Under Siege

Hussein Owda/UNRWA

Ananke O v er v i ew Ed i t i o n 20 23

UNDER SIEGE H Heeaall tt hh

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22 38 30

Aida Saifi

Enabling Humanity Beyond Bor der s

Demystifying Str uctur al Ramifications of Colonialism

f o s y a D 16 m s i v i t c A

Editor ial Executive Editor Sabin Muzaffar sabin@anankemag.com Editorial Manager Nuzhat Nisar Ahmed Design & Production Sabin Muzaffar Email: media@anankemag.com Socials Ananke

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Opinion Ashen faces of children not opening their once sparkle-filled eyes, ashen faces of mothers who have lost their babies, fathers desperately digging to find life underneath the rubble. Only to find muffled screams, lifeless bodies ? passing on, leaving hell in the hopes to finding heaven? A land they might hopefully? finally call home, where they might at last be free? ?I am not just a number!?This was a tweet of a young Palestinian woman, I read several days ago. W ith no means of communication, there is no telling, if she in fact has become what she feared the most ? becoming but a number.

Since the beginning of the siege in Gaza, the most vulnerable have borne the brunt of asphyxiating hate and devastating violence. And now, you hear, watch and bear witness to more than 4000 children dying, countless orphans or rather WCNSF (a wretched acronym coined in Gaza): Wounded Child No Surviving Family in dire need of care. According to reports, 40 percent of wounded are children. Doctors taking out shrapnel, treating severe burns.

Helpless, hapless!

I recently read another tweet for I couldn?t bear to watch the video of a girl writhing in pain in a hospital surrounded by tanks and snipers. Same hospital that has been left with no fuel or electricity. W here 37 premature infants had to then be taken out of their incubators: their key to survival. Three infants are already dead. It is mind numbing, gut wrenching to even comprehend that the fate of the rest might already be sealed!

A UN Women report had earlier revealed that more than 493,000 women and girls have been displaced from their homes in Gaza, 900 women are now heads of their families due to the deaths of male family members.

These are all mere numbers! Figures drenched in blood, yet nonetheless, it seems that it is all these will ever be ? mere numbers. W hile people across the world come out in numbers to protest, rally and campaign, it seems highly unlikely for the powers that be to curtail.

Trouble not just brews, it simmers and erupts once you stop calling spade ? well, a spade! This is not a war. Wars are not fought with those fighting for survival in concentration camps.

Yes, there can never be any justification for violence, regardless of which side one is on. That said, oppression does create pathways to resistance and inescapable radicalization.

It is indeed not untrue to claim that history repeats itself for we never learn! We are a fickle specie hell bent on death and destruction. Human rights, democracy, free speech and justice are just imperialist farcical mumbo jumbo coined to divert and appease us ? the bewildered herd.

If there is hope, one might just find it underneath the rubble?

- Sabin M uzaffar

Making Healthcare Hostage B y Sa b i n M u z a f f a r No individual should be physically restricted from accessing health care in their country, or arbitrarily denied when they need to leave their country for health care abroad. The right to health is one of the most widely acknowledged and respected of human rights and enshrined in major international laws and conventions as a ?fundamental human right indispensable for the exercise of most other human rights.?

Article 56, Geneva Convention IV; Article 12, International Covenant on Economic, Social and Cultural Rights; General Comment 14 (2000), Committee for Economic, Social and Cultural Rights.

Post 1967, the lived experience of an ordinary Palestinian has increasingly been catastrophic in not just socio-economic and political spheres; but also in terms of safety, security and most importantly health. The Occupied Palestinian Territory (OPT) has one of the largest humanitarian efforts in place; performed by 78 UN agencies and partners working under the umbrella of the Humanitarian Country Team (HCT); UNRWA being the largest UN agency operating on the ground. That said, OPT was already a region with complex challenges due to Israelis occupation and its consequent imposition of restrictions on access, movement and mobility.

Citing security reasons, Israel executed a stifling sea, land and air blockade in 2007 after Hamas came into power in Gaza after winning the 2006 legislative elections.

Restrictions only multiplied on access and movement of goods and basic amenities in the years to come.

In Focus: Palest inian Demography By mid of 2023, the World Health

Organization (W HO) estimated in its May 2023 report submitted at the Seventy Sixth World Health Assembly that the population living in OPT would be 5.49 million. This included 2.23 million in the Gaza Strip and 3.26 million in the West Bank which includes East Jerusalem. ?Refugees registered with the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) comprise a quarter (28 percent or 0.90 million) of the Palestinian population in the West Bank and over two-thirds (70 percent or 1.55 million) of the population of the Gaza Strip.?In the municipality of Jerusalem, over 350,000 are Palestinian residents.

Approximately 11 percent or one in 10 households in OPT were headed by females in 2021. The situation has drastically changed with 900 more women now heads of their families due to the deaths of male family members.?Children comprise 44 percent of the Palestinian

population;youth aged 18 to 29 comprise 22 percent;and persons aged 60 years and older comprise six percent.

Healt hcare Governance: From Fragment at ion to Conflict Palestine suffers from deeply entrenched fragmentation when it comes to its healthcare system. And it all boils down to the framework imposed on the citizens of the occupied territories.

There are several entities that run as well as fully or partially control OPT?s healthcare system. Israel has absolute control when it comes to access to health.

Being a member of the World Health Organization (W HO), Israel ?is legally boundby all of its (W HO?s) provisions, including those pertaining to the right to health, which are applicable to all territories and populations under its effective control.?Simply put, Israel is responsible for safeguarding the right to health of all Palestinians living under

occupation in all territories: the Gaza Strip, West Bank including East Jerusalem.

