Gaza's children, stunted bodies and scarred minds

October 22, 2012
Sarah Benton

Walking through sewage in Gaza: photo from Save the Children Fund, see second item below

Creepy Israeli Planning for Palestinian Food Insecurity in Gaza Revealed
By Juan Cole, Informed Comment blog
October 18, 2012

An Israeli human rights organization, Gisha, sued in Israeli courts to force the release of a planning document for ‘putting the Palestinians on a diet’ without risking the bad press of mass starvation, and the courts concurred. The document, produced by the Israeli army, appears to be a calculation of how to make sure, despite the Israeli blockade, that Palestinians got an average of 2279 calories a day, the basic need. But by planning on limiting the calories in that way, the Israeli military was actually plotting to keep Palestinians in Gaza (half of them children) permanently on the brink of malnutrition, what health professionals call “food insecurity”. And, it was foreseeable that sometimes they would slip into malnutrition, since not as many trucks were always let in every day as the Israeli army recommended (106 were recommended, but it was often less in the period 2007-2010).

Planning for keeping people on the edge is nearly as bad as planning actually to starve them. A prudent person would know that a blockade is a blunt enough instrument, with shipments up and down in a given week, that such a policy would from time to time produce real misery. Were any physicians involved? They should be boycotted by the international community.

And, the Israeli army’s way of trying to minimize the document must be the worst example of propaganda in history! They are saying that the plan was produced but not consulted. But this document aimed at making sure just enough trucks got in to keep people on the edge. If the government didn’t consult it, does that mean it did not care if the food shipments slipped below the basic calorie allowance? Wouldn’t it have been better if they had known about the 106-truck recommendation?

The food blockade had real effects. About ten percent of Palestinian children in Gaza under 5 have had their growth stunted by malnutrition.

A recent report [pdf] by Save the Children and Medical Aid for Palestinians[see below] found that, in addition, anemia is widespread, affecting over two-thirds of infants, 58.6 percent of schoolchildren, and over a third of pregnant mothers.

I mean, don’t those figures make you want to do something for those mothers and children? Wouldn’t they melt anyone’s heart?

Although, under international pressure, the Israeli government eased its blockade slightly in 2010, and foodstuffs are no longer interdicted, it still limits imports into Gaza, and its wide-ranging ban on exports has thrown Palestinians into unemployment at Depression levels, imperiling their ability to afford food even when it is available.

A UN Report out last month predicts that if Israel does not change its policies toward Gaza, the strip will be uninhabitable by 2020, when the population will likely be 2.1 million (think Houston). The deterioration of the water, and the sharp downward mobility of the Palestinians, are only some of the problems the territory will face.

Note that the Israeli government did not voluntarily cease its policy of keeping Palestinians on a diet in 2010. It was forced to by Turkish and European aid activists, and 9 people, one an American citizen, were martyred for this change when Israeli commandos illegally boarded a civilian, unarmed ship in international waters and shot it up.

In any case, there are other ways to starve out the people of Gaza than bluntly preventing food from coming in. Nobel-prize-winning economist Amartya Sen showed that the real cause of famines is not lack of food but that the price of the food rises above the ability of people to pay for it. By keeping Gaza on the edge of economic collapse, the Likud government has continued the food blockade by other means.

The Israeli members of Gisha, who are Mensches, care that their government is contributing in a systematic and deliberate way to damaging childrens’ health because of the way their parents voted in 2006! And they want to embarrass it into ceasing this illegal and inhumane treatment of people who are under Israeli military Occupation and protected from such measures by the Geneva Convention of 1949 (a convention on occupation designed to prevent a recurrence of the excesses and atrocities of the Fascist Powers in World War II, and which you would think an Israeli government would be embarrassed to contravene).

Aljazeera English has [this] video report, valuable because unlike CNN or other Western cable news channels, it actually interviews the Palestinians affected.

It is precisely because the Israeli blockade of Palestinian non-combatants in Gaza is considered creepy and evil not just by me but by any ethical person that a number of European members of parliament have boarded the aid ship Estelle, and will make another attempt to deliver food and other aid to Gaza, despite Israeli threats.

The blockade has medical as well as nutritional bad effects. Palestinians in Gaza have to get Israeli permission (!) to leave the strip for medical care. Palestinian hospitals, having been starved of funds and materiel by Israel, are dilapidated. A study published this month in The Lancet found that 10% of such requests were delayed or rejected by Israeli authorities (the rejection or delay rate for the Palestinian territories over all is nearly a fifth). Israel’s delays murdered 6 Palestinians in Gaza last year, as surely as though they had been taken out and shot twice behind the ear. How would you like to have to apply to an arbitrary foreign government for permission to go next door to a neighboring country for medical care?

