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Source: UN Relief and Works Agency for Palestine Refugees in the Near East (UNRWA)
31 December 2003




Twenty-third progress report - October - December 2003

Emergency Appeal 2003



The cycle of violence continued throughout the last quarter of 2003 and all efforts to revive the stalled negotiations between Israelis and Palestinians failed. Despite criticism from high-ranking former and current members of the Israeli defence establishment, Israel failed to moderate the repressive measures that make daily life in the occupied Palestinian territory intolerable for so many of its inhabitants.

On 4 October, the eve of the Jewish Day of Atonement, Yom Kippur, 22 people were killed and 45 wounded when a suicide bomber blew herself up in a restaurant in Haifa. It was one of the deadliest attacks in the three-year-old intifada. Five days later, on 9 October, the Israeli Defence Forces staged a devastating raid into the Rafah refugee camp in the Gaza Strip. Dubbed Operation Root Canal, the raid was reportedly aimed at uncovering tunnels used to smuggle arms from Egypt. In the space of only three days, IDF troops demolished or damaged beyond repair 148 shelters in the camp, 142 of them belonging to refugees. The devastation continued during the reporting period with a total of 3,251 people made homeless in Rafah after 337 houses were destroyed. The Rafah operation resulted in an increase in the number of fatalities and casualties in the Gaza Strip, with 95 Palestinians killed (including four pupils from UNRWA schools) and 464 injured (including 20 pupils).

UNRWA recorded 64 Palestinians killed and 553 injured in the West Bank in the last quarter of 2003. Four of the dead had been students in Agency schools, one of them only six years of age. On 1 December, during an IDF incursion into the Amari refugee camp, 22 students in the Agency's boys' school were injured by rubber bullets. Two others, struck by live rounds, had to be hospitalised.

On Christmas day, a day after the IDF killed three Palestinian militants in an air attack in the Gaza Strip, an 18-year-old male from Nablus killed four Israelis in a suicide attack near Tel Aviv. Two days later, Israeli troops raided the Nablus Casbah and the Balata refugee camp, imposed a curfew on the residents and conducted house-to-house searches. Five shelters in the refugee camp were demolished in the course of the incursion. Three shelters elsewhere in the West Bank were demolished in the quarter and six sustained serious structural damage.
As the year came to an end, the issue of greatest concern to the United Nations in the occupied Palestine territory was Israel's continuing construction -- despite widespread international condemnation -- of the separation barrier and the imminent construction of the barrier within Jerusalem. When completed, Palestinian neighbourhoods, including A-Ram and Dahyiet al-Barid as well as the Shucfat refugee camp, will be isolated from other parts of the city. In a resolution passed on 22 October, the UN General Assembly called on Israel to halt its construction.

By the end of 2003, UNRWA had only received 45 percent of its total requirements as set out in its two Emergency Appeals of 2003. The Agency was again forced to reprogramme its response toward food aid, direct employment, and cash assistance. Lack of funds meant a cancellation or severe curtailing of priority programmes in the area of education, health and shelter repair and reconstruction.

Emergency Employment Creation

A central component of UNRWA’s response to the deepening poverty stemming from the crisis in the oPt is emergency employment creation. Projects in this area directly tackle the high levels of unemployment, help stimulate the economies in the West Bank and the Gaza Strip and improve the living conditions in refugee camps. They include the direct hire of employees on short-term contracts or the implementation of building and maintenance projects via private sector contracts or community-based projects.

a. Direct hire

UNRWA offers temporary employment in a wide range of professional, technical, support and unskilled positions in connection with its regular and emergency programmes, including teachers in its schools, medical professionals in its health centres, engineers on project sites, and administrative and clerical workers in its field offices and headquarters. Between October and December, 4,928 individuals were offered temporary employment with UNRWA, 1,276 of them in the West Bank and 3,652 in the Gaza Strip. Their contracts typically ran for up to of three months. In the professions, however, where incumbents have become familiar with UNRWA's procedures and where consistency is desirable, i.e., teachers, contracts may be valid for longer periods. Due to funding shortfalls, this programme offered 500 fewer contracts than in the previous reporting period.