An official government agency, the Palestinian Ministry of Health ? run by the Palestinian Authority (PA), covered all occupied territories before Hamas won the legislative elections in 2006. This assumption of responsibilities in relation to delivering healthcare services across the West Bank and Gaza Strip was a product of the Oslo Accord.

According to Associated Press, the Palestinian Authority still retains power over health services in Gaza. Based in West Bank, the Palestinian Authority primarily administers its own ministry in Ramallah and ?still provides medical equipment to Gaza, pays Health Ministry salaries and handles patient transfers from the blockaded enclave to Israeli hospitals.?

Controlled by Hamas, the ministry of health in Gaza is a mix of new hires and older civil servants affiliated with the

secular nationalist Fatah party.

W ith complicated health governance and about 45 percent of population across the occupied territories holding refugee status, UNRWA has also been serving as the focal provider of healthcare to Palestinian refugees.

As a result of this messy construct, the entire healthcare system is in shambles.

Devastation is only multiplied manifold due to poor policies, socio-economic conditions and its resultant abject poverty.

The Economics of St ruct ural Dismant ling of OPT?s Healt hcare One out of four Palestinians lives below the poverty line, this was the situation prior to recent tumultuous events ? not only in Gaza but also the West Bank where violence has also gained increased momentum. In a press release published in September 2023,Stefan Emblad, World Bank Count ry Director for West Bank and

Gaza said: ?The Palestinian territories have been in a de facto customs union with Israel for thirty years, but contrary to what was expected when the agreements were signed, the divergence between both economies has continued to widen, with income per capita in Israel almost 14-15 times higher than in the Palestinian territories. Poverty rates are stubbornly high.?

Emblad had further noted: ?The fiscal constraints weigh heavily on the Palestinian health system and particularly

on its ability to cope with the mounting burden of non-communicable diseases.

The many barriers to healthcare access have turned the system of outside medical referrals for treatment in non-Palestinian hospitals into a complex process - one that is affected by restrictions on the movement of Palestinian patients and a lengthy, bureaucratic regime of permits, often making it very hard to provide adequate or timely life-saving healthcare.?

The World Bank earlier stated:

?Significant physical and administrative constraints limit timely access to outside medical referrals (OMRs) for the treatment of cancers, heart disease, maternal and child health conditions, which are unavailable in public hospitals in the West Bank & Gaza. The Israeli occupation, the fragmentation of the Palestinian territories, and the broader macro-fiscal context described have significantly impacted the Palestinian healthcare system?s ability to deliver these services in public hospitals.

The situation is particularly critical in Gaza, which suffers from a more limited health

system capacity and where patients struggle to get needed medical exit permit applications on a timely basis.?

On t he Grotesque Ramificat ions of Permit Systems The Palestinian Healthcare System has historically been a hostage to a number of trials and tribulations; such as the obstruction of movement between Gaza and the West Bank. A permanent blockage, what this means for Palestinians was preventing free access to their ?only national tertiary-referral hospitals?.

In The Lancet, Peter Hall and Robert Giel explain in their article published in 1998, Palestinian Health Care: ?A survey in March, 1996, found that 38 percent of the health workers were unable to reach work and five of ten hospitals had a 50 percent or greater reduction in emergency cases?

Exit permits were introduced and issued for Palestinians after the 1967 occupation

of the Gaza Strip and West Bank. W hile these enabled free movement especially between the occupied territories, it gradually changed particularly after the first Intifada in 1988. Situation gradually deteriorated in 1993 when Israel imposed a general closure on the ?Gaza Strip and West Bank, during ?which no one could leave the OPT or enter Israel without individual permit. The general closure has

remained in effect until today. Along with the closure, the criteria for permits to exit from the oPt to Israel were made considerably stricter, and the number of permits issued by Israel dropped dramatically.?This was a collective punishment levied on the ordinary Palestinian after 16 Israelis were killed.

The impact of restrictive measures on

movement, be it delay or denial of permits, translated into damaging outcomes for patients. ?From 2018 to 2021, 43 per cent of children approved permits to travel did not have approval of one of their parents as a companion. Cancer patients from Gaza initially delayed or denied permits for chemotherapy or radiotherapy from 2015 to 2017 were 1.5 times less likely to survive in the coming months and years.?About 69

percent of requests for CT/ Xray equipment or spare parts were denied by the Israeli authorities.

According to a paper by the World Health Organization (W HO) and Health Cluster ? OPT titled 15 Years of Blockade and Health in Gaza, published in July 2022: ?Barriers to accessing healthcare arise from constraints on movement affecting patients, companions, and healthcare workers; limitations and inequities affecting medical supplies and equipment; and gaps in protection that contributed to 645 attacks on health care in the Gaza Strip since 2018.?

to the Palestinian population. Focusing on establishing a better healthcare system, the World Health Organization had also created the Palestine Institute of National Health. In 1991, the Palestinian Children?s Relief Fund (PCRF) was also established by ?concerned humanitarians in the USA, (which) provides free medical care to thousands of injured and ill children yearly who lack local access to care within the local health care system.?The organization also created a Pediatric Cardiac Surgery Programin Gaza as well as the Gaza Amputee Project.

Moreover, these challenges also gravely limited opportunities for professional development of healthcare personnel from within the two occupied territories.

According to the Palestinian Bureau of Statistics, the total number of hospitals in Palestine was 85 in 2019 with 53 in the West Bank having 3950 beds and 32 in the Gaza Strip containing 2485 beds.

