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United Nations Children's Fund (UNICEF)
27 January 2009
Preparing for children in emergencies
TERRITORY IN 2009
Since 27 December 2008, Israel’s military offensive on Gaza has exposed the already vulnerable population to even more physical and psychological damage. As of 18 January 2009, 1,300 people were reported dead, more than 410 being children. Over 5,300 people had been wounded and some 38,000 people were seeking shelter from the violence in 41 United Nations Relief and Works Agency (UNRWA) centres. Basic services had almost completely collapsed. Children account for some 56 per cent of the population of Gaza and they carry the brunt of the suffering. Health, education, water and sanitation, and psychosocial needs are at critical levels, with a risk of further deterioration. In addition, the West Bank continues to suffer from the worst drought in 10 years impeding development and adding to the suffering of children there. UNICEF’s humanitarian assistance programme will target 1.8 million children and 0.9 million women.
* Funds received against this appeal will be used to respond to both the immediate and medium-term needs of children and women as outlined above. If UNICEF should receive funds in excess of the medium-term funding requirements for this emergency, UNICEF will use those funds to support other underfunded emergencies.
** The total includes a maximum recovery rate of 7 per cent. The actual recovery rate on contributions will be calculated in accordance with UNICEF Executive Board Decision 2006/7 dated 9 June 2006.
*** This amount includes the revised requirements of the CAP 2009 and the UNICEF Humanitarian Action Update (14 January 2009) in response to the Gaza crisis. The UNICEF requirements are likely to further increase as the humanitarians will most likely be granted access to conduct needs assessments in Gaza strip conflict areas.
1. CRITICAL ISSUES FOR CHILDREN AND WOMEN
According to the Ministry of Health, as of 18 January 2009 a total of 1,300 people were killed and 5,300 injured since the beginning of the Israeli military operation in Gaza. During the same period, 410 children and 104 women were killed and 1,855 children and 795 women injured. The reason for the high increase in the death count is the identification of many anonymous bodies or bodies found under the rubble in areas previously not accessible. Such alarming numbers of children falling victims to the military operations are considered likely to grow. More than half (56 per cent) of Gaza’s 1.4 million residents are children, and the military operations have unfortunately highlighted that there are no safe spaces in Gaza in which to take refuge. No recognized safe heaven can fully protect the children of Gaza, as they become the captive victims in an area where only a very few of the critically ill or injured are able to flee.
Even prior to the commencement of the most recent conflict indicators on children’s well-being revealed corrosive trends. Child survival rates had stagnated since 2000.
Presently one in ten children is stunted, up from 7.2 per cent a decade ago.
The prevalence of anaemia among children aged 9–12 months is 61.6 per cent, and 29 per cent among pregnant women.
More than one in five children under age five suffers from vitamin A deficiency.
Basic education enrolment rates have dropped from 96.8 per cent in 2000–2001 to 91.2 per cent in 2006–2007 and learning achievement is plummeting. In 2008, only 19.7 per cent of 16,000 sixth-graders in Gaza passed standardized tests in Arabic, mathematics, science and English. At least 30 per cent of adolescents do not enrol in secondary school. Violence is prevalent and rising, even in homes and schools, and especially for children at risk or in conflict with the law. At end-August 2008, some 293 children, including 5 girls, remained in Israeli prisons and detention facilities and, among them, 13 children, including 2 girls, were being held in administrative detention (without charges or trial).
Gaza has remained virtually sealed off to the outside world, with only a trickle of people and goods entering and exiting the Strip, despite a truce declared with Israel on 19 June 2008. At least 51 people, including 11 children, died after denials or delays in accessing medical care outside of Gaza between October 2007 and July 2008,
and dozens of students with places in universities abroad have been refused exit permits. While the delivery of basic services has been a challenge the current emergency has exacerbated this. Shortage of drinking water and sewage overflows in residential areas are becoming an imminent public health danger. Much of the population is now dependent on their own stored water supplies and limited sales by private distributors. Incidental reports appear to indicate that some areas are cut off from any access to water for days on end, forcing some residents to brave the conflict to find limited quantities of drinking water for themselves and their families. Sewage overflows are most serious in northern Gaza and partners say they are increasingly concerned that a sewage lake will overflow into nearby communities. Movements of people or goods are reportedly increasingly dangerous, with growing fears of possibly high numbers of unexploded ordnance littering the areas where missiles and bombs have fallen. These lethal remnants of war pose a direct threat to children and their families.
