, Ramallah governorate, where Israeli settlers also set fire to a mosque and spray-painted Hebrew graffiti on its walls during one of more than 50 settler attacks documented across the West Bank during the week of 12-18 May 2026. Photo by OCHA. On 14, 15 and 16 May, during the annual Israeli “Jerusalem Day” and accompanying “Flag March” events, Israeli settlers and other Israelis, including Israeli officials, marched through the Old City of Jerusalem and several Palestinian neighbourhoods in East Jerusalem under protection by Israeli forces. Israeli forces erected barriers, restricted Palestinian movement and access, including to Al Aqsa Mosque, and facilitated the marches throughout the Old City and surrounding areas. During the events, settlers assaulted Palestinians and damaged Palestinian-owned property, including shops and homes, while chanting anti-Arab and anti-Palestinian slogans. In Silwan neighbourhood, settlers physically assaulted and injured a 16-year-old Palestinian boy with a metal stick, causing facial fractures, while in the Old City two Palestinian shop owners were injured after settlers attacked their stores and sprayed them with pepper spray. According to local sources, Israeli forces also physically assaulted and arrested at least 20 Palestinians during the three-day events. Demolitions and Displacement During the reporting period, Israeli authorities demolished four homes and 20 agricultural and livelihood-related structures for lacking Israeli-issued building permits, which are nearly impossible for Palestinians to obtain. Overall, 19 structures were demolished in Area C and five in East Jerusalem, resulting in the displacement of five households comprising 26 people, including nine children, of whom 15 people were displaced in East Jerusalem and 11 in Area C. Eighteen of the 19 structures demolished in Area C were agricultural or livelihood-related structures, including 12 structures demolished in a single incident on 13 May in Area C of Al Marwaha area of Beit Hanina, on the Jerusalem side of the Barrier. During the incident, the Israeli Civil Administration, accompanied by Israeli forces, demolished animal shelters, caravans, and storage and sales facilities for construction materials, in addition to surrounding fences, affecting seven Palestinian households comprising 41 people, including 23 children. The demolition resulted in significant financial losses, as affected families were unable to remove most materials and equipment prior to the operation. Since the beginning of 2026, about 71 per cent of the approximately 400 structures demolished in Area C for lacking Israeli-issued building permits have been agricultural, livelihood-related, or water and sanitation structures. Humanitarian Impacts of Raids and Movement Restrictions During the reporting period, OCHA documented more than 40 raids and other operations by Israeli forces across the West Bank, involving house searches, mass detentions, temporary home evacuations, and movement restrictions, disrupting access to livelihoods, education and essential services and heightening fear and distress among affected communities. In multiple governorates, including Tubas, Salfit, Jenin and Nablus, Israeli forces carried out prolonged raids involving large-scale house searches, temporary takeover of Palestinian homes for military use, detentions, and reported physical assaults. In one raid on 17 May in Burin village, home to about 3,000 Palestinians southwest of Nablus city, Israeli forces closed all entrances to the village for nearly 19 hours, reportedly after alleging that stones had been thrown at Israeli vehicles. The closure disrupted movement and access to work and education, forcing shops to close and leading some schools to postpone exams and suspend classes. Separately, Israeli settlers, reportedly from nearby settlement outposts and often accompanied by Israeli forces, carried out repeated attacks against homes in Burin village during the reporting period. At least two attacks included attempted break-ins, damage to property, and physical assaults against residents. In one of these attacks on 13 May, a 13-year-old Palestinian girl was reportedly struck on the head with a stick by an Israeli settler while her family attempted to protect their livestock during an attack on their home. She was treated at the scene by Palestine Red Crescent Society paramedics. Moreover, about 100 students attempting to reach a Palestinian school in the H2 area of Hebron city through As Salaymeh (160) checkpoint were reportedly subjected to repeated delays and restrictive measures imposed by Israeli forces, including demands to present birth certificates and, in some cases, be accompanied by a parent. On 11 May, 103 students were unable to reach the school altogether. Similar restrictions and delays were again reported on 14 and 18 May, disrupting students’ access to education. For key figures and additional breakdowns of casualties, displacement and settler violence between January 2005 and March 2026, please refer to the OCHA West Bank March 2026 Snapshot. Gaza Strip The humanitarian situation in Gaza remains critical, with many displaced families continuing to shelter in overcrowded tents, schools, or damaged structures due to the lack of safe alternatives. Access to essential services also remains severely constrained, including limited availability of clean water and inadequate waste management systems that are unable to effectively address growing public health risks, including the spread of pests and rodents. Many residential areas across Gaza remain unsafe and exposed to recurrent strikes, shelling, and shooting incidents in or near populated areas. Ongoing insecurity and access constraints are disrupting some humanitarian and community‑based activities, while aid workers continue to report significant access impediments in areas where Israeli authorities require humanitarian teams to coordinate their movements with them. Between 16 and 17 May, humanitarian partners recorded the displacement of more than 150 families from eastern Khan Younis and eastern Gaza city. Affected families said they fled because of tank movements or bombing. Forty of the newly displaced families have been identified by partners as requiring emergency assistance as they fled with only what they could carry, and a response by multiple partners has been initialized. Simultaneously, Israeli strikes continued to be reported during the reporting period, affecting residential areas and makeshift shelters. In one incident on 18 May, an airstrike hit Jabalya Camp, reportedly damaging 35 families’ tents and tarpaulins and displacing dozens of them. Data by the Ministry of Health (MoH) in Gaza indicates that between 12 and 20 May, 24 Palestinians were killed, five bodies were retrieved, two died of wounds, and 159 people were injured. This brings the overall reported casualty toll since the announcement of a ceasefire agreement on 10 October 2025 to 881 fatalities and 2,621 injuries, according to MoH. Severe shortages of engine oil continue to disrupt critical water, sanitation, and hygiene (WASH) services across the Gaza Strip. The WASH Cluster estimates that approximately 7,000 litres are required every month and life‑saving activities are increasingly curtailed. Key infrastructure is already affected, as demonstrated by the shutdown of the Sheikh Radwan stormwater lagoon in Gaza city on 11 May to preserve generator lifespan after prolonged operation. Water and wastewater levels have since risen significantly, raising the risk of flooding in the coming weeks and posing serious public health threats, according to the WASH Cluster. At the same time, solid waste management continues to rely on temporary dump sites located near active displacement sites. Humanitarian partners report that displaced families are increasingly affected by skin infections and other illnesses, as rats and insects enter shelters and contaminate food. While efforts are ongoing to improve sanitation and pest control, more sustainable responses require restored access to Gaza’s sanitary landfills near the perimeter, where Israeli forces remain deployed, as well as the entry of debris removal machinery and other critical supplies such as trucks, compactors, loaders, containers or personal protective equipment. To address pest infestations, WASH Cluster partners and local organizations, in coordination with the United Nation’s Development Programme (UNDP), have launched a response plan targeting over 1,700 locations across the Gaza Strip on 17 May. It involves spraying, rodent control, and awareness raising activities. The supplies for the campaign – 3 tonnes of rodenticides and 3,000 litres of pesticides – were brought into Gaza last week by UNDP. Partners indicate that a full response to rodents and pests requires the Israeli authorities to facilitate access to Gaza’s landfills where waste can be safely disposed of and approve requests to bring into Gaza items necessary for the removal of debris and the clearance of explosive ordnance – as well as inputs necessary to keep that equipment running. According to the Site Management Cluster (SMC), some 1,600 displacement sites across Gaza are currently hosting about 1.7 million people, or 354,480 households. This is based on non-exhaustive data collected through in-person visits or – in some cases – phone interviews, between 3 February and 10 May. Nearly 88 per cent them reside in makeshift sites, while others are accommodated in collective centres or scattered locations. Population movements over the preceding month indicate largely localized displacement patterns, with most sites reporting no significant change, though some continue to experience inflows and outflows. Incoming Supplies Kerem Shalom and Zikim remain the only operational entry points for humanitarian and commercial goods into Gaza. Between 11 and 17 May, offloading rates were 81 per cent across all corridors, with every other truck from Egypt still unable to offload at the Israeli crossings along Gaza’s perimeter, based on data tracked by the Logistics Cluster; this does not include bilateral humanitarian donations or the private sector. On the commercial front, according to the Chamber of Commerce and other humanitarian partner market assessments, prices remained elevated but generally stable with fresh products continue to show the greatest volatility. The Cash Working Group (CWG) continues to advocate for an increased number of commercial trucks entering Gaza to support market recovery, a reduction in fees applied to essential commodities, and a more appropriate balance between essential and non‑essential items being imported to better meet priority needs and stabilize markets. Between 7 and 20 May, the United Nation Office for Project Services (UNOPS) took into Gaza more than 2.1 million litres of diesel petrol into Gaza and distributed just over 2 million litres of diesel (including from stocks brought in before that period) in support of humanitarian operations. The UN is only able to confirm the entry of supplies tracked by UN 2720. For breakdowns of those, see the online UN 2720 Mechanism Dashboard. For a detailed account of the latest humanitarian operations in Gaza, see Annex 1 below. Funding Annexes Annex 1: Humanitarian Operations in the Gaza Strip by Cluster Read more This section covers 11 to 17 May unless otherwise specified. Food Security As of 18 May, partners provided general food assistance to 122,000 households (440,000 people) as part of the May monthly distribution. Each family receiving two parcels, one 25-kilogram flour bag and 2.5 kilograms of high energy biscuits, covering 75 per cent of the minimum caloric needs – the same as in April. Additional caloric needs are still covered through other modalities. As of 13 May, partners continued preparing and serving about 1 million meals every day through 103 kitchens and to almost 1,800 different locations. While these efforts remain critical, partners have scaled down cooked meal production due to funding constraints and rising operational costs. As the same time, responders are seeking to diversify assistance modalities, to include more cash and livelihood support. Humanitarian partners continue to support bread production through subsidized bakeries, community ovens, and partners’ own baking facilities, producing at least 300 metric tons of bread daily – about 36 per cent of the Strip’s estimated bread needs. More than 35 commercial bakeries are involved in these efforts, alongside flour distributions by partners and bilateral government actors to help families bake bread at home. As of 17 May, 28 subsidized bakeries were producing approximately 130,000 two-kilogram bread bundles per day, with about 80 per cent sold at a subsidized price of 3 NIS (US$0.85) through 168 contracted retailers and the remaining 20 per cent distributed free of charge to over 300 shelters and community sites. Meanwhile, under the “diesel-only” model, five private bakeries supported with free fuel by humanitarian partners resumed operations late April and have gradually increased production, despite ongoing challenges related to high fuel, spare parts, and engine oil costs. A few examples of what is still needed: Scaling up home gardening requires strengthened technical support, including real-time advisory channels, the use of organic compost, seed-saving practices, and the provision of seedlings to improve germination rates. Proper site assessments are also essential to ensure feasibility, taking into account water and soil quality, available space, and safe access for households. At a broader level, restoring local food production depends on the timely and unrestricted entry of agricultural inputs through commercial and humanitarian channels, alongside enabling local importers to directly source and import the materials needed to restart and sustain production at scale. Water, Health and Sanitation (WASH) Fifty-four partners provide approximately 24,000 cubic metres of water per day to people in more than 2,000 locations, as 74 per cent or all households in Gaza rely on such deliveries. Between 4 and 17 May, UNICEF distributed 15,343 hygiene kits, 2,448 dignity kits, and 7,350 jerry cans benefitting almost 116,000 people. A few examples of what is still needed: Generator and vehicle spare parts and consumables – including engine oil, air filters, and tires – are urgently needed, alongside emergency repair kits for the Israeli Mekorot and UAE water pipelines as well as water pipes of various sizes. Additional priorities include reverse osmosis units, spare parts and accessories for existing systems, and solid waste compactors, as well as access to landfills near Gaza’s perimeter to ease pressure on temporary dump sites in southern Gaza. Health Between 11-17 May, partners supported the medical evacuation of 59 patients, including six children, to Egypt via Rafah Crossing, alongside 87 caregivers. Partners provided medical consultations, with reportable diseases accounting for 21.4 per cent of the consultations across 181 reporting sites. Increasing trends were observed in skin diseases, acute watery diarrhea, and bloody