Healt h Infrast ruct ure: Systemic Challenges

In a Fortune article, Palestinian Global

W ith a severe lack of a centralized healthcare, official as well as private entities, NGOs and humanitarian agencies altogether provide services

Health Expert, Yara M Asi wrote: ?Beyond the sheer immediate devastation of the current conflict ? in which thousands of Israelis and Palestinianshave been killed? there will be significant and undoubtedly long-lasting implications for the Gaza Strip?s health system. As a Palestinian expert in global health who has worked with medical professionals from Gaza, I know that even before this latest escalation of violence, health services in Gaza were in a poor shape.?

To reiterate, health and well being of the entire Palestinian population has been shattered by incessant conflict, violent emergencies as well as lack of sustainable and development-driven policies.

Prior to the October conflict, OCHA?s Humanitarian Needs Overview 2023 ?

OPT stated: ?The Humanitarian Country Team (HCT) estimates that in

Humanitar ian Needs Over view 2023 OCHA

2023, approximately 2.1 million Palestinians across the OPT will require some form of humanitarian assistance.?

Consistently escalating hostilities have not only resulted in a massive loss of lives, permanent disabilities, injuries and psycho-social trauma, it relentlessly places the already debilitated health system in peril. In addition to this, each wave of violence puts hospitals and other health infrastructure directly in the line of fire.

Coming to the current situation, the W HO reported: ?As of 14 November, more than half of the hospitals in the Gaza Strip (22 out of 36) were non-functional due to lack of fuel, damage, attacks and insecurity. Health systems in Gaza City and Northern Gaza are on the verge of breaking

down entirely. OCHA reports that as of 14 November only one of the hospitals, Al Ahli, is still operational at a minimum level. All other hospitals have ceased operations due to the lack of power, medical consumables, oxygen, food and water, compounded by bombardments and fighting in their vicinities?

Almost two weeks ago, Israeli forces besieged one of the largest health complex in Gaza, the Shifa Hospital.

W ith severe scarcity of food, no fuel even for ventilators or incubators and accumulation of decomposing bodies ? as reported by Al Jazeera ? as well as thousands of internally displaced people, the assault began with tanks within the hospital after?continuous, aggressive gunshots, bombardments and attacks since yesterday evening,? revealed Ahmed El Mokhallalati, a

surgeon, told Al Jazeera. Over 7000 people which include premature babies as well as critical patients were sheltered and cared for at the hospital during the time of the raid.

On November 18 th and 19 th, nine out of 22 UNRWA health centers were still operational in the Middle Area and the south with about 19,162 visits by patients.The Indonesian Hospital in Beit Lahiya (North Gaza) came under attack on November 20th, and reportedly resulted in at least 12 fatalities, including patients and their companions, alongside many injuries, reported OCHA. Through the assistance and coordination with various humanitarian agencies, approximately 500 patients and staff of the Indonesian Hospital were eventually evacuated to a hospital in Khan Younis (in the south) on

November 21st .

On November 20, news outlet Al Jazeera reported that a group of 28 premature babies in catastrophic condition were evacuated from the besieged Al Shifa Hospital to Egypt?s Al-Helal Al-Emirati Maternity Hospital in Rafah in southern Gaza. A total from 31, the babies wore ?only nappies and tiny green hats.?

W hile Israeli operations at the Shifa Hospital were ongoing on November 21st , with 19 health workersand 259 patients remaining there, the Al Awda Hospital in North Gaza also came under attack, killing four doctors and injuring several patients.Médecins Sans Frontières (MSF), which operates in the hospital,called for the urgent and safe evacuation of more than 200 patients to a functioning medical

facility.

report explaining what happened.

On November 23, Al Jazeerareportedthat the Israeli army had arrested Al Shifa Hospital?s director,Mohammad Abu Salmiya, andheld for questioningon the premise that ?evidence showing that Shifa Hospital, under his direct management, served as a Hamas command and control centre?, the Israeli military said in a statement.?Two nurses and another doctor was also detained. All medical personnel were travelling in a W HO convoy with patients when they were stopped and detained by the Israeli forces.

Demanding an explanation from the World Health Organization, Gaza?s Ministry of Health spokespersonAshraf al-Qudra told Al Jazeera, The World Health Organization has not yet sent us any report to explain the situation including the numbers and names of those detained.?Adding that the ministry had decided to stop coordination with the W HO regarding evacuations until they send them a

OCHA reported that W HO has documented 178 health attacks in the Gaza Strip since the beginning of the war. It has resulted in 22 fatalities and 48 injuries among on-duty healthcare personnel working in the frontlines.

Further noting: ?Only two small hospitals to the north of Wadi Gaza (hereafter: the north), one in Gaza city and another in Beit Lahiya, are estimated to be partially operational and admit patients, with the remaining 22 being out of service. Of the 11 medical facilities in the south, seven are currently functional.?

Depleted essential resources, fuel shortages as well as persistent attacks have resulted in a massive decline in hospital bed capacity across Gaza from 3500 beds before October 7th, 2023 to presently 1400. This is only magnified due to exponential surge in patients seeking treatment due to the siege.

image: CNN

Special Pr otections Under the Rules of Militar y Engagement To give some perspective centering on International Humanitarian Law (IHL): ?Healthcare facilities are civilian objects that have special protection under the laws of war against attacks and other acts of violence, including bombing, shelling, looting, forced entry, shooting into, encircling, or other forceful interference such as intentionally depriving facilities of electricity and water,?states apaperpublished by the Human Rights Watch (HRW ).

The HRW adds that under the laws of war, protected healthcare facilities and transport include ambulances, hospitals, laboratories, clinics, blood transfusion centers, clinics, first aid posts, medical and pharmaceutical stores of these facilities; be it military or civilian. Moreover, doctors, nurses as well as other medical personnel (both civilian or military) must be allowed to do their work and be protected under all circumstances.

The only way medical personnel lose their special protection is if they commit ? ?outside their humanitarian function ? ?Acts Harmful To The Enemy?(AHTTE).?

