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Office for the Coordination of Humanitarian Affairs (OCHA)
12 October 2004
Humanitarian Situation Update - Northern Gaza
Tuesday, 12 October 2004
The Israeli military operation “Days of Penitence” has been ongoing for nearly two weeks and is aimed at pushing Palestinian missiles out of range of Sderot, an Israeli town. The incursion came in the wake of the continued firing of homemade rockets by Palestinian militants towards Israel, and the killing of three soldiers in Morag settlement on 23 September and one settler in Neve Dekalim a day later.
Israeli tanks remain deployed on As Sika Road to the east of Salah el Din Street, Tal el Zatar, Glebo and Um Al Nasr bedouin village to the north of the Beit Lahiya sewer treatment plant. All movement in and out of Beit Hanoun (population 30,000) is controlled by the Israeli Defense Forces (IDF).
A UN inter-agency assessment team visited Beit Lahiya and Jabalia on Monday, 11 October to obtain a more comprehensive assessment of humanitarian needs in northern Gaza since the start of the current Israeli incursion on Tuesday, 28 September. These agencies included the United Nations Children’s Fund (UNICEF), the Office of the United Nations Special Coordinator (UNSCO), the World Health Organization (WHO) and the Office for the Coordination of Humanitarian Affairs (OCHA).
According to the Palestinian Ministry of Health (MoH), 119 Palestinians have been killed in the Gaza Strip since 28 September, 105 of the deaths occurring in the northern Gaza Strip. Roughly 28% – 33 total deaths in the Gaza Strip – are children aged 18 and younger. Of those 33 deaths, 29 occurred in northern Gaza. Five Israelis have died, including two children who were killed by homemade rockets fired by Palestinian militants from the northern Gaza Strip into Sderot on 29 September. In the northern Gaza Strip, 399 Palestinians have been injured, of which 170 – roughly 43% – are children.
The military operation has resulted in some of the highest Palestinian casualties in the last four years of conflict. This is not just related to the duration of the incursion, as previous incursions into Beit Hanoun in June 2003 and July 2004 both lasted over one month but had notably lower casualty rates. For example, between 29 June and 5 August, the MoH reported that 19 Palestinians were killed and 154 injured.
Dr Mohammed Al Asali, director of Kamal Adwan Hospital in Jabalia, attributes the use of tank rounds and air-to-ground missiles by the IDF in densely populated areas for this high casualty rate, particularly the number of multiple loss of limbs and open abdominal injuries that often prove fatal.
Homes and Property
According to the North Gaza Governor Sakher Bseiso, approximately 95 homes have been destroyed or damaged beyond repair, while 280 have been damaged and are in need of repair. This number of homes destroyed is consistent with estimates made by the International Committee of the Red Cross (ICRC) from its field visits over the course of last week.
The governor also highlighted the issue of internally displaced persons. Most of these were living in blocks 2 and 4 in the east of Jabalia camp and Tal el Zatar who have left their homes on account of the fighting and who have sought temporary relocation elsewhere. The municipality has provided $15,000 in rental assistance to around 200 displaced families.
The governor believes that between eight and 10 wells have been destroyed or seriously damaged in the northern Gaza Strip since the start of the incursion. Two of these wells have been reconnected with the restoration of power lines in the affected areas. However, a third well in the Shusha area near the old civil administration building has reportedly resulted in contamination of the water supply with sewage.
To help counter water problems, Save the Children (US) has recently provided 8,000 litres of bottled water via the North Gaza Governorate. From its field visits, ICRC believes that breaks in the water and electrical supplies are becoming increasingly localised as repairs have been able to proceed and no new significant ruptures in the networks have emerged.
The North Gaza Governorate estimates that more than 6 kilometres of asphalt road and 10 kilometres of agricultural tracks have been damaged. Damage has been caused by IDF tanks that have created corridors running east-west across the northern Gaza Strip, particularly across Salah el Din Street, estimated at 10 metres in width. A number of workshops and small business units on either side of Salah el Din Street are reported to have been destroyed.
Two Palestinian National Security posts have reportedly been destroyed. One of these posts was the large compound to the south of the Palestinian District Civil Liaison Office, next to the eastern side of the Erez Industrial Estate.
According to the governorate, between 700 and 800 dunums (70 to 80 hectares) of land containing olives and citrus fruits have been levelled, and a further 250 dunums (25 hectares) of land producing strawberries in Beit Lahiya were also levelled. Twenty-five greenhouses are reported to have been destroyed. These estimates are consistent with other reports of widespread land destruction between As Sika Road and Salah el Din Street to the east of Jabalia camp.
The United Nations Relief and Works Agency (UNRWA),and the World Food Programme (WFP), distributed food on Monday, 11 October. This was the second distribution – the first being on Thursday when 300 food parcels were delivered to families in the As Sika Road area. The latest distribution was to the eastern edge of block 4 of Jabalia camp. However, it was not possible for UNRWA and WFP to directly enter this area, thus a distribution point was established outside the area. Families were able to collect food parcels with the assistance of donkey carts – 200 parcels were distributed.