Across the West Bank, the number of children injured by Israeli security forces during anti-barrier protests has risen sharply and attacks on Palestinians by Israeli settlers have intensified. Access and movement restrictions are literally strangling socio-economic life, with around 630 physical obstacles to movement at end-August 2008, compared with 376 when the Access and Movement Agreement was signed in November 2005. New procedures applied to the movement of UN agencies including searches of UN property, refusal to accept UN identification, and requiring UN Palestinian staff to walk through crossings pose significant challenges and costs to operations. Ongoing construction of the 723-kilometre barrier wreaks untold suffering and humiliation on children and their families. Access to basic services is especially challenging for residents in Area C, which is under full Israeli military and administrative control, communities in the ‘Seam Zone’ between the barrier and Green Line, and areas near Israeli settlements and military zones.
The intra-Palestinian divide has also proven lethal for children. Hamas has retained de facto control of Gaza since it wrested power in June 2007. Between July and September 2008, factional fighting in Gaza killed 5 children and injured at least 24. In August, the school year opened to a strike by education workers to protest transfers/removals of ‘Fatah-affiliated’ staff by the Hamas authorities in Gaza. Health workers followed suit, further straining an already overstretched system. Striking workers were immediately replaced by new staff, many of whom have not received proper training. Over 180 communitybased organizations were shut down in July and August, including 10 UNICEF-supported adolescent-friendly learning centres. Two remain closed and confiscated equipment has not been returned.
The most severe drought in a decade is affecting poor rural communities from southern Hebron to as far north as Jenin. Average per capita consumption in hard-hit areas is as low as 15 litres per person per day, a tenth of the World Health Organization (WHO) minimum requirement. The majority of villages in the north-east rely totally or partially on trucked water, with some families spending as much as 30 per cent of household income on water.
The shortage of safe water and the dumping of solid waste around West Bank settlements constitute public health concerns.
2. KEY ACTIONS AND ACHIEVEMENTS IN 2008
In close collaboration with local and international partners, UNICEF’s humanitarian response focuses on health and nutrition, water, sanitation and hygiene (WASH), education, protection, and adolescent development, targeting eight districts where the needs are greatest. Key challenges to implementation include the closure of Gaza together with the January military action, access and movement restrictions across the West Bank, the institutional and administrative divide within Palestinian authorities, and violence related both to the conflict with Israel and internal Palestinian fighting.
By September 2008, around 87,400 children (75 per cent of the target group) had been immunized with vaccines procured by UNICEF for the Ministry of Health and the United Nations Relief and Works Agency (UNRWA) since the beginning of the year. UNICEF provided tankered water to 120 schools serving around 220,000 children and teachers, and constructed two wells serving around 40,000 residents previously unconnected to water networks. In Gaza, UNICEF supported a rapid nutrition survey covering over 700 children in three districts; procured micronutrient supplements, including vitamins A and D and iron/folic acid for 225,000 children and 100,000 pregnant/lactating mothers; printed 240,650 mother and child health handbooks; trained over 1,000 health professionals in nutrition and growth monitoring; and developed a national strategy on infant and child feeding practices.
UNICEF prepositioned 100,000 remedial worksheets, mainly in Gaza, to ensure that children can keep learning despite the blockade. With the Ministry of Education, UNICEF identified the 100 schools with lowest achievement scores for a broad package of support including supplies and training. Mathematics and science kits have been provided to 1,500 schools in marginalized areas, and a summer remedial learning programme reached 3,300 low-performing students in Gaza and the West Bank. In-service training, including on remedial education for children with learning difficulties, was provided to 500 teachers. UNICEF also piloted early childhood activities in 32 centres in Gaza to help prepare children for primary school.
By August 2008, 14 UNICEF-supported psychosocial teams across the Occupied Palestinian Territory (OPT) had provided assistance to 64,475 children and 8,136 caregivers in need. This included group counselling benefiting 20,767 children, in-depth counselling for 3,739 children in distress; fun days to relieve stress and encourage interaction for 25,986 children; and emergency home and hospital visits following violent events that reached 3,047 children.
To help adolescents (aged 13–18 years) overcome their frustration through meaningful programmes outside schools, UNICEF supported the establishment of 68 adolescent-friendly learning spaces that reach around 44,000 adolescents (at least 50 per cent girls) with after-school remedial education and recreational activities. UNICEF also supported sports activities and life skillsbased education in 60 youth centres benefiting around 11,000 adolescents. Forty outdoor playgrounds have also been installed in deprived, isolated or incursion-prone areas enabling around 40,000 children aged 5–12 years to play in a safe environment.
In the early days of January 2009 and as an initial element of response, UNICEF provided to partners still operational in Gaza some 350 first aid kits, and 20 resuscitation kits, complementing some 13 emergency kits provided earlier and prepositioned, allowing to serve up to 30,000 people for one month with basic medical items. Additionally, UNICEF made available significant amounts of WASH supplies which were prepositioned in its warehouses as well as those of its partners. This included water purification tablets, family water kits with water and hygiene items for upward of 6,000 families, large water tanks with a capacity to support drinking water needs of up to 8,300 persons per day as well as back-up generators for broken or failing water pumps and clinics. As the cluster approach was adopted, UNICEF dispatched senior cluster coordinators to Jerusalem to support the cluster activities in nutrition and WASH.
3. PLANNED HUMANITARIAN ACTION FOR 2009
Coordination and Partnership
The 2009 Inter-Agency Consolidated Appeal Process (CAP) is based on a needs assessment framework prepared by UN agencies, Palestinian Authority ministries and international and local NGOs. UNICEF has the sector lead in water, sanitation and hygiene (WASH), education, nutrition and child protection (psychosocial support), and participates in the health sector. Coordination of humanitarian and development activities is through the United Nations Country Team (UNCT). Advantages and capacities of a cluster approach are currently being discussed/reviewed by the Humanitarian Country Team.
Linkages of HAR with the Regular Programme
The UNICEF Country Programme for 2009-2010 aims at realizing Palestinian children’s rights to survival, development, protection and participation. It supports the Palestinian Authority in meeting the Millennium Development Goals and national goals for children. The programme focuses on capacity-building, service delivery and policy development and is designed to be flexible and adaptable to the prevailing operational conditions.
In 2009, UNICEF will focus on protecting children and women from the worsening humanitarian context in the West Bank and Gaza, support the Palestinian Authority and partners to prevent, and where possible, reverse declines in children’s and women’s well-being, as well as mitigating the impact of violence on children resulting from the unprecedented military operations in Gaza.
Health and Nutrition (US$ 9,508,650)
For 2009, the overall goal is to support the Palestinian Authority and partners in ensuring child survival, growth and development through health and nutrition services delivery for around 600,000 children under age five, 120,000 infants and 120,000 pregnant women in the West Bank and Gaza. Support will include the following key activities:
• Respond to the Gaza emergency through provision of first aid kits; resuscitation kits; generators to • support the blood bank preservation; essential drugs and disposables; obstetric and midwifery kits; and ensuring vaccine security through maintenance of cold-chain system;
• Respond to the Gaza emergency providing basic essential micronutrient supplements to infants and children under age five; support therapeutic treatment centres; provide policy guidelines on infant and young child feeding practices in emergencies, including the use of breastmilk substitutes;
• Support child survival through ensuring safe delivery and newborn care;
• Provide routine immunization services, including children in restricted areas;
• Strengthen skills of health providers in appropriate care and support of sick children and those with severe and acute malnutrition, including behaviour, change and communication of family and community practices;
• Eliminate micronutrient deficiency through food fortification and supplementation activities in MCH services;
• Strengthen disease and nutrition surveillance system;
• Develop policies and guidelines to provide infant and young child feeding and vaccine security.
Water, Sanitation and Hygiene (US$ 7,883,222)
For 2009, the overall goal is to support the water authorities to improve water and sanitation systems, especially in schools and health centres in marginalized communities, as well as respond to the Gaza emergency targeting around 500,000 beneficiaries. Support will include the following key activities:
• Ensure water trucking to and/or restore WASH services in gathering sites in Gaza (IDPs in school and public buildings), and hospitals;
• Provide water and sanitation to 30 family centres (emergency child protection and psychosocial centres for psychosocial support of children/mothers/adolescents) in Gaza;
• Conduct sanitary and technical assessment of sewerage systems (including waste ponds and remediation/repairs) in Gaza;
• Provide generators, spare parts and mobile fuel tanks for the maintenance of sewage pump stations and main water network pump station in Gaza;
• Address production and capacity of water in five vulnerable districts, including Jordan Valley, Tubas and Hebron areas;
• Rehabilitate and improve water supply and sanitation facilities in 282 schools in West Bank and Gaza;
• Promote hygiene education and hygiene awareness programmes in 282 schools and 15 or more vulnerable communities West Bank and Gaza;
• Provide safe drinking water to 300,000 students in 282 schools;
• Train water and sanitation management teams in information management and water quality monitoring for emergencies;
• Conduct water quality surveillance and undertake hygiene promotion activities.