W hile special protection granted to medical services is fundamental, it is certainly not absolute, notes the International Review of theRed Cross.Acts that cause harm to the enemy and falling outside its humanitarian function result in the loss of the special status. According toICRC Commentary: ?The definition ofharmfulis very broad. It refers not only to direct harm inflicted on the enemy, for example, by firing at him, but also to any attempts at deliberately hindering his military operations in any way whatsoever.?

In the same publication titled The notion of ?acts harmful to the enemy?under international humanitarian law, authors Robert Kolb and Fumiko Nakashim further explain: ?Examples of AHTTE leading to the loss of special protection for medical units include ?firing at the enemy for reasons other than individual self-defense?, ?installing a firing position in a medical post?, ?the use of a hospital as a shelter for able-bodied combatants or fugitives, as an arms or ammunition dump, or as a military observation post?, the use of a hospital ?as a centre for liaison with fighting troops?and ?the placing of a medical unit in proximity to a military objective with the intention of shielding it from the enemy's military operations?. This last act is specifically prohibited under Article 12(4) of AP I. Examples of AHTTE leading to the loss of special protection for medical transports include ?the use of the vehicle as a mobile military command post or as a base from which to launch an attack?and ?the transport of healthy troops, arms or munitions.?

It must be notedthat there are a various types of acts which do not constitute AHTTE for instance small arms found from the wounded in the hospital or presence of armed guards. Most importantly, the Humanitarian Law clearly states: ?Even if military forces misuse a hospital to store weapons or shelter able-bodied combatants, the attacking force must issue a warning to cease this misuse, setting a reasonable time limit for it to end, and attacking only after such a warning has gone unheeded.?

In Truce We Trust On November 22nd , 2023, the world heaved a nervous sigh of relief as news came that a four day truce between Hamas and Israel was mediated by Qatar along-with the US. According to reports the agreement not only includes the release of 50 hostages ? women and children ? held captives in Gaza, the release of 150 Palestinian women and children in Israeli jails; but also the allowance of the desperately needed humanitarian aid for the people of Gaza.

The Associated Press also reported that Israel ?said that the truce would be extended an extra day for every additional 10 hostages freed by Hamas.

The International Committee of the Red Cross said it can assist with any release.? *** So what happens after the four-day truce ends? Is the pause ?humanitarian? when there is avowed rhetoric that war will continue? In other words, there is a time bomb ticking away ominously till the moment arrives when Palestinian children, women and men begin to relive trauma again.The situation as it stands today is one on the edge of annihilation. Perhaps the reached truce has been a major breakthrough when all seemed to be lost. But for the ordinary Palestinian in all the territories, what does it really entail? W hen one assumes things couldn?t get worse, recurring situations starkly display it can go abysmally further downhill. All that is left is rubble, complicit silence and trauma.

Reflections come easy for the privileged with time, space and a

non-belligerent ?physical reality?.To reiterate, Is this pause ?humanitarian?or a text book Hansel and Gretel story?

We the members of the international community have the privilege to wait, watch and witness!

I Come From There I come from there and I have memories Born as mortals are, I have a mother And a house with many windows, I have brothers, friends, And a prison cell with a cold window.

Mine is the wave, snatched by sea-gulls, I have my own view, And an extra blade of grass.

Mine is the moon at the far edge of the words, And the bounty of birds, And the immortal olive tree.

I walked this land before the swords Turned its living body into a laden table.

I come from there. I render the sky unto her mother When the sky weeps for her mother.

And I weep to make myself known To a returning cloud.

I learnt all the words worthy of the court of blood So that I could break the rule.

I learnt all the words and broke them up To make a single word: Homeland.....

MAHMOUD DARWISH

Humanitar ian Needs Pr e- October 2023 OCHA Repor t (Working Document - Jan 2023)

Education Under Siege B y Sa b i n M u z a f f a r

Palestinian education system has borne the brunt of an array of not decades rather century long challenges and crises. From being under external control such as the British Mandate to coercively adhering to rules set by the occupying force of Israel as

well as lack of development-focused policies, recurring conflict and relentless bombardment or violent onslaught on infrastructure; not just the system but also Palestinian children have gravely suffered when it comes to learning and human

development.

Historical Perspect ive Basic education is mandatory in the Occupied Palestinian Territories (OPT) with around 95.4 percent children enrolled in basic education, according to UNICEF. W hile statistics have been encouraging, these disguise numerous challenges that impede real learning.

The educational system after the colonial British Mandate ? 1917-1948 ? was then taken over by the Jordanian and Egyptian Governments, for West Bank and Gaza Strip respectively (1948-1967). In the year of the Nakba in 1948, approximately 30 percent of children across Palestine of relevant age groups attended school. The British Mandate had set only three teacher-training seminaries, only ten Palestinian high schools including two for girls by 1948.

There was not a single Palestinian institution of higher education. .

Felix Sanchez Broco and Jumana Trad, Research fellow and member of the Executive Committee of the Centre for Middle Eastern Studies of the Foundation for the Social Promotion of Culture (CEMOFPSC) writes: ?From 1948 until the Israeli Occupation in 1967, the educational system of Palestinians living in the West Bank and Gaza was the responsibility respectively of Jordan and Egypt as both territories were left under their sovereignty while for the Palestinians or Arabs living in the Israeli territories, the responsibility was of the State of Israel.?

Another key player that focused on development and learning was UNRWA. Established in 1949, after the Nakba, the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) has been a focal provider of education to Palestinian Refugees for the past 75 years.

