Health and Nutrition
Chronic malnutrition in children under five has now increased to almost 10 percent from 8% in the year 2000– meaning that close to 100,000 children have not grown to the normal height for their age, and will never be able to make up the deficit. Currently, professional health staff in health facilities are not equipped to deal with the psychosocial issues of very young children who suffer from distress or post-traumatic stress. Basic equipment for maternal and newborn health is lacking, meaning that the quality of health services is declining. Maintaining the country’s Polio-free status as well as sustaining high immunization coverage rates has been a real challenge. Most recently, outbreaks of rubella and mumps have been reported in several heavily-populated areas in the West Bank, requiring urgent control measures to avoid further outbreaks. An integrated approach to managing common childhood illnesses has been recognized as an appropriate response towards ensuring the health and well being of the Palestinian children in oPt.
The major issues of concern at this time is to ensure full access to education services for Palestinian children and guaranteeing that the quality of learning is high and provided in a child-friendly environment. Access to education continues to be challenged by restrictions of movement, in particular for the teachers. The quality of education is showing signs of decline and in the worst affected areas, the learning achievements for students are deteriorating. Few children have the opportunity to experience a child-friendly learning environment with safe spaces and opportunities for sports and recreation. In addition, children lack educational materials and schools lack good teaching aids. While the child-friendly school concept is being promoted throughout oPt, the concept is challenged in particular in confrontational areas. In these areas it is necessary to adapt the child-friendly school concept to learners’ needs and link with psychosocial and child protection services, while ensuring outreach to local communities.
Adolescents have limited opportunities to play and exercise in safe areas. Close to half of the children in West Bank and Gaza spent very limited time on extra-curricular activities such as sports or playing outdoors. The expansion of the West Bank barrier has exacerbated this situation, and has reduced access for NGOs, UN agencies and others. Overall, young Palestinians spent their spare time at home and fewer girls get opportunities to interact with peers outside their homes. Violence in the lives of adolescents is on the increase – both at home and in school. There is now, more than ever, a need to create safe and friendly spaces to foster opportunities for play and exercise.
Psychosocial Well-being and Child Protection
The level of conflict-related violence has decreased since the start of the year, particularly in Gaza. However, after more than four years of conflict and continuous violence, children are still living with distress and continue to be vulnerable. The chronic anxiety, undermined self-esteem and feelings of loss of control being felt due to the erosion of households’ coping mechanisms adversely affect family relationships. The violence in homes and schools is an issue of growing concern and closely linked with the surrounding pressures stemming from the external environment. The threat of unexploded ordinance (UXO) is augmenting and has become an issue of more concern within the last few months. This is due to the fact that children now have access to areas they could not reach before and are therefore increasingly being exposed to these life threatening devices. Three children were killed and 13 injured by UXO in the first four months of this year alone.
As of June 2005, there are 330 Palestinian children in Israeli detention, of which seven are girls. Extensive use is made of pre-trial detention. Since the beginning of 2005, 31 children have been killed due to the conflict – compared to 82 for the same period last year.
2. ACTION FOR CHILDREN
UNICEF’s humanitarian action is based on our Core Commitments for Children (CCC) and focuses on child survival, nutrition, ensuring that children are able to continue learning despite schooling being disrupted and catching up once schooling resumes. Children receive psychosocial support after occurrence of violent events and receive follow-up support for themselves and their caregivers. Safe spaces are created for children and adolescents to meet with their peers and to enjoy recreational and sports activities.
UNICEF works in close collaboration with UN agencies and other partners, including OCHA, UNDP, OHCHR, WHO, UNSCO, UNESCO, UNFPA, UNRWA as well as international and local NGOs, under the overall framework of the LACC (comprising all donors, UN Agencies and PA) as well as OCG West Bank and Gaza. UNICEF’s recent involvement in the sector coordination mechanisms, like sector working groups (health, education) and thematic groups (nutrition, management information system and public information) will contribute to this. Formal and informal networks such as: HealthInforum and the EU informal group on humanitarian policy will also be used to strengthen the links with UN Agencies, NGOs and civil society.
In the West Bank, UNICEF focuses on five main areas: Jenin, Tulkarem, Qalqiliya, Nablus and Hebron. In the Gaza Strip the focus is on three flashpoints: Rafah, Khan Younis and Northern Gaza. In addition, three other areas (Al Mawasi, Siafa and Al Ma’Ani) are of key concern because of their isolation. The UNICEF zonal offices in Jenin, Tulkarem, Nablus, Hebron, Rafah and Gaza ensure assessment, swift response and monitoring of humanitarian assistance. UNICEF has a total of 11 international and 59 national staff on the ground in OPT.
All vaccine and vaccine-related supplies needed for 2005 and the first quarter of 2006 have been procured and delivered to the Ministry of Health (MOH) warehouse. Two rounds of a sub national Polio mop-up campaign were launched on 9 April and concluded in May for immunization of some 80,000 children under five, representing 100% coverage. To respond to an outbreak of rubella and mumps and to ensure sustainable control of vaccine-preventable diseases, a supplementary immunization campaign against measles, mumps and rubella was launched. As a result, more than 653,000 children between 6-18 years have received the vaccine in all the 10 districts of the West Bank over a period of three weeks in May. The Gaza portion of the campaign will be commenced once schools reopen in September.