Together, these temporary employees worked 380,371 days. The programme enhances the pride and self-esteem of the participants, while the wages they earn ensure that they can meet the basic needs of their families. The 4,928 participants supported 34,937 dependants.

Since UNRWA launched its emergency response programme in late 2000, close to 4 million work days have been generated under the Direct Hire Programme.

b. Indirect Hire

A total of 31,130 work days were generated through UNRWA indirect hire projects under the Emergency Appeal between October and December. 18,257 days of labour were generated in the West Bank, and 12,873 days in the Gaza Strip. In the West Bank, indirect hire projects included the construction of 43 additional school classrooms, a further 12 specialised classrooms and one latrine. A new health centre was built in the Askar Refugee Camp and a classroom and clinic were constructed at Ramallah Men’s Training Centre. In addition, the construction of a school was underway in Nur Shams refugee camp.

A number of community-based contracts were issued in the West Bank resulting in the paving of 23,474 square metres of pathways, the laying of 2,582 drains and the construction of 1,895 retaining walls. A number of maintenance projects were also undertaken during the same period, creating 702 work days. In addition to providing meaningful employment, these works improve the overall condition of West Bank refugee camps.

In the Gaza Strip, a school was completed in Beit Lahia and construction of a school in Qarrara continued. Work is progressing on a number of other projects, including the construction of six classrooms (Maghazi Preparatory and Elementary Schools), two workshops at the Gaza Training Centre, and the reconstruction of 81 shelter units.

Since the launch of the Emergency Appeals, a total of six schools and 130 individual classrooms have been constructed in the Gaza Strip under the Indirect Hire programme. The Agency has also been able to reconstruct 355 shelters for Special Hardship Case families (a further 81 shelters are underway). These shelters had already been identified as priorities for reconstruction because of their poor

Emergency Food Aid

UNRWA provides emergency food aid to households in the oPt, supplying staple commodities that contribute to nutritional security including flour, rice, chick peas, sugar and oil. While having the same overall objective, this programme is implemented differently between the two UNRWA Fields of operation in Gaza and the West Bank. This variation in approach is explained by geographical and demographic differences between the two fields, as well as the different tactics being used by the Israeli army in the West Bank and Gaza Strip.

UNRWA has the largest food aid programme, with the lowest cost per commodity, in the West Bank and Gaza Strip. A total of 176,827 families received food parcels during the reporting period (94,310 in the Gaza Strip and 82,517 in the West Bank). A total of 16,760 tons of food were distributed over the three-month period. The distribution programme experienced some interruptions as a result of a port strike at Ashdod, delaying the deliveries of basic commodities to both Fields. Further disruptions were experienced in the Gaza Strip as a result of delays of flour deliveries from the local mill. In the West Bank, curfews and closures resulted in food aid distributions being disrupted on 19 different occasions during the quarter.

Due to a shortage of funds for the food aid programme in the last quarter of 2003, a food parcel in the West Bank that had originally gone to a two person household was required to support a household of three. Therefore only 40% of nutritional requirements were provided to refugees (rather than the Agency norm of 60%).

The Agency has now distributed more than 3.4 million food parcels since the first Emergency Appeal was launched in late 2000.

Emergency Relief and Social Assistance

a. Cash and In-Kind Assistance
Selective cash assistance on a small scale is provided to those households in extreme crisis, for example as a result of the death or injury of a principal breadwinner or the destruction of housing. Grants enable families to buy basic items such as food or meet urgent utility or school expenses.

UNRWA's cash assistance program benefited 6295 families comprising 33,910 individuals between October and December (4,141 families in the West Bank and 2,154 families in the Gaza Strip). A majority of these grants were given to households that have not had any source of income for many months. Cash assistance was also provided to those families requiring relocation due to home demolition.

UNRWA provides in-kind assistance to families which have lost their homes or have been forced to relocate as a result of the emergency. A total of 634 families benefited from in-kind assistance during the reporting period: 450 in the West Bank and 184 in the Gaza Strip. Since the beginning of the emergency programme, the Agency has provided a total of 1,631 tents, 102,762 blankets and 3,874 kitchen kits to Palestine refugees in the West Bank and Gaza Strip.

b. Post-Injury Physical and Social Needs Assistance
UNRWA provides physiotherapy and staff visits, as well as the cost of prosthetics and home adaptations for those suffering emergency-related injuries.

