Occupied Palestinian Territory: Humanitarian Needs Overview 2018, November 2017

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The humanitarian context of the oPt is unique amongst today’s crises and remains directly tied to the impact of the occupation, which marked its 50th year in June 2017. A protracted protection crisis continues. At least 1.9 million Palestinians experience, or are at risk of, conflict and violence, displacement and denial of access to livelihoods, among other threats. The most vulnerable Palestinians are currently denied or restricted in their access to essential services such as water and health care. A recurrent cycle of shocks, natural and manmade, has eroded the resilience of vulnerable households to cope with the prolonged nature of the humanitarian crisis.

These dynamics are significantly magnified in the Gaza context by the protracted blockade, imposed by Israel citing security concerns after the takeover of Gaza by Hamas in 2007, three major escalations of hostilities in less than ten years and the intensification of the internal divide between the West Bank-based Palestinian Authority (PA) and the de facto Hamas authorities during the course of 2017. Combined, these factors have devastated public infrastructure, disrupted the delivery of basic services and undermined already vulnerable living conditions. Across the oPt, one in two Palestinians, or roughly two and a half million people, will need some form of humanitarian assistance in 2018.


The humanitarian situation in the Gaza Strip deteriorated markedly in 2017 due to an escalation in the internal Palestinian political divide, following the decision in March by the de facto Hamas leadership to establish a parallel structure to run local ministries in Gaza.In response, the PA reduced payments for electricity, the allowances of public employees, and payments for the referral of patients for treatment outside Gaza. Longer power outages have negatively impacted basic health and water and sanitation services and limited the ability of farmers to irrigate their lands, further undermining food security and livelihoods. Following Egyptian mediation, the two sides reached an agreement in October 2017, which envisages the PA resuming control of the Gaza crossings, as a necessary first step towards alleviating the humanitarian situation and achieving the goal of Palestinian unity under a single, democratic and legitimate national authority. The measures put in place in Gaza in 2017 by the PA had yet to be reversed at the time of preparation of the Humanitarian Needs Overview (HNO).

The magnitude of the challenges facing Gaza is underlined in a recent United Nations report projecting the situation of Gaza in the year 2020. The study revisited key indicators first published in 2012, and found “that most of the projections for 2020 have in fact deteriorated even further and faster than anticipated” with the population increasing and the economy and basic infrastructure and services deteriorating, and “simply unable to keep up with demand.” Real GDP growth in Gaza has slowed to only 0.4 per cent in the first quarter of 2017, while the unemployment rate for the second quarter rose to 44 per cent. Unemployment among those aged between 15 and 29 has reached a “staggering” 62 per cent. According to The Economist, “In real terms, Gazans are about 25 per cent poorer today than they were at the time of the Oslo Accords.” The standard of living in Gaza, with Gross Domestic Product (GDP) per person of $1,700 a year in 2015, is comparable to Congo-Brazzaville; the West Bank figure, $3,700 a year, is similar to Egypt; while Israel, $35,000 a year, is “much the same as France”.

The August 2014 ceasefire continues to hold, with a relatively low number of Palestinian fatalities (17) and injuries (221) by Israeli forces as of November 2017, and no further conflict-related displacement recorded. Approximately 23,500 people still remain displaced from the 2014 conflict, as of November 2017. The Gaza Reconstruction Mechanism (GRM) has played a key role in facilitating increased imports of construction materials; however, it has been less successful in facilitating the import of dual use materials beyond cement and re-bar, also critical for public works projects.
As of November 2017, 5,755 out of the 11,000 totally destroyed housing units have been reconstructed and work on an additional 818 is underway. Insufficient funding is the primary obstacle to completing the remaining residential reconstruction projects.

Most of the two million Palestinians in Gaza remain unable to access the remainder of the oPt and the outside world, with only a minority eligible for exit permits via Israel, primarily patients, business people and the staff of international organizations. Although the number of Palestinian exits increased after the 2014 hostilities, figures have declined significantly again since the second half of 2016, with the figure for November 2017 some 47 per cent below the 2016 average. While there has been a gradual increase in the absolute number of medical patients allowed through the Israeli-controlled Erez crossing, the approval rate has also been declining, at 55 per cent in October compared to 93 per cent in 2012. While the number of approved permit applications for United Nations national staff to leave Gaza increased by 19.7 per cent from the second half of 2016 to the first half of 2017, the Israeli authorities have significantly increased the time necessary for processing permits, from 26 to 55 working days, impeding humanitarian operations.
Movement constraints have been compounded by the protracted closure of the Rafah terminal, which has only partially opened for 29 days in 2017, allowing 1,222 patients to exit for medical treatment.


