WITNESS 07

The victory of Hamas in Palestinian elections in
After several weeks of violence in Gaza in which
Dear Supporter, January redrew the political landscape. When a nearly 20 Palestinian civilians were killed,
Hamas government was sworn in at the end of Palestinian militants launched a raid on an Israeli
When we took the decision to focus this issue of Witness on Gaza, few could have predicted March, the US, followed by the EU, cut off all military post near the Kerem Shalom crossing on
that a war between Israel and Hizbullah was just around the corner. The impact of that war direct financial assistance to the Palestinian 25 June. Two Israeli soldiers were killed and one,
Authority, prompting financial crisis in the Cpl Gilad Shalit, was abducted.
on Lebanon's civilian population was devastating. One in four Lebanese were displaced and
Occupied Territories.
over a thousand lives were lost. Normality is returning slowly and people are starting to
On 28 June, Israel launched 'Operation Summer
rebuild their lives, but a very high price has been paid, both in terms of human life and
Under intense media scrutiny and amid warnings Rain', aimed, it said, at securing the release of
physical destruction. that the Palestinian health system faced imminent Cpl Shalit and ending Palestinian rocket attacks
collapse, the EU announced in mid-May that it on southern Israel.
Civilians in Gaza are also counting the cost of conflict with Israel. Throughout the summer would develop a Temporary International

In mid-July, conflict erupted between Israeli and
months, the crisis in Gaza has raged, largely overshadowed by events in south Lebanon. Mechanism to provide assistance to the Palestinian
Hizbullah forces. A fragile ceasefire was finally
Suffering under economic sanctions, Israeli siege and daily incursions, the situation has people. Two months later the TIM began operation.
achieved on 14 August.
reached breaking point.

OVERVIEW: UNFOLDING EVENTS

Under such enormous pressure, tensions are rising. Violent clashes between rival Palestinian Gazans requiring emergency medical treatment in Israel wait for hours at the Erez crossing.
factions are growing increasingly common and armed crime is on the rise. MAP's programme
staff in Gaza tell me that 'carjacking' at gunpoint is occurring in broad daylight, while fewer
and fewer people are taking to the roads at night.
With the withdrawal of international funding, the economic situation has deteriorated
rapidly. The effects on health have been devastating. In this issue we explain how civilians in
Gaza feel that they are being collectively punished for their choice of government. With food,
medicines, electricity, fuel and water all scarce, there is a growing sense of hopelessness and
abandonment. Crossing points in and out of Gaza are also closed to Palestinians, increasing
the sense of isolation. Gaza is often described as one vast prison and this has never been
truer than it is now.
It has been a difficult summer, but our emergency and development projects have been
able to continue, thanks to the generosity of our supporters and the commitment of our
partners on the ground.

