. UNRWA UNRWA Headquarters Gaza External Relations Office Tel: +972.8.677.7720 Fax: +972.8.677.7698 e-mail: ero@unrwa.org web site: www.unrwa.org Emergency Appeal.......... 4 Fourth progress report (1 February -31 March 2001)
. Emergency Appeal Fourth progress report on UNRWA s flash appeal launched 4 October and emergency appeal launched 8 November 2000. This report covers the period 1 February 31 March 2001. Background During the months of February and March 2001, Israel imposed further restrictions on the movement of Palestinians in the West Bank and Gaza Strip, and the Israeli Defense Forces continued to apply heavy-handed security measures in response to ongoing unrest. There were also signs of escalation in the conflict as the IDF stepped up its attacks. In the Gaza Strip, land, sea and air strikes were launched against a range of Palestinian targets. In the West Bank, the IDF continues to resort to tank shelling in retaliation for armed Palestinian attacks. The blockade of the West Bank and Gaza, imposed in response to the Palestinian uprising at the end of September, continues to cause further hardship by prolonging the severe economic crisis in Palestinian controlled areas. It has left ordinary Palestinians desperate and added to the explosive mood by radicalising many who are prevented from getting to work in Israel or within the territories. One in three Palestinians now live below the poverty line. Unemployment is estimated to be above 40%. The budget deficit of the Palestinian Authority is estimated at US$ 250 million, whereas the overall cost to the Palestinian economy is believed to be around US$ 1 billion so far. All economic sectors have been severely affected. Some farmers, for instance, have effectively been barred from working on their farms or taking produce to markets, leading to local food shortages. In the West Bank, trenches large and deep enough to stop a car, have been built around Ramallah and Jericho, preventing Palestinian motorists from evading Israeli checkpoints. The Israeli army has used road blocks there to prevent Palestinians moving between the patchwork of areas administered by the Palestinian Authority. All passes, that would have normally allowed Palestinians to move through Israeli controlled areas and into Israel, were revoked. Reports that Palestinians are unable to get to hospitals in nearby Palestinian towns because of the road blocks are being filed with UNRWA. Gaza remained almost entirely cut off from the outside world during the months of February and March. It was also cut in half for some time during this reporting period, preventing Palestinians from moving from the north to the south of the strip. Similarly, Gaza s airport and port remained closed to the Palestinians for most of the time. Attacks on Israeli settlements in the Gaza Strip and on access roads have led to a major increase 2
of the Israeli army presence. In Gaza and elsewhere, buildings, trees and crops have been leveled to destroy any cover that might hide Palestinian attacks. These measures, seen as legitimate security tactics by the IDF, are viewed as nothing short of collective punishment by the Palestinians. The IDF's restrictions have also posed serious obstacles to aid organizations. A number of international NGOs working in Gaza have also scaled back or cancelled some operations because of their inability to get in essential supplies such as medicines. Hand in Hand campaign in Syria On 20 January 2001, UNRWA pupils in Syria presented the UNRWA Commissioner- General with an exceptional contribution to the emergency appeal. Over Ramadan and Christmas, the children and their teachers, together with other UNRWA staff in the Syria Field, showed in a practical way their concern for Palestinian children and their families who were suffering in the West Bank and Gaza. With the approval of the Syrian Government and gracious co-operation of Syrian officials and the media, they launched a fund-raising campaign under the slogan Hand in Hand. Sympathetic individuals, businesses, mosque and church congregations, and communities throughout the country raised an impressive 25.4 million Syrian pounds, over US$552,000. This result places Hand in Hand high in the ranking of donors to the emergency appeal. Relative to the resources of the givers, it has even greater value. Many made considerable personal sacrifice. Children gave their Eid el Fitr pocket money and went without the traditional new clothes for the feast. Among the personal jewelry donated were no less than six wedding rings. Above all, it was an outpouring of compassion and human solidarity from the Palestine refugees in Syria and their host country citizens to fellow refugees in greater need. The funds are now being used, as announced in the campaign message: to provide physiotherapy and prostheses for the injured, to rehouse families whose homes have been severely damaged or destroyed, and to support those who have lost their incomes because of the death of a breadwinner or as a consequence of the economic closures. Emergency employment creation In the West Bank, the programme is being carried out through mobilisation of the community by means of Memoranda of Understanding with Camp Committees