Supplies and equipments for upgrading maternal and child health services were delivered in order to provide an extended range of front line health services in Gaza. Training of trainers was undertaken for 30 health professionals in Gaza and the West Bank to introduce the psychosocial components for addressing psychosocial problems of very young children. This is the first time that a psychosocial component is introduced in the Integrated Management of Childhood Illnesses (IMCI) and will ensure fast detection and immediate response by health professionals to help younger children. Action on iodine deficiency disorder (IDD) includes advocacy, awareness raising and capacity building of key ministries and amendments on salt iodization legislation.
UNICEF has pre-positioned emergency health supplies in Gaza to ensure swift responses to childhood illnesses and emergency health interventions, including Emergency Health Kits for 210,000 for one month (i.e. for half of the identified vulnerable population), midwifery sets and obstetric care kits, and 1,250 Safe Water Kits for 6,000 families. Medical staff have been trained in order to better detect and respond at both community and health facility levels.
UNICEF has positioned emergency educational supplies in Gaza to ensure continued learning. 450 school in a box kits (serving 36,000 students) have been pre-positioned or distributed containing basic teaching aids for language and science and mathematics, including exercise books and school supplies. An additional 900 kits (for 72,000 students) are on their way for both Gaza and West Bank distribution. In addition, 225 teaching kits were distributed in Gaza and associated training was organized for 100 teachers in 20 primary schools to facilitate teaching and learning processes and to ensure that quality learning continues. UNICEF has ordered 750 recreation kits to serve 67,500 children for extra curricula activities and for input in programmes to reduce psychological stress.
UNICEF’s remedial education in West Bank and Gaza has so far helped 90,000 children to continue their education despite regular interruptions to their schooling. In addition, 75,000 remedial worksheets in the four main subject areas of Arabic, English, Math and Science for Grades 1-3 and 30,000 copies for Grade 5 are in the process of being printed for distribution in September when the new school year starts. In addition, 4,800 remedial worksheets on CD-ROMs are being produced. Some 200 parent meetings were held in 17 districts to introduce and gain parental support for remedial education activities. This helped to clarify the role of parents and the workshops provided very positive feedback on the usefulness and importance of the worksheets. Workshops for teachers on the use of remedial worksheets were started in six districts. In May, Road Safety training was provided as part of a three-day workshop for 35 participants in Ramallah.
One national and six district 10-day training workshops (three hours per day) were held for 800 teachers of the 32 new Child Friendly Schools in the West Bank and Gaza. The purpose of the workshop was to train the teachers with the newly developed Training Manual on the Child Friendly School (CFS) concepts and required practice in making schools child friendly. The Child Friendly Cities (CFC) initiative includes making minor infrastructure repairs to windows, walls, and playgrounds. This is implemented through the joint co-operation with UNDP.
As part of the Child Friendly Cities Initiative, 20,000 children were given access to recreational activities in eight safe play areas in Gaza. In the West Bank, the development of four new play areas is ongoing and in Gaza 15 Alternative Safe Play Areas are being established, of which four are already active. Animators and volunteers from each community are currently being trained to ensure the provision of regular activities in each of the sites. Sports competitions have also been launched in 172 schools allowing some 6,500 boys and girls to participate in weekly sports programmes. Sports and recreation help adolescents to relieve their stress and are an important strategy towards mitigating the damaging effects of violence on children. To this end, 70 Sports for Development clubs in the West Bank and Gaza were established – providing three activities 10 times per week for 150 adolescents each. Promoting adolescents’ positive participation in their communities, over 12,000 boys and girls went to the polls to elect two Children’s Municipality Councils in Tubas and Nablus. Girls made up 50% of the voter turn out which saw the election of 66 boys and girls as council members. In Khan Younis and Hebron, 20,000 boys and girls went to the polls to participate in primary elections.
Psychosocial and Child Protection
From January to end-June, 9,000 children in the Gaza Strip and the West Bank attended debriefing sessions with the teams of trained psychologists and social workers, aimed at reinforcing their capacity to cope with distress.
Working in parallel, 5,000 parents attended sensitisation sessions in the Gaza Strip and West Bank. All of them were equipped with basic skills on how to detect signs of distress among children and to provide increased care and protection. Parents also learned how to manage their own stress in crisis situations. The psychosocial teams, often working under challenging circumstances, carried out 41 home visits in Gaza to bring support to injured children and their families. Cases requiring specialized services were referred. In order to anticipate a changing situation in Gaza, the teams have gradually started to introduce issues of abuse in homes and schools in their sessions with parents and children. Furthermore, 72 university students were qualified through an intensive professional training course to become peer counsellors for adolescents. Following the training, the university students started a series of peer to peer psychosocial support sessions whereby over 1,000 adolescents will be provided with opportunities to relieve their stress and frustration, learn stress management techniques and express their opinions and concerns.
UNICEF, in cooperation with the National Mine Action Committee (NMAC), the Palestinian Broadcasting Corporation and the EU Co-ordinating Office for Palestinian Police Support EUCOPPS, launched mine risk education activities, including a public awareness campaign. Special attention was given to high risk areas, particularly those surrounding Israeli settlements. The action aims at making children and families aware of the dangers of explosive ordinance through participatory means. Educational materials have been distributed, interactive TV programmes show animated films, and art competitions and awareness raising sessions are undertaken in newly created safe play and recreation areas in Gaza.
3. 2005 APPEAL REQUIREMENTS AND RECEIPTS
UNICEF’s appeal for US$ 12,720,884 in the Humanitarian Action Report 2005 has been increased to a total of 14.2 million, in order to meet children’s needs in health and nutrition, education, and psychosocial support. To date, some US$ 5.1 million1 has been received against the old appeal (40%) as follows: