The situation in the West Bank and Gaza continues to be characterized by ongoing violence (incursions, house demolitions), and restrictions on movement (curfews and closures). Furthermore, the long-lasting effects of the crisis in terms of rising poverty (more than 60% are now living on less than US$ 2.1 a day), and unemployment have gradually eroded households' coping mechanisms, thereby putting the physical and psycho-social condition of children under significant strain. Many parents in the West Bank and Gaza feel that they do not have the ability to meet the basic needs of their children for care and protection.
Since the last Donor Update in June 2004, more than 600 residential buildings have been demolished in the Gaza Strip, affecting more than 6,000 Palestinians, half of these children. Out of these, 450 houses were demolished in Rafah and South Gaza. Jabalya, in the northern Gaza Strip, saw a major incursion between 28 September and 14 October 2004 where 135 Palestinians were killed, 34 out of which were children and 521 were injured of which 170 were children. Overall between January and October 2004, at least 162 children have been killed in the conflict and around 3,170 injured. This is some 50% higher than in 2003.
Health and nutrition
The recent Demographic and Health Survey (DHS) indicates an increase in chronic malnutrition and a degradation of the nutritional status of small children. Increased levels of anemia and micro-nutrient deficiencies have been observed. The stunting rate has increased since 2000 and one in ten children under five is now suffering from stunting. The damage to the water and sewage infrastructure has resulted in water-borne epidemics, which combined with a collapse of adequate hygiene practices, have caused the number of diarrhoeal diseases to double. Availability of primary health care services is reduced due to the lack of supplies and limited attendance of health staff due to restrictions on movements. The quality of health services is reduced due to the disruption of training and capacity development of health staff. Utilization of health services by rights holders is decreasing due to the restriction on access.
Clearly, the situation in Gaza is worsening. For instance under-five mortality rates and infant mortality rates between 2000 and 2004 have declined in the West Bank but have increased in Gaza. Nearly 50% more children in the West Bank receive vitamins A and D than in Gaza and roughly the same difference applies for acute and chronic malnutrition rates.
Despite efforts to maintain high immunization coverage and the commitment of caregivers to immunize their children, it was found that less than two-thirds of all children had the necessary immune protection against measles. At birth, pregnant women have reduced or no access to obstetric care and skilled attendants - causing life threatening complications for mother and child. There is an increase in the numbers of home deliveries without skilled attendants (in the West Bank) and attendance at antenatal care facilities dropped over the last year by more than 10%.
Children's right to education is directly threatened by the restrictions of movement. Closures, curfews, barriers and checkpoints are hindering access to schools. They lose school days or have their school days disrupted. More than 226,000 children in 580 schools find going to school impossible, irregular or very risky. Many children are exposed to live fire while in their classrooms or on their way to school. In addition many schools are damaged including the water and sanitation facilities, classrooms, and play and sports areas.
The quality of education services is affected since professional staffs are restricted from reaching schools. Enrollment rates are now down by 1.5% for the second year in a row, which means that some 15,000 less children enter into the school system each year.
The impact of the crisis on children's psychosocial well-being is serious. Children show important signs of distress, including bedwetting, nightmares, aggressive behavior among children and low school achievement. They are exposed to violence not only in their external environment but also at home and in school. Some 30.8% of children are reported to have been exposed to some type of violence, of which over two thirds have experienced violence in the home environment, and 30% from teachers. Parents increasingly report feeling unable to provide care and protection to their children.
Children and their families lose their personal belongings such as clothes, toys and school materials due to house demolitions (at an average of 120 residential buildings every month). Families have to relocate and seek shelter, requiring children to change schools and lose friends. Children have limited opportunities to play and exercise in areas that are safe for them and where they can be with their peers.
2. ACTION FOR CHILDREN
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 the Northern Gaza. In addition three other areas (Al Mawasi, Siafa and Al Ma'Ani) are of key concern. UNICEF is coordinating action through the main office in East Jerusalem. The UNICEF zonal offices in Jenin, Tulkarem, Nablus, Hebron, Rafah and Gaza ensure assessment, swift response and monitoring of humanitarian assistance. Total UNICEF staff comes to 60 international and national staff members.
Health and Nutrition
A measles immunization campaign, together with the administration of vitamin A, was conducted in July 2004 and covered nearly 500,000 children, more than 98% of the children in the 9 month to 5 year age group. In some cases, the campaign was conducted under the very difficult circumstances in the West Bank and Gaza including an incursion in Beit Hanoun. The vitamin A campaign was undertaken for the first time, covering children's needs for the next 6 months, thus protecting them from the risk of micronutrient deficiency. In addition, more than 400 health workers from 10 out of the 15 districts were trained in implementing cost-effective, quality care in their day-to-day practice towards better health services for children.
In Rafah district, 7,000 families were provided with safe water storage devices, water purification kits, soap, as well as with awareness–raising materials. Moreover, 300 sessions of hygiene promotion are being facilitated at the community level.
In Jabalya, emergency health kits were distributed to health facilities or mobile teams in the acute crisis areas of Gaza - containing drugs, medical supplies, and basic medical equipment and sterilization items. One kit covers 30,000 beneficiaries for one month. Forty-five basic family water kits, collapsible water tanks and generators, were distributed in Gaza to provide families with water containers to carry and store water. Water purification tablets and soap for hygiene purposes were also distributed. Prepositioning of safe water supplies was also undertaken in Rafah district in partnership with the Municipality and Care International (with funds provided by the German Government).
Midwifery kits were provided to health facilities not normally equipped to respond to emergency deliveries – as pregnant women in labour were prevented from reaching an appropriate facility. One midwifery kit allows the setting up of a delivery room and the management of 50 deliveries. The emergency obstetric kits allow for 100 complicated and normal deliveries, including obstetric surgery.
Based on the previous experiences, a team of experts and key teachers reviewed and revised the remedial Arabic, Math, Science and English worksheets for G1-3, G4 and G6. After the revision, 90,000 copies were printed and distributed to the West Bank and Gaza. The worksheets for G4 and 6 are presently in the process of being reprinted. 1,000 teachers are in the process of being trained and 200 sessions with parents are being held to orient parents on the use of remedial worksheets. In turn, the parents will provide support or supervision to the children during closures or military curfews. Some 20,000 children participated in 100 summer camps, providing girls and boys a safe place to spend about two weeks of their school holidays and at the same time giving them a chance to have fun and learn important life skills.
Over 40,000 school bags were distributed to both UNRWA and government school students in Gaza during the October emergency in Jabalya. UNICEF made available 390 school-in-a-boxes for Gaza to facilitate teaching and learning for over 31,000 students and 500 teachers. A further 30,000 school bags are presently being purchased for pre-positioning purposes. About 120 recreation kits are on their way from suppliers to facilitate the extra curricular activities for the students. The purpose of these activities is intended to support children's resiliency and their ability to cope with the stresses of the occupation.
Psychosocial emergency teams have been established in Hebron, Nablus, Tulkarem and Jenin as well as in the five governorate of the Gaza strip. UNICEF and its NGO partners have identified competent organizations, selected professional team members and ensure coordination of action plans and outreach. Teams are dispatched following an incursion, or any type of violent event, to provide counseling sessions to children. Counseling sessions are subsequently continued in groups. In parallel, caregivers are equipped with basic skills on how to detect signs of distress among children and to provide support. Caregivers also learn how to manage their own stress in crisis situations and how to maintain a stable family environment.
Peer-to-peer psychosocial support is provided by selected university students to adolescent groups living in areas most affected by conflict in Gaza, and West Bank (Nablus, Ramallah and Jerusalem) through counseling sessions, hotline services (hotline is open 6 days a week for 7 hours a day), print and broadcast media, thereby helping children to help each other in overcoming the psychological stress caused by the crisis.
19 safe play areas and 12 adolescent friendly youth clubs are being created and rehabilitated. These child friendly spaces provide an outlet for stress and tension and a child friendly environment in which children can feel safe to play, that equip children and adolescents with life skills like stress management, tolerance and conflict resolution that enables them to deal with everyday challenges, and which provide an opportunity to reach out to caregivers with important messages on child care and the environment. Thus, over 30,000 children have access to playgrounds offering children a real opportunity to play and interact with peers in a safe and child friendly environment.
The kindergarten Tel-Al Zatar, destroyed during the Jabalya incursion, was temporarily relocated and equipped with basic materials and furniture, thus providing a safe space for 500 children living in one of the worst affected and poorest areas in the Gaza Strip.
An extensive mine risk education campaign was initiated in September following the Jabalya incursion and is ongoing, including awareness raising on the issues through TV spots, awareness sessions in schools, dissemination of posters and leaflets, and coordination with law enforcement. Palestine TV and 10 private channels air key mine risk messages three times daily. In addition, a documentary was shown on the dangers of unexploded ordinance, and a talk show was produced with key actors in the National Mine Action Committee together with children who had benefited from summer camps on the dangers of mines and unexploded ordinances. Posters and leaflets were distributed through the Palestinian Red Crescent Society and the National Mine Action Committee. The campaign will continue through the month of November. In Jabalya, 300 family kits with clothes, shoes, toys, and school stationary were distributed to families in the crisis areas who had lost their homes and to the displaced.
3. 2004 APPEAL REQUIREMENTS AND RECEIPTS
As part of the 2004 Consolidated Appeal for the OPT, UNICEF requested US$ 13.8 million to provide humanitarian relief to the affected children and women in the territory. To date, some US$ 4 million has been received as follows:
In addition to the above emergency contributions, UNICEF received US$2,612,900 in regular other resources from the Government of Japan for the Expansion of Immunization Programme in the Palestinian Administered Areas.
4. CURRENT PRIORITIES
The immediate funding needs from November to end December amount to US$ 1,690,000. The priority activities and funds required include the following:
Further details of the emergency programme can be obtained either by visiting the UNICEF OPT website at www.unicef.org/opt or from:
Tel: + 972 2 583 00 13
Fax: + 972 2 583 08 06
GenevaTel: + 41 22 909 5655
Fax: + 41 22 909 5902
Tel: + 1 212 326 7009
Fax: + 1 212 326 7165