Annual Report of the Department of Health 2010 - Unrwa

DELIVERING HEALTH TO THE VICTIMS OF CONFLICT
DELIVERING HEALTH TO THE VICTIMS OF CONFLICT
The international community must assume its responsibilities to facilitate progress – and, where necessary, insist on
it…in the aftermath of the tragic conflict in Gaza, this is more urgent than ever.
Secretary-General Ban Ki-moon, January 2009
As an Agency working in a chronically unstable environment, UNRWA is continuously challenged by upsurges
of violence. Conflicts in Lebanon and more recently in the Gaza Strip have forced the health programme to
react rapidly in order to ensure continuity of services. New services such as mental health to deal with the
consequences of protracted violence and insecurity and physiotherapy and rehabilitation were established.
UNRWA’s Health Programme is strongly decentralized and able to adapt rapidly to limits imposed by logistic
impediments and security concerns. This has limited the disruption of activities like epidemiological surveillance
and treatment of chronic diseases that suffer the most in times of conflict.
THE WEST BANK AND THE GAZA STRIP – A PERSISTENT HUMANITARIAN CRISIS
In the decade since the start of the Al Aqsa Intifada, the West Bank and the Gaza Strip have been in the grip of a
protracted humanitarian crisis. The occupied Palestinian territories (oPt) have suffered recurrent episodes of violent
conflict, repeated destruction of homes and infrastructure and longstanding restrictions on movement. These
conditions have eroded coping mechanisms and driven hundreds of thousands of Palestinians into poverty.
2010 saw a decrease in violence and conflict-related casualties in Gaza compared with the escalations of 2009.
However, in the absence of a just and lasting peace and an end to Israeli occupation, Palestinians remain extremely
vulnerable.
Palestinians continue to face a range of security threats, including conflict-related violence, settler violence, Palestinian
inter-factional violence and unexploded ordnance. Between January and September 2010, there were 65
conflict-related civilian deaths and 1,199 injuries throughout the oPt. In Gaza 3,415 new injury cases were admitted
to UNRWA physiotherapy services during 2010. Access to quality health care has become severely constrained. The
effects of the on-going conflict, human rights violations and enforced isolation have had a debilitating effect on the
mental health of the refugee population in the Gaza Strip and in the West Bank and in particular on children and
young people. Symptoms reported include intense fear, eating and sleeping disorders, hyperactivity and, in the long
term, increased anti-social behaviour during adolescence and neurotic problems during adulthood. Violence against
women and girls is also on the rise.
Financial constraints remain a serious concern for UNRWA’s work in the oPt. Since 2009, the health program was not
able to reimburse costs for all deliveries taking place in hospitals, opting to select only cases at high and moderate
risk. For the same reason, life-saving tertiary care treatments, such as dialysis are still not reimbursed by the Agency.
Furthermore, restrictions to movement of health staff and goods continued to complicate logistics and
consequently contributed to increasing operational costs within the oPt. This, combined with increases in already
high prices of goods Programme (including medicines), was one of the main challenges to the UNRWA health
program during 2010. Despite the difficult circumstances, UNRWA continued to provide primary health care,
support for access to secondary and tertiary care, and community mental health care to the populations of the Gaza
Strip and the West Bank.
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