A total of 1,533 home visits were made between October and December. During this period, the Agency provided funds for 64 prosthetic devices to patients suffering injuries from emergency-related incidents in the West Bank. In the same field, home adaptations were undertaken on 78 houses to accommodate the needs of people with disabilities, and occupational therapists worked with 292 disabled persons in learning how to look after their daily needs unassisted, for instance with washing and feeding themselves, improving their motor skills and learning to adjust to new prosthetic devices. In the Gaza Strip, the Agency assisted 91 cases for post-injury care, the majority of these patients received assistance in their homes.

Emergency Shelter-Repair and Reconstruction

Military incursions, shelling, and armed confrontations have caused damage to and the destruction of refugee shelters in the oPt. UNRWA provides assistance to families made homeless by repairing or rebuilding shelters. In some cases, UNRWA assists the families with cash grants paid in instalments as the families carry out the work on a self-help basis, with technical advice and supervision provided by the Agency's engineers. In others, the work is undertaken by contracting companies under the supervision of the Agency's engineers.

The dramatic increase in shelter destruction observed in the third quarter of 2003 intensified, particularly during October. In the Gaza Strip, a total of 337 housing structures were completely destroyed and a further 675 suffered damage during Israeli military incursions. Most of the damage or destruction occurred in Rafah refugee camp. As a result of these actions, an additional 3,251 Palestinians joined the thousands of Rafah refugees who have already become homeless as a result of previous home demolitions.

Any humanitarian looking at the sheer number of innocent civilians who have lost their homes can only condemn Israel’s house demolition policy as a hugely disproportionate military response by an occupation army. The nearly 15,000 people whose homes and possessions have been ground into the sand by Israel’s bulldozers can hardly be blamed if they have come to believe that they are the victims of collective punishment.
Peter Hansen, Commissioner General of UNRWA

UNRWA now faces a bill of $42.5 million for the cost of its re-housing efforts in the Gaza Strip alone. As of 31 December 2003, approximately 14,000 refugees had been made homeless in the oPt since October 2000.

A total of six shelters sustained major structural damage and seven were demolished in the last quarter of 2003 in the West Bank.

Re-housing and Repair in Gaza

On 15 October, phases one and two of the Khan Younis Rehousing Project were completed providing 120 new dwelling units to refugee families. Ten days later work was completed on the reconstruction of 17 dwelling units in the Middle Camps, six dwelling units in the north area of Gaza Strip and seven in Rafah. By 31 December 2003, the Agency had re-built 288 shelters, accommodating 301 families, in the Gaza Strip since the crisis began.1 An additional 411 housing units are at various stages of construction and design.

The Agency also undertakes repairs to buildings that are damaged, but not completely destroyed. Since October 2000, UNRWA has undertaken structural repairs on 1,035 shelters. As stated above, the final quarter of 2003 saw a dramatic increase in the number of shelters suffering damage. No repair work could be undertaken during this period due to a shortage of funds.

Re-Housing and Repair in the West Bank

Since the events of April 2002 during “Operation Defensive Shield”, far fewer structures have been destroyed by the IDF than in the Gaza Strip. A total of 24 shelters with major damage were repaired during the final three months of 2003 in the West Bank. Work was underway on the repair of 18 shelters with major damage and another 45 that had been completely destroyed.

Jenin Rehabilitation Project

As of 21 January 2004, invitations to tender for construction of 276 of the 436 housing units that will ultimately be built had been issued. Architectural and engineering designs of 118 other housing units were under preparation. Designs are scheduled for completion by the end of March 2004. As of mid-January 2004, work on 63 housing units had been completed, and work on 61 others was in progress. Work on another 301 was ready to be tendered. All 436 housing units are due to be completed by September 2004. Of the 436 housing units, 211 will be built in the devastated heart of the refugee camp. Another 99 will be located on a 14,203m2 newly acquired plot of land. The remaining 126 housing units are located in 63 apartment buildings scattered about the camp.

Contracts for the road, water, storm water drainage and sewerage networks were signed on 8 September 2003. Work on the storm water drainage network, a wastewater trunk line and roads was 30 per cent complete by mid-January 2004. Work on the main wastewater trunk line began on 16 November, almost two months behind schedule, because the Nablus-based supplier was unable to manufacture the pipes required owing to IDF operations in the city. On 3 December 2003, work began on the sewerage network. A contract for the electrical network was signed on 15 December.

UNRWA’s Field Engineering and Construction Services Department in Jerusalem completed the detailed designs of a school, a Women’s Programme Centre, a kindergarten, and a community and youth centre. The designs and bills of quantities were forwarded to the donor, the Red Crescent Authority of the United Arab Emirates for review. Construction of these community facilities, which comprises Phase III of the project, is scheduled for March 2005.

The Israeli military occupation of major West Bank cities continued to result in serious access restrictions, and was the main source of problems in the Agency’s provision of emergency healthcare. Despite the difficulties, UNRWA continued to provide emergency health services to refugees in need.

In spite of UNRWA’s attempts to sustain the full immunization coverage attained prior to the crisis, access difficulties have had an adverse impact on immunization coverage in several localities including Jerusalem health centre, Amari, Hebron Town, Doura, Camp No. 1 and Silet Daher. This could ultimately lead to an outbreak of disease.

As a result of health-related needs arising out of the ongoing crisis, the Agency continues to employ supplementary medical staff to assist its operations in the health programme in the West Bank and Gaza Strip. Between October and December, 403 supplementary medical staff were hired, 121 in the Gaza Strip and 282 in the West Bank. These staff included physicians, nurses, midwives, pharmacists and various support staff.

Prior to the intifada, UNRWA’s hospital in Qalqilia provided care to a large number of refugees throughout the northern West Bank. The bed occupancy rate was 67.5 per cent. As a result of restrictions on movement, including curfews and closures and more recently the construction of the separation wall around the city, this rate has fallen to only 43.5 per cent. The number of patients from outside the city who are now treated in the hospital has declined from 38.6 per cent to only 16.7 per cent. Similarly, the number of surgical procedures performed has fallen from an average of 1,154 before the intifada to only 305 a year. The only positive outcome of this fall in the number of patients treated has been a reduction in waiting time for surgery, from five to six months previously to only one to two weeks. Beginning in October, so as to ensure better utilization, UNRWA began to refer patients in the region around Nablus in need of surgery or gynaecological care to the hospital, transporting them there by ambulance.

Upon receiving additional contributions to its emergency programmes, on 17 October UNRWA was able to re-negotiate lapsed contracts with hospitals in the West Bank to provide supplementary services to refugees unable to reach hospitals where the Agency normally arranges for services on their behalf.

UNRWA continued to cover a portion of the hospitalisation bills for patients who were in need of emergency care and could not reach hospitals with which UNRWA has contracts. In the last quarter of 2003, UNRWA helped 445 patients settle part of their hospital bills. In all, $104,734 in hospitalisation costs was covered. Some of the patients assisted were in need of emergency care. Premature infants, new-born babies with Respiratory Distress Syndrome, pregnant women at high risk, and the chronically ill such as patients with cardiac disease, who required extended stays in hospital, were also assisted.

Five mobile health teams operated in the West Bank during the fourth quarter of 2003, two serving villages in the district of Nablus, two others the villages around Hebron and the fifth in the vicinity of Jerusalem. In three months, the teams made 342 visits to isolated villages and saw 28,246 patients. They treated patients suffering from a wide range of communicable and non-communicable diseases, including diabetes, anaemia, osteoarthritis, and parasitic infestations, and provided first aid to those who had been injured in confrontations with IDF troops.

In the Gaza Strip, 64 new Intifada-related cases were admitted into Agency physiotherapy clinics and 896 treatment sessions were provided for these patients during the reporting period. In the West Bank, physiotherapists visited 283 patients in their homes to provide therapy and instruct their families in assisting them with their exercise regimes.

