Gaza Strip - OCHA - Humanitarian Fact Sheet (Nov. 2007)

Since 15 June 2007, when Hamas took control of the Gaza Strip, Israeli restrictions, the lack of funding and the lack of coordination between Palestinian bodies have resulted in shortages of food, medical and relief items, spare parts for critical health and water sanitation equipment, materials for humanitarian projects and raw materials for the Gaza Strip’s commerce and industry. The sanctions on fuel, proposed reduction on the delivery of electricity, and further restrictions on imports, will have additional repercussions for the densely populated Gaza Strip. This fact sheet highlights the humanitarian concerns in the Gaza Strip, which are increasing as a result of these events.

Main findings:

• From mid June until the end of October 2007, 400 Qassams and 510 mortars have been fired towards Israel, injuring 75 Israelis (6 civilians, including one child, and 69 IDF soldiers). During the same period, 142 Palestinians, including 12 children, were killed and 293 were injured, including 17 children due to the Israeli-Palestinian conflict.

Health:

•17.5% of patients who have requested access to East Jerusalem, Israel or abroad for emergency or chronic medical treatment have been denied permits since June 2007.

•Due to the lack of spare parts, equipment of the Ministry of Health is no longer functioning.

•20% of essential drugs and 31% of essential medical supplies were at zero availability in October 2007, while 11 out of 18 psychiatric medications in use in primary health care facilities are unavailable since August 2007.

•The UNRWA Community Health Programme and Palestinian Centre for Democracy and Conflict Resolution have observed a growing proportion of the population experiencing psychological symptoms.

•The proportion of deaths among hospitalized neonates at Gaza’s pediatric hospitals has increased from 5.6% during the period January-October 2006 to 6.9% during the corresponding period in 2007.

Food security:

•Although critical UN humanitarian food supplies are being allowed in, only 41% of Gaza’s food import needs are currently being met.

•Significant price increases and shortages of basic food commodities have been reported in Gaza since July.

•The purchasing power of the population is extremely low, resulting in a reduction in expenditure of food and clothing.

•The reduction in food expenditure resulted in reduced purchases of meat (98%), dairy products (86%) and fruit (99%) as well as in the quality (95%) and quantity (79%) of the food acquired.

Water and Sanitation:

•In October, the public provider of water and sanitation services received 50% of the amount of fuel it needs to operate its wells, pumping stations and treatment plants.

•Since July, Israeli authorities have denied coordination for spare parts and equipment required for a number of essential projects.

•As a result, 210,000 people are able to access drinking water supplies for only 1-2 hours a day.

•The poorest households who cannot afford to buy water from private companies have started to alter their hygiene and sanitation practices.

Shelter and Relief:

•The lack of access of goods into the Gaza Strip has meant that humanitarian projects valued at USD 213 million are on hold.

•The suspension of UNRWA and UNDP housing and construction projects has translated into the loss of an estimated 1,380,000 work-days for the construction sector, thereby increasing unemployment and economic hardship for thousands of workers and their families.

HEALTH (WHO)

Patients’ access to specialized medical services

•Of the 782 patients who have submitted requests to the Referral Abroad Department of the Israeli Ministry of Health to access specialized health care services in East Jerusalem, Israel or abroad since 9 June 2007, only 100 patients have received permits.

•713 patients out of 4,074 applicants (17.5%) have been denied permits to cross into Israel for medical treatment since June. The proportion of patients who were denied permits increased to 22.9% in October. Of those who were granted permits in October and attempted to cross, at least 27 patients were denied access after being questioned by Israeli authorities at the crossing.

•Two patients, a 77 year-old patient with a stomach hemorrhage and a 21 year-old cancer patient, died in October 2007 after being delayed for more than two hours at Erez crossing. Two patients in critical condition, a 46 year-old patient who was injured by an Israeli rocket and a 42 year-old patient with cerebral hemorrhage, died at Erez crossing after their permits were delayed more than four days (November). Another seven patients died in Ministry of Health (MoH) hospitals in October and November after the issuance of their permits was delayed.

Availability of pharmaceuticals: drugs and medical supplies

•91 drug items out of the 416 essential drugs and 188 medical supply items out of the 596 essential medical supplies are at zero availability (October) due to problems faced by one of the contracted suppliers to deliver the requested supplies.

