With the occupied Palestinian territory (oPt) in its fiftieth year of occupation, the major drivers of humanitarian vulnerability remained unchanged during 2017. Humanitarian assistance is required by an estimated two million people, including 1.2 million refugees, mostly in the Gaza Strip, and in the West Bank Area C and East Jerusalem. In 2017 alone, up to 31 March, 321 individuals, including 184 children, had been displaced in the West Bank as a result of demolitions. Forty-six communities in the central West Bank (a combined population of approximately 7,000, of whom 70 per cent are Palestinian refugees) are at risk of forcible transfer due to Israeli plans to 'relocate' them; this constitutes a grave breach of the Fourth Geneva Convention. In the Gaza Strip, a critical lack of fuel is causing blackouts of up to 20 hours per day. Health facilities face having to close operating theatres and hospital departments, potentially endangering the lives of patients. Meanwhile, 46% of permit applications to exit Gaza through the Erez crossing to access health care were delayed or denied in the period of Q1 2017. Overall, the context remains that of a protracted protection crisis driven by a lack of respect for international law, the systematic denial of Palestinian rights and a lack of accountability for violations.
OVERVIEW OF THE CHANGES IN THE CRISIS
Affected so far in 2017
Power cuts have reached a critical point of 16-20 hours per day and affect health care provision by the Ministry of Health (MoH) and the NGO sector. It is estimated that 210 patients in intensive care units and 650 patients requiring hemodialysis are at risk if the electricity supply were to shut down completely. The top five specialties needed for Gaza patients are oncology, hematology, ophthalmology, heart catheterization and pediatrics.
The cumulative impact of prolonged occupation and ten years of blockade fuel despair, increase psychological distress and put pressure on the population, exposing vulnerable groups such as women and children to GBV, and pushing households toward negative coping mechanisms such as school drop-out and child labour. The ongoing blockade of the Gaza Strip affects all 583,398 basic, secondary and kindergarten students. The 4,517 students who attend the 13 schools in Access Restricted Areas (ARA) continue to endure Israeli military incursions, crossfire and activities by armed Palestinian groups.
Of 22 HRP WASH projects covering Gaza, only 1 project has received funding during Q12017, leaving 70,000 people at risk due to the severe shortage of drinking water. Over 37,000 people remain displaced due to the destruction of their homes in 2014 and delays in reconstruction. There is a severe and immediate lack of funding for Temporary Shelter Cash Assistance (TSCA) to support these families in their ongoing displacement.
Reconstruction of agricultural productive assets damaged during the 2014 conflict is proceeding at a slow pace and there are still at least 140 non-functioning licensed water wells and approximately 210 completely destroyed greenhouses. High unemployment rates (more than 40%) clearly reflect the difficulties of the overall economic environment, including agricultural production, although exports of agricultural goods improved over the same quarter of the previous year. Dependency on humanitarian aid is high, especially for food assistance, both in kind and through e-vouchers. Israeli enforcement of the arbitrary 'dual-list' continues to limit certain productive activities. Access restrictions by Israeli forces in the ARA, on land and at sea, continue to result in civilian casualties and hinder access to livelihoods.
The expansion of settlements, which are illegal under international law, continues in a framework of impunity and Palestinians in Area C, H2 and EastJerusalem are at risk of forcible transfer. There are ongoing concerns about the arrest of children by Israeli forces in East Jerusalem; at least 136 children have been arrested and/or detained. The Palestinian Authority continues to have only limited access to schools and students in Area C(48,258 students) and EastJerusalem (68,277 students). Students in these areas face the risk of forcible displacement, demolitions and a shortage of school infrastructure, particularly in the Bedouin communities of Khan al Ahmar, Jabal al Baba, al Mintar, Khirbet Tana and Massafer Yatta. Students in remote communities often have to walk up to 10 kilometers to and from school.
None of 11 HRP WASH projects covering the West Bank has received funding during Q1 2017 and some Area C communities may face greater difficulties in accessing drinking water, particularly during the summer. Demolitions of livelihood assets in the West Bank pave the way for the forced displacement of herders and farmers in Area C. Without well-tailored and timely support, communities dependent on livestock and crop production in Area C are less likely to sustain themselves under these conditions. The legal status of many communities, particularly those faced with legal injunctions, makes it increasingly difficult to provide humanitarian assistance despite the urgent need for shelters to be upgraded.
Over 31 highly vulnerable communities in Area C are without access to primary health care services, and in the coming months a further three clinics in Massafer Yatta will close due to lack of resources by health cluster partners. These localities often have a high prevalence of high-risk pregnancies, chronically malnourished children and non-communicable diseases. Without access to primary healthcare services, the community faces major health threats.
