The humanitarian fallout from the escalating hostilities in the Middle East and beyond is increasing by the day, with civilians bearing the brunt across the region. Civilians and civilian infrastructure have come under attack; millions have been put in danger; hundreds of thousands have been forced to flee their homes; and access to basic services and life-saving assistance has been cut off or disrupted for civilians, including internally displaced people, refugees and migrants, in the areas that have been hardest-hit.
In Iran, at least 1,200 people have been killed, including over 200 children, according to the Ministry of Health and Medical Education (MOHME). This includes 168 girls killed when a strike hit the Shajareh Tayyebeh girls’ elementary school in Minab on 28 February. More than 1,110 people have been hospitalized, and nearly 19,000 have been treated and discharged, including at least 1,530 injured children—55 of them under two years old. Strikes by the United States and Israel have reportedly affected 190 districts across 20 provinces, with damage to urban infrastructure, including homes, health care facilities, schools and a water desalination plant. Displacement is increasing and access to services is under strain. Hazardous “black rain” linked to strikes on oil depots poses serious short‑ and long‑term health risks, including for pregnant women.
In Lebanon, more than 1,000 people have been killed and nearly 20 per cent of the population were displaced within two weeks, according to Government figures. Communities south of the Litani River, in parts of Baalbek and the Bekaa Valley, and in Beirut’s southern suburbs are heavily affected by intensified Israeli military activities and displacement notices, with at least half a million people caught in ongoing hostilities. At least 50 primary healthcare centres and five hospitals have closed, while 65 attacks harming health care were recorded between 2 and 25 March, killing 53 health workers and injuring 91 others while on duty.
In Israel, 18 civilians were killed and over 4,900 injured, including 715 children, between 28 February and 25 March, according to official figures. Iranian and non-statearmed groups’ strikes were reported on residential and industrial zones, increasing risks for civilians and civilian objects in these areas. Approximately 4,900 people in 41 municipalities are reported to be displaced due to complete damage to their houses.
In the Occupied Palestinian Territory (OPT), regional hostilities have resulted in lifethreatening consequences for civilians due to border crossing closures and humanitarian access constraints. On 28 February, Israeli authorities shut all crossings into Gaza, halting the entry of aid, fuel and commercial goods, as well as medical evacuations, humanitarian staff rotations and the return of residents from abroad. Limited fuel reserves in Gaza were rationed until 3 March, when Kerem Shalom crossing reopened for the passage of fuel, some aid and humanitarian personnel. Large quantities of essential supplies continue to be stuck in ports. Four women in the West Bank were killed by munition that fell during an Iranian strike on 18 March. Movement restrictions have tightened further, limiting access to essential services. Settler violence has resulted in deaths, and some homes have been taken over for use as military posts.
The escalation has caused people to flee from Iran to Afghanistan and from Lebanon to Syria, while humanitarian operations in both countries face heightened pressures due to supply chain disruptions. In Afghanistan, 36,000 people, mainly men, have returned from Iran through the Islam Qala and Milak crossings since the start of hostilities. Further returns from Iran are expected after Eid-al-Fitr. The closure of the Afghanistan-Pakistan border since October 2025 had caused half of all trade into Afghanistan to cross through Iran, making the impact of disruptions immediate: half of all humanitarian commodities are at risk of a pipeline break. The wider escalation comes at the same time as Afghanistan and Pakistan have engaged in renewed clashes, which have affected ten provinces in Afghanistan. Meanwhile, in Syria, more than 180,000 people have crossed from Lebanon, mostly Syrian nationals, while sporadic missile and drone debris have caused civilian casualties and limited infrastructure damage. Many of those entering Syria face significant challenges, including limited access to housing, livelihoods, and essential services.
- The hostilities have also killed or injured civilians or damaged civilian infrastructure in multiple other countries. Civilians, including migrant workers, have reportedly been killed or injured by Iranian strikes in Bahrain, Jordan, Kuwait, the Kingdom of Saudi Arabia (KSA), Oman, Qatar, and the United Arab Emirates (UAE). Casualties due to the ongoing hostilities have also been reported in Iraq.
