WUNRN
GAZA WOMEN & CHILDREN
ICRC -
International Committee of the Red Cross
29-06-2009
GAZA:
1.5 MILLION PEOPLE TRAPPED IN DESPAIR
Direct Link to Full Document:
Six
months after Israel launched its three-week military operation in Gaza on 27
December 2008, Gazans still cannot rebuild their lives. Most people struggle to
make ends meet. Seriously ill patients face difficulty obtaining the treatment
they need. Many children suffer from deep psychological problems. Civilians
whose homes and belongings were destroyed during the conflict are unable to
recover.
· New ICRC film From
the field series Gaza: paying
the price (download and order online).
During the 22 days of the Israeli military operation,
nowhere in Gaza was safe for civilians. Hospitals were overwhelmed with
casualties, including small children, women and elderly people. Medical
personnel showed incredible courage and determination, working around the clock
to save lives in extremely difficult circumstances. Meanwhile, daily rocket
attacks launched from Gaza put thousands of residents at risk in southern
Israel. Medical workers in Israel provided care for the traumatized population
and treated and evacuated casualties.
©ICRC/VII/
T. Domaniczky / il-e-00106
Many
children witnessed violence during the military operation. Bedwetting, insomnia
and agitated behaviour are widespread. Thousands of children and adults need
counselling to deal with emotional scars and post-traumatic stress.
Many
children witnessed violence during the military operation. Bedwetting, insomnia
and agitated behaviour are widespread. Thousands of children and adults need
counselling to deal with emotional scars and post-traumatic stress.
Many
people in Gaza lost a child, a parent, another relative or a friend. Israel's
military operation left thousands of homes partly or totally destroyed. Whole
neighbourhoods were turned into rubble. Schools, kindergartens, hospitals and
fire and ambulance stations were damaged by shelling.
This small coastal strip is cut off from the outside
world. Even before the latest hostilities, drastic restrictions on the movement
of people and goods imposed by the Israeli authorities, particularly since
October 2007, had led to worsening poverty, rising unemployment and
deteriorating public services such as health care, water and sanitation.
Insufficient cooperation between the Palestinian Authority in Ramallah and the
Hamas administration in Gaza had also hit the provision of essential services.
As a result, the people of Gaza were already experiencing a major crisis
affecting all aspects of daily life when hostilities intensified in late
December.
Six months later, restrictions on imports are making it impossible for Gazans
to rebuild their lives. The quantities of goods now entering Gaza fall well
short of what is required to meet the population's needs. In May 2009, only
2,662 truckloads of goods entered Gaza from Israel, a decrease of almost 80 per
cent compared to the 11,392 truckloads allowed in during April 2007, before
Hamas took over the territory.
No
reconstruction allowed, public health at risk
Gaza
neighbourhoods particularly hard hit by the Israeli strikes will continue to
look like the epicentre of a massive earthquake unless vast quantities of
cement, steel and other building materials are allowed into the territory for
reconstruction. Until that happens, thousands of families who lost everything
will be forced to live in cramped conditions with relatives. Others will
continue to live in tents, as they have nowhere else to go.
Emergency repairs carried out after the military operation
have made it possible to restore water and sanitation services, but only to the
already unsatisfactory level prevailing before December 2008. The
infrastructure is overloaded and remains subject to breakdown. Although
chlorine is used to disinfect the water, the risk of sewage and other waste
matter seeping into the water supply network represents a major threat to
public health.
Every day, 69 million litres of partially treated or completely untreated
sewage – the equivalent of 28 Olympic-size swimming pools – are pumped directly
into the Mediterranean because they cannot be treated.
Thousands
of homes only have access to running water on certain days. Because the water
supply network cannot be properly maintained, it is leaking, making it harder
to maintain sufficient water pressure. Even when water is available in the
pipes, many homes do not have sufficient power to pump it into rooftop storage
tanks.
The taps of tens of thousands of people run dry when
Gaza's municipal water wells break down, which frequently happens because of
insufficient supplies of new water pipes, electrical spare parts, pumps and
transformers.
The ICRC has occasionally found ways of repairing infrastructure without
relying on imports. For example, it used recycled materials (including used
water pipes and concrete segments of the old Rafah border wall destroyed in
January 2008) to upgrade a wastewater treatment plant serving 175,000 people in
Rafah.
However, on its own this is insufficient. Other repairs and reconstruction
projects are urgently needed to prevent the further deterioration of the water
supply system, carry out essential maintenance and stem the steady decline of
the water and sanitation system throughout the Gaza Strip. The fact that water
and sanitation services could collapse at any moment raises the spectre of a
major public health crisis.
The only way to address this crisis is to lift import restrictions on
spare parts, water pipes and building materials such as cement and steel so
that homes can be rebuilt and vital infrastructure maintained and upgraded.
Insufficient
access to health care
"I
have a pancreatic tumour. At first, there was hope that I would be given an
operation, but as time went by I stopped hoping. I am in pain and I know all
too well that my disease is life threatening." Do'aa, 26 years old, Gaza
City - She has been waiting since January 2009 for permission to transit
through Israel for an operation in Jordan.
Gaza's
health-care system cannot provide the treatment that many patients suffering
from serious illness require. Tragically, a number of them are not allowed to
leave the Strip in time to seek health care elsewhere. Health issues in Gaza
are often politicized and patients find themselves caught up in a bureaucratic
maze. The procedures for requesting permission to leave the territory are
complicated and involve both the Palestinian and Israeli authorities. Seriously
ill patients sometimes have to wait for months before the relevant authorities
allow them to leave the Gaza Strip.
Even when patients do obtain the necessary permits to leave, the transfer through Erez crossing into Israel can be arduous. Patients on life-support machines have to be removed from ambulances and placed on stretchers, then carried 60-80 metres through the crossing to ambulances waiting on the other side. Patients who can walk unassisted may face extensive questioning before they are allowed through the crossing for medical treatment – or, as sometimes happens, before they are refused entry into Israel and turned back.
The
shortage of basic medicines is a constant problem for Gaza hospitals and health
clinics. They depend on a timely and reliable supply of medicines from the
Palestinian Authority's Ministry of Health in the West Bank, but the supply
chain often breaks down. Cooperation between the health authorities in the West
Bank and Gaza is difficult. Complex and lengthy Israeli import procedures also
hamper the reliable supply of even the most basic items such as painkillers and
X-ray film developers. As a result, some patients, including people suffering
from cancer or kidney failure, do not always get the essential drugs they need.
"Four of our 14
specialized ventilators for newborn babies are out of order. It is currently
impossible to get spare parts into Gaza so that we can have the ventilators
fixed. This is a real problem if we have many newborns in the intensive care
unit at the same time."
"Four
of our 14 specialized ventilators for newborn babies are out of order. It is
currently impossible to get spare parts into Gaza so that we can have the
ventilators fixed. This is a real problem if we have many newborns in the
intensive care unit at the same time."
Majdia Jouda, head of the neo-natal department at Shifa Hospital.
An
estimated 100-150 people who lost limbs in the recent military operation are
waiting to be fitted with artificial limbs. The ICRC-supported Artificial Limb
and Polio Centre (ALPC) is the only physical rehabilitation centre in Gaza that
can provide them with adequate rehabilitation and professional customized
appliances. Being the only limb fitting centre in the Gaza Strip, the ALPC has
to respond to the entire demand for artificial limbs. Yet importing prosthetic
materials and components is still a difficult and lengthy process.
Gaza's hospitals are run down. Much of the equipment is
unreliable and in need of repair. Complicated procedures for obtaining approval
to import spare parts make it difficult and time consuming to bring in and
maintain hospital equipment, such as CT scanners, and spare parts – even for
hospital washing machines. The ICRC has had to wait as long as five months to
import medical equipment for operating theatres, such as orthopaedic external
fixators.
Daily power cuts and power fluctuations continue to damage medical equipment.
Most hospitals have to rely on backup generators for several hours a day, but
it is never certain that enough fuel will be available to run them.
Seriously ill patients should be given prompt and safe passage out of the
Gaza Strip in order to access the specialized medical care they cannot get
inside the territory. Essential medical items such as drugs, disposables and
spare parts must be allowed into the Gaza Strip without delay and in sufficient
quantities to ensure essential health services for the population.
A
strangled economy
One of the gravest consequences of the closure is soaring
unemployment, which reached 44 per cent in April 2009, according to the Gaza
Chamber of Commerce. Restrictions on imports and exports of goods imposed since
June 2007 have shut down 96% of industrial operations in Gaza, with the loss of
about 70,000 jobs. This has also had a severe impact on the capacity to export
products to Israel and the West Bank, which has become almost impossible.
The
tunnels under the Egypt-Gaza border do not present an alternative route to
economic development and are not ensuring a sufficient supply of affordable
goods for the population.
The collapse of the Gaza economy has led to a dramatic
increase in poverty. An ICRC household survey conducted in May 2008 showed
that, even then, over 70 per cent of Gazans were living in poverty, with
monthly incomes of less than 250 US dollars for a family of 7 to 9 members (1
dollar per household member per day, excluding the value of humanitarian
assistance which they may receive). Up to 40 per cent of Gaza families are very
poor; with a monthly income of under 120 dollars (0.5 dollar per household
member per day). On average, each person who does work – whether as a paid
employee or running their own business – has to support their immediate family
of 6-7 people and a few members of their extended family.
This increase in poverty has taken a heavy toll on the population's diet. Many
families have been forced to cut household expenses to survival levels.
Generally, people are getting the calories they need, but only a few can afford
a healthy and balanced diet. Poor families often substitute cheaper
alternatives such as cereals, sugar and oil for fruits, vegetables, meat and
fish. For tens of thousands of children, this has resulted in deficiencies in
iron, vitamin A and vitamin D. The likely consequences include stunted growth
of bones and teeth, difficulty in fighting off infections, fatigue and a
reduced capacity to learn.
Most of the very poor have exhausted their coping mechanisms. Many have no
savings left. They have sold private belongings such as jewellery and furniture
and started to sell productive assets including farm animals, land, fishing
boats or cars used as taxis. They are unable to reduce spending on food any
further. The declining living standards will affect the health and well-being
of the population in the long term. Those worst affected are likely to be
children, who make up more than half of Gaza's population.
Gaza's alarming poverty is directly linked to the tight closure imposed
on the territory. Local industry and other businesses have to be allowed to
rebuild, to import essential inputs and to export their products. But even that
would take time. The crisis has become so severe and entrenched that even if
all crossings were to open tomorrow it would take years for the economy to
recover.
The
closure has also badly hit farming families, which make up over a quarter of
Gaza's population. Exports of strawberries, cherry tomatoes and cut flowers
used to be an important source of income. They have come to a virtual
standstill. Many farmers have had their income halved as they find it difficult
to sell their entire harvest inside Gaza. Even if they succeed, the price they
obtain is only a fraction of what they would normally earn from exports to
Israel or Europe.
During the latest military operation, the Israeli army
uprooted thousands of citrus, olive and palm groves, including those far inside
the Gaza Strip. The army also destroyed irrigation systems, wells and
greenhouses.
Many
farmers are effectively denied access to parts of their land because of the
Israeli-imposed "no-go" zone on the Gaza side of the border fence
with Israel. At least 30 per cent of the arable land in Gaza lies within this
buffer zone, which can extend up to one kilometre from the fence. A farmer
never knows for sure if it is safe to work his land or to harvest within the
zone. Farmers risk being shot at when tending to their land and incursions by
the army often leave fields and parts of the harvest destroyed.
Getting agricultural production up and running again is
difficult not only because of the destruction that has occurred, but also
because Israel does not allow the importation of suitable fertilizers and
because many types of seedlings are difficult or even impossible to find in
Gaza.
Fishing has also been hard hit by the Israeli-imposed restrictions on movement.
Last January, the area at sea within which Israel allows fishing was cut from
six to three nautical miles from Gaza's coastline, reducing catches and
therefore the availability of this protein-rich food. Bigger fish and sardines,
which constituted some 70 per cent of the catch before 2007, are found mainly
outside the three-nautical-mile zone.
Urgent steps must be taken to allow farmers to resume growing their crops
in safety. Fertilizers, spare parts for machinery, plastic sheeting for
greenhouses and fodder must be allowed into the Gaza Strip in quantities that
will ensure that they are sold at prices farmers can afford. At the same time,
farmers must be permitted to resume their exports of produce in order to earn a
proper living. Recent restrictions on fishing should be rescinded.
"Being
stuck here gives me a sombre view of the future,” says Ibrahim Abu Sobeih, a
24-year-old student from Gaza. “I would like to be educated and to make
something of myself. I want to be able to help my family financially. But it is
very difficult when I am trapped. I feel very angry and hopeless."
Ibrahim Abu Sobeih, 24 years old, Gaza City: Received a scholarship from
Clarion University in Pennsylvania, but was not allowed through Israel to go
there. He now works for a local NGO.
People
in Gaza are trapped. Because Israel has shut the crossing points, Gazans have
scant opportunity for contact with relatives abroad or for further education or
professional training. The restrictions on leaving and entering the Gaza Strip
also apply to Palestinian staff of international organizations such as the
ICRC. To make matters worse, it is seldom possible to use the Rafah border
point with Egypt.
The emotional fallout from
the closure is particularly apparent among families with relatives imprisoned
in Israel. In June 2007, Israel stopped ICRC-supported visits by about 900 Gaza
families to their detained relatives. As a result, many children have lost
their one remaining link with a detained parent or sibling. These families must
be allowed to resume visits to their relatives in Israeli detention.
Often, university students with grants to study abroad are not allowed to leave
Gaza. Those who cannot leave are left with limited options for further
education within the coastal enclave. University professors, teachers and
health professionals are often prevented from participating in training courses
and seminars abroad that would help them upgrade their skills and expertise.
Breaking
the cycle of despair and destitution
Over the last two years, the 1.5 million Palestinians living
in the Gaza Strip have been caught up in an unending cycle of deprivation and
despair as a result of the conflict, and particularly as a direct consequence
of the closure of the crossing points.
The ICRC has repeatedly pointed out that Israel’s right to address its
legitimate security concerns must be balanced against the right of the
population in Gaza to lead a normal and dignified life. Under international
humanitarian law, Israel has the obligation to ensure that the population's
basic needs in terms of food, shelter, water and medical supplies are met.
The
ICRC once again appeals for a lifting of restrictions on the movement of people
and goods as the first and most urgent measure to end Gaza's isolation and to
allow its people to rebuild their lives.
The almost 4.5 billion dollars that donor countries pledged for reconstruction
at an international summit in Egypt in March 2009 will be of little use if
building materials and other essential items cannot be imported into the Gaza
Strip.
In any case, reconstruction alone does not offer a sustainable means of getting
Gaza back on its feet. To go back to the situation prior to the latest military
operation would be unacceptable, as that would only perpetuate Gaza’s plight.
A lasting solution requires fundamental changes in Israeli policy, such as
allowing imports and exports to and from Gaza, increasing the flow of goods and
people up to the level of May 2007, allowing farmers to access their land in
the de-facto buffer zone and restoring fishermen's access to deeper waters.
Humanitarian action can be no substitute for the credible political steps that
are needed to bring about these changes. Only an honest and courageous
political process involving all States, political authorities and organized armed
groups concerned can address the plight of Gaza and restore a dignified life to
its people.
The alternative is a further descent into misery with every passing day.
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