Brian Constant
Chairman OCTOBER 2006
 F F
COLLECTIVE PUNISHMENT
Ordinary Palestinians in Gaza are
living in an environment of
extraordinary violence, uncertainty
F E AT U R E : C O L L E C T I V E P U N I S H M E N T
and fear. The civilian death toll in
Gaza is rising while people's homes
and livelihoods are being destroyed.
Unable to leave in search of safety,
Gazans are, in effect, imprisoned and
many feel utterly forgotten.
Incursions, air strikes and artillery shelling are
putting Gaza's civilian population under intolerable
strain. In violation of international conventions,
Israel is employing the tactics of collective
punishment. And it's no secret either. Israeli Prime
Minister Ehud Olmert said as much in early July
when he publicly confirmed that he had instructed
Israel's armed forces to “make sure no one sleeps
in Gaza at night.”
And Olmert has been true to his word. Throughout
the crisis, Israeli air force jets have carried out low-
altitude sorties over Gaza causing powerful sonic
booms. Sometimes averaging three or four a night,
the sole purpose of these sorties is to deny sleep
Water is also in short supply. The Gaza Water Utility
is relying on its own backup generators to keep
water wells and sewage facilities functioning and
daily operations have been cut by two thirds. Most
households in the urban areas now have only 2-3
hours of running water per day. This means that
families in Gaza have insufficient water to wash
and to create an enduring sense of anxiety and fear clothes or dishes, to flush toilets or to bathe
among the civilian population. The impact on children regularly. With the breakdown of the sewerage
is particularly severe. Panic attacks, sleep disturbances, system, 60,000 cubic metres of raw sewage are
F E AT U R E : C O L L E C T I V E P U N I S H M E N T
bed-wetting, loss of appetite and loss of concentration being pumped into the sea each day. By early July
are all commonly reported effects. there had already been a 160% increase in cases of
diarrhoea compared with the same time last year.
Then there is the electricity. Following an Israeli air
strike on Gaza's only power plant on 28 June, the And with no fuel, the municipal authorities cannot
entire Gaza Strip has been without electricity for maintain regular services such as rubbish collection.
between 12 and 18 hours every day. In soaring Bags of rubbish are piling up on the streets,
temperatures, that has meant no fans, no fridges and attracting children from the most needy families
no lights. Many shops are using generators to provide who pick through the litter looking for anything
power when the electricity fails, but the noise on the they can use or sell. Key roads and bridges have
streets is deafening and the fumes get into your nose been destroyed in Israeli air strikes and movement
and throat, causing nausea and headaches. around Gaza has become a nightmare.
Health services too are suffering. Fuel donations from July was the deadliest month in Gaza for nearly
the international community are partially supporting two years. The continuing violence is having a
A demonstration in Gaza city in July.
essential services, such as kidney dialysis machines, in devastating impact on civilians and the civilian
Gaza's hospitals, but the generators have insufficient infrastructure and there is no end in sight. According
power and frequently cut out, causing dangerous to one UN official, “The Palestinians are struggling
stoppages in the power supply. Primary health care to survive; their preoccupation is security, water,
facilities are also reporting chronic power shortages food and electricity. It doesn't get any more basic
and a lack of generators. Immunisation services across than that.”
much of Gaza have already been reduced or
suspended because vaccines have spoiled in
refrigerators without power. Sources: UN OCHA, BBC, B'Tselem, Independent, Guardian
 MAP’S PARTNERS
Palestine Save the Children Foundation
Situated in the middle area of the
Gaza Strip, Maghazi refugee camp is
home to around 28,000 Palestinians.
More than 750 families in the camp
are registered as special hardship
M A P ’ S PA R T N E R S : P S C F
cases and even before the current
escalation in violence, unemployment
stood at 70-80%. It's a tough place
to live.
An Israeli incursion into the camp between 19 and
20 July killed 17 Palestinians and caused widespread
destruction. Lives were shattered, homes were
destroyed and life got even tougher.
Over 100 people were injured, among them 17-year-
old Thae'r Mansour, who was in the streets with
hundreds of other youths, watching as Israeli tanks
and helicopters overran the camp. When a missile
fired from an apache helicopter hit the crowd, some
were killed. Thae'r was rushed to hospital. Both his
legs had to be amputated above the knee and his
right eye was lost. Thae'r remained unaware of what
had happened to him for over two weeks.
He wanted to become a blacksmith. Now his mother,
Tamam, cannot bear to think about his future.
Or her own. Tamam's husband left her ten years ago
Thae'r is her youngest son, but his three younger
sisters all have learning disabilities and require
much of her time and attention. Now, Tamam has
and she has brought up their 12 children alone. It no idea how she is going to cope. With MAP's help,
has been a struggle. PSCF is offering her and others like her the only
respite they have.
Sometimes he would ask if anyone had seen his legs,
but no one answered. His family didn't know what
to say.
Thae'r Mansour in al-Shifa Hospital, one week after the attack in which he lost both his legs.
Since the Israeli incursion into Maghazi camp, MAP's
partner organisation, the Palestine Save the Children
M A P ’ S PA R T N E R S : P S C F
Foundation (PSCF), has received countless requests for
support from families whose lives have been
devastated by injury and loss. PSCF is already working
with another international organisation to improve
conditions for the physically disabled within the camp.
Long term they plan to offer a range of services
including physiotherapy, occupational therapy, family
awareness training and social support.
But for many in Maghazi, the immediate problems
are the most basic. MAP has responded quickly to
these needs, providing technical aids such as
wheelchairs and medical airbed mattresses to 47
residents of the camp who have lost one or both legs
in the current conflict.
Before the incursion, Thae'r was planning to leave
school and attend the Gaza vocational training centre
run by UNRWA, the UN agency responsible for the
welfare of Palestinian refugees.
 The Israeli army gave
Fatma's family half an
hour to leave their home
before they destroyed it
in the early hours of 19
July. A quick phone call in
the middle of the night.
THE BIG PICTURE

There was no one to

complain to, no time to
appeal. Fatma and her
husband have seven
young children. They have
no home, no money and
no idea what they are
going to do.
 F F
Tons of produce ripe for export have gone rotten

