Aid agencies: Suspension of aid is accelerating slide into crisis

A Palestinian man searches for usable things to sell at garbage dump in the West Bank village of Zatara near Bethlehem March 27, 2006. As the Palestinian economy is deteriorating more people is forced to take desperate measures to survive. (MaanImages/Magnus Johansson)

The Association of International Development Agencies (AIDA) cautioned donor governments and Israel that the strategy of starving out the newly elected Hamas government by rerouting aid to outside agencies is deepening the suffering of civilians. Thirty-six aid agencies operational in the occupied Palestinian territories said the suspension of direct aid to the Palestinian Authority — a move initiated by Canada, the US and EU — is accelerating a slide into crisis. The sanctions have left unpaid for a second month the entire Palestinian public sector, comprising 150,000 police, doctors, teachers and other public service workers. Aid agencies the situation is most acute in the Gaza Strip.

Humanitarian Situation in Gaza Six Months After Redeployment

International non-governmental organizations (NGOs) are witnessing a rapidly deteriorating situation in the Palestinian territory. While the situation in the West Bank remains challenging due to continued construction of the Wall, expansion of Israeli settlements, and restricted movement and access, it is the humanitarian situation in Gaza that is of utmost concern to International NGOs at present. Six months after the Israeli redeployment to the periphery of Gaza, we have come together to express our deep concern over the rapidly deteriorating humanitarian situation in Gaza.

Despite initial hopes following the redeployment in September 2005, the humanitarian situation in Gaza has not improved. In fact, the situation has deteriorated due to three key factors:

  • The continued and increased closure of border crossings and restrictions on movement, which have decimated the economy and seriously depleted stocks of essential goods in Gaza;
  • The withholding by the Israeli government of Palestinian tax revenues, which provide roughly half of the Palestinian monthly revenue; and
  • The suspension of direct aid to the Palestinian Authority (PA) and the shifting donor priorities to channel humanitarian assistance through United Nations and NGOs, which seriously undermines the PA’s ability to deliver essential services to the Palestinian population.

    With the PA providing services to 80% of the Palestinian population, these factors seriously undermine the PA’s ability to provide these services. The UN and international and local NGOs cannot fulfill the core public sector responsibilities by setting up parallel mechanisms. More practically, the UN and NGOs do not have the capacity to coordinate, manage and administer the wide range of essential social services in the West Bank and Gaza, only to complement and support existing public sector structures as in the case of a humanitarian crisis.

    Therefore, international NGOs call on the Israeli government, the PA, and the international community at large to:

  • Recognize that the delivery of needed humanitarian assistance to the Palestinian people in the Palestinian territory should not be jeopardized because of political developments; and
  • Implement existing agreements related to movement and access in and out of Gaza.


    Gaza is one of the most densely populated areas in the world, with a total Palestinian population of 1.3 million people living in an area of only 365 square km. There are two main crossing points between Israel and Gaza: Erez in the north, and Karni in the center, with an additional crossing point to Egypt at Rafah.

    The situation since 2000

    Prior to the Israeli redeployment, indicators showed that the social and economic situation in Gaza had already seen a severe and rapid decline since the outbreak of the second Intifada (or Palestinian uprising) in 2000.

    The economy was unable to recover from the severe recession of 2000-2003, which resulted in a poverty rate of 78% by 2005. The World Bank cites border closures and related restrictions on movement as the most significant cause of economic recession, unemployment, and increasing poverty in the territory.

    Food insecurity rose to 39% of the population. Food consumption levels had fallen by over 54% per capita by 2005. Protection and Education: The areas around settlements and military checkpoints became areas of high conflict. With restrictions on movement within Gaza, pupils found it difficult to get to school, limiting their access to education. Poor teacher training and the isolation of teachers brought a decline in the quality of education. The under-five mortality rate increased by 30%, and mental health became an increasing concern due to the stress of living with conflict and insecurity.

    The situation today

    Despite the redeployment the situation in Gaza has deteriorated rather than improved.

    Military actions continue inside Gaza. The Israeli military continues to launch airstrikes from the Gazan periphery, including into heavily populated areas, which have resulted in civilian casualties. Palestinian militants continue to launch rockets into Israel proper.

    Full internal movement has been restored inside Gaza since the redeployment and previously blockaded enclaves are open to the rest of Gaza, with significantly positive implications for these residents. However, the demarcation of a “no-go buffer zone” in northwestern Gaza has caused particular difficulty for the residents there. The total buffer zone area is approximately 2.5% of the total Gaza Strip area, affecting an estimated 5,000 Palestinians in surrounding villages.

    Continued restrictions on movement between Gaza and Israel are limiting trade and access to essential goods and services and the economic and humanitarian situation inside Gaza is actually worsening daily. International NGOs echo the fears expressed by United Nations organizations that the humanitarian situation will significantly decline.