Im age by hosnysal ah f rom Pixabay [Pal est inian phot ographer based in t he Gaza St rip]

The education system came under direct control of Israel after 1967. The Oxford Research Encyclopedia states: ?Beginning in 1967 at the end of the Six-Day War, the Israeli government took control of Palestinian educational systems, controlling the entire educational experience of Palestinian students, including curriculum, construction, and maintenance of schools, and employment of educators.?

W hile the Jordanian and Egyptian curricula continued after 1967, these were subjected to heavy censorship, with books being banned, words, paragraphs as well as entire sections of textbooks deleted.

A study was conducted in the central region of the West Bank in 1990 to ascertain the skill level of about 3000 elementary school children. It showed that these students had great difficulties acquiring even basic skills in Arabic and Mathematics.

Educat ion in Chains Children continued to attend the three types of schools: government schools under Israeli responsibility, UNRWA schools primarily for refugees as well as those run by private entities usually with a religious affiliation.

W ith heavy censorship on learning by the Israeli military occupation with ? as experts opine? no interest in development and innovation for the betterment of a population under its rule, it forced a huge majority of the population to join the Israeli labor market. The system itself broken coerced youth to leave school to earn money.

Palestinians were then pushed into illiteracy after the first Intifada when Israel shutdown huge numbers of schools, educational institutions and universities sometimes even for as long as six months, again as a

Humanitar ian Needs Over view ( Jan) 2023 OCHA

collective punishment. Suffocating policies also included refusing any modification or innovation in terms of curricula upgrade etc.

Experiencing a broken ? rather a diseased ? system, recurring hostilities and constantly erupting violence, the population has been systemically bulldozed into illiteracy with far reaching repercussions including pyscho-social trauma, devastating mental well-being, and various levels of difficulties when it comes to coping mechanisms to begin with.

According to a research: ?The impact of war on children is tremendous and pervasive, with multiple implications, including immediate stress-responses, increased risk for specific mental disorders, distress from forced separation from parents, and fear for personal and family?s safety. Thus, the experiences that children have to endure during and as consequence of war are in harsh contrast to their developmental needs and their right to grow up in a physically and emotionally safe and predictable environment.?

Sit uat ion Post OsloAccord After the signing of the Oslo Accord, the Palestinian Authority took the reins over from the Israel government. Some mightsuggestthat the education system began to develop in 1994 after the Accord.

This would include the development of the first Palestinian curriculum and the entity spearheading various ?innovative breakthroughs?. However, opportunities weregreatly limited by the Occupation. There has also been a lack of appropriate funding and even the right to build or renovate schools is restricted without Israeli building permits. ?The current apartheid system is a multifaceted economic blockade, with walls, checkpoints, and armed military guards denying Palestinian students and teachers access to a range of essential services, such as education and healthcare. All of these restrictions of movement and encroachments by the Israeli government and military represent violations of the United Nations human rights conventions,?revealsthe Oxford Research Encyclopedia.

The impact of war on children is tremendous and pervasive, with multiple implications, including immediate stress-responses, increased risk for specific mental disorders, distress from forced separation from parents, and fear for personal and family?s safety.

Thus, the experiences that children have to endure during and as consequence of war are in harsh contrast to their developmental needs and their right to grow up in a physically and emotionally safe and predictable environment

UNRWA?s Role in Learning And Development UNRWA has been playing a major role when it comes to education and development, focusing primarily the refugee population. The organization envisions to give Palestinian refugee students opportunities to develop as well as reach their full potential and transform into ?confident, innovative, questioning, thoughtful, and open-minded, to uphold human values and tolerance, proud of their Palestinian identity and contributing positively to the development of society and the global community.?

Prior to the October 2023 war, UNRWA operated 706 elementary and preparatory schools in its five fields of operation. This includes eight secondary schools in Lebanon, providing free basic education for some 543,075 Palestine refugee children. In addition, technical vocational training and higher education is provided at eight Vocational Training Centers for approximately 8,000 Palestine refugees in all fields of operations and for 2,009 students in two educational science faculties (teacher training institutes, one in the West Bank and one in Jordan).

Additionally, four generations of Palestinian refugees have also benefitted from a 65-year long UNESCO-UNRWA partnership even during times of crisis.?In 1950 UNRWA started out with 93 schools and around 35,000 students and since the 1960?s, girls have made up around half of UNRWA students. In 2014, the Director-General of UNESCO and the Commissioner-General of UNRWA renewed the commitment of the two Agencies to work together for quality education for Palestine refugees by signing a memorandum of

understanding. The long-standing support to the UNRWA education program

by UNESCO was exemplified in the education reform through the leadership of the UNESCO Director of Education,?statesthe UNRWA website.

Darkness Pervades at t he End of t he Tunnel Much can be written and lamented about the Palestinian educational system as well as its infrastructure. W hat was first a place of learning, gradually became shelters and now most of them are death zones such as the Al-Fakhoora School decimated by an Israeli airstrike. At the moment, number of schools devastated by war is largely unknown.

On May 19th, 2021, Relief Web reported that about 50 schools in Gaza were damaged by Israeli airstrikes with Save the Children revealing that the devastation had impacts 41,897 children. Three were reported to have been damaged in Israel by rockets fired from Gaza. ?63 children in Gaza and two children in southern Israel have been killed since the escalation of the conflict began on 10 May. In Gaza, 450 children have been injured. Save the Children continues to demand an immediate ceasefire to protect children and their families,?said Relief Web. The situation worsens with each year passing. There has been a consistent onslaught on schools post Oct 7th.On November 23rd, UN-affiliated school in the Jabalia refugee camp in northern Gaza came under Israeli attack just a day before the planned truce. About 27 fatalities were further reported from an airstrike on the Abu Hussein School run by UNRWA, reported Al Jazeera.

