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Source: Office for the Coordination of Humanitarian Affairs (OCHA)
17 December 2008

Following the resumption of violence on 4 November 2008, Israel has intensified to an unprecedented level the blockade on the Gaza Strip, imposed in June 2007. The 18 - month long blockade has created a profound human dignity crisis, leading to a widespread erosion of livelihoods and a significant deterioration in infrastructure and essential services. The consequences for the Palestinian population are profound, pervasive and difficult to reverse.

The functioning crossings (Kerem Shalom, Nahal Oz and a conveyor belt next to Karni) have remained closed on most days since 5 November, with only limited quantities of food, industrial fuel, animal feed and a few other essential items, allowed in erratically. An average of six truckloads has been allowed into Gaza per day through the end of November – down from an average of 123 in October 2008 and 475 in May 2007.

The daily lives of most of 1.5 million Gazans are increasingly consumed by completing the most basic tasks, such as collecting and storing clean water, and searching for food, fuel and other essential supplies. Many have reported a growing sense of being trapped, physically, intellectually and emotionally.

The impact of the blockade is further exacerbated by the freeze of investments in developmental projects aimed at ensuring the functioning of services and infrastructures, as well as by the rift between the Palestinian Authority in Ramallah and Hamas in Gaza.

The blockade since June 2007:
    • The closure of Karni, the largest commercial crossing
    • The suspension of all exports and most industrial/non-humanitarian imports
    • A severe reduction in the amount of fuel allowed entry
    • A ban on movement of Palestinians through Erez, the sole passenger crossing with Israel and the West Bank.
    • An almost total closure of the Rafah crossing point, the only crossing point with Egypt.
    • A reduction in the sea area in which Palestinian fishermen can access

Key Points:

The electricity demand in the Gaza Strip is estimated at an average of 237 MW (megawatt); 51% of which (122 MW) is purchased from Israel and another 7% (17 MW) from Egypt. Gaza’s sole power plant can currently produce, at full capacity, approximately 34% of the demand, leaving an 8% electricity deficit.

In November 2007, following the designation of Gaza as a ‘hostile entity’, Israel began reducing the amount of fuel allowed into Gaza, including the amounts of industrial fuel used for the operation of the power plant. Since then, the plant can operate at 75-80% of its capacity (65 MW), thus expanding the electricity deficit to approximately 15%. On a number of occasions in the last 18 months, including during the latest intensification of the blockade, the power plant has been forced to shut down completely, resulting in power cuts across the Gaza Strip, lasting for up to 16 hours per day in Gaza City.

Prolonged periods of shutting down, lack of spare parts and poor maintenance severely threaten the working life of the plant. With spare parts delayed in Israel for many months, engineers have resorted to using car batteries in an effort to keep the plant functioning, at risk of severely damaging the plant’s turbines.

Key points:
The power outages, coupled with the severe shortage of fuel and spare parts for back-up generators, have disabled part of the water and sanitation system. About 80% of Gaza’s water wells are currently functioning only partially and the remaining are non-functional. As a result, over half of the population of Gaza City is having access to water only several hours once a week. 1

While the shortage of fuel is directly linked to the blockade, the problem has been compounded since late August 2008, due to a conflict between the Palestinian Water Authority (PWA) in Ramallah and Hamas in Gaza. As a result, the funding allocated by the PWA to buy fuel for water and sanitation facilities in Gaza was suspended.

In addition to the intermittent water supply, a lack of synchronization between water and electricity supply has left many people living in multi-storey buildings without water at all, as they depend on electrical pumps.

Almost no new infrastructure for the water and sanitation system has been constructed or expanded since the imposition of the blockade in June 2007. Much needed maintenance is impeded by a lack of pipes, spare parts and construction materials. The resulting degradation of the system is posing a major public health hazard, likely to result in an increase in morbidity rates and impede overall socio–economic development in the long run.

Eighty per cent (80%) of the water supplied in Gaza already does not meet the WHO standards for drinking. The shortage of chlorine used to disinfect water following the tightening of the blockade has increased the risk of an outbreak of waterborne diseases.

The practice of discharging untreated and raw sewage into the sea (about 70 million litres a day) has resulted in significant environmental damage, including to marine life.2 In addition, the precarious situation of the waste water system increases the risk of flooding during the winter season and other related health hazards.

Experts estimate that further salinization and pollution of the aquifer will be irreversible. To prevent this scenario from materializing, large scale infrastructure projects, such as the construction of a desalination plant and the artificial recharge of the aquifer, must be urgently implemented.

Key Points:

The blockade has had a destructive impact on the livelihoods of Gaza’s population. Unemployment (relaxed definition) rose from 32.3% in the second quarter of 2007 to an unprecedented 49.1% in the same period of 2008. 3 The forced unemployment of over 100,000 persons, willing and able to work, is one of the key factors in this human dignity crisis.

Already in 2007, more than 79% of Gaza’s households lived below the official poverty line (4 US$ per capita/day) and almost 70% below the deep poverty line (3US$ per capita/day), these poverty figures exclude remittances and food aid. These figures are expected to rise in the coming months. Prior to the blockade, more than 54% of employment in Gaza was private sector-driven. Manufacturers in Gaza imported 95% of their inputs; about 76% of their furniture products, 90% of their garments and 20% of their food products used to be exported to Israel, and some to the West Bank. The Palestinian Federation of Industries estimates that currently only 23 out of 3,900 industries are operating and 34,000 workers in the industrial sector have lost their jobs.4

Approximately 40,000 permanent and temporary jobs have been lost in the fishing and agricultural sectors. A lack of spare parts and fuel, the IDF restrictions on access to the sea, and the degradation of marine life as a result of the discharge of raw sewage into the sea, are among the main factors affecting the fishing sector.

The ban on exports and lack of essential inputs have paralyzed large parts of the agricultural sector. FAO reports that 70% of agricultural lands in Gaza are no longer being irrigated. This has triggered a gradual process of desertification. Moreover repeated Israeli incursions into Gaza have damaged land, crops and equipment and rendered large agricultural areas located in the so-called Buffer Zone (areas adjacent to the border with Israel), off-limits to Palestinians. A shortage of animal feed and cooking gas used for heating, has led some chicken hatchery owners to destroy their birds en masse.

According to the Palestine Trade Center, for any sort of economical revival to start, exports should resume immediately and a minimum of 850 truckloads of market-triggered imports per day should be allowed in.

A lack of cash allowed into Gaza is affecting the flow of money, leaving beneficiaries of humanitarian organizations, PA employees and pensioners unable to collect their salaries, pensions, and welfare payments in cash. Beyond immediate hardship, this phenomenon may have longer term consequences, including the collapse of the system following a run on banks due to lack of confidence.

Due to the blockade, an alternative “tunnel economy” has developed along the Egypt-Gaza border, largely regulated by Hamas. While the tunnels have provided access to otherwise unavailable commodities and allowed some economic activities, they constitute a very precarious and unsustainable mechanism, which by no measure can substitute the normal functioning of crossings.

Key Points:
The lack of income, compounded by the global inflation in food prices, has had a significant impact on the food security and nutrition level of the people. Accordingly, despite the large inflows of aid, a UN survey covering the first quarter of 2008 shows that 56% of Gaza’s population is food insecure, up from 53% in 2006. 5 This means that about 45,000 Gazans have become food insecure since 2006 and are in need of food assistance.

The average Gazan household now spends two thirds of its income on food.6 The latter is the combined result of the severe erosion of livelihoods with a steady increase in food prices.7 The price of red meat and chicken, for example, has risen from 40 and 8.5 NIS/kg in October to 60 and 12 NIS/kg in November respectively making it no longer affordable for many people. Dairy products and some fruits and vegetables are in short supply.

The analysis also reveals that a reduction in the quantity and quality of food constitutes one of the main coping mechanisms used by the population. In that framework, there has been a gradual shift in the diet of Gazans from high-cost and protein-rich fruit, vegetables and animal products to low-cost and high-energy cereals, sugar and oil. This change is likely to be reflected in increased rates of micro-nutrient deficiencies, with children and women of child-bearing age being the worst-affected.8

Key Points:
Hospitals and health clinics continue to function, however the quality of services and their accessibility are severely affected by the blockade, the lack of investment in development and the internal Palestinian rift.

Most hospitals and health facilities have had to rely extensively on back-up generators to ensure the provision of medical services during long power cuts. This is a precarious and unsustainable solution, as generators are not designed to function for prolonged periods of time. Power cuts and water impurities have caused damage or mal-functioning of medical equipment. The situation is further compounded by the lack of maintenance and spare parts due to the blockade. As in other sectors, the lack of building materials and inputs continue to prevent the repair and/or expansion of health facilities and infrastructure.

The rift between the Palestinian authorities in Ramallah and Gaza, including the strike in the health sector, which started on 30 August on the background of that rift, has also contributed to the deterioration in the quality of health services. A recent WHO study showed that, the number of admissions to hospitals decreased by 18% in September 2008 (compared to the parallel period in 2007); out-patient admissions by 34%; surgical operations by 32%; and consultations at PHC clinics by 19%.9 Furthermore, since the Ministry of Health (MoH) in Ramallah assumed responsibility for the supply of pharmaceuticals to Gaza in September 2008, only three truckloads of drugs from the MoH have reached the Central Gaza Drug Stores. As a result, 20% of essential drugs are currently at zero level (less than one month stock).

Other ramifications of the blockade include the total inability of medical staff to update and upgrade their knowledge and skills and participate in vocational training, as a result of the travel ban. Like in other sectors, the lack of building materials and inputs has prevented the implementation of projects aimed at expanding or repairing the physical infrastructure of the health facilities.

Many patients are referred for specialized care to hospitals in Israel, Jordan and Egypt because the skills and/or equipment are lacking in Gaza. The number of patients exiting Gaza through Erez has increased since the Rafah crossing was closed in June 2007. However, the proportion of patients who have not been able to cross because their permits have been denied or delayed by the Israeli authorities has increased substantially, from 9.8% in 2006 to 22.5% in the first nine months of 2008. In total, there are 2,691 patients, suffering from cancer, heart disease and other severe conditions, who have been unable to get the treatment they need.

With an ongoing shortage of drugs, non-functionality of medical equipment, scarcity of specialized medical staff and restrictions on referrals outside Gaza, patients with chronic illnesses (such as cancer, or diabetes) cannot be adequately treated or cared for.

1Information provided by Gaza’s Coastal Municipalities Water Utility (CMWU).
2OCHA, Gaza Strip Humanitarian Situation Report : Impact of Fuel Shortages on Gaza Sanitation – Polluting the Sea, 29 April 2008.
3Palestinian Central Bureau of Statistics (PCBS), Labour Force Survey Q1, Q2, 2008. The ILO definition of unemployment includes persons (15 years old and above) who do not work and are actively seeking a job. PCBS’s “relaxed definition” adds to this definition people willing to work but currently not engaged in active job search (known as ‘the discouraged’).
4World Bank, Palestinian Economic Prospects: Aid, Access and Reform, Economic Report to the Ad Hoc Liaison Committee, September 2008
5WFP/UNRWA/FAO, Joint rapid security survey in the occupied Palestinian territory, May 2008.
7Between January and April 2008 the Consumer Price Index for food in Gaza has risen by 23% (PCBS).
8WFP/UNRWA/FAO, Joint rapid security survey in the occupied Palestinian territory, May 2008.
9See WHO, Gaza Health Workers’ strike, impact of the strike on health services provision, August – November 2008.

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