diarrhea, while acute respiratory infections declined, likely reflecting seasonal variation. Environmental surveillance results for March and April 2026 confirmed all samples negative for Poliovirus, marking 12 consecutive months without detection; in line with WHO guidance, the outbreak may be considered over pending Poliovirus Outbreak Response Assessment (OBRA) desk review. A risk assessment for rodent-associated diseases remains ongoing. Partners completed a training on infection prevention and control (IPC) and isolation protocols for over 400 clinical staff across five major hospitals, as well as more than 100 environmental cleaners and emergency medical services personnel. A few examples of what is still needed: Water testing equipment and liquid chlorine supplies are lacking in hospitals, primary health-care centres, and medical points because of administrative impediments from Israeli authorities. For more information, see the online Heath Cluster Dashboard. Shelter Between 11 and 17 May, partners provided 14,429 households with shelter and non-food assistance through in-kind and cash-based modalities. Assistance included 14,936 bedding items, 3,173 bedding kits, 2,922 tarpaulins, 1,114 sealing-off kits, and 839 clothing kits. The Rapid Joint Distribution Mechanism supported 55 households with emergency shelter and essential household items, including 10 packages of tents and non-food items and 45 sealing-off kits. Partners installed 115 emergency shelters in Gaza and Khan Younis using Shelter Cluster Emergency Shelter Kit designs and specifications. A few examples of what is still needed: More essential household items are needed, as available stocks are merely enough to support fewer than 3,400 additional households. Administrative impediments imposed by Israeli authorities should be lifted along with restrictions on shelter items. For more information, see the Shelter Cluster website. Protection Between 11 and 17 May, 11 protection partners delivered lifesaving and protection-related services to almost 11,000 people: Mental health and psychosocial support (MHPSS), including psychological first aid and individual and group counselling, was provided to 8,259 people; Legal aid and legal awareness support was provided to 219 people; Referrals and case follow-up were provided to 232 people; Other support was provided to 341 persons with disabilities; Group psychosocial support sessions were provided to 350 people; Mine action and explosive ordnance risk education were provided to 168 people; Relief was distributed to 1,265 people; Staff-care activities were conducted for 25 responders. During the same period, partners offered services to 146 returnees from Egypt; since the reopening of the Rafah border and as of 14 May, 2,429 returnees have been assisted, including 885 currently receiving follow-up protection services. Protection monitoring activities continued through eight focus group discussions and 130 key informant interviews across 16 neighbourhoods, reaching 1,155 people. A few examples of what is still needed: It is critical to address the psychological distress affecting staff members, alongside persistent fuel shortages, rising transportation costs, cash flow constraints, and the limited availability of essential materials and spare parts. For more information, see the online Protection Cluster dashboard. Child Protection Between 11 and 17 May, partners: provided MHPSS services to over 4,000 children and approximately 1,500 caregivers. Services included structured psychosocial support sessions, recreational and resilience-building activities, art and drama interventions, individual counselling, Psychological First Aid, parenting support, and community-based psychosocial programmes. conducted child protection awareness and community-based protection activities for another 4,700 children and caregivers through awareness sessions, risk mitigation activities, positive parenting sessions, safety mapping exercises, and community outreach across shelters, camps, schools, and displacement sites; provided individual case management support to 56 newly identified high-risk children, while continuing follow-up for more than 3,000 active child protection cases involving children without parental care, highly distressed children, and children exposed to violence, neglect, exploitation, family separation, and unsafe living conditions. conducted 135 follow-up contacts for unaccompanied and separated children to assess wellbeing, care arrangements, and protection concerns; A few examples of what is still needed: Additional funding and operational support are needed to sustain high-risk child protection case management, MHPSS services, outreach activities, and child-friendly spaces, many of which face disruptions. Partners also require increased fuel, transportation, and operational supplies to maintain home visits, referrals, and follow-up activities, particularly in underserved and newly displaced areas. Additional trained case workers, MHPSS specialists, accessible safe spaces, and psychosocial materials