Update 00/02 on activities of the International Red Cross and Red Crescent Movement in Israel/occupied territories/autonomous territories
19-10-2000 Operational Update
Violence continues despite diplomatic agreement
At the emergency Middle East summit at Sharm el-Sheikh in Egypt, the Israeli and Palestinian leaders agreed to issue public statements calling for an unequivocal end to the violence. They also agreed to take immediate concrete measures to end the current confrontation, to maintain calm and prevent a recurrence of the recent events, and to restore the situation that existed before the crisis erupted 20 days ago. This includes Israel withdrawing its soldiers from the West Bank and Gaza, ending the closure of the West Bank and Gaza Strip, and re-opening the Palestinian airport in Gaza. A fact-finding committee is to be set up, under the auspices of the US and in consultation with the United Nations Secretary General, to investigate the responsibility for the clashes.
Meanwhile, violence continued in the West Bank and Gaza, albeit at a lower level than last week. The deaths of two protesters on Tuesday added to a toll already well over 100.
With the decrease in violence, the humanitarian situation has improved slightly. The number of wounded received in clinics/hospitals run by the Palestine Red Crescent Society (PRCS) or the Ministry of Health is decreasing.
The International Red Cross and Red Crescent Movement must nonetheless urgently enhance its preparedness. Although there is as yet no danger of a complete collapse of the health system in the autonomous territories, there are obvious shortcomings and needs are great. Medical supplies remain the first need, including organization of their transfer across the West Bank and to Gaza.
Although the PRCS's appeal of 4 October for medical supplies and ambulances has been well covered, it should be noted that 18 PRCS ambulances were damaged during the clashes and that additional ambulances may be requested shortly.
The total closure of Gaza and the West Bank is beginning to paralyse the economy. While it is highly unlikely that food supplies to the territories will be entirely cut off, daily life for the population is becoming more difficult, owing to a reduction in economic activities in the territories and the loss in earnings for the thousands of Palestinians who can not go to work in Israel. Were the present situation to continue, it could lead to shortages of basic items such as fuel in the coming days or weeks.
Other institutions and organizations are addressing other humanitarian and social needs. At present, in addition to local NGOs, there are 35 international NGOs operating in the autonomous and the occupied territories.
The Israeli authorities have given the ICRC assurance that they will facilitate its humanitarian efforts in order to avoid shortcomings of essential goods. The Jordanian authorities will facilitate ICRC's logistics base in Amman.
Response by the International Red Cross and Red Crescent Movement
1. ICRC activities
Three ICRC teams, including one medical team, have been present monitoring the situation during the clashes and collecting information on the use of force, with a view to making repr esentations to the respective authorities where necessary. ICRC delegates are present in Nablus, Ramallah and Hebron and are able to move around. ICRC field officers have been monitoring the situation in Jenin, Tulkaram and Bethlehem.
Medical delegates have visited the wounded in hospitals in Gaza and the West Bank, to evaluate their state of health and assess the need for evacuation to hospitals elsewhere (e.g. Saudi Arabia or Qatar).
The constant presence of the ICRC in the field remains highly important and much appreciated by the population. The delegates are in a position to detect and assess present and future needs. The ICRC team in Jerusalem has been reinforced by four additional expatriates, including one delegate dealing with relations with the media. Three extra delegates are now based in Amman.
The ICRC has been actively supporting the PRCS, whose emergency medical services have been providing care for the wounded, transportation to hospitals and in-field treatment at the various field clinics deployed. In the field, ICRC delegates have relayed information between the PRCS and the hospitals, transferred medical supplies and equipment, at the request of the PRCS and/or the Palestinian health authorities, throughout the West Bank and to Gaza, and monitored their access to hospitals and to the wounded. Where necessary, the ICRC has made representations to ensure that PRCS ambulances can carry out their work.
Since the beginning of the clashes, the PRCS has treated 3,081 casualties at its field clinics, transported an estimated 567 to various emergency rooms, transported blood units between hospitals and borders, and transferred 19 wounded to Jordan for specialized medical treatment. 23 PRCS ambulances have been hit by rubber-coated metal bullets and/or live ammunition. One emergency medical technician was shot and killed while trying to perform a medical evacuation. Several others ha ve been injured.
Given the scale of the response to the PRCS's appeal for medical stocks and equipment, which the ICRC took up in its update of 5 October, the ICRC's delegation in Amman, Jordan, is to be backed up by an additional logistics coordinator. He will organize the arrival of the international assistance and transport between Israel and the occupied territories, and within the occupied and the autonomous territories. The ICRC will also be increasing its fleet of vehicles (1-2 trucks, 1-2 vans and 6 landcruisers), for use in the West Bank and Gaza and in Amman, in order to enhance the efficiency of the operation. Should the closure of the territories continue, the ICRC plans to send a specialist to monitor the economic situation of vulnerable people, as daily life becomes more difficult.
In order to ensure coordination of the relief operation, in particular for donors wishing to ship goods directly to the field, on 16 August the ICRC issued a set of guidelines to National Societies and governments. The guidelines also sought to inform donors of the present logistical set-up in the region and, most importantly, to clarify the ICRC's role in facilitating shipments.
The ICRC as neutral intermediary
As regards the three IDF soldiers captured at the Lebanese frontier on 7 October, the ICRC made representations to Hezbollah and to the Lebanese government, requesting access to the three. In its role as a neutral intermediary the ICRC, at the request of the Israeli authorities and of Hezbollah, is facilitating the implementation of humanitarian solutions to the problem.
The ICRC also continues to visit Lebanese detainees held in Israel and to address the Israeli authorities with a view to gaining access to the one detainee that ICRC has not been allowed to visit so far, and to enabling repatriation of all these detainees .
The ICRC continues to visit Palestinian detainees in Israel.