ACCESS TO HEALTH CARE - GAZA
DEMOLISHED STRUCTURES IN WEST BANK
• Protect the rights of Palestinians under occupation in accordance with International Humanitarian Law (IHL) and International Human Rights Law (IHRL)
• Ensure acutely-vulnerable Palestinians under occupation in the Gaza Strip and the West Bank have access to essential services
• Strengthen the ability of acutely-vulnerable Palestinian households to cope with protracted threats and shocks
SITUATION OVERVIEW AND ANALYSIS
· Around 33,000 individuals subjected to demolition/eviction orders were provided with legal support.
· Cluster partners provided 104 field briefings to diplomats on a range of protection concerns.
· GBV sub-cluster established case management SOPs and referral pathways in Gaza.
· Child protection services were delivered to 1,434 children and 2,063 caregivers, including life skills and parental care.
· In the West Bank, including East Jerusalem, structured psychosocial support was provided to 5,231 children (3,109 boys and 2,122 girls) and 2,478 adults (1,274 women and 1,204 men). The MHPSS working group has begun mapping all actors by locality in each governorate to harmonize coordination efforts, and avoid overlaps and gaps in service provision.
· Lack of funding for GBV projects and the resulting lack of progress in GBV targets poses challenges in reaching GBV survivors.
· Providing coordinated multi-sectoral services to GBV survivors as the response is fragmented in the West Bank.
· Increasingly restrictive environment for humanitarian and legal assistance.
· Legislative measures to annex the West Bank and allow the retroactive confiscation/seizure of private Palestinian land; and the appointment of settlers to the Israeli Supreme Court.
· Growing need for legal services due to the increase in punitive measures.
· Targeting men for psychosocial support and child protection awareness, mainly due to perceptions that this is seen as a purely female domain, especially in Gaza.
· Agricultural livelihood activities have very little to report given the lack of funding for 2017 projects.
· With 1.4 million people reached, yearly food assistance targets are on track, but the flow of funding must be sustained. Food assistance is an ongoing process and the fact that 100% of beneficiaries were served in Q1 does not imply that the goal for 2017 has been achieved. In fact, current funds cover only 22% of total yearly needs.
· Cash-based activities continue to be an important resource for addressing high unemployment. Approximately 20,000 people from Gaza and the West Bank have benefitted so far this quarter, representing roughly 13% of the total yearly target.
· To date, all funding ratios are lower than Q12016.
· The negative trend of inadequate funding for agricultural and livelihood-based activities has continued into 2017 with less than 1% of the total budget covered, representing a funding gap of 99%. Humanitarian assistance is critical to protect and support vulnerable livelihoods, avoid a further deterioration in the resilience of communities and to mitigate negative coping mechanisms.
· At the end of the 1st quarter, 22% of the funding needed for 2017 had been secured. This includes activities such as food in kind and e-voucher support. Funding for the overall yearly target should be provided in a timely manner to avoid an interruption in service delivery. Assistance through food and cash-based programmes is still required as only 8% of the funding needed for cash-based programmes has been provided to date.
· Funding shortages in this quarter have forced agencies providing food assistance to reduce their basket to maintain the target number of beneficiaries. WFP has reduced its voucher entitlements by 20% to 180,000 people in both Gaza and the West Bank, and also reduced food rations to 140,000 Palestinians in both regions. As of April 1st, WFP will not have sufficient resources to continue its food and voucher assistance with the Ministry of Social Development beyond June in Gaza, and July in the West Bank. WFP urgently needs US $19million to provide uninterrupted food assistance to all people in need, including US $13 million for beneficiaries in Gaza.
SHELTER AND NFI
· Rehabilitation and upgrading of 137 substandard shelters in south Hebron and Jordan Valley.
· Response to all demolition cases in EastJerusalem and Area C by providing material or cash assistance, alongside continued innovation by partners and the introduction of new mechanisms to work in the areas most at risk.
· Depopulation of caravans and closure of TDS sites in Gaza through HF support to 176 families with TSCA.
· 5,300 families received winterization assistance in Gaza.
· 250 FHH and 120 households with PWD benefitted from assistance to protect against harsh weather conditions and to improve living conditions.
· Assistance was delayed in 8 demolition response cases in Q1 due to the complex legal situation and the high-risk environment.
· High number of demolitions in East Jerusalem (56% of shelter-related incidents in 2017).