are also needed to respond to growing protection concerns among children and adolescents across Gaza. Mine Action UNMAS conducted 36 explosive hazard assessments in support of debris removal and other partner activities, and three inter-agency missions. Partners conducted explosive ordnance risk education activities, reaching almost 3,480 people between 10 and 14 May. Since the October 2025 ceasefire announcement, 109 accidents have been recorded, leading to 265 Palestinians injured and 49 killed. Emergency Telecommunications Between 11 and 17 May, ETC continued close collaboration with UNDSS on the Communications Plan, providing final technical inputs with completion expected by 31 May. Coordination also continued with PRCS and ICRC to support technical recovery of the damaged VHF network in Gaza, building on earlier VHF coverage assessments conducted along the Gaza city–Zikim route. A few examples of what is still needed: Despite progress, connectivity in Gaza remains severely constrained, limiting humanitarian coordination. The VHF network remains only partially functional due to security constraints and limited technical capacity.

Dignity restored and lives regained through fistula repair in rural Bangladesh

Country: Bangladesh Source: United Nations Population Fund SHERPUR, Bangladesh — Banessa Bibi, now in her nineties, cannot remember how many children she brought into this world. She only recalls the three daughters and two sons who survived. In her village, childbirth once meant labouring in the dark corner of a room into the hands of an unskilled birth attendant. Little had changed even by the time her two daughters, Jamena and Jamila, had children. For both, the consequences were devastating. Jamila, now 45, experienced severe complications as she delivered her second child at home. Prolonged obstructed labour caused an obstetric fistula, a traumatic childbirth injury. Preventable and treatable Obstructed labour is a deadly condition if not urgently treated – and treatment is both well established and available in most referral health facilities. Usually, this means a Caesarean section delivery. When women are unable to access care, the consequences can include death of the baby, death of the mother, or long-lasting physical injuries like obstetric fistula. The fistula, a hole in the birth canal, often causes incontinence and stigma. Women with this injury are often ostracized. Preventing and treating obstetric fistula is a human rights imperative, according to UNFPA, the United Nations Population Fund, which is the UN’s sexual and reproductive health agency. A flicker of hope After her obstructed labour, Jamila was left with regularly leaking urine and a foul odor coming from her body. Out of shame and humiliation, she withdrew from public life for two decades. Even her own granddaughter refused to go near her, she described. Jamila still shudders recalling years of feeling trapped in isolation. When she first learned her fistula could be cured by doctors at the UNFPA-supported Dhaka Medical College Hospital, she finally felt a flicker of hope. Two free surgeries followed, bringing the miracle of recovery. “They gave me my life back,” Jamila said. “At first, I was scared of what would happen to me. But their kindness, counselling and stories of other recovered women gave me strength. For the first time in nearly a quarter of a century, Jamila could breathe freely, sit comfortably beside others and live with dignity. Jamena, 55, also developed an obstetric fistula while delivering the first of her seven children. For years, she concealed her injury, fearing she might lose her job as a domestic worker. In 2025, after hearing about her younger sister’s surgery, she started to believe that healing might be possible for her too. With support from a UNFPA-supported fistula coordinator, Jamena sought treatment. Today, both sisters are healthy. They laugh, work, socialize and move through their community without fear or shame. A better future For as long as anyone can remember, gaps in maternal healthcare services in Sherpur had left pregnant women at high risk of fistula. But today, midwives conduct weekly outreach sessions, bringing maternal healthcare directly to local community clinics and reaching women who might otherwise never seek care. This includes midwives deployed by UNFPA with funding from Global Affairs Canada. UNFPA has also trained healthcare workers in the area, helping to dismantle long-standing barriers to care. As maternal health services improve, childbirth complications are being addressed, helping to prevent obstetric fistula from happening in the first place. And health teams are in place to provide comprehensive follow-up and treatment if it does occur. Even deep-rooted notions that home births are cheaper and less "troublesome" than going to a hospital are shifting through public awareness campaigns supported by UNFPA and the Government of Bangladesh. Banessa and her daughters lived a painful reality, one shared by generations of women in the past – but not the future.