Tight restrictions on movement continue to result in deteriorating standards of environmental health in the oPt. In the West Bank, 718 loads of solid wastes were removed from Shucfat, Fawwar, Amcari, Tulkarm and Kalandia camps. In addition, the Agency was able to replace 300m of corroded water pipes in Aqabet Jabr Camp and lay more than 2,500m of drains in 15 camps across the West Bank.

In the Gaza Strip, 42 persons recruited under the Job Creation Programme, were tasked with health education and environmental awareness activities at schools and other public venues. A total of 1,176 labourers were employed within the Gaza Strip to provide sanitation services within the camps.

Psychological Support and Counselling

Under its emergency psychological counselling programme, the Agency assigns counsellors to schools and health centres throughout the oPt. Armed conflict, the tight regime of closure, poverty and prolonged curfews are the sources of acute psychological stress for Palestinians, both adults and children. The signs of stress – particularly with children – are readily apparent. The Agency provides a range of services aimed at promoting the development of constructive coping mechanisms for refugees in crisis situations and preventing long-term psychological consequences. Programmes targeting schools, health centres, social services and community based centres were underway throughout the reporting period.

In the Gaza Strip, projects aim to assist in psychological and psychosocial support of a population under stress. These employ 152 counsellors as well as five area school counsellors.

Group guidance activities in UNRWA’s Gaza Strip schools covered more than 77,000 children during the reporting period alone. These included sessions providing recreational activities and role playing exercises that enabled children to express their fears and anxieties. To ensure that support could also be provided in the home environment, more than 100 group meetings were held with parents of school children to help them deal with children suffering from trauma.

In the Gaza Strip support was also offered to refugees of all ages who had undergone trauma as a result of the current fighting. In many of these cases, Relief and Social Services counsellors, working in close cooperation with Agency social workers were able to conduct home visits. In other cases, personnel based in UNRWA’s health facilities were able to offer a range of group and individual interventions including a referral service for those requiring psychiatric assistance. In total, activities were undertaken according to the chart below.

In the West Bank outside of its education programme, 307 refugees, including 177 women, 71 men and 59 children met with one of the 14 mental health counsellors for a one-time consultation. Another 449 refugees met with the counsellors on a regular basis in 5,489 sessions. The 778 individuals who sought counselling included 325 children, 317 women and 136 men.

Counsellors conducted 128 group sessions with 3,240 participants. A total of 35 support groups with 334 participants were formed. Emphasis was placed on providing psychological support for adolescents.

Figures for the educational psychological support programme in the West Bank are shown in the following table.

Nine workshops on life skills were conducted for teachers, parents, school counsellors and school supervisors. Forty-two school counsellors, 157 teachers participated in 11 workshops designed to help them identify the signs of psychological stress and cope with stress. A three-day workshop on learning difficulties was conducted twice, with 54 teachers and school supervisors in attendance. Nine school supervisors took part in two workshops on crisis intervention. Seven consultants in the field of psychological health conducted 13 workshops for 234 employees of UNRWA, including doctors, nurses, social workers, teachers and school counsellors. One of these workshops was on the subject of trauma and abuse. Three-day workshops were conducted on four occasions for a total of 92 teachers and school counsellors. Seventeen doctors and nurses attended a workshop on the subject of psychopathologies prevalent among adults.


The crisis in the oPt has resulted in a major disruption in education at all levels, with students and teachers often unable to attend school because of closures and curfews. In addition to suffering academically, students have also witnessed events that have led to severe psychological trauma. When adequate funding permits, UNRWA provides remedial classes, extra-curricular and self learning activities in an attempt to counter the negative impact faced
by children.

Due to lack of available funds, all emergency education activities have ceased in the Gaza Strip.

In the West Bank the number of students enrolled in remedial classes went from 7,919 in October to 9,241 by the end of December, 4,951 of them in Arabic and 4,290 in mathematics. The number of teachers giving remedial lessons likewise increased, from 145 in October to 176 by the end of the year.

To complement the psychological support programme, recreational activities were offered in 10 schools in the West Bank during the quarter. In all, 413 children took part in activities that included arts and crafts, sports and computer training.