Educational system has almost ? if not completely ? been decimated. And it is not just merely the infrastructure that is the victim of this colossal disintegration.

Children exposed to war and displacement have life-long and a broad range of distress and stress reactions, psychosomatic symptoms, PTSD and a high prevalence of depression and other mental disorders as primary outcomes.

W ith no end in sight as far as the ongoing siege is concerned, although a truce has been recently announced and now in effect, there is no way of knowing what is in store for the Palestinian children and youth. Is there hope? a future for the future generations?

In Sear ch of

Climate Justice

By Sabin Muzaffar

The Occupied Palestinian Territory lies within the Mediterranean Climate Zone and is one of the most vulnerable countries in terms of climate change. A typically hot, arid and water scarce region, the entire area has experienced an alarming rise in temperature over the past 50 years. That said, it is ironic that Palestine has negligible contribution to global emissions ? less than 0.01 percent.

A UN Factsheet, published in May 2022

stated: ?Palestine?s per capita emissions were 0.8 tCO2e in 2011, less than the global average of 6.73 tCO2e per capita at that time.?

W hile worldwide temperatures rose by an average of1.1°C since pre-industrial times, the situation displayed an alarming scenario in Israel and OPT with temperatures rising by 1.5°C(2.7°F) between 1950 and 2017. As per the Israeli Meteorological Service?s forecast, temperatures will increase by 4°C (7.2°F)

by the end of the century.

Systemic Challenges vis-à-vis Climate Vulnerabilit ies It is certainly not rocket science to see that issue of climate change is not just a natural but a political challenge as far as Palestine is concerned. A wide array of problems arise not just due to its geographic positionality, but also because of the restrictive measures, debilitating policies and gripping control by Israel.

Palestinian lands have been subject to massive water scarcity and food insecurity especially due to the air, sea and land blockade beginning in 2007. According to a 2022 article byRelief Web: ?The lives of more than two million Palestinians in besieged Gaza are affected by Israel?s direct and indirect targeting of the environmental components and their right to live in dignity is denied.?

Natural resource management, lack of funding and as well as an incapacitated infrastructure has had dire ramifications in terms of OPT?s environmental crisis. There has been little or no upgradation or repair over the last one decade, states an OCHA report. Implementing new infrastructural projects in high risk flooding areas have been limited due to lack of funding as well as import restrictions on essential material.

Chronic energy crises, not only a consequence of the decades-long blockade but the constant onslaught of violence as well as restriction on mobility has destabilized the operational capacity of facilities.

Additionally, about 90 percent of electricity to Palestine was supplied

by Israel Electric Corporation.

Cour tesy: UNICEF

In additionto this, lack of or restrictive access to land and natural resource by the indigenous population has resulted in water scarcity, water, land and air contamination; leading to water quality deterioration, air pollution and desertification.

Another dire form of climate oppression also materializes in the form of land grabs or what

is termed as green colonialism/ imperialism. ?In the occupied Gaza Strip, 20 percent of arable land is limited from use within the Israeli-imposed buffer zone near the apartheid fence, which leading to a deterioration in food insecurity. Overexploitation of Palestinian natural resources in the occupied Palestinian territory contributes to the exhaustion of non-renewable resources and the exacerbation of climate change-related endangerment of fragile ecosystems.Since the 1960s, the Dead Sea has shrunk by one third of its surface due to combined factors including temperature rises, accelerating evaporation, mineral extraction and agriculture-related water pumping,?states a paper submitted to the Office of the High Commissioner for Human Rights (OHCHR).

Even more distressing is the fact that about 95 percent of water in Gaza has been deemed undrinkable as of 2020. And with the current state of affairs, the situation is more likely to have gravely deteriorated.

W hile Palestine was reported to experience medium water stress and being the 28thmost water-stressed country in the world, projections to 2040 do suggest incremental stress levels.

Palestine, states UNICEF, ?has a total of renewable water resources per capita of the equivalent of 472 liters per capita per day, which is 40% lower than the Middle East and North Africa (MENA) median, and 18 times lower than the global median (FAO, 2018). Only 3% of the 190.5 Million Cubic Meters (MCM) of water, extracted yearly from the coastal aquifer, can be considered potable, according to World Health Organization (W HO) standards (PCBS, 2022).?

As a ripple effect, water contamination, scarcity and desertification inadvertently leads to massive food insecurity. Rise in

salinity in groundwater along with unavailability of clean water sources leads to harmful impacts on coastal agriculture. ?Adverse impacts are gravely felt on the olive sector, where rising temperatures and humidity, scarcer water resources and increased violent winds impact flowering and growth, cause direct stress on the olive trees, the quality and quantity of their fruits, cause loss of leaves, fruit destruction and definitely endanger livelihood security, and small farmers?ability to compete with larger producers.?

In a report published by MinorityRights.org, Palestinian environmental activist, Abeer Butmeh narrated how farmers have had to innovate adaptive measure to counter not just climate shifts but also Israeli occupation practices. ?The Israeli occupation has now designated more than half of the agricultural land in the Jordan Valley as closed military zones.

Consequently, Bedouin communities who depend heavily on pasture land and livestock have had to adapt to limited access to ever-shrinking areas and natural resources. Relying on rainwater for their agriculture and animal husbandry means that they are highly vulnerable and at risk because of fluctuating rainfall and temperature change,?she explained.

Palestine is also vulnerable to natural disasters including floods, droughts, landslides and earthquakes.

Another pivotal issue that has impacted the environment is solid waste management, with no proper management strategy which may also be directly linked to restrictions imposed by the Israeli government in terms of access to land and resources. The territory also suffers heavily from air pollution, a direct result of waste water

discharged directly into the Mediterranean sea as well as persistent airstrikes, bombardment and its consequent infrastructural destruction and air pollution.