    Trade and Economy

    The conditions for sustained trade and economic growth in the Gaza Strip are severely constrained due to a number of factors, most notably the restricted flow of goods and labor into and out of Gaza. This, along with the suspension of tax revenue transfers to the PA (see below), is further crippling an already distressed economy and further undermining the livelihoods of the approximately 78% of Gaza’s population who live below the poverty line.

    Restricted movement

    The Palestinian economy is highly dependent on external trade, with exports and imports in 2005 accounting for $3.4 billion or 83% of Gross Domestic Product (GDP) for the Palestinian territory. Economic benefits in Gaza due to improvements in internal movement following the redeployment in September 2005 have been largely offset by the continued difficulty in accessing external markets, shortages of basic imported goods, and diminished labor opportunities in Israel.

    Movement of goods: Despite commitments made by the Government of Israel (GOI) and the PA in November 2005 under The Agreement on Movement and Access to extend the operating hours and raise productivity at the Karni crossing, there has been little progress. Karni has been closed or working at levels far below capacity since January 2006. Each day of closure results in an estimated loss in export trade of $500,000 to $600,000: the closures between 15 January and 5 February 2006 alone resulted in an estimated loss of $10.5 million. The closures have also resulted in shortages in Gaza of basic goods such as dairy products, sugar and flour, as well as medical supplies and construction materials.

    Most affected by border closings and restrictions is the agricultural sector which depends on the timely export of horticultural products such as strawberries, which are wasted as the local market cannot absorb these products intended for export. Strawberry producers lost $70,000 per day during periods of closure. From the 22 February until 8 March 2006, 40 tons per day of strawberries have been destroyed, with losses reaching $816,960.

    Movement of labor: Erez is the only crossing point for workers into Israel, a critical source of employment for Palestinians and revenue for the Gazan economy. In 2000, over 21,000 men were daily crossing Erez to work inside Israel: by Feb 2006 the number had dwindled to 3,698. Sporadic closures of Erez and age restrictions for permits have significant consequences for these workers and their families, given the stagnant Gazan economy.

    Reduced revenue: Gaza’s economy is highly dependent on the financial in-flows from tax revenue collected by the GOI, as well as external donor assistance. Currently as agreed under the Paris Accords of 1994, the GOI transfers duty and Value Added Tax (VAT) revenue for goods entering the Palestinian territory to the PA on a monthly basis. The approximately $60 million of monthly revenue to the PA under this arrangement has been suspended by GOI since the recent Palestinian Legislative Council (PLC) elections in January 2006. Also under review following the recent PLC elections is external donor assistance, which amounted to $1.3 billion in 2005.

    Although positive economic growth rates were recorded between 2003 and 2005 in the West Bank and Gaza, incomes in the territory remain considerably lower than pre-intifada levels, with real GDP per capita 31% lower than in 1999. Further economic stagnation or contraction due to these factors would further jeopardize the economic and food security situation of Gazans, particularly the most vulnerable portions of the population.

    Food Security

    Food security for many Gazans remains tenuous in terms of both affordability of and access to food. A significant proportion of Gaza’s population is currently food insecure (39%), due primarily to declining economic conditions and the restricted movement of goods in and out of Gaza.

    Food shortages Since 15 January, successive closures of the Karni trade crossing demonstrate how dependent Gaza is on the sustained flow of goods in and out. The majority of basic goods in Gaza are imported so the closures have lead to lower availability and higher prices (in particular for sugar and wheat flour, which provide around 80% of the total dietary energy supplies). In March, wheat flour shortages hindered the production and consumption of bread, the staple food, leading to rationing. On average, the prices of basic commodities have increased by 32.5% since January 2006. The poorest households are most at risk since they are the most dependent on food assistance, and their coping capacities to absorb such price shocks have diminished over time.

    Coping mechanisms The combination of food shortages, rising prices, and declines in purchasing power since the start of the second Intifada has forced many Palestinians to rely on a variety of unsustainable coping mechanisms to secure food, such as selling assets, reducing food consumption, using savings, borrowing, and incurring debt. These strategies have caused further impoverishment and are now virtually exhausted. By 2005, 54% of the population had decreased the amount of food they consumed. There has also been a decrease in the consumption of animal protein as meat and poultry have become too expensive for poor households.

    This could be exacerbated further, with the continued closures of Karni and the withholding of VAT transfers causing greater food insecurity and an increase in the number of Palestinians dependent on food aid. Indeed, by June 2006 the proportion of food insecure Gazans could climb by 30%, putting more than 92,000 people at risk.