The [pdf] Lancet article says,

“In 2011, 1082 (10%) of 10,560 applicants in the Gaza Strip had their access permits denied or delayed, with no reason given, and 197 (2%) were called for security interview. Patients aged 18–40 years had the highest rate of denied or delayed permits. Tracer interviews with Gazan families of patients who had their permits denied or delayed showed that six patients died while waiting for the permits.”

The Gaza Strip is a small expanse of land on the coast of the Mediterranean to Israel’s southeast, which also borders on Egypt’s Sinai Peninsula. Some 40% of its 1.7 million people are victims of Israel’s 1948 ethnic cleansing campaign, and many, having been chased off their farms and out of their homes by the military forces of the Yishuv (the Jewish settler community in British Mandate Palestine), still live, or their descendants do, in refugee camps. The territory was captured by Israel in 1967, and until 2005 Israelis were actually encouraged to colonize it. The Kadima government gave up on that enterprise, but did not let its Palestinian people go.

In January of 2006, Hamas won the elections for the Palestine Authority (it had been allowed to run at the insistence of Bush, who, however, backed down in a cowardly way from ‘democratization’ when the Israelis insisted that the outcome was unacceptable). The Bush administration and the Israeli government connived in staging a coup by Fateh in the West Bank. The coup failed in Gaza, where the elected Hamas government retained control.

From 2007, Israel imposed a blockade on the exports and imports of the Palestinians of the Gaza Strip. It vastly limited the number of trucks that were allowed in from Israel and disallowed most exports. Dov Weinglass, an aide to then Prime Minister Ariel Sharon, announced that the Palestinians would be ‘put on a diet.’ That is, the Israeli government had decided to wage economic and nutritional warfare against the Palestinians.

Obviously, allowing them to become malnourished would raise an outcry even in an international community that typically allows Israel’s settler colonialism to get away with murder toward the Palestinians. So the policy was to keep the Palestinians “food insecure.” That is, they wouldn’t be starved, but they’d be one step away from starving — if they lost a source of income, for instance.

Wikileaks revealed a US embassy cable that confirmed, “As part of their overall embargo plan against Gaza, Israeli officials have confirmed to [U.S. embassy economic officers] on multiple occasions that they intend to keep the Gazan economy on the brink of collapse without quite pushing it over the edge…”

Note that the cowardly US government went along with this policy of ruining the lives of civilian non-combatants as a way of trying to defeat the Hamas party-militia (five years later, I think we can safely pronounce the policy a failure).

The most horrible thing is that the Israelis, and the international community, have no long-term plans for Gaza. There is no light at the end of the tunnel. There is no vision for how this blockade of innocents will ever end. People pay lip service to a ‘two state solution,’ but everyone knows that Israel won’t allow the Palestinians to have a state! Although Qatar has just announced a multi-million-dollar aid program, it remains to be seen whether Israel will allow it. And, aid is secondary to the dignity of being citizens in a state, which is what Palestinians really need (the economic efflorescence would come from that statehood better than from outside charity). The people of Gaza are apparently to be kept in a large out-door concentration camp forever. Unless the world cares enough to rescue them from that fate.

Gaza’s Children:
Falling Behind, the effect of the blockade on child health in Gaza

By Save the Children and Medical Aid for Palestinians
June 2012


Executive Summary

As of June 2012, the blockade of Gaza will be five years old. This report shows that the extensive restrictions placed on the movement of people and goods in and out of Gaza continues to have a real and negative impact on the lives and health of Gaza’s children. The blockade has been the single greatest contributor to endemic and long-lasting household poverty in Gaza. This has meant that families are unable to buy nutritious food and are less able to produce nutritious food themselves.

● Stunting, or long-term exposure to chronic malnutrition, remains high, found among 10% of children under five.

●Anaemia, usually caused by dietary iron deficiency, affects
most children in Gaza (58.6% of schoolchildren 68.1% of children 9-12 months) and one-third (36.8%) of pregnant women. If untreated, iron-deficiency anaemia adversely affects child development and pregnancy outcome.

●Sanitation-related diseases with serious implications for child mortality, such as typhoid fever and watery diarrhoea in children under three years of age, have increased at clinics serving refugees in the Gaza Strip. Gaza’s polluted water supply will have long-term health implications, but current monitoring is insufficient to measure the impact of untreated sewage and poor water quality.

Every child is entitled to an adequate standard of living, the right to survival and to develop their full potential. To have the best chance of a healthy, happy life, each child needs nurturing relationships, a safe environment in which to explore and play, nutritious food and clean water, and access to professional and responsive services, including medical care.