Afghanistan: Humanitarian Update, March and April 2026

Country: Afghanistan Source: UN Office for the Coordination of Humanitarian Affairs Please refer to the attached file. Cross-border hostilities continue to drive humanitarian needs in Afghanistan Cross-border hostilities between Afghanistan and Pakistan since October 2025 have caused significant humanitarian consequences, including civilian casualties, displacement and disruptions to essential services. Although a ceasefire reached in October 2025 temporarily reduced the intensity of hostilities, violence has continued intermittently in border provinces. Between January and March 2026, cross-border armed violence between Afghanistan’s de facto security forces and the Pakistani military resulted in 769 civilian casualties, according to the United Nations Assistance Mission in Afghanistan (UNAMA). This includes 372 people killed and 397 injured, among them 72 women, 554 men, 48 girls and 95 boys. UNAMA reports that the majority of incidents occurred in February and March, largely driven by airstrikes following Pakistan’s announcement of Operation Ghazab lil-Haq on 26 February. Airstrikes accounted for approximately 64 per cent of total civilian casualties, while the remainder resulted from indirect cross-border fire and isolated incidents, including the targeted killing of a humanitarian worker. Displacement and damage to civilian infrastructure Humanitarian partners estimate that more than 100,000 people have been displaced across Khost, Kunar, Nangarhar, Nuristan, Paktia, and Paktika provinces since the escalation of hostilities. While displacement has largely been temporary, affected populations continue to experience significant humanitarian needs. Assessments indicate that airstrikes or clashes linked to cross-border violence have been reported in 11 provinces. In addition, nearly 1,000 homes have been damaged or destroyed. Civilian infrastructure, including schools, health facilities and water systems, has also been damaged or destroyed. Approximately 19 health facilities have been suspended, closed or reduced to partial operations, limiting access to health care for an estimated 78,000 people. In the education sector, more than 13,000 students in Kunar and Nangarhar provinces have experienced disruptions. Access constraints and operational challenges Humanitarian access has been constrained in several affected areas due to insecurity, shelling, and road closures. In Kamdesh and Bargmatal districts of Nuristan Province, access to nearly 100,000 people was restricted for almost two months, limiting the delivery of essential services. The main supply route between Nari District in Kunar Province and Kamdesh District in Nuristan Province was closed due to ongoing hostilities, causing shortages of food, medicine, and fuel, and disrupting health referral pathways and humanitarian operations. On 13 April, the road was reopened following engagement by community elders from both sides and humanitarian actors. Since then, humanitarian organizations have resumed the delivery of food, medical supplies and other essential assistance to affected communities. Humanitarian needs and ongoing response Despite intermittent improvements and ongoing humanitarian response efforts, humanitarian needs remain severe across the affected provinces. Needs assessments conducted in affected areas have identified critical gaps in food security, emergency shelter, health services, nutrition support, water, sanitation and hygiene (WASH) and multi-purpose cash assistance. The World Food Programme estimates that approximately 160,000 people in affected areas are facing heightened food insecurity. Nutrition partners have also raised concerns regarding acute malnutrition among children under five, as well as pregnant and breastfeeding women. Protection risks remain high in conflict-affected areas, particularly for women and children exposed to displacement, shelling, and explosive remnants of war. While the intensity of hostilities has fluctuated in recent weeks, the humanitarian situation remains fragile. Continued insecurity, restricted access and funding shortfalls are likely to sustain humanitarian needs in the coming months. Humanitarian partners emphasize the importance of sustained humanitarian access, the protection of civilians, and adequate funding to ensure the continuity of life-saving assistance. Floods in Afghanistan: Widespread destruction amid compounding climate risks Between late March and April, heavy rainfall triggered widespread flash flooding across Afghanistan, affecting 31 of 34 provinces, 165 districts, and 546 villages, approximately one-third of the country. The floods caused significant loss of life, extensive damage to homes and infrastructure, and major disruption to livelihoods, leaving thousands of families in urgent need of humanitarian assistance. Scale of impact and humanitarian needs An estimated 31,000 people (9,984 families) were affected by the floods