    Avian Flu Food insecurity will grow with the arrival of Avian Flu in Gaza and the subsequent culling of poultry. 88.3% of domestic animal protein production was poultry based in 2003/2004, with 73% of all animal protein consumed coming from the local poultry sector.. Gazan households have started substituting their consumption of chicken with fish, the only alternative animal protein source. As a consequence of this increased demand, there have been fish shortages and price rises, affecting the food security and protein intake of the poorest populations.


    Six months after the Gaza redeployment, protection concerns remain a key priority for the population of Gaza. While the removal of the Israeli military and settlements from inside Gaza significantly reduced the likelihood of internal Palestinian/Israeli confrontations, there has still been an upsurge in violence within Gaza.

    Child protection and psychosocial wellbeing Fear of continued shelling, other forms of military violence, and internal instability continues to affect children, who say they still do not feel secure after the redeployment. Burdened with daily constraints and pressure, parents face an increasing erosion of their capacity to manage their children’s distress together with their own, inevitably bringing tensions into their homes. Parents report that they have repeatedly witnessed signs of nervousness in their children over the last six months, and many parents continue to witness violent and aggressive behavior in their children. Currently, schools are the main provider of a sense of normality and protection for the half million school-age children in Gaza.

    Education Prior to the redeployment, many children faced difficulties reaching their schools, in particular those children that had to pass through military checkpoints or that lived in one of the several blockaded enclaves around Israeli settlements. Infrastructure improvements were not made and teachers were unable to participate in Ministry of Education and Higher Education and UNRWA trainings.

    Access to education: The population of Gaza now enjoys increased internal access to most areas of Gaza (with the exception of the no-go buffer zone in northern Gaza). Children and young people therefore now have access to their schools, and no longer have to pass areas of high conflict (military checkpoints, settler roads) on the way. However, university students studying in locations in the West Bank and abroad have encountered progressively more restrictive policies. For example, currently no students from Gaza are permitted to study in West Bank universities.

    Quality of education: Although access to basic and secondary education has improved, the quality of education remains a major concern, most particularly in those areas of Gaza that were isolated in the past. Plans are now in place to construct 560 new classrooms and train 6400 new teachers to improve the situation.

    The Palestinian Ministry of Education and Higher Education (MEHE) currently manages 62% of schools in Gaza, and runs all five vocational training institutes. The school system is currently under considerable duress as teachers and administrator salaries have not been paid, seriously impacting the school system’s ability to continue operating.


    After more than five years of widespread military conflict, border closures, unemployment and impoverishment, the overall health status of the population in Gaza has deteriorated. The accessibility, affordability, and quality of health care services have declined and health indicators have fallen sharply.

    Access to services There are 56 Ministry of Health (MoH) Primary Health Care centers in Gaza, supported by 51 non-governmental clinics and 18 UNRWA centers. Given the high population density in Gaza, these centers are overwhelmed offering services for up to 130 patients per clinic a day. The declining economic situation has put an additional burden on UNRWA and MoH services as the cost for care at private clinics has become beyond the reach of most people.

    Despite the range of service providers, many services are not available or are inadequate to meet the needs of the population. Limited treatment facilities mean patients often need to be referred to Egypt, Jordan, or Israel. Although movement through Rafah crossing into Egypt has been eased, difficulties remain in obtaining permits to enter Israel through Erez, which has prevented patients from access to treatment. The closure of the Karni crossing for extended periods of time has also led to a shortage of basic drugs, disposable equipment, and diagnostic materials in Gaza.

    Declining health indicators Health indicators in the Palestinian territory are relatively stable, although UN agencies and international NGOs document worrying trends. The health sector responded to closures and the fragmentation of the health system by increasing the number of small and mobile clinics focusing on primary health care, resulting in a decline in the quality of services. Increased poverty, access challenges, and declining quality have resulted in:

    * A continuous increase in chronic malnutrition in children under five, which now reaches 10%. * An increase in mortality in children under five by about 30% since the start of the Intifada, due to poor newborn care in hospitals resulting from disruptions in the supply of safe water, inadequate sanitation systems, improper food, and a lack of basic medical equipment. * An urgent need for drugs and supplies including antibiotics, micronutrients, and disposables at all levels of the health care service delivery system.

    More recently, Avian Flu has been confirmed in Gaza and the culling of the infected poultry is underway. By 10 April 2006, more than 339,986 birds in 36 farms had been culled in Gaza. Farmers who manage poultry farms remain reluctant to inform the Ministry of Health and Ministry of Agriculture of suspected cases due to lack of financial compensation. While no human cases have been detected so far, the nutritional consequences of the outbreak are grave as poultry products are the main source of dietary protein in Gaza.

    All health care service providers rely on donor financing to sustain operations and deliver services. Reduced assistance to the health sector will in the short term result in a decline in the quality of care, with likely long term negative impacts on the most vulnerable groups, women and children.