2. International Federation of Red Cross and Red Crescent Societies
After the PRCS issued its appeal on 30 September, the International Federation consulted with the ICRC regarding the first update, which confirmed the ICRC's role as lead agency. A joint press release was issued on 6 October. The Federation has welcomed National Societies’ requests concerning the best way to express their solidarity to the Palestine Red Crescent Society (PRCS).
International Federation ongoing programmes
In parallel to the emergency operation run by the ICRC in its capacity as lead agency to help the victims of the violence, the International Federation works with the PRCS in the following programmes in the autonomous territories and the occupied territories: institutional development, community health, community-based special education, women and children health project, and disaster preparedness.
In view of the ongoing crisis, these activities - as detailed in the International Federation's 01/41.2000 appeal - take on an ever greater relevance. As at 30 September the response to the appeal covered 54% of the needs. International Federation health programmes are still running in the occupied and the autonomous territories. They also benefit the crisis victims.
3. Updated Movement appeal to cover urgent needs
Following a joint needs assessment conducted by the ICRC and the PRCS, and coordinated with the Federation at field level, the following needs were identified, based on the current situation.
It should be noted that these needs reflect the situation today. Any serious deterioration of the situation would of course lead to a revision of the assessment. ICRC delegates are in the field, receptive to needs, so as to be ready to react to the changing situation as necessary. In view of a possible worsening of the situation, contingency planning is being finalized and will be communicated shortly to all donors.
In these conditions, the main needs that the Movement should try to satisfy will remain primarily in the medical and paramedical spheres.
Medical equipment and supplies for the PRCS
After the arrival of an ICRC five-tonne shipment (11 October), PRCS central storage in Gaza and Ramallah is well stocked. There are enough supplies for 1-2 weeks of ongoing confrontations, if need be. Additional supplies have been pledged by different Arab National Societies. A further serious deterioration of the situation might require further emergency shipments.
The ICRC is at present evaluating the situation in hospitals. Donors will be informed in due course.
Eight ambulances received from the Norwegian Red Cross are already being used by the PRCS in the field and six more ambulances are on the way (provided by the ICRC thanks to ECHO funding). According to the PRCS, three ambulances have been pledged by the UAE Red Crescent, one by the Iranian Red Crescent, two by the Moroccan Re d Crescent, and one by the American Red Cross. Based on that, the fleet is considered to be sufficient for the time being. Having said this, additional ambulances might again be needed as part of the contingency planning.
PRCS-run clinics (Primary Health Care - PHC)
These clinics are in an obvious danger of geographical isolation if closures last and cuts in power supplies occur. Up to now only PRCS headquarters have received one 100kwh generator. There is a need/request from PRCS to upgrade the 22 PHC clinics, at present under-equipped, yet handling a significant portion of the workload. Furthermore, PHC staff needs training in how to handle emergencies effectively. Reporting and communication procedures were seriously hampered because of the absence of fax machines.
Equipment: emergency medical equipment, oxygen cylinders etc., and supplies are envisaged. 22 clinics x 7500 USD = 166,000 USD (no detailed lists are specified at this stage)
Training: 100 persons / 2 seminars / 3 days = 45,000 USD
Fax machines: 20 clinics (two have already) x 400 USD = 8,000 USD
Generators: 22 clinics x small generators (PNS involvement would be coordinated with Federation).
Youth and Volunteers
Extra assistance is needed to provide expertise and know-how in youth and volunteer matters (defining the role of youth and volunteers in a National Society, consolidating and developing programmes). The ICRC already supports the training of 2,500-3,000 first-aiders each year. Yet there is a need to train them in particular for mass casualty scenarios, evacuation procedures, triage, safety and security, etc. Upgrading of the Youth and Volunteer Department, branch network building, special training camps, etc. are envisaged.
The tentative budget for this training would be between 25,000 - 50,000 USD. (PNS involvement would be coordinated with Federation).
Wounded management in Emergency Rooms (in hospitals)
Despite some start-ups (Netherlands Red Cross) to address the problem, the hand-over of patients to the emergency rooms (ER) continues to be a bottleneck. Efficient emergency medical procedures once a patient has been delivered/transferred to the ER have still to be fully implemented. Today the PRCS has the best EMS training facilities in the territories (staff + teaching equipment) and is therefore in a good position to carry out the respective training endeavours. Some extra training material for the special target group would be needed.
Training of 100 ER staff x 5 days = 9,000 USD
Training material = 10,000 USD
15 Red Crescent flags (10x10 metres) for PRCS field hospitals and/or first-aid centres are needed, as are reflector jackets for use during medical operations at night, for volunteers and for EMS teams. The PRCS has a ver y small number of such jackets at the moment.
Budget: 15,000 USD.
Warehouse management/logistics and radio communication
An assessment of issues such as warehouse management/logistics and radio communication has been initiated. Additional expertise might be necessary at a later stage for a more comprehensive evaluation of needs. Donors will be kept informed.
4. Humanitarian response of the Magen David Adom (MDA)
Since the 29 September, the MDA has taken care of 350 victims (6 dead, 24 seriously wounded, 30 relatively seriously wounded and 290 lightly wounded), 87 of whom are members of the Israeli security forces. 11 regional MDA stations have been involved in evacuating the wounded. 23 ambulances have been damaged by burning, vandalizing and stoning.
Four MDA staff have suffered injuries.
The ICRC-Federation joint needs assessment found that, with regard to the MDA, apart from the difficulties they have encountered during their ambulance operations, there are, as regards emergency medical services, no immediate shortcomings or needs to be addressed for the time being. The MDA has offered to help out the PRCS with medical supplies if needed.
The MDA's main concern at the moment is that it should be able to carry out its humanitarian tasks in safety.