Leaked Cables on Israel:
Humanitarian Situation in West Bank and Gaza

UNCLAS SECTION 01 OF 03 TEL AVIV 001546

E.O. 12958: N/A
TAGS: ECON KWBG IS ISRAELI PALESTINIAN AFFAIRS ECONOMY AND FINANCE HUMANITARIAN AID
SUBJECT: HUMANITARIAN CONDITIONS IN WEST BANK AND
GAZA: NOT GETTING ANY BETTER

This cable has been cleared by ConGen Jerusalem.

¶1. Summary: Overall, the humanitarian situation in West Bank and Gaza (WB/G) has not improved. Despite some minor improvements in mobility, the range of socio-economic indicators remain dismal. Over 60 percent of the WB/G population live below the poverty line; Unemployment rates as of fourth quarter 2003, under ILO standards, were 20.7 percent for West Bank and 31.9 percent for Gaza. If we include "discouraged workers", the rates climb to 27.8 percent for the West Bank and 37.2 percent for Gaza, according to the World Bank. According to a recent WFP/FAO survey, 41 percent of Gazans and 39 percent of West Bankers suffer from food insecurity. The GOI has allowed Gazans to work in Israel, despite a series of recent terrorist attacks at Erez crossing and has consistently re-opened the crossing to laborers after very brief closings following these incidents. Access to agricultural lands, however, remains problematic, despite some recent minor improvements in the West Bank. In Gaza, however, farmers have reported more, not fewer, problems in accessing their fields.

¶2. In the realm of health, there has been a positive trend of improved access for ambulances and emergency medical teams. However, there still are far too many delays. The lack of financial resources means that many families forego routine and preventative medical care. In general, international staff members of relief agencies have been able to travel to and from the West Bank and Gaza. Due to recent attacks at Erez, there are however, serious delays in gaining access to Gaza. However, there have been no improvements in the ability of these agencies to deliver services to enclosed communities in Gaza and the GOI has yet to fullfill its long outstanding committment to allow direct food delivery into El- Mowassi. End Summary.

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Checkpoints/ General Movement: Too Many and Not Enough
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¶3. In general, there has been a marginal improvement in mobility in the West Bank and Gaza for people and goods, including workers. However, these modest improvements have not been enough to impact socio- economic conditions, and are unlikely to positively influence any of the broad health and humanitarian indicators - acute and chronic nutrition, food security, unemployment, poverty levels. The GOI has claimed it has removed 22 internal manned West Bank checkpoints, while the Office of Coordination of Humanitarian Assistance (OCHA) could only confirm nine. OCHA reported that nearly 600 concrete road barriers and earth mounds continue to restrict travel on internal West Bank roads. Flying-checkpoints in the West Bank are an almost daily occurrence. In Gaza, North-South travel has in general been possible with fewer delays at Abu Khouli checkpoint. Travel, however, to and from enclosed communities such as El- Mowassi and Seafa remains extremely restricted.

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Land Confiscations/Demolitions Continue
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¶4. Land confiscations, leveling, and demolitions all continue in both the West Bank and Gaza. These actions are associated mostly with construction of the separation barrier in the West Bank; while in Gaza they are prompted by enhancement to security perimeters and infrastructure near settlements.

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High but Stabilized Unemployment/ Improved Access to Agricultural Lands
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¶5. As of fourth quarter 2003, unemployment rates (ILO definition) stood at 20.7 percent for the West Bank and 31.9 percent for Gaza. While this is an improvement over the peak Intifada unemployment rates registered in second quarter of 2002 (WB 31.4 percent; Gaza 42 percent), the numbers are still drastically higher than pre-Intifada numbers of 7.5 percent for the West Bank and 15.4 percent for Gaza. With population growth at 4.3 percent per year, dependency ratios - the total population divided by the number of employed persons - have increased significantly over the Intifada period. In the third quarter of 2000, each job holder in the West Bank was supporting 4.3 persons, by the fourth quarter of 2003, each employed person was supporting 5.4 persons. In Gaza, the dependency ratio increased more dramatically, from 5.9 to 7.7.