The Palestinian Authority has set goals to meet those needs, repeatedly establishing well-intentioned plans to improve crucial child health benchmarks. But time and again in Gaza, those plans have been waylaid. Today, the reason for this failure is due to the far-reaching impacts of the blockade on the broader social determinants of health. In addition, the blockade has exacerbated political differences between Gaza and West Bank authorities and contributed to a lack of national, coordinated strategic planning and delivery of services. At every level where children seek support, that support has been shrinking due to the blockade: families bear the strains of prolonged poverty and food insecurity, with no end in sight; the community is torn by political disputes and critical services, including health, have been unable to recover from conflict; and the environment is heavily polluted, with Gaza’s residents being squeezed into an ever-shrinking, increasingly unhealthy space with almost no clean water. It is the lack of this that makes children particularly vulnerable to the spread of diseases.

According to Article 6 of the Convention on the Rights of the Child, to which Israel is a signatory, “States Parties recognise that every child has the inherent right to life” and “shall ensure to the maximum extent possible the survival and development of the child.” The Convention also ensures, in Article 24, the child’s right to the “highest attainable standard of health”, specifically mentioning the child’s right to access health services, and the State Party’s duty to decrease infant mortality, disease, malnutrition and the risks of pollution. Yet there is evidence to suggest that conditions in Gaza are causing the avoidable deaths of children.

A comprehensive 2009 study in the health journal The Lancet observed that the rate at which children die in the first year of life has not improved in Gaza for decades, while nearly all other countries in the world have improved in this respect. Data gathered on infant mortality rates since the blockade began is inconclusive and not comprehensive. Since 2007, 605 children in Gaza have been killed and 2,179 injured as a direct result of the conflict, and 60 children were killed and 82 injured in Palestinian factional and other fighting. In 2012 alone, three children drowned in pools of open sewage that cannot be adequately addressed as long as the blockade hinders sanitation development.

Delays and denials in the issuing of permits for Gaza children seeking medical care in Israel are also putting lives at risk. About one out of every 20 children (174 of about 3,949) referred abroad in 2011 for treatment missed his or her appointment due to delays in issuing the travel permit. Three were denied permission. Three children died while waiting for permission to travel.

Ongoing conflict has also put Israeli children at risk, in particular those living in communities near the perimeter of Gaza. Children have lost school days as a result of rocket fire from Gaza, and live in fear when there is active conflict. The Palestinian Authority devotes around 11% of its Gross Domestic Product to healthcare, more than most middle-income countries.

In addition, hundreds of millions of dollars in international aid are directed towards the occupied Palestinian territory every year and yet child health in Gaza is deteriorating. Aid is helping to reduce many of the symptoms of this crisis but its solution demands political will. Israel, as the Occupying Power, has the right to address legitimate security concerns but it must also allow for the free flow of goods, people and services. According to the international laws of war, Israel is responsible for the welfare of Gaza’s civilian population. At this key moment, five years on, we call on Israel to fulfil its responsibilities and end the blockade of Gaza immediately and in its entirety.
Families reporting Psychosocial symptoms resulting from Operation Cast Lead
observed behaviour          no. of families reporting      Percentage out of total
behaviour from at least       families surveyed
1 member
crying attacks                                1,198                                      42.5%
fear of permanent darkness     1,651                                      58.6%
exaggerated fear of blood           723                                      25.7%
nightmares                                     1,210                                      43%
sleep disturbance                        1,535                                     54.5%
feelings of frustration                 1,626                                    57.7%
bad mood                                         1,811                                     64.3%
decreased appetite, weight          425                                      15.1%
increased appetite                           344                                      12.2%
increased yelling                          1,751                                       62.2%
increased thoughts of death    1,027                                      36.5%
bedwetting                                      1,053                                      37.4%
increased irritability                  1,751                                       62.2%
lack of interest in self                      332                                       11.%
lack of interest in children            124                                         4.4%
inability to perform daily activities
in last two weeks                               442                                          15.7


Key Recommendations 

●As a matter of urgent priority for the health and wellbeing of Gaza’s children, israel must lift the blockade in its entirety to enable the free movement of people and goods in and out of Gaza, including to the West bank and east Jerusalem.

●Recognising that relying on humanitarian assistance to mitigate the devastating impacts of the blockade has not worked, robust funding and development strategies must be devised and implemented for Gaza based on aid effectiveness principles that include long-term assistance into key services. the Ad hoc liaison committee should immediately be tasked with developing such a strategy and action plan by the end of 2012.

●The international community, along with the relevant authorities, should implement as a matter of priority long-term strategies specific to improving the nutritional status of Gaza’s children.

● Given the direct relationship between a supply of clean water and deteriorating water and sanitation systems, on one hand, and child mortality on the other, all planned water and sanitation projects should be implemented immediately, and a clear timetable provided by the israeli authorities for their completion.

● It is essential that the Palestinian Authority facilitates the impartial and rapid material provision and funding of medical supplies and services in Gaza, and all Palestinian authorities work as a matter of urgency to unify the health care system.


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