Education (US$ 8,313,600)
For 2009, the overall goal is to work with the Ministry of Education and Higher Education (MOEHE) and partner NGOs to fill gaps in learning achievement due the conflict and closures, to improve teachers’ skills as well as to respond to the Gaza emergency. Support will include the following key activities:
• Provide remedial education for 100,000 students (grades 1 to 4) in the affected areas in Gaza and preposition 900,000 copies for emergency use even in the West Bank;
• Provide mathematics and science kits to help improve the teaching and learning process in 50 additional schools in hardto- reach areas in the West Bank and Gaza;
• Continue the pilot project serving children with special needs, which will have increased coverage as a result of military operations in Gaza;
• Equip 400 primary schools, serving around 396,000 children, with quality teaching and learning materials, focusing on Gaza, South Hebron and the Jordan Valley;
• Enhance the capacity of 2,000 teachers, 500 school principals, and 1,000 parents on remedial education immediately after conducting a rapid assessment;
• Conduct extracurricular activities, including psychosocial counselling, to promote learning even during emergencies benefiting about 60,000 primary students;
• Equip 115 kindergartens in most affected areas in the Gaza Strip;
• Conduct minor school repairs such as classroom windows, whitewash etc. targeting at least 200 schools in Gaza;
• Raise awareness for early childhood development (ECD) caregivers on psychosocial issues and non-violence;
• Provide 30,000 school bags and stationery items as well as stationery sets to 2,000 teachers and 6 Education Directorates in Gaza;
• Conduct Back-to-school campaign in Gaza and the West Bank before the new 2009–2010 school year.
Child Protection (US$ 11,494,850)
For 2009, the overall goal is to support the Ministry of Social Affairs and NGO partners to reduce stress, mitigate the impact of violence, and strengthen coping mechanisms of children and caregivers, as well as respond to the Gaza emergency targeting around 223,476 children and 115,126 caregivers. Support will be provided through the following key activities:
• Respond to the Gaza emergency in terms of rapid response, medium and longer-term needs (establishment of 30 family centres; mine-risk education; monitoring reporting mechanisms and coordination);
• Establish child protection committees;
• Develop protocols and referral systems for responding to violence/abuse;
• Develop and implement non-violence in schools’ policy applicable to both teachers and pupils;
• Conduct initial (Gaza) and in-depth group counselling sessions for children (West Bank and Gaza);
• Conduct sessions with parents and other caregivers to better equip them to protect children against the effects of conflict-related violence;
• Provide emergency response teams that give immediate support through home and hospital visits following situations of acute conflict;
• Establish child-friendly units within the police;
• Provide socio-legal assistance through specialized centres and toll-free line.
Adolescents (US$ 5,050,400)
For 2009, the overall goal is to support the Ministry of Youth and Sports and NGO partners to improve secondary school retention, reduce violence, enhance adolescent participation, and raise awareness on healthy lifestyles and improve national youth policy as well as respond to the Gaza emergency. Around around 170,000 adolescents will be reached through the following key activities:
• Respond to the Gaza emergency by addressing adolescents’ needs through 30 family centres jointly set up with child protection programme (i.e., engage and mobilize adolescents through community initiatives, peer-to-peer psychosocial support, health referral, recreational activities and life skills via buddy system with professional community workers);
• Maintain 70 adolescent-friendly learning spaces that empower adolescents with remedial support in literacy and mathematics; and support courses in information technology, music, sports, drama and life skills sessions (including MRA, HIV prevention, peer support and reproductive health) targeting around 70,000 adolescents;
• Provide sports and recreational activities as well as psychosocial support to 100,000 children and adolescents in 100 safe play areas;
• Support the 70 centres to conduct adolescent-led initiatives; and provide youths and adolescents with an active role in community work and outreach;
• Support youth media to reach 100,000 youths and adolescents through TV, Internet and radio spots on daily concerns and issues for youth.
Palestinian Family Health Survey, 2006.
Palestinian Central Bureau of Statistics, 2007.
Nutrition Department/Ministry of Health/Palestinian National Authority, Nutrition Surveillance System Report, 2007.
Ministry of Health/Palestinian Authority and MARAM Project, 2004.
World Health Organization (WHO), Access of Patients to Specialized Medical Services, Summary Situation, July 2007-July 2008.
OCHA, Water and Sanitation, The Humanitarian Monitor, No. 28, August 2008, p. 8.
WHO, Situation report on the sea water pollution, June 2008.
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