· Two and a half years on, 37,000 people in Gaza remain displaced due to the destruction of their homes in 2014 and require temporary assistance.
· Lack of funding for TSCA for all non-refugee displaced families and for Q2-4 2016 for refugee cases.
· Restrictions on imports of generators and blast film are delaying the completion of Designated Emergency Shelters (DES) adaptation projects.
· Lack of funding for 2017 projects prevents progress in the majority of cluster targets.
· Some 14,854 people benefitted from one project conducted in Bani Suhailah in Gaza to minimize the risk of flooding during winter.
· Lack of funding is putting around half a million people in Gaza and the West Bank at further risk due to the lack of predictable WASH-related humanitarian assistance support.
· Around 70K in Gaza and 90K people in the West Bank are urgently in need of drinking water.
· 120K people in Gaza need material support for sanitation.
· 14K in Gaza and 5.5K people in the West Bank need hygiene material support.
HEALTH AND NUTRITION
· 32,103 beneficiaries living in Area C only have access to basic primary healthcare services through mobile clinics as there are no alternative facilities for these communities.
· 13,500 pregnant and lactating women in Gaza were given essential supplements.
214 people with disabilities in Gaza were provided with rehabilitation services and adaptive devices.
· The Health Cluster produced monthly reports, with case studies, on access to health and the barriers facing patients in Gaza. In February a legal seminar on the Right to Health targeted the legal and human rights community.
· The Health Cluster publicized the impact of fuel shortages on essential health services in Gaza, particularly for neonatal intensive care units, intensive care units and dialysis units. · The Health Cluster supplied fuel to maintain essential services in Gaza up to the end of March 2017.
· In February the Health Cluster team organized workshops with partners to establish a 24-month work plan, in agreement with the MoH as the Cluster co-chair.
· Israeli permits, without which many mobile clinics cannot access targeted villages and communities in Area C such as Arab Ramadin in Qalqilia, which is located behind the checkpoint between Qalqilia city and Bartaa (in Jenin). UNRWA mobile teams face similar issues. There is a growing concern that access for mobile health clinics to Area C is increasingly being restricted.
· Funding shortages have led to the closure of essential PHC mobile clinics, affecting over 31 vulnerable and isolated communities in Area C who have no alternative primary health care facilities. In the coming months, further mobile clinics operating in Masafer Yalta, south of Hebron, will also be closed. These clinics provide essential vaccinations for children, antenatal visits for high-risk pregnancies, and treatment and follow-up for chronic patients.
· In December 2016, a primary health care (PHC) caravan was confiscated by the Israeli authorities in the community of Mirkez, along with two similar caravans, which were issued with stop-work orders, in Isfey al Fauqa and in Kirbet al Majaz. These clinics provide level two basic primary health care services that would not otherwise be accessible. The mobile clinic confiscated in Massafer Yatta by the Israeli authorities is yet to be returned.
· The fuel crisis in Gaza continuesto undermine health services. On 14 April 2017, the Gaza Power Plant was shut down due to lack of fuel and the MoH has no funds to procure the fuel needed to operate hospital electricity generators. Interruptions to the electricity supply can be fatal in hospitals where patients rely on electrical medical equipment. Some 210 patients in intensive care units and 650 patients under hemodialysis are at direct risk if the electricity supply shuts down completely.
· During electricity cuts, diagnostic and dental services are forced to halt in 26 of the 49 MoH primary health care facilities without a generator. A further 16 PHC facilities will also have to halt their services during electricity outages as their stocks of fuel will be depleted within few days. Services in 13 NGO hospitals are limited and they operate only when electricity is available via the main supply.
· Access to education was facilitated in high-risk locations in the West Bank, particularly Area C, by providing a protective presence to 3,634 children and 376 teachers on their commute to and from schools.
· 3,153 parents, teachers and students in 49 schools benefitted from legal aid and awareness-raising sessions.
· 17,808 students in 49 schools were provided with stationery and other school materials.
· 1,593 students received psychosocial support interventions.
· in the West Bank, the harassment of children on the way to school by Israeli soldiers and settlers continues to be of concern. Military ordnances placed by Israeli soldiers sometimes prevent protective presence partners from entering areas where children and teachers are exposed to the greatest risks. Security-related incidents have also affected school infrastructure in Area C and in areas close to settlements, while recent demolition orders put children in Area Cat risk of losing their access to education.
· The primary challenge in Q1 2017 has been funding gaps which have a detrimental effect on the implementation of planned activities. So far, Gaza has not received any funding under the HRP although its needs are the greatest.