Food parcels have come from a number of sources and not just from the larger international agencies including UNRWA, WFP and the ICRC. The governorate has provided 708 food parcels on behalf of the Palestinian Authority (PA) while the Ministry of Social Affairs provided 310 parcels. The Zakat Committee has also provided 500 food parcels to families in Izbat Beit Hanoun and the An Nadr Towers area.
Between 29 September and 7 October, all UNRWA and PA schools were closed affecting 38,000 students, according to UNICEF. Since Saturday, 9 October the Ministry of Education (MoE) has been operating a system of compensatory schools whereby schools are being opened outside of the conflict areas to which students are encouraged to attend. UNICEF believes that between 50% and 60% of PA students are receiving some education, although on the basis of a reduced curriculum. PA schools remain closed in Beit Hanoun, as does the only school in Um Al Nasr bedouin village.
UNRWA schools (which are separate from the PA school system) have also reopened since Saturday, with the exception of Beit Hanoun where there are 10,300 students. UNRWA estimates that between 80 and 90% of students are now attending daily classes in northern Gaza
Five UNRWA schools have been partially damaged since the start of the incursion.
Dr Al Asali confirmed that the Kamal Adwan Hospital had sufficient supplies of drugs, consumables, blood and oxygen in spite of the high influx of casualties over the last two weeks. The hospital has received 66 dead and 217 injuries of which many have been “multiple wounds”. Dr Al Asali described these injuries as the worst he has seen in his 27 years of experience.
Kamal Adwan Hospital in Jabalia has 57 beds, including two assigned to the intensive care unit (ICU). The health staff consists of 68 doctors including 15 surgeons, and 72 nurses. Dr Al Asali stated that 10 doctors and six nurses have not been able to reach the hospital in the last two weeks due to the presence of Israeli forces around their homes. These staff members
have been replaced by local volunteers – eight doctors and 10 nurses. In addition, an orthopedic surgeon has been sent to Kamal Adwan from Shifa Hospital. Dr Al Asali stated that while there is a sufficient number of doctors to cope with the case load, there are not enough nurses. Seven ambulances are based at Kamal Adwan, of which two have ICU facilities.
A major concern of Kamal Adwan Hospital is its ability to cope with a major influx of casualties. To overcome this capacity problem, the hospital has adapted its preparedness/referral policy to provide first aid and stabilisation measures to the injured and then transfer them as soon as possible to Shifa Hospital. As a tertiary health care hospital, Shifa has far greater capacity. In exceptional circumstances when Shifa has been unable to cope with the caseload, patients have been transferred to Al Quds Hospital run by the PRCS in Gaza City. Dr Al Asali believes this triage role adopted by Kamal Adwan Hospital has
worked so far.
The North Gaza governor also confirmed that the health system was coping in spite of the daily pressures it was under. However, Beit Hanoun lacks secondary health care facilities. When faced with a tight closure as is currently in place, all secondary care referrals require coordination out of Beit Hanoun. During the first week of the incursion, both MoH and PRCS ambulances were reporting delays of up to eight hours in some cases when trying to get patients to Kamal Adwan and Al Awda Hospitals. While coordination now appears to be smoother, the North Gaza governor felt there was a need to upgrade an existing health facility to secondary care level - this could cost between $600,000 and $700,000.
NGOs continue to support health needs in the northern Gaza Strip. Save the Children (US) on the basis of urgent needs assessments collected from the northern municipalities and international organisations, has recently provided baby milk powder, 96 cartons of oral rehydration solution as well as emergency medication, consumables and equipment in accordance with the needs of the MoH. In addition, an emergency medical kit has been provided to a community based mobile unit in block 4.
Medecins du Monde had been seeking coordination on 12 October, to accompany a mobile clinic run by the Palestinian Medical Relief Services (PMRS) to the Glebo and As Sika Road areas to the east of Jabalia. However, coordination by the IDF was not approved.
Growing concern is being expressed by UNICEF and Medecins Sans Frontiers (MSF) about the long-term psychological impact on those communities who faced a high level of concentrated violence.
MSF is particularly concerned about the traumatic effects on the medical teams that have had to cope with treating multiple deaths and violent injuries. It will provide counseling and debriefing sessions to medical staff at Kamal Adwan and Shifa Hospitals. UNICEF will be working through local partners to provide counseling to those children from the worst affected areas who are now reconvening at schools.
The majority of UN international staff that had been prevented from entering Gaza since 21 September were able to return with prior coordination from the IDF on Saturday, 9 October. Passage took place through Erez crossing and continued on the “humanitarian road” leading north of Al Nadr towers through Um Al Nasr Bedouin village and then into Beit Lahiya. The IDF, as a rule, is still not allowing UN staff with the exception of diplomatic passport holders to cross Erez in vehicles - although exceptions to this rule have been allowed.
Northern Gaza Emergency Committee
The North Gaza governor highlighted the role of the northern Gaza Strip emergency committee in responding to and managing the current crisis. The PA established emergency committees throughout the Gaza Strip more than three years ago in anticipation of Israeli incursions.
The northern committee is chaired by the governor and includes representatives from the MoSA, MoH, MoE, Ministry of Local Government, Civil Defense, the Palestinian DCL and representatives of the national and Islamic groups. The principal aim of the committee is to provide immediate assistance to areas in crisis. The committee has received NIS 500,000 from the Palestinian prime minister’s office towards this objective.