to repair camp pathways and drains. The committees hire labour and buy materials under UNRWA's supervision. As of 31 March 2001, the following had been completed: - 7,753 square meters of road asphalting (i.e. 66 % implementation rate); - 41,500 square meters of pathways (i.e. 52% implementation rate); - 5,650 Meters of Road Drains (i.e. 39% implementation rate). Under the contractual maintenance of premises/construction of recreational areas component in the West Bank, 24 contracts have been awarded for maintenance works at 27 schools (8 in Jerusalem, 12 in Nablus and 7 in the Hebron area), 8 health centres and Health Points (1 in Jerusalem, 4 in Nablus and 3 in the Hebron areas), as well as one warehouse. In addition, seven tenders for the construction of recreational areas in 10 camps have been received and are being analyzed (3 in the Jerusalem area, 2 in the Hebron area and 5 in the Nablus area) UNRWA s West Bank field office also hired an additional 542 temporary staff to assist in the implementation of the emergency appeal, ranging from psychological 3
counsellors, to youth co-ordinators, replacement teachers, social workers and medical officers to a dental surgeon. In Gaza, 551 persons were hired under the emergency employment creation scheme during the month of February, while 151 persons were recruited in March 2001, bringing the total number of persons currently benefiting from the programme in Gaza to 2,506. These temporary employees have been assigned to the various departments within the Agency s Field Office and Headquarters in Gaza as follows: - Procurement and Logistics Department: 4 clerks, 246 food packing and distribution labourers and 3 assistant head storekeepers; - Administration Department: 2 lawyers, 1 personnel assistant, 14 clerks and 3 data-entry clerks, 3 senior clerks to monitor labourers hired under the scheme in their places of work and report back to Administration, 9 cleaning labourers, 2 messengers, 2 gardeners and 467 guards at schools and other UNRWA installations; - Relief and Social Services Department: 21 clerks, 46 social workers, 156 instructors in different trades at community-based centres in the refugee camps, including women programme centres, youth activities centres, community rehabilitation centres and the Rehabilitation Centre for the Visually Impaired, 18 cleaners, 2 registration supervisors and 1 secretary; - Technical Department: 3 civil engineers, 6 electrical engineers, 18 site engineers, 3 architects/planners, 5 technical assistants, 6 construction foremen, 1 accountant, 5 clerks, 4 blacksmiths, 4 electricians, 5 plumbers, 5 builders and shutterers, 5 plasterers and tilers, 9 carpenters, 13 painters and 18 labourers; - Health Department: 15 medical officers, 1 obstetrician/gynaecologist, 13 dentists, 1 ophthalmologist, 11 physiotherapists, 1 pharmacist, 15 assistant pharmacists, 8 staff nurses, 11 practical nurses, 16 lab technicians, 17 clerks and 5 cleaners; - Special Environmental Health Department: 8 engineers, 9 surveyors, 1 quantity surveyors, 14 assistant surveyors, 477 sanitation labourers, 51 sanitation foremen, 8 sanitation supervisors and inspectors, 4 secretaries and 6 building labourers; - Education Department: 5 education supervisors, 333 teachers, 336 school cleaners and 6 clerks; - Microfinance and Microenterprise Department: 2 cleaners; - Finance Department: 7 clerks; - Headquarters, Gaza: 2 secretaries, 1 clerk, 2 drivers, 3 security guards, 4 cleaners and 2 messengers. During the months of February and March, the following activities were also carried out under the emergency employment creation scheme in the Gaza Strip: - 343 newly graduated men and women joined the Agency s Head Start Graduate Job Experience Programme. They have been assigned to the Agency s various departments in the Gaza Field as follows: 18 at Relief and Social Services, 46 Technical, 49 Health, 11 Special Environmental Health, 205 Education, 13 Microfinance and Microenterprise and 1 Administration. - Survey and design of the work relating to the pavement of sandy alleyways, with block-pavers, in the Jabalia and Beach refugee camps (phase I) continued. Awarding of the contracts relating to the manufacturing of the block-pavers and hiring of engineering equipment was completed, however, signing of the contracts was not possible because of the shortages of construction materials on the local market. See Obstacles Encountered. - All materials and supplies required to carryout urgently needed maintenance works at various UNRWA installations in the Gaza Strip were procured, and about 90 percent of all the work completed. 4
- 6 computers, 2 printers and 6 UPS units, required for the operations of the Administrative Unit overseeing the implementation of the scheme were purchased. - The design and tender documentation relating to the construction of a toilet unit at one of the Agency s warehouses in Gaza was being finalised. Emergency food aid In February and March 2001, respectively, some 23,500 and 33,100 families received basic food commodities and food cash subsidies in the West Bank bringing the total number of beneficiaries to 90,000 families. In the Gaza Strip, 256,008 food parcels were distributed during the months of February and March, bringing the total number of parcels distributed under the Agency s emergency food distribution operation in Gaza to 365,849. The 123,845 benefiting families are divided into three groups as follows: 114,430 refugees, 8,842 refugee women married to non-refugees and 573 non-refugees, residents of areas placed under siege by the Israeli Army, including El-Mawasi area of Khan Younis and Beit Hanoun town. Selective cash assistance for families in extreme crisis During February and March 2001, respectively, some 3,730 and 2,780 affected families in the West Bank were provided with selective cash assistance to assist them in covering urgent expenditures as a direct result of the current emergency situation. This brings the total of families who have received selected cash assistance to 8,580 for a total amount of US$ 421,050 (i.e. average contribution of US$ 49 per beneficiary family). Similarly in Gaza, during the month of February, a total of US$ 69,900 was issued in cash to 225 families who are in dire need of such assistance as a result of the current crisis. In March, a total of US$ 257,900 was issued in cash to 795 families. In all, US$ 684,064 has been issued in cash to 1,842 families (i.e. average contribution of US$ 352 per family), since the current crisis began, as follows: - US$ 83,639 to 123 families who have lost their breadwinner; - US$ 111,011 to 414 persons who sustained serious injuries and are unable to work; - US$ 324,550 as relocation fees to 860 families who were forced to vacate their homes as a result of the Israeli shelling of their areas of residence; - US$ 128,864 to 445 families with pressing emergency-related cash requirements, such as utility payments, which they could not afford otherwise. Shelter rehabilitation In the West Bank, cash assistance was provided to 262 (February) and 123 (March) affected families to assist them in conducting basic repair work on their shelters. The total number of families in the West Bank that have received assistance at the end of March 2001 to repair their shelter is 424. In Gaza, 241 shelters, damaged as a result of Israeli shelling, were identified for repair/reconstruction under the Emergency Appeal. 5
Because of the persisting security threats, actual work has not yet been possible. See Obstacles Encountered. Post-injury physical rehabilitation In the West Bank, 60 persons with disabilities resulting from the current crisis in February and 19 in March were assisted with the modification of their shelters, thus bringing total disabled persons assisted up to 79. A total of 30 disabled refugees in February and 39 in March have been provided in March with prosthetic devices, bringing the total up to 69 persons. The 335 wheel chairs and 276 walkers for use on a loan basis by temporary disabled persons are in the final stages of procurement. Several training workshops and awareness lectures were organised in February and March, attended by some 1,000 refugees and their families in February and 650 in March. These workshops focus on mechanisms on how to live a meaningful life as handicapped persons. Recreational activities involved about 4,000 persons in February and 3,150 in March (both disabled and their families) with the objective to develop positive attitudes towards the disabled persons and to enhance their acceptance in their families and the local community securing a smooth socio-economic re-integration to the greatest extend possible. In addition, some 500 disabled refugees in February and 250 in March were referred for specialist assistance and treatment and vocational assessment in the West Bank. The physiotherapy programme in the West Bank was extended to camps where such service is not available. Five temporary assistant physiotherapists were hired in February and an additional three in March to provide services to traumatised and post-injury handicapped patients. They conduct home visits to those unable to reach the clinic. The number of patients who visited the physiotherapy programme in February and March are 262 and 282, respectively, while in March alone, 545 patients were visited at home. The total number of physiotherapy sessions provided in February and March is 757 and 852, respectively. In Gaza, the procurement of wheelchairs for 160 additional persons who became disabled as a direct result of the current crisis is underway, bringing the total number of wheelchairs procured for Gaza under this emergency appeal to 263. Indicator Health Indicators of drop in the rates of access to, and coverage with, UNRWA s primary health care services during the last quarter of 2000 in Gaza Strip and the West Bank, compared to previous quarter of the year, are as follows: 6 Gaza Strip Drop in rate West Bank Pregnant women registered for ante-natal care -27.2% -16.2% Attendance of pregnant women to ante-natal clinics -5.6% -11.7% Women covered by post-natal care -- -12.9% New acceptors of family planning -20.9% -6.8% Hospital deliveries -- -10.2% Infants registered for preventive care -- -13.9% Attendance of children for MCH clinics -- -10.5% Immunisation of infants: BCG -- -24.4% DPT -- -13.4% Poliomyelitis -- -12.3%
Measles -- -10.1% Hepatitis B -- -11.9% NB: (1) Where no figures are provided, there has been no drop in rates. (2) As is apparent, preventive services were more affected in the West Bank than Gaza because of problems associated with mobility and access. On the other hand, there has been a significant increase in other indicators that are normally associated with inadequate access to health care and/or undesirable health outcomes, as can be seen below: Indicator Rate Gaza Strip West Bank Home deliveries +21.1% +37.1% Still births +22.0% +41.2% While statistics are not available on the possible increase in the rates of abortions and early miscarriages, there are good reasons to believe that they are on the increase due to psychological trauma and compromised nutrition. During February and March, some 500 and 638 refugees in the West Bank, respectively, suffering from injuries, premature deliveries, neurosurgical and orthopedic cases were referred and admitted to either contracted or non-contracted hospitals. UNRWA s Qalqilia Hospital admitted 272 and 328 patients, respectively, in February and March (refugees and non-refugees) to various departments and rendered consultations to 982 and 1,162 patients in the emergency room. The demand on first aid supplies and drugs for chronic cases, cardiac, mental and hypertensive patients has increased by some 30% to 40% (compared to the same period last year). In February, a one month stock reserve of medical supplies was provided to clinics in Nablus and the Hebron areas, while clinics in the Jerusalem area were provided with a stock reserve in March. The stock reserve makes clinics less dependent on deliveries from the Central Pharmacy, which has become irregular due to the internal and external closures. In addition, some 13 local hospital and health institutions in the West Bank received first aid medical supplies during the month of February. In the West Bank, additional staff has been hired in February and March to shoulder part of the heavy burden on health centre staff and replace those who are unable to reach their reporting stations. The additional staff hired includes 4 medical officers, 11 nurses, 3 assistant pharmacists, 4 laboratory technicians, 4 clerks, 4 cleaners, 8 assistant physiotherapists, 1 dental surgeon and 40 sanitation labourers. At UNRWA s Qalqilia Hospital, 2 medical officers have been temporarily recruited, as well as 4 nurses, 1 midwife, 1 secretary and 1 cleaner. In addition, two specialists have been seconded by other health care providers to ensure readiness to perform major surgery around the clock, if required. Since the current crisis began, UNRWA in the Gaza Strip has provided emergency medical care, including treatment of minor wounds at its health centres and mobile clinics, ambulance transport facility, physical rehabilitation and prosthetic devices, to a total of 1,484 refugees and non-refugees injured during the clashes. In Gaza, the following activities were completed during the months of February and March: - All physiotherapy equipment, spare parts and instruments procured under the appeal were received and distributed to the Agency s health centres; - The remaining items of drugs and first aid supplies ordered under the appeal were received and distributed to the health centres. 7
- 4 fetal-heart-detectors, 24 sphygmomanometers, five wheel stretchers and 13 steam sterilisers were received. - The Agency s Headquarters Contracts Committee approves a contract for the procurement of three ambulances and a purchase order was raised. - Recruitment of the two Mental Health Team members, each comprising one specialist in mental health, two nurses and one driver is expected to be finalised by mid-may. A purchase order covering two vehicles for the use of the two teams was raised and the expected delivery date is 30 May. The two teams will be responsible for identifying patients, reporting to the Agency s health centres, with mental health problems requiring treatment. Those in need of therapy will be referred to specialised centres. - The renovation and alteration works at the Agency s health centre in Rafah to accommodate the new X-ray machine, procured under the ppeal, was completed. Owing to border restrictions, transporting of the machine from the Agency s Field Office in Jerusalem to Gaza has not yet been possible. Emergency compensatory education In order to promote youth activities in the West Bank, 32 UNRWA youth centres (both male and female) organised the following activities in February and March: - Fun days, film and play shows, competitions and library activities in both February and March took some 10,000 male and female children out of a hostile environment and provided them with an environment of support, normalcy and relaxation; - First aid training was provided to about 150 male and female youngsters in February and 190 in March; - Workshops and lectures on the effects of the crisis on children and youth and on how to handle crisis situations were organised for over 1,000 youngsters in February and 1,600 in March; - Training in folklore, sports and scouting was organised for about 500 children in February and 300 in March; - Supplementary classes were organised for about 2,252 male and female students of the secondary cycle whose studies were disrupted by the current situation, mainly in English, physics and math; - Training in computer skills and internet use was conducted for about 480 children; - Several exhibitions of photographs were organised, which were attended by large numbers of children and youth; - Graduation Ceremonies were held to honour 3,248 participants who completed/participated in various courses. The prolonged crisis situation continues to have an adverse effect on the psychological health of children, especially those exposed to shooting, shelling and killing. In accordance with the activities listed in the first emergency appeal, UNRWA has jump-started activities to promote psychological well-being as well as a Crisis Intervention for Camps initiative. A preliminary meeting with interested NGOs was held in March, whereby Terms of References and mechanisms of implementation were discussed and agreed upon. Six Special Service Agreements were concluded with Counselling Centres to initiate implementation of planned activities; three Contracts have been prepared with Artistic and Community 8
Education Centres to organise arts workshops and training of trainers for teachers, social workers and counsellors. Some 57 newly recruited counsellors (35 for schools and 22 for Health & Social Services Programme) are working closely with the subcontracted NGOs. Two booklets on Management of Crisis and Childhood in War Situations were produced and distributed. A workshop on How to manage children and families under crisis was held in Ramallah which was attended by several leading NGOs, as well as UNICEF and UNRWA. The PA also participated in the event. UNRWA s Gaza Field Office elaborated a similar proposal to provide psychological counselling in Gaza. The main objective of the initiative will be to provide psychological support to the refugee population in the Gaza Strip in order to promote the development of constructive coping mechanisms in the current crisis situation and to prevent the ulterior development of a structured psychopathology. This proposal will be shared with the French government for funding. Recruitment of the project s Management Team, comprising a project manager and three assistants, will commence soon. The after school activities programme in the West Bank started in March with 7 contracts for conducting puppet shows at UNRWA schools, training for the school choirs, training in painting & drawing training, as well as conducting entertainment activities. Obstacles encountered Delivery of the following items of medical supplies and equipment has not yet been possible as a result of the continued Israeli restrictions on entry into the Gaza Strip of Agency medical supplies and equipment, or a delay on the part of suppliers: - An in-kind contribution of medical supplies from Saudi Arabia; - 0.7 percent of the medical supplies ordered under the emergency appeal.; - 13 steam sterilisers; - 158 sphygmomanometers. By 31 March, approximately 40 ten-tonne truckloads of supplies are being held at the Agency s West Bank Field Office awaiting transport to Gaza. As a matter of principle, the Agency is refusing to adhere to the back-to-back procedure at the Karni checkpoint for bringing its supplies from the West Bank to Gaza, a costly and time consuming procedure. The Agency continued to face some difficulties in transporting food commodities by Agency trucks to distribution points as a result of the security measures imposed by the Israeli soldiers at the checkpoint leading to Gush Qatif settlement. The average delay is 2 hours per day. No technical assessment or design or construction of the 241 shelters, which were damaged during the current cycle of violence, took place because the areas where these shelters are located are still subjected to the same security threats. The current shortage of construction materials on the local market would still prevent commencement of the construction work at this time, even if the security situation had improved. Construction projects undertaken by the Agency either by its Environmental Health Programme Department or by the Technical Department within the framework of the Emergency Employment Creation scheme, such as pavement of alleyways within the refugee camps, continued to face delays as a result of the shortage of construction materials on the local market, such as base-course aggregates, gravel, etc. Access to the main Gaza landfill site was still not possible and the Agency s refuse trucks continued using an alternate dumping-site identified by the Gaza Municipality. 9
Implementation progress to date A table is attached with financial information detailing the funds allocated under both emergency appeals as at 7 April 2001. Updates UNRWA will issue monthly updates on the status of UNRWA s emergency appeal. The next update of this progress report, covering the 1-31 April 2001, will be issued during the first week of May 2001. Annexes A. Pledges received towards UNRWA s flash appeal and funds allocated as at 7 April 2001. B. Pledges received towards UNRWA's first emergency appeal and funds allocated as at 7 April 2001. C. Pledges received towards UNRWA's second emergency appeal and funds allocated as at 7 April 2001. 10