Vocational Training
UNRWA has been able to offer a limited number of vocational training opportunities to young people using its existing facilities. A computer-training course with 50 participants in two class sections at the Ramallah Men’s Training Centre began on 13 October. The course will run for three months, and those who successfully complete it will earn an International Computer Driving License. There was five times the number of applicants for the 50 available places.

A 40-hour training course on using a computer was offered at the Kalandia Training Centre. Twenty-five trainees completed the course on 10 November.

Operational Support

Throughout October to December, Operations Support Officers (OSOs) continued to focus on facilitating the transfer of food, medicines and other forms of humanitarian aid in both the West Bank and Gaza Strip. During the quarter the programme assisted UNRWA staff in gaining access into a number of areas under closure. In the Gaza Strip, this role was critical in enabling essential services to be provided to the population in IDF restricted areas such as Dugit and Al Mawasi.

In the West Bank OSOs focused their attention on the effects of the separation barrier on villages in its path, particularly the effects on the livelihoods and living conditions of refugees. During the course of 2004, UNRWA may need to alter its emergency response as a result of their findings. Their reports are available at

Obstacles Encountered

Strikes and work slowdowns by Israeli government workers that began on 29 September led to delays in clearing goods through customs. At the end of November there were 60 consignments held either in the port of Ashdod or at Ben Gurion airport awaiting customs clearance. Consignments of perishable goods such as food commodities and medicines, however, were cleared.

The IDF continued to enter UNRWA’s installations in the West Bank. On 24 October, IDF troops forcibly entered the Ramallah Men’s Training Centre. Soldiers took up positions around the campus, restrained the guards, and forced an employee to lead them through the dormitories. They inspected the identification cards of all 250 students boarding at the centre and arrested two of them. Around midnight on 13 November, IDF troops again forced their way into the Ramallah Men’s Training Centre.

Closures and curfews continued to disrupt UNRWA’s operations in the West Bank and Gaza Strip. In the West Bank during October, students in 20 schools lost 55 days in the classroom, and on average 59 teachers were absent each day that month. The next month, there was some improvement. Only 20 school days were lost and there were only 393 absences among teachers. In December, however, schools lost 108 days and teachers’ absences climbed to 1,606. In the three training centres, 298 absences among instructors were recorded during the quarter.

In the Gaza Strip 6,943 teaching days were lost in UNRWA schools and 935 in the Gaza Training Centre during the reporting period as a result of closures. Closures of commercial crossing points and key roads within the Gaza Strip also hampered the movement of staff and resulted in a shortage of construction materials affecting most of the Agency’s construction projects (including the emergency rehousing projects). During the reporting period more than 1000 staff members within Gaza Strip were unable to travel to or from their workplaces; in some cases this necessitated the provision of accommodation in Gaza City to essential staff.

UNRWA’s health services were likewise disrupted on account of movement restrictions. A total of 355 absences of staff were recorded in the last quarter of 2003. Health centres and points were unable to open on four occasions.

On average only 63 per cent of West Bank employees requiring permits possessed them in each month of 2003, far short of the number required if UNRWA is to operate efficiently. The short validity of permits, along with difficulties faced in having them renewed promptly, resulted in disruptions in the Agency’s operations and posed an administrative burden. On 10 December, UNRWA’s new director in the West Bank, Anders Fänge met with senior representatives of the Israeli Civil Administration to discuss the matter. By the end of the month the situation had improved as 84 per cent of employees needing permits held them.

The IDF continued to cause damage to UNRWA installations over the reporting period. In the Gaza Strip this included 12 installations, including schools and health centres, mostly in the south.

A. UNRWA Emergency Fact Sheet
B. Spreadsheets: pledges and contributions received, all appeals, as of 31 December.
C. Spreadsheets: expenditure report, 2003 Emergency Appeal; Combined expenditure report, earlier appeals.

1 This does not include the shelters rebuilt for Special Hardship Case families under the Emergency Job Creation component of the Appeals.
2 Please see additional information regarding the psychosocial programmes offered under Health and
Relief and Social Services on pp 9-10 of this report.

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