CASH CRISIS at the crossing or been dumped by farmers who

The checkpoints and the settlers
are gone, but one year after
disengagement, the celebrations
have long since ended. Israel's
unilateral pullout from Gaza offered
the prospect of peace and prosperity
F E AT U R E : C A S H C R I S I S
People have certainly had to tighten their belts. Across
the Occupied Territories, the PA employs around
165,000 civil servants whose wages support up to a
quarter of the population. Starved of cash, the PA is
unable to pay them regular salaries and no one quite
knows how they are surviving. EU emergency
payments have eased the suffering of a few, but many
cannot get their goods to market.
Imports have also been hit. The United Nations
Development Programme says that over $70 million
worth of its infrastructure projects are on hold due
to the shortage of construction materials in Gaza,
resulting from the closure of Karni. These projects, it
claims, would create 875,000 paid working days for
Palestinians in a year.
The funding crisis also has grave implications for
health care provision. Hospitals are experiencing

after 38 years of occupation, poverty
and unemployment. That was the
dream, but the reality couldn't be
more different.
After months of civil strife came financial
catastrophe. The funding crisis is being felt
throughout the Occupied Territories, but Gaza has
been particularly hard hit. The freeze on
international financial assistance means the
Palestinian Authority (PA) is struggling to carry out
the most basic functions of government. And it's
F E AT U R E : C A S H C R I S I S
thousands of families are still struggling to make ends shortages of drugs and disposables while many
meet. More than 70% of Gazans now require outside have found their capacity to provide diagnostic
help to meet the daily food needs of themselves and
services, outpatient appointments, laboratory
their children. services and elective surgery reduced.
And its not just government employees who are A forced rationalisation of drugs is in place in
feeling the squeeze. Any Gaza shopkeeper will tell you hospitals throughout the West Bank and Gaza.
the same story. No one is buying. No one has any Medical equipment is not being adequately
money. Most people have sold any assets they had maintained and vital diagnostic equipment is
and in Gaza that usually means gold. Yet the shelves inoperable because the necessary consumables,
in the jewellery shops in Gaza city are empty. We're such as X-ray film, are not available. Medical
not closed, they say, but we can't display our stock. staff are frustrated by circumstances that prevent
People are just too desperate. them providing a minimum standard of care.

A boy collects water in Gaza city.

the people who are paying the price.
Israeli political adviser Dov Weisglass summed up
the situation. Put enough pressure on the
Palestinians and they will reject the Hamas
government they elected. We don't want the
Palestinians to starve to death, he said earlier this
year. We just want them to “lose a little weight”
(Guardian, 25 May 2006).
They are doing their best but no one is in any
Then there are the closures. Despite disengagement,
Israel retains a stranglehold on Gaza. The Erez doubt that these coping strategies are having a
crossing into Israel has remained closed to Palestinian disastrous impact on patients. The system is
workers and traders since 12 March. The Karni stretched to its limits.
crossing, the main access point for the transport of
goods in and out of Gaza has been subject to
frequent closure and no exported goods have crossed Sources: UN OCHA, World Health Organisation, BBC, Guardian
through Karni since 23 June.
 MAP’S PARTNERS
Palestinian Ministry of Health
As the funding crisis began to bite in
early May, the Palestinian Ministry of
M A P ’ S P A R T N E R S : M I N I S T R Y O F H E A LT H
Health appealed for urgent stocks of
medicines and disposables for
hospitals throughout the Occupied
Territories. Many essential drugs had
run out completely and the lives of
seriously ill patients were at risk.
The Ministry of Health had no money to restock
depleted stores and there were shortages of
everything from disposable needles and adhesive
tape to antibiotics, syringes, intravenous solutions,
surgical gloves and suture sets. In several hospitals,
food stocks had also run out and staff could not
provide patients with anything to eat.
Renal failure patients were in a particularly
desperate situation. Without basic medicines such as
Hemiodialysis Powder, hospitals were unable to
provide essential dialysis. MAP's emergency appeal,
launched in mid-May, reported that three dialysis
patients had already died at al-Shifa Hospital in
Gaza. “As you read this letter, 628 people need
dialysis in the West Bank and Gaza and if urgent
supplies do not arrive soon, some of them will die.”
MAP's newspaper advertisement featuring three-year-old Abdullah Nahal.
The public response was overwhelming. By 29 May,
MAP had delivered thousands of units of Hemiodialysis
M A P ’ S P A R T N E R S : M I N I S T R Y O F H E A LT H
Powder to the Ministry of Health stores for dispatch to
hospitals in Ramallah, Jenin, Tulkarm, Beit Jala, Hebron,
Nablus and Gaza.
MAP's emergency appeal also went out in the national
press. Full-page ads drew support from many who had
never previously given to MAP. These press ads
featured a photo of a Palestinian child in urgent need
of dialysis. Six-year-old Abdullah Nahal's picture had
previously appeared in a Daily Telegraph news story
and, moved by the image, MAP contacted his family.
In early July, MAP followed up on Abdullah's story.
They found him back at al-Shifa hospital in Gaza
where he had begun receiving the vital treatment he
required. Abdullah had been diagnosed with renal
failure when he was four and at the age of five he
underwent surgery to insert lines for the dialysis. It was
This time, though, the Rafah crossing was closed and Today there are still many drugs unavailable and
a complicated procedure and Abdullah's condition
Abdullah and his father waited for seven days at the Abdullah's father says the dialysis schedule has been
deteriorated suddenly.
border without dialysis or medical attention. When abandoned. Worried there won't be enough medicine
Doctors at al-Shifa arranged for Abdullah's urgent they finally returned to Gaza, Abdullah had or disposables when their turn comes, families now
referral to Israel, but with the Erez crossing closed, developed further complications that now require turn up at the hospital and wait to get the dialysis
Abdullah went with his father to Egypt. There he constant medication. His parents have no doubt that when they can. The future is uncertain for everyone,
received treatment and, when his condition had the delay was to blame. but for children like Abdullah, it really is a case of
improved, he was referred back to Gaza. taking it one day at a time.
 DARRIN WALLER
SPEAKING OUT
How would you characterise Gaza in
“
the weeks before disengagement?
“There was an air of heavy expectation. With
restricted movement, Palestinian police could not
patrol the Strip effectively and inevitably local
fiefdoms took root. Coupled with the already
SPEAKING OUT: DARRIN WALLER
tense situation between the Islamist group Hamas
and Fatah, the then ruling party, the future did not
look good."
What was the impact of disengagement and
the destruction of the settlements?
“The Strip erupted into a frenzy. Whole communities
were flattened, personal effects lay strewn in the
rubble. For many Israeli children, Gaza had been
their home, the place where they had gone to school,
grown up. Palestinians and Israeli children both
suffered for this failed experiment of trying to
colonise Gaza."
How has the Hamas election victory in
January 2006 affected life in Gaza?
“The international community responded almost
immediately with one of the most draconian sanctions
regimes ever enforced against a people. All aid was
stopped, investment and training ceased, salaries
went unpaid.”
Darrin Waller has been working at the Palestinian
Human Rights Centre in Gaza for the past year.
He will take up his new post as Chief Executive
of MAP in November 2006. MAP asked him a
few questions about his impressions of Gaza.
*
Palestinians in Gaza have lived through bad
times before. What makes this different?  Since 25 June, 281 Palestinians, including 59 children,
‘Many say that this is the worst situation Gaza has have been killed by Israeli forces. 181 of these were
ever experienced - imprisoned, bombed and denied
adequate food, medicine and fuel supplies. I was at a killed in July alone.
meal with friends who have children and when the
sonic booms exploded, kids under five just started
crying and wetting themselves."  More than 1034 Palestinian civilians, including 298
And what is the impact on health? children, have been wounded by Israeli gunfire.
“Chronic malnutrition and dietary-related diseases
T H E D E TA I L S
are increasing in Gaza. Iron-deficiency anaemia
affects 25% of children under five and 33% of  Nearly 30% of essential life-saving drugs are
women of child-bearing age. Infant mortality rates
are 30% higher in Gaza than in the West Bank. Per unavailable in Gaza hospitals.
capita income in Gaza is now less than Afghanistan
and only slightly higher than Sierra Leone. Gazans
are dying because of shortages in drugs or  An estimated $15.5 million of damage has been
inappropriate treatment.”
caused to Gaza's civilian infrastructure as a result
What can the international community do?
“Israel is continuing its military offensive with of Israeli attacks, quite apart from the damage
complete disregard for international norms and caused to the Gaza power plant.
human rights law. An international protection force
is urgently needed to protect Palestinian civilians
and their property, to uphold a ceasefire and to Sources: PCHR, UN OCHA
ensure freedom of movement for people and goods.
The High Contracting Parties to the Fourth
Geneva Convention must fulfil their moral
”
and legal obligations by ensuring the same.”
DONATION
HOTLINE
020 7226 4114
Donate online at www.map-uk.org

COVER: A Gaza bridge destroyed by an Israeli

air strike in late June. This was the main route
linking Gaza city and the north with the rest
of the Gaza Strip.

All Photographs: Teisha Leigh

Medical Aid for Palestinians is a registered charity, number 1045315.

33a Islington Park Street, London, N1 1QB www.map-uk.org