This is a rapid appraisal of 34 villages and one refugee camp located in the Tulkarm district, investigating the living environment of a rural and isolated population from 29 March 2002, the date the Israeli government and army launched their invasion and reoccupation of West Bank cities, to 25 April 2002, the time at which the survey was completed. The sample was randomly chosen, taking into consideration location (border villages, villages close to settlements, close to bypass roads, etc.