across Afghanistan. At least 55 people were killed and 148 injured. In total, 7,751 houses were damaged and 1,731 destroyed, forcing many families into temporary shelter arrangements or unsafe living conditions. The eastern region, particularly Nangarhar Province, was among the most affected, followed by southern and western regions. Rural communities were among the hardest hit, with widespread damage to agricultural land, irrigation systems, and rural infrastructure further weakening already fragile livelihoods and food security. Beyond immediate shelter needs, the floods have significantly deepened existing vulnerabilities. Many households have lost both their homes and primary sources of income, particularly in rural areas dependent on agriculture and seasonal labour. Displacement patterns remain fluid. While some families have returned to partially damaged homes due to a lack of alternatives, others remain in temporary shelters. Access to safe water, sanitation, and basic services remains limited in several affected districts, increasing health and protection risks. Humanitarian response Humanitarian partners, in coordination with local authorities, have scaled up emergency response efforts across affected areas. As of May, 37,845 people have received assistance (including 22,821 people with food assistance, 37,536 with non-food items, 16,151 with shelter support, 32,473 with WASH assistance and 21,232 with cash assistance). Response efforts are ongoing, but challenges persist due to damaged infrastructure, access constraints, and limited resources in some of the hardest-hit areas. Funding constraints are also contributing to critical gaps in assistance, particularly in hard-to-reach and severely affected communities where needs remain unmet. Multiple shocks, growing needs The recent floods are part of a broader pattern of climate-related shocks affecting communities across Afghanistan. Environmental pressures, fragile infrastructure and climate change continue to increase exposure to disasters and deepen existing vulnerabilities. At the same time, prolonged drought conditions continue to affect large parts of the country. Afghanistan is facing its sixth consecutive year of drought-like conditions, with continued below-normal precipitation and higher temperatures expected into 2026. These overlapping shocks are compounding humanitarian needs, particularly in rural areas where households have limited coping capacities and depend heavily on agriculture and seasonal labour. Sustained humanitarian support remains critical to address immediate needs and help strengthen the resilience of communities increasingly exposed to recurring climate shocks. A small clinic Is a lifeline for remote communities in Kabul Province, but Its future Is uncertain For families in the Paghman district of Kabul Province, even the most basic health care is often out of reach, requiring long walks across difficult terrain, journeys that can delay critical, sometimes lifesaving, treatment for women and children. In these isolated communities, a small clinic supported by Johanniter International Assistance (JUH), with funding from the Afghanistan Humanitarian Fund (AHF) and co-financing from the European Union through the European Civil Protection and Humanitarian Aid Operations (ECHO), has become a lifeline. The project focuses on underserved communities where humanitarian assistance is limited, and where internally displaced people, returnees and host communities face persistent barriers to health care. Through support to health facilities and outreach services, it provides primary health care, maternal and child health services, nutrition treatment, immunization, mental health and psychosocial support, treatment for common illnesses and health education. For many residents, the clinic is the only accessible source of health care. “This is the only clinic around here,” said Amina Noorzai, a nutrition counsellor who has worked at the facility for the past eight months with JUH. “Before this, people had to travel nearly 10 kilometers to reach another health center. Most families could not afford transportation and many women simply stayed home when they became sick.” Each morning, the clinic’s waiting area fills early. Mothers sit closely together holding infants as health workers move between patients, checking vital signs, providing counselling, and distributing medicines. Nearly 80 per cent of patients are women and children. For Amina, the work is deeply personal. One case still haunts her. “It was one of my first weeks here,” she said quietly. “A seven-month-old child came for growth monitoring and counselling, suffering from severe acute malnutrition and dehydration. Later, I learned the child had died.” The condition, she explained, was treatable — but the family arrived too late. “They did not know it could be treated,” she said. “If they had come earlier, we might have saved her.” Health workers say such cases are common in remote