¶6. Gazans working in Israel continue to hover in the 10,000/day range. Recent terrorism attacks at Erez have resulted in the crossing being closed for only small periods of time - one or two days - before workers were allowed to resume crossing into Israel. Overall, according to a World Bank/PCBS study conducted over the past four months, Gazans who have jobs report "few" or "no" problems in accessing their places of employment. (Note: It is not clear if Gazan respondents include both those employed in Israel and within Gaza, or just the latter. End Note.) West Bankers reported greater difficulties with the average falling between "few problems" and "difficult." Nablus has reported the most difficulty. There, fully 35 percent of those employed said they found it "very difficult" or "impossible" to reach their places of employment in the January survey.

¶7. Roughly one third of the households in the West Bank and 15 percent in Gaza have agricultural land that they cultivate. In World Bank/PCBS surveys conducted over the past four months, West Bank households reported a slight improvement in access to that land, while in Gaza the trend was negative. Overall, West Bankers still report more difficulties in accessing farmland, than do Gazans.

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Food Security: International Assistance Averts a Catastrophe
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¶8. The donor community has managed to reduce global acute malnutrition through massive amounts of food assistance, technical support and awareness raising with the Ministry of Health. However, there have not/not been significant improvements in overall food security which exists when people have physical and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life. A recent FAO/WFP Food Security and Vulnerability Profiling Assessment concluded that 41 percent of Gazans and 39 percent of West Bankers suffer from food insecurity. The majority of cases in the West Bank were reported along the route of the separation barrier. In a pilot study examining coping strategies, WFP reported that 89 percent of its beneficiaries said they frequently or always consume less quality and variety of food; 63 percent limit the portions of meals; 56 percent forego health and education expenses; and 55 percent reduce the meals of adults in favor of children. The survey also concluded that among WFP beneficiaries, humanitarian assistance is the main/main source of income in the Gaza Strip, whereas in the West Bank, it remains employment and casual labor.

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Health Access: The Worst is Over
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¶9. OCHA reported that medical staff and patients continue to face checkpoint delays of up to four hours. There have, however, been fewer cases of ambulances being denied access altogether, under "normal" conditions. During periods of major clashes, OCHA reported that the coordination mechanisms between Israelis and Palestinians tend to break down, resulting in serious delays. Since the beginning of the year, there have been 12 incidents where ambulances and medical teams have been denied access; and 45 incidents in which medical personnel were delayed from 40 minutes up to four hours.

¶10. Access to routine medical care is less problematic than access to emergency services. In joint surveys carried out by the World Bank and PCBS over the past four months, for the approximately 70 percent of households in Gaza reporting a need for medical attention, most said that access to that care posed "few problems." In the West Bank, access was more problematic, with West Bank village residents reporting the most difficulty in accessing care; and camp residents reporting the least problems, probably due to the existence of UNRWA clinics in the camps. Financial wherewithal remains a key determinant to whether a family receives routine and preventative health care in both Gaza and the West Bank, but this factor is more pronounced in Gaza.

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Access for Relief Agencies: Okay in the West Bank - Problematic in Gaza
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¶11. International organizations and NGOs are not generally encountering major obstacles delivering services in the West Bank. Access to and from Gaza has been difficult lately as a result of a series of recent terrorist attacks at Erez crossing. Currently, internationals are not allowed to bring cars into Gaza. We have heard informally that access to vehicles will be restored by the end of the week.

¶12. However, NGOs and international organizations continue to face more systematic access problems in delivering services to enclosed communities in Gaza -- El-Mowassi and Seafa. Despite numerous pledges, commitments, and meetings dating back over one year, the GOI has still failed to allow UNRWA and WFP to make direct food deliveries to El-Mowassi for example.

¶13. The GOI has recently issued some permits to local Palestinian staff members of UN organizations. However, there is still room for improvement in this regard.