•First line pediatric antibiotics are no longer available in the MoH as it is produced by the only drug manufacturer in Gaza that is now unable to import the necessary chemical precursors.

•Certain expensive drugs not on the essential list and that the MoH has no budget to procure have run out, including:

•The oncology drug Glyvic is no longer available. 20 patients are currently in critical need of it.

•The labor induction drug Dinoprostone is no longer available. Lack of availability will increase the proportion of C-section deliveries.

•Two kidney transplant immunosuppressant drugs Tacrolimus and Sirolimus are no longer available. 8 patients are currently in critical need for them.

•One patient with kidney failure died in August after a medical item (Subclavion catheter G # 20) that is needed for kidney dialysis was not available. A 21 year-old leukemia patient died after the drug Cisplatinum was no longer available in the MoH, and after denial of a permit to cross Erez for treatment in Israel.

Medical equipment functionality – availability of medical spare parts

•As a result of the lack of spare parts, the majority of diagnostic laboratory equipment, x-ray machines and equipment needed for orthopedic surgeries are not functioning, forcing many patients to seek diagnostic services in private clinics. This represents an increase in expenses which many patients cannot afford.

•Ceiling operating lights in two operating rooms in the Shifa and Nasser hospitals are not functioning.

•7 out of the 17 incubators in Gaza pediatric hospitals are not functioning properly.

Food for patients

•Suppliers have stopped the delivery of food items as a result of delays in payment leading to reports of shortages of dairy products and fresh fruit and vegetables for distribution to patients at Gaza’s hospitals.

Infrastructure

•Projects for the construction of new buildings for 3 major hospitals valued at USD 8.9 million have had to be suspended (specialized surgery building for Shifa hospital, two additional stories for Al-Aqsa hospital in Deir Al-Balah and new building annex for Nasser hospital).

Mental health and child protection (UNICEF/UNRWA)

•Specialized agencies have observed a growing proportion of the population experiencing psychological symptoms such as hyperactivity, lack of motivation, insomnia, anxiety, depression and bedwetting among children. Studies show that up to 40% of children would suffer from insomnia and 34% from anxiety. 26% of the parents report severe to very severe anxiety.

•MoH reports that 11 out of 18 psychiatric medications in use in primary health care are unavailable since August 2007. This is due to the difficulties experienced by the MoH in procuring and financing these drugs. Consequently, a number of the 3,600 chronic patients have had their treatment interrupted.

•Resulting from the challenges faced by the MoH in providing mental health services and the general deterioration of the population’s mental health, UNRWA reports a 206% increase in the use of drugs prescribed to mental health patients in its clinics.

FOOD SECURITY (WFP/UNRWA)

Access (UNRWA/WFP)

•There has been a 44% drop in the average number of food and animal feed trucks entering monthly into Gaza between the period January-May 2007 and the period June-October 2007.

•Although critical UN humanitarian food supplies are being allowed in, only 41% of basic commercial food import needs were met during the month of October until mid-November.

•Following the closure of Sufa crossing on 29 October, the average number of trucks entering Gaza through Kerem Shalom fell by more than 50% to 30 truckloads per scheduled day (22 days per month), illustrating the crossing’s insufficient capacity and prompting Israel to announce the reopening of Sufa. However, as of 28 November, the crossing has not been reopened.

•The cost of bringing a container of food through Kerem Shalom and Sufa instead of Karni has risen by 97% – 149% compared to the cost at Karni, depending on the commodity and crossing (Sufa was on average 10% cheaper than Kerem Shalom).

Market (WFP)

•Localized shortages have been reported for wheat grain, vegetable oil, dairy products, and Nido baby milk.

•Since June, the price of many basic items has increased: chicken by 10-40%; wheat flour by 46%; rice by 11%.; yogurt by 20%; Nido powdered milk by 7%; olive oil by 11,5%; bananas by 43%; fresh beef by 31%.

•Meanwhile, the price of some locally produced agriculture products has decreased, thereby undermining the livelihoods of farmers: potato and tomato prices have both declined by almost 40% compared to 2006 levels.