    Donor Commitments

    Following the Israeli redeployment in September 2005, the Quartet (the US, EU, UN and Russian Federation) reaffirmed its commitment to coordinate the international donor community to address Gaza’s humanitarian needs. The Quartet’s special envoy, James Wolfensohn, developed the “Quick Impact Economic Programs” initiative which included the disbursement of $750 million in the last quarter of 2005 for infrastructure and basic service improvements throughout Gaza.

    Donor governments had yet to disburse $220 million by the end of 2005. More recently, key donors, including the European Union, the United States, Great Britain, Denmark, the Netherlands, Norway, and Canada, among others, have declared that they are suspending direct assistance to the PA. Donor pledges that were made to support the development of Gaza in September 2005 are particularly critical at this moment as Gaza faces extreme economic and humanitarian difficulties.


    The humanitarian situation in Gaza has deteriorated since the Israeli redeployment to the periphery, and may deteriorate even further if current and additional humanitarian and development activities are jeopardized.

    The international relief and development agencies represented here therefore recommend that:

  • The international community and donor governments continue to provide essential humanitarian assistance to the Palestinian people, as well as the Quick Impact Economic Programs and other development activities aimed at improving the socio-economic wellbeing of Gazans.
  • The administrative, management, and coordination responsibilities of public sector institutions are not replaced by NGOs or UN agencies. Setting up parallel systems of public service delivery through NGOs or UN agencies is not viable. UN agencies and NGOs do not have the capacity or the responsibility to administer public services, in particular when there are capable administrative structures already in place.
  • The Government of Israel and the Palestinian Authority uphold the Agreement on Movement and Access of 15 November 2005 in relation to the movement of people and goods through the main crossing points, particularly by extending the operating hours and raising the productivity of Karni trade crossing.
  • All parties uphold International Humanitarian Law, and ensure the protection of civilians in the occupied Palestinian territory.

    Aid agencies signatories: ACSUR Las Segovias; Asamblea de Cooperación por la Paz (ACPP); Campaign for the Children of Palestine; Comitato Internazionale per lo Sviluppo dei Popoli (C.I.S.P); Centro regionale d’Intervento per la Cooperazione (CRIC); Diakonia; EDUCAID; Enfants du Monde - Droits de l’Homme; Enfants refugies du monde; FCD Solidarité Socialiste; Gruppo Volontariato Civile (GVC) Italy; HAGAR Centers for Rehabilitation ; Handicap International; International Christian Committee; International Relief Fund for the Afflicted and Needy (IRFAN - Canada); Italian Consortium of Solidarity; Japan International Volunteer Center; Medical Aid for Palestine (MAP-UK); Médecins du Monde France; Médecins du Monde Suisse; Médecins du Monde Greece; Mennonite Central Committee; Mercy Corps; Merlin; Middle East Aid ; Movimiento por la paz, el Desarme, y la Libertad (MPDL); Norwegian Church Aid; Norwegian People’s Aid (NPA); Quaker Service- Jerusalem (American Friends Service Committee); Save the Children Sweden ; Save the Children UK ; Solidaridad Internacional; Swedish Organization for Individual Relief (SOIR); Swedish Cooperative Centre (SCC); Volontariato Internazionale per lo Sviluppo (VIS); World Vision Jerusalem.

    More Information

  • Allyn Dhynes - World Vision Jerusalem -; Jennifer Moorehead - Save the Children UK -


    All information for this Fact Sheet came from the following sources: CARE International Health Surveys IUED Public Perceptions Survey, July 2005 International Relief Fund for the Afflicted and Needy Office of the Special Envoy for Disengagement Periodic Reports Quartet Statement on Middle East Peace, 20 September 2005 Save the Children UK focus groups with children, 2006 UN Standing Committee on Nutrition report, November 2004 UNICEF various reports United Nations Consolidated Appeals Process 2006 United Nations Family Planning Association United Nations Office for the Coordination of Humanitarian Affairs (UN OCHA) Humanitarian Updates and Situation Reports World Bank Periodic Updates World Bank, Economic Update and Potential Outlook, 15 March 2006 World Food Program, various reports World Food Program/VAM Food Insecurity in the West Bank and Gaza Strip, 2005/6 World Health Organization WHO Gaza strip avian flu update, 30th March 2006 WHO, UNICEF, Palestinian Ministry of Health, “The state of nutrition, West Bank and Gaza Strip”, June 2005 World Vision 2005 study. Other sources for statistical data: Palestinian Central Bureau of Statistics (PCBS), Demographic Health Survey, 2004; Labor Force Survey, 2005 Palestinian Ministry of Education and Higher Education Palestinian Ministry of Health, Annual Report 2004 Palestinian Water Authority Israeli Ministry of Finance.

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