Update 00/03 on Medical and other needs in Israel/ occupied territories/ autonomous territories
17-11-2000 Operational Update
Violence continues despite diplomatic efforts
This week was marked by a worsening of the situation in the occupied and autonomous territories, with continuing clashes between Palestinian demonstrators and Israeli forces. Over 230 people have died since the violence began in September, most of them Palestinians. The successive meetings of US President Clinton with the Palestinian leader Yasser Arafat and Israeli Prime Minister Ehud Barak, in an attempt to stabilize the situation in the Middle East and implement last month's Sharm el-Sheikh peace deal, have not brought visible developments.
In addition to the direct casualties of the confrontations, the prolonged obstacles to the mobility of the Palestinian population within the West Bank and Gaza, between the West Bank and Gaza, and between the territories and Israel, are leading to an economic crisis for the Palestinian population. Confrontations, roadblocks and checkpoints restrict the internal circulation of people and goods, isolating towns and villages in the territories for long periods of time. This leads to a substantial loss of income as many people cannot reach their place of work.
The ongoing confrontation and the closures also affect the well-being of the civilian population in other ways. The psychological effects on adults and on children ali ke, often traumatized by the violence, will have long-lasting consequences which will need to be addressed.
The ICRC has staff deployed in the Gaza Strip, the West Bank and East Jerusalem who are closely monitoring the humanitarian aspects of the situation there. To provide an appropriate response to the humanitarian consequences of the situation, the ICRC has mobilized extra staff, including medical delegates, and has increased its presence in the field from 28 to an average of 35 expatriates.
As a complement to the regular monitoring by the ICRC delegation, from 5-14 November a medical evaluation was conducted, within the framework of a mission from ICRC Geneva, to determine the present needs of the Palestinian population, in particular the wounded, and to anticipate future needs in terms of assistance programmes. At the same time, the delegation carried out an assessment of new and emerging needs of the Palestine Red Crescent Society (PRCS).
ICRC medical evaluation
The number of casualties resulting from the confrontations is high. According to the PRCS, over 8,000 wounded have been registered. Those with light injuries are treated at PRCS first-aid posts, set up near the site of the clashes. Serious cases are treated in the Palestinian hospitals. Those with very serious injuries are evacuated abroad, to Arab countries and recently to Germany. So far the ICRC has provided only little medical/surgical assistance, as various other organizations and governments are meeting current needs.
The main problems are linked to the closure of the territories, towns, villages or areas. When closed, an area is completely isolated from the rest of the territories. PRCS ambulances have difficulties in evacuating the wounded from the site of the clashes to the ho spitals, or from one hospital to another. The ICRC has contributed to facilitating the safe passage of PRCS ambulances when requested. Transfers of Ministry of Health (MOH) medical material is also hampered by closures.
The transfer of medical material from the MOH central warehouses in Ramallah or Gaza to the hospitals is also problematic because of the closure of the territories and the numerous checkpoints within the territories. The ICRC offers the possibility of effecting such transfers, and has done so on several occasions.
Primary health care (PHC) is ensured by Palestinian organizations, the MOH and UNRWA. The PRCS with the support of the International Federation of Red Cross and Red Crescent Societies run a PHC programme with 28 health centres.
Rehabilitation centres and care for handicapped people: Among the severely injured people, dozens will be permanently disabled, and will therefore need lifelong adequate care. The existing structures are not in a position to respond to the new needs.
Psycho-social programmes: The current situation will have long-lasting psychological effects on adults and children alike. The ICRC is aware of two centres, one in Gaza and one in Nablus, which run programmes to help the direct and indirect victims of violence to cope with their traumatic experiences and their physical and psychological injuries. The ICRC is ready to give support to these programmes.
The PRCS is also interested in setting up two psycho-social programmes, one aimed at alleviating the psychological trauma of EMS staff, the other at addressing the psychological difficulties of the general population, with special focus on vulnerable groups.
If the present situation in the occupied and the autonomous territories persists, the paralysed economic activity (imports /exports, employment) will soon give rise to blatant additional needs, as most of the population is already living on and spending their savings. Moreover, with winter coming soon, other needs can be anticipated.
In order to define assistance programmes to meet needs, the ICRC will be carrying out an economic security assessment.
Joint ICRC/PRCS needs assessment: update
For now the priority remains the facilitation of PRCS continuous lifesaving services, in particular the mobile first-aid stations (field hospitals). Based on the ICRC/PRCS assessments the following immediate needs were identified:
medical support for PRCS clinics in the West Bank and Gaza . Material to respond to medical emergencies owing to the present situation (surgical kits, blood pressure devices, iv holders, emergency cabinets, around 200 blankets, pillows, bed sheets, flashlights): around 110,000 USD
for the handicapped. Needs will appear in the field of rehabilitation for the severely wounded and permanently handicapped. The provision of material (crutches, wheelchairs, ergotherapy equipment) could be of great help for the organizations / MOH working in this field, cash contributions also. (ca. 100,000 USD).
Other needs for PRCS field hospitals: 20 weather-proof tents (ca. 25 m 2 ); 20 kerosene heaters; 20 generators, devices to prepare hot water.
With the present situation, the running costs of the EMS have also increased considerably.
The ICRC continues to coordinate the Movement's relief response.
The ICRC, as lead agency for the Movement's activities in the occupied and the autonomous territories and in Israel, pursuant to the 1997 Seville Agreement, is coordinating the assistance work of all the National Societies and their Federation. A logistics structure has already been set up at the ICRC delegation in Amman, Jordan, with a two-month budget of 300,000 Sfr. The first convoy of medical supplies crossed the Allenby Bridge border on 16 November, and was delivered to PRCS warehousing in Ramallah (Al Bireh). The convoy included 3 consignments of ICRC medical supplies, following the PRCS's appeal (total 16,000 kg) and other donations (865 kg of emergency health kits for the PRCS, provided by the American Red Cross).
If required, this logistic structure can rapidly be adapted to new needs.