•The purchasing power of the non-refugee population is currently extremely low due to a 22% loss in income and rising unemployment (75,000 private sector workers out of 110,000 laid off since June). In June, 54% of these families survived on NIS 1000 (USD250) a month, a proportion that increased to 70% in October.

•14% of households surveyed by WFP have one family member who lost his/her job in the past 4 months and 58% of those recently unemployed are the main breadwinners of the family.

•According to a WFP study, of 62% of respondents who stated a decrease in expenditure, 97% reported a decrease for clothing and 93.5% for food. The reduction in food expenditure resulted in reduced purchases of meat (98%), dairy products (86%) and fruit (99%) as well as in the quality (95%) and quantity (79%) of the food acquired.

Agriculture (FAO)

•According to FAO, losses in the agriculture sector for the period from June to October have been limited to USD 4.5 million due to the fact that this period falls between planting and export seasons.

•With increased production costs (prices for key inputs such as seeds and fertilizers were 67 to 128% higher in August and September compared to June), compounded by decreased selling prices stemming from export production being dumped on the local market, the Ministry of Agriculture (MoA) estimates that farmers will lose another USD 50 million on crops planted on the local market this season.

•Due to the closure, 35,000 MT of potatoes and vegetables products destined for export markets have already been lost or sold on the local market at a fraction of their price (local prices are only 10 to 15% of export prices). Total estimated losses for the export market are estimated by MoA at USD 34 million.

•If the closure regime continues until April or May 2008, a much more significant collapse of the sector can be expected as farmers are unable to plant due to lack of inputs and cash.

•According to the municipalities and the Ministry of Agriculture, 2,232 dunums of agricultural land (approximately 3% of total planted land) was leveled by the IDF in areas adjacent to the Green Line during military operations since 12 June.

Fishing

•Total fish catch for September and October decreased by 32% since the same time last year.

•The Gaza Strip’s fishing limit has been reduced from 20 nautical miles (per the 1995 Oslo Agreements) to 6 nautical miles. In addition to access issues, fewer fishermen can afford the costs of fishing trips. As a result, a reduction has been reported in the number of fishermen working and in the number of trips organized.

WATER AND SANITATION (UNICEF)

Fuel and electricity cutting

•Due to Israeli imposed restrictions, the Coastal Municipalities Water Utility (CMWU) is receiving only 50% of the amount of fuel it needs to operate its wells, pumping stations and treatment plants 24 hours a day (70,000 liters).

•Since May 2007, 23 of 149 public wells in Gaza have had insufficient fuel due to lack of funding by the Palestinian Authority and cannot be maintained as there are insufficient spare parts due to the closures. As a result, 210,000 people are able to access drinking water supplies for only 1-2 hours a day.

•In these areas, the poorest households who cannot afford buying water from private companies have altered their hygiene and nutrition practices. Families have started sending their children to fetch water from neighbors, shower less often and bring their laundry to relatives.

Lack of spare parts

•CMWU is responsible for the maintenance of the majority of water/waste water networks, pumping stations and water wells in the Gaza Strip. Since July, Israeli authorities have denied coordination for UNICEF funded water sanitation spare parts and equipment (pipes, valves, water and waste water pumps and electromechanical spare parts) required for these projects.

•As of mid-November, 10 wells serving 150,000 people throughout the Gaza Strip need to have their electrical motor replaced. Similarly, 10 pumping stations serving 600,000 people from Gaza city (5), Jabalia (3) and Rafah (2) require urgent repairs that cannot be carried out because of the lack of spare parts. The inevitable breakdown of machinery that will follow, should spare parts not arrive in Gaza, will lead to the reduction/cessation of services and further reduce people’s access to water.

•UNRWA’s 10 water wells serve 17% of the camp population and are also affected by the lack of spare parts. Spare parts that were ordered in July have not been allowed to enter Gaza. If the diesel engines break down, the water wells will not longer be operational.

North Gaza treatment plants (Beit Lahia, North-East)

•In Um Al Nasser/Beit Lahia, even though the waste water treatment plant is now capable of processing 20,000m3 of waste water/ day, a third temporary lagoon is required in order to absorb the extra volume of sewage produced during the winter months and to make up for the delays in completing the North-Eastern Gaza project. While USAID has indicated an interest in funding the lagoon, the only site where Israeli authorities have authorized CMWU to build it is on an elevated area, which would put the life of Um Al Nasser’s 2,500 inhabitants at risk as witnessed last March when a similarly located lagoon burst its banks.