communities, where poverty, low literacy and limited health awareness often prevent families from seeking timely care. Many people have never received basic information about nutrition, hygiene or early signs of illness. As part of the project, health-care workers conduct awareness sessions to help families recognize symptoms early and understand when to seek treatment. “We try to teach people that diseases can be cured,” Amina said. “They should not wait until it becomes an emergency.” The clinic also provides mental health and psychosocial support, services that are rarely available in remote Afghan communities despite widespread trauma linked to poverty, displacement and years of crisis. “Many women come here carrying emotional pain that nobody talks about,” she said. “Mental health struggles are often hidden, but it is very important. We tell them treatment is available and they can come here for help.” Sustained humanitarian support remains urgently needed. In Paghman district alone, the closure of this Basic Health Center in 2026 will leave an estimated 12,000 people without access to essential health-care services. Without continued donor funding, vulnerable communities risk once again losing access to even the most basic medical care a gap that, in remote and hard-to-reach areas, can quickly turn treatable illnesses into life-threatening emergencies. “We hope this project continues,” Amina said. “These communities really need health-care support. Even basic services can save lives.” Months after the earthquake, families in Kunar continue still struggling to recover Several months after the powerful earthquake that struck eastern Afghanistan in August 2025, families across Kunar Province are still struggling to recover from the disaster. While emergency assistance provided critical support in the immediate aftermath, many households remain without adequate shelter, stable livelihoods and long-term recovery support. For 35-year-old Abdul Majeed Khan from Gorbaz village in Mazar Dara, Nurgal district, the earthquake continues to shape every aspect of daily life. "It was around midnight when the earthquake happened," Abdul Majeed recalls. "We lived in a three-storey house. When we realized what was happening, we were all buried under rubble and dust." Within moments, the family home collapsed, causing devastating losses. Abdul Majeed lost his father and three of his children. He, his wife and his sister survived with serious injuries. Months later, Abdul Majeed still walks with crutches. "For the first three months, I could not walk at all," he says. Rescue teams reached the area the following morning and transferred injured family members by air to Jalalabad for emergency treatment. Abdul Majeed spent nearly four months in hospital and still requires follow-up medical care. Beyond the physical injuries, the earthquake caused severe damage to the family's living conditions and financial security. The family's five-room house, built over many years, was completely destroyed. "Our house was completely destroyed and nothing was left," he says. The disaster also wiped out the family's primary source of livelihood. Four cows that supported household income died when the house collapsed. "I had four cows, and all of them died," he says. Abdul Majeed's sister also sustained injuries that left her permanently disabled, adding further challenges to a family already coping with loss and displacement. Today, the family remains in temporary shelter under arduous conditions. Without permanent housing, livestock or a reliable source of income, recovery remains a significant challenge. Following the disaster, the family received humanitarian assistance including emergency shelter, food assistance, cash support and winter clothing. While this support provided essential relief during the immediate response phase, Abdul Majeed says families now require support that can help them rebuild their lives. "Families need long-term support to stand on their own feet," he says. He also highlights the importance of livelihood opportunities, including support for women, to help families restore income and strengthen their resilience. Across Kunar Province, many earthquake-affected families continue to face similar challenges. Although emergency assistance helped address urgent needs in the immediate aftermath, housing support, livelihood recovery and sustained assistance remain urgent priorities for communities still struggling to recover. For survivors like Abdul Majeed, rebuilding means more than replacing what was lost; it means creating the conditions for families to recover and move forward. UNAMA HUMAN RIGHTS MONITORING AND REPORTING | UNAMA Afghanistan Situation Update #4: Humanitarian Impact of Afghanistan-Pakistan Military Escalation (28 April 2026) - Afghanistan | ReliefWeb Natural Disasters Dashboard | ReliefWeb Response This story was produced with the support of OCHA Afghanistan colleagues at the sub-national level, Said Alam Khan.