Across the region, protection risks are rising as conflict deepens, particularly for women and girls. Widespread landmine and unexploded ordnance contamination are a major threat to civilians, and the current conflict is increasing the presence of new explosive hazards. Meanwhile, displaced people, returnees and migrants are exposed to heightened risks, including discrimination, exploitation, trafficking, loss of documentation, family separation, and gender‑based violence, while limited access to services and restrictive legal systems further undermine their safety. The regional escalation has created gender-specific risks and needs across different countries, including heightening women and girls’ risk of exposure to violence, exploitation and trafficking, and hampering women and girls’ access to vital aid and services.
The Middle East was already home to the world’s largest number of people in need of humanitarian assistance and protection at the beginning of 2026, with their situation further exacerbated by the direct and indirect consequences of the current hostilities. Some 3.6 million people are in need of urgent humanitarian assistance and protection in the OPT following unprecedented destruction and devastation; 16.5 million people in Syria require urgent support as the country strives to recover from more than a decade-long war; and in Yemen, 22.3 million people require urgent assistance and protection. Across the region, 3.7 million registered refugees from Syria continue to face significant humanitarian and protection needs in host countries and rely on the continued commitment of host governments, host communities, and the international community to sustain access to protection, essential services and support towards self-reliance. Some 5.9 million Palestine refugees spread across Jordan, Lebanon, Syria and the OPT require urgent protection and assistance, delivered first and foremost through the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA). In Afghanistan, 21.9 million people need humanitarian assistance. Iran is hosting over 1.65 million Afghan refugees and others in need of international protection. The sudden and intense socio-economic shocks caused by the escalation are having immediate reverberations across the region and may push people who were on the road to recovery back into an urgent need for humanitarian assistance.
The escalation is further constraining an already extremely difficult and insecure operational environment for humanitarians, increasing risks for humanitarian workers, limiting people’s access to humanitarian services, restricting the ability of humanitarians to reach communities in need and undermining ongoing aid operations. Social tensions are escalating, contributing to an erosion of the social fabric and weakening conditions conducive to the acceptance of humanitarian actors. At the same time, misinformation and disinformation are further polarizing communities and undermining trust in humanitarian efforts. Across the region, national and local aid workers, who are the backbone of each response, are operating under immense, sustained and compounding strain. Many are themselves directly affected by conflict— displaced, grieving, or struggling to meet basic needs—while simultaneously being expected to deliver life-saving support to others. At the same time, local and national organizations have endured the harshest impacts of global funding cuts.
The crisis is causing the most significant global humanitarian supply chain disruptions since COVID-19 and the onset of the war in Ukraine, increasing the cost of partners’ operations, and delaying delivery of vital, life-saving aid in the region and beyond. Humanitarian supply lines across the Middle East are being severely disrupted, threatening the timely delivery of life‑saving food, medical items and emergency relief to millions. Conflicts in the Middle East have elevated risks across key maritime chokepoints and corridors that humanitarian supply chains rely on, affecting shipping, energy, and fertilizer markets with clear knock-on effects. Rising oil prices are already raising fuel and transport costs for humanitarian partners. A significant share of the global fertilizer supply transits through the Strait of Hormuz, any disruption risks reduced availability, lower crop yields, and higher global food prices. The situation also risks renewed global inflation, with effects on food prices—and food security— worldwide. An additional 45 million people could be pushed into acute hunger globally—up from a projected 318 million—if the conflict continues through June, with acute concern regarding the situations in Sudan and Somalia. To mitigate these disruptions, humanitarian partners are adapting their supply routes, but each adaptation comes with a potential increase in costs and a likelihood of delayed delivery at a time when millions of people in the Middle East and beyond are reliant upon humanitarian assistance to survive.