W hile continuously banning the entry of breakwater rocks from the West Bank to the Gaza Strip essential to prevent coastal erosion, Israel?s perpetual airstrikes, dropping of missiles, bombs, and explosive containing toxic chemicals as well as spraying W hite Sulphur as recent as post October 7th, bulldozing Palestinian farmlands has severely compromised especially Gaza?s environment.

Seeking Climate Just ice The ramifications of the climate crises on the land and population of Palestine are imminent and certainly not far away with depleted food and water resources, an environment impacting young and old alike.

Climate is a crisis of justice as it also exacerbates inequities that are

reverberating across the entire region.

Inequities and injustices inflicted upon an innocent population, again is another form of collective punishment. An overview of the crisis at hand, data vehemently informs us about the discrimination and injustice suffered in terms of resource distribution, and rightful access. The situation at hand has transcended from its natural or scientific origins, it is a political as well as a diplomatic phenomenon and it needs active support, advocacy from the international community ? especially now more than ever. It is time to wake up.

OCHA Repor t Jan 2023

Aida Saifi Enabling Humanity Beyond Bor der s

Aida Saifi is a humanitarian and development professional with 10 years of experience in international non-governmental organisations, covering humanitarian medical care in hostile contexts such as epidemics, conflicts, emergency response, and natural disasters.

She currently serves as the strategic regional partnerships manager of The Fred Hollows Foundation. In her role, she is responsible for building and maintaining strong partnerships with major funders and work with them to have a greater impact in addressing blindness. Before joining The Foundation, Aida worked at Doctors without Bordersand Restless Development. She holds a Bachelor's Degree in Sociology and Anthropology, and Master?s Degree in Community Development

1.Tell us about yourself, your choice of education and initial work.

I was born and raised in East Jerusalem, to a family of doctors and nurses. Their work exposed me in my early years to rural Palestine and the shortage of health and medical service. I remember hiding under my father?s clinic bed watching him work.

As a Jerusalemite, living in East Jerusalem, it was clear that in order to survive and live in the city, I needed to follow my passion for studying the nature of human beings and their origins. Graduating with degrees in Anthropology, Sociology and Global Community Development Studies has helped me achieve my goal. These experiences have further rooted my resilience and identity as a young Arab woman living in one of the most unrest

cities in the world.

My enthusiasm for volunteering in my early years propelled me to actively search for opportunities to help children with disabilities and those coming from disturbed and violent households throughout my academic years. I was determined to use my education to help local charities which in return guided my understanding of the world around me, as well as helping me understand the world?s impact on Palestinian daily life in East Jerusalem and beyond.

2.Belonging to a region that is engulfed in conflict, pain and suffering, how important it is to have individuals and especially women (representation) like yourself in the development sector?

There has been a relative recent urge for women to play a larger role in the international nonprofit sector.

Moreover, a general notion to localize their efforts and work. Before realizing that a

terminology has emerged from years of foreign aid work in the region, we always lead in our own contexts, usually for reasons of cultural sensitivity. However, it wasn?t always properly acknowledged, especially for women. Furthermore, Arab women are encouraged to find their way, while explaining to us that challenging choices will be filled with obstacles, inherited ones.

I am proud to be an Arab woman and the achievements which have shaped and molded my life. I am certain that my unique perspective allows me to understand the overwhelming pain and suffering of many has empowered me to facilitate the alleviation to this suffering and its causes.

In my early days working as an interpreter in refugee camps in the West Bank. Being the only female in the group of researchers I distinctly remember certain interviews and observations which required female

Palestinian perspective to facilitate the translations. In such delicate circumstances, it was and is very important to translate and interpret the nuances of both the spoken and unspoken words by reading the context, understating various expressions and interpreting the Palestinian refugee narrative and experience as a whole.

3.What are the challenges as a humanitarian and development professional when working within hostile contexts and dealing with medical care?

I recall a vivid experience while working with Doctors Without Borders (MSF) in East Jerusalem and the West Bank. It was New Years Day, and a field visit brought my team and I to one of our mental health program areas in East Jerusalem, to conduct assessments and to meet our

patients who were mainly children with their mothers. Without warning, an attack was shot in our direction. People were screaming and running in all directions in a panic. Fortunately, no one was physically harmed but you can imagine the trauma that this caused to the children. I went home that day thinking, how can we empower these kids and build their resilience and improve their mental health when even as adults who are seemingly accustomed to these situations, we are still horrified and shocked by these sudden and unprovoked attacks.

You feel helpless at times when you don?t have answers or the means to help the immediate needs of the group of people you are supposed to support.

Moreover, operating in conflict areas requires a level of trust and safety to be

able to perform the honest duty you are assigned to. That is not always easy, as opening up and sometimes asking for support comes with the threat of being exposed to the community and its prejudiced stigma toward mental health needs.

We operate under clear humanitarian charters. It is not easy to share stories of patients as we try to perform our duties with the utmost respect for the patient centered approach. Respecting their privacies, although in sometimes not be the safest one is a constant dialogue among the corridors of many humanitarian agencies, in the end we should not impose our ways of working nor our solutions, it is a combination of knowledge, experience and trusting the local expertise.

4.Based on your experience as well as your Masters degree in Community Development, in your opinion, what kind of strategies and planning are needed to identify a community?s development needs (in regions of conflict, man-made emergencies as well as natural disasters) in order to deliver better and better interventions?

While there are many ways to approach community development, it undoubtedly is based on adopting a holistic approach grounded in principles of empowerment, inclusion, social justice and collective action.The purpose of community development is to bring people together to work towards a common goal.