Although the 2014 ceasefire has held, the ongoing restrictions on the movement of people and goods and the threat of a new round of hostilities are major protection concerns for Palestinians in Gaza. These concerns are exacerbated by the rising hopelessness and deterioration in the humanitarian situation, as well as by the shooting of rockets at Israel and the digging of attack tunnels, among other factors. The risk of Explosive Remnants of War (ERW) remains and high levels of psychosocial distress are reported across the population, particularly among children, leaving them with a deep sense of insecurity, fear and hopelessness. The protracted humanitarian crisis has also exacerbated genderbased-violence (GBV) in all its forms, including sexual violence, domestic violence and child marriage. The Protection Cluster continues to identify accountability for violations during the Gaza hostilities in 2014, by all sides, and for violations during the daily enforcement of restrictions in the Access Restricted Areas (ARAs) as an urgent priority.


No new displacement was recorded in Gaza in 2017. The GRM has provided access to vital construction materials, but as of November 2017 funding is lacking for the reconstruction of about 3,800 destroyed and over 56,500 damaged housing units from the 2014 round of hostilities. Displacement continues for 23,500 people who are primarily reliant on temporary shelter cash assistance (TSCA) to rent accommodation until their homes are reconstructed or rehabilitated. TSCA been disrupted due to significant funding shortages with anecdotal evidence suggesting that this has resulted in debt accumulation and the adoption of negative coping mechanisms such as withdrawing children from school or engaging children in income generation.10 Some 4,500 families who have not yet received assistance to repair conflict-related damages are in urgent need of support due to continued exposure to the elements, high vulnerability and lack of resources. In addition, 8,100 families are at risk of exposure due to inadequate protection against the natural elements.

Access to essential services

The provision of basic services in Gaza remains a key humanitarian concern. Increasing electricity cuts are undermining basic services already depleted by the blockade, recurrent hostilities and restrictions on the import of goods considered “dual use”. Surgeries are being delayed, some diagnostic services are being put on hold, and there has been a disruption in the delivery of primary healthcare (PHC) and secondary healthcare (SHC) services by the Ministry of Health (MoH). Health provision is also impeded by delays in the shipment of essential drugs and disposables from the PA Ministry of Health, which has also recently been delaying or suspending payment for the referral of patients for medical treatment outside Gaza. The number of permit applications denied or delayed by Israel to access health care outside Gaza has also been on the increase, reaching 45 per cent of applications in October 2017.

The blockade and escalations in hostilities have also resulted in repeated damage and the destruction of infrastructure, the deaths of students and teachers and psychosocial stress among children and teachers. Increasing electricity shortages are affecting children’s right and ability to access education at school and at home, restricting study time and their ability to concentrate.
Some 70 per cent of UNRWA schools and over 63 per cent of Ministry of Education schools operate on a double or triple shift system which has reduced instruction time to about four hours a day, and limited the time available to reinforce learning, support slow learners, and offer remedial education and extracurricular activities. Psychosocial services are also struggling to cope with the nearly 300,000 children who require some form of mental health support or psychosocial intervention.

Water and sanitation (WASH) infrastructure and delivery has also been impacted by recurrent conflict, the over exploitation of resources and restrictions on the import of “dual use” WASH items. Over 95 per cent of the water extracted from the aquifer is unfit for human consumption, with the result that 90 per cent of people in Gaza rely on purchasing desalinated water from private trucking, posing a heavy financial burden on already impoverished families and health risks due to widespread contamination of that source. Increased electricity cuts have further reduced the drinkable/ piped water supply and the operation of approximately 130 critical water and sanitation facilities. This has resulted in the discharge of untreated sewage into the sea, contaminating the majority of Gaza beaches, and heightening the risk of the overflow of raw sewage onto the streets.

Erosion of resilience

Recurrent hostilities, the blockade, degraded infrastructure and cuts in the allowances of public employees have impaired economic growth and perpetuated high levels of poverty, unemployment, (particularly among youth), and food insecurity. About 80 per cent of people in Gaza receive food assistance and other forms of social transfers which enable scarce cash resources to be spent on other essentials, preventing a further deterioration of food security and livelihood status, and reducing the impact of negative coping mechanisms. Increased power shortages have further undermined economic activity, particularly in the manufacturing and agriculture sectors, with some 30,000 out of 80,000 dunums planted with seasonal vegetable crops at risk due to irregular irrigation, and dairy cattle farmers and poultry breeders also facing significant losses. The condition of the aquifer, Gaza’s sole source of natural water, is of particular concern as it will be “unusable” by end-2017, with damage “irreversible” by 2020, “unless immediate remedial action is taken.”

UN Office for the Coordination of Humanitarian Affairs
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