•Any reduction or cessation of electricity supplies for the machinery that is pumping excess sewage from the main lake into temporary lagoons would increase the likelihood of a major flood. A collapse in the main lake would lead to a flood of 1.5 million cubic meters of sewage into surrounding areas, threatening the life and property of 10,000 people.

•The construction of a permanent North-Eastern Gaza treatment plant to fully address wastewater needs in North Gaza is currently halted. In spite of some progress with regards to the construction of the transmission line and the infiltration basins, essential valves and pipes central to the operation of the pumping station have yet to receive Israeli clearance.

Khan Younis

•The construction of an essential sewage system east of Khan Younis by UNRWA is on hold because no construction materials are allowed to enter the Gaza Strip.

•At the moment, the majority of Khan Younis’ (both city and camp) untreated sewage is being diverted to an open lake originally built for storm water collection. While ICRC is connecting 2 new lagoons to the storm water lake in order to solve this urgent problem, this only represents a temporary solution.

•Winter precipitation could cause the level of the storm water lake to rise to dangerous levels and expose the 25,000 population living in the vicinity to 1 million cubic meters of flooding. In addition, a significant proportion of Khan Younis’ 200,000 inhabitants could be potentially affected by untreated sewage flooding the streets, should the over-stretched pipe system break down as often occurs during the winter months.

Solid waste

•The lack of fuel and spare parts is already negatively impacting on solid waste management by Gaza’s 25 municipalities. With the closure, essential maintenance of solid waste collection and removal vehicles cannot be carried out on a regular basis, and 40% of Gaza municipality’s vehicles and 600 containers currently need replacement.

•UNRWA now spends USD 116,000 per month to support the municipalities in meeting their solid waste management requirements. UNRWA has no independent stock of fuel for this purpose – the amount provided to municipalities is taken from UNRWA’s general fuel supplies which are obtained from local suppliers. Should fuel supplies to Gaza continue to be reduced, UNRWA may no longer be able to support municipalities.

•Recurrent strikes of municipal workers (protesting for non payment of salaries since February 2007) and the lack of fuel have led to an accumulation of solid waste in the streets (the Gaza Strip produces 940 MT of solid waste per day, and UNRWA collects 200 MT of this total), exposing the population to health hazards.

•An increase in the number of children below 3 attending UNRWA clinics has already been noticed (plus 25.5% in September 2007 compared to 2006) and could be linked to the deterioration of the general sanitary situation (WHO).

SHELTER AND RELIEF (UNRWA)

•Lack of construction materials on the local market has forced UNRWA to suspend 8 housing/re-housing and infrastructure projects worth more than USD 90 million, thereby preventing the construction of 2,474 housing units for 2,645 families, or 18,204 beneficiaries. Three projects for the repair of 1,226 refugee shelters were also suspended, affecting 1,512 families, or 8,744 beneficiaries. In addition, UNRWA suspended projects to construct 3 schools and 3 health centers at a value of more than USD 3.5 million.

•UNDP has had to suspend 2 important humanitarian re-housing projects in the Gaza Strip, preventing the construction of 500 housing units for non-refugee beneficiaries.

•The suspension of these UNRWA and UNDP projects translated into the loss of an estimated 1,380,000 work -days for the construction sector, thereby increasing unemployment and economic hardship for thousands of workers and their families.

•Provision of rental subsidies for refugees waiting for new shelters now on hold is costing UNRWA an additional USD 150,000 per month or about USD 750,000 since June 19.

•As commercial imports of relief items have not been permitted since mid-June, blankets, mattresses and gas cylinders are not available on the local market despite a growing demand with the approach of winter.

•The prices of some basic relief items such as kitchen kits, storm lamps and water tanks have increased by about 30% on the local market.

•Local producers of relief items (mattresses, mats) have had to stop operations due to the lack of raw materials caused by the closure.

•Humanitarian actors in Gaza have sufficient stocks to address less than half the needs for essential relief items in case of natural or man-made disaster displacing up to 15,000 people.

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Gaza Strip – OCHA – Humanitarian Fact Sheet (Nov. 2007)

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