Making it to Nepal after the 2015 earthquakes, hoping to implement all the theoretical work I?d learned at university, made me realize that just as in any context, adapting and re-evaluating the plan is as important as setting the initial plan. At the end of the day, we need to add value and not waste resources to assist the large numbers of people in need in emergency settings.

Upon arriving in Nepal, I worked on assessing and defining the scope and goals for the community, and with the help of my local mentor and partners, we identified two components of work that could be enhanced and developed with several stakeholders. The first was the actual documentation of the relief work of the local community and grassroots organizations, using evidence to highlight the involvement and contributions of the various community actors and build on it for further projects. The second was to highlight success stories and community champions that came to the challenge in the aftermath of the destruction of the earthquakes. These champions were trained and empowered to tell their stories though their own lenses.

My time in Nepal was eye opening and resulted in looking in an in-depth look into the volunteering trends in times of crisis.

5.Can you tell us about your work focusing mental health interventions as well as cultural sensitivity putting it in context of conflict affected regions?

In general, mental health has been stigmatized over the years. One of the key challenges in implementing mental health interventions in times of conflict and post conflictis how to develop trust with people.

The ability to open up when many sensitive details cannot be shared outside the immediate family, is part of the journey to recover from trauma or to acquire skills to adapt to difficult recurring situations and hardships.

6.How important is it to engage and encourage youth when it comes to emergency response interventions are concerned?

It is indispensable to have youth resources, enthusiasm, innovation, and drive to help.

It is also important to identify areas where professional relief and aid workers can delegate work to robust youth to help

perform their work. Balanced and well-planned interventions for youth should no longer be overlooked, as I have witnessed in multiple occasions during my time with the Palestinian Red Crescent.

With the right leadership and mentorship, young people can work hand in hand with professionals in times of crisis and after math, from simple first aid response and packaging relief kits, to first count observations and actual pioneer projects.

Young people have plenty of energy and passion - when deployed and structured, it can create greater impact.

7.Tell us about your work at Doctors Without Borders and the role of stakeholder engagement, especially when it comes to mobilizing resources and transfer of knowledge (local capacity building).

My professional experience with Doctors Without Borders in the UAE, led to a

distinct change in my relationship to the humanitarian world. I have been part of a talented regional development and fundraising team. The opportunity to learn about philanthropy and donor engagement in a diverse country like the UAE has been so enriching.

It is satisfying to be able to build philanthropic partnerships with different stakeholders to raise and mobilize funds for emergency responses work in Africa, the Middle East, South Asia, and beyond, from individuals to corporates to running campaigns in solidarity with the world and in action in the times of the COVID pandemic.

The psychology of donors is in essence understating the beauty of helping each other, giving in times of distress, believing in a better future, and recognizing that those who are most in need should get help wherever they are and whoever they

are.

The work of Doctors without Borders, through my first-hand experience in Palestine, in Jordan and the UAE, has shaped the way I approach my work and relationship to what I do.

8.Tell us about your work at the Fred Hollows Foundation.

I joined The Foundation in 2022 and I was part of Philanthropy and Government Relations team. My role is to lead and build regional strategic partnerships with like-minded organizations to deliver a world in which no person is needlessly blind or vision impaired. Partnerships team don?t work alone, and we work together closely with internal stakeholders such as public affairs and programs as well as external stakeholders such as philanthropists, Official Development Assistance, and corporates. The role provides a great blending opportunity from strategic thinking, relationship-building skills, to a deep understanding of the philanthropic landscape to ensure sustainable impact.

9.The Foundation has an impactful footprint across the Global and we have seen that in Palestine as well. Can you tell us more?

The Fred Hollows Foundation has been working in Palestine since 2013. It was among the first international development organizations aiming to fight avoidable blindness and vision impairment in East Jerusalem, West Bank and Gaza. Currently The Foundation is focusing on treating the leading causes of vision loss by treating patients, training the national health workforce, equipping facilities, and strengthening health systems in collaboration with our local implementing partner.

10.The Foundation also focuses on culture, please explain what that entails?

Culture is one of our strategic drivers to ensure all people have more equitable access to better eye health outcomes and can contribute more to their communities economically, socially and culturally.

Different approaches will be needed in different contexts. For example, women make up around 55 percent of people globally with vision loss. One of the causes on why women and men experience different rates of vision loss are barriers created by social and cultural factors and traditional gender roles.

To close the gender gap in eye health, we must understand and respond to the cultural and local circumstances that give rise to gender inequities. We develop locally-based solutions to achieve gender equity and empower women and girls. So, we understand the context and the needs of patients, treat men as allies and beneficiaries of gender equity within eye health, and build the capacity of our staff and partners in gender equity.

In addition, as strategic regional partnerships manager I bring the voice of our patients, partners, and donors into our conversation and factor in what they might need in my decision making to ensure we have sustainable impact in eye health.

I do operate with the words of Peter Drucker who said: ?Culture eats strategy for breakfast?. That is my compass always, in fundraising, partnerships and field work.

11.How do development organizations and their representatives work or plan strategies in terms of aid, development, work on the ground in hostile environments?

Many organizations employ various strategies to achieve their objectives, such as advocacy, capacity-building, engaging and empowering communities, fundraising, resource mobilization, and collaboration with other stakeholders to

create greater impact. In addition, they support partners and staff on the ground to be able to perform their work and assess and adapt the plans to accommodate the most urgent needs.

12.Any last words?

I deeply wish we reach a time where humanitarian aid will only be needed in unfortunate natural disasters or disease outbreaks ? and not for man-made crisis. I also hope we reach a level where development work achieves its goals and find communities self-sufficient, well equipped to carry on the work and close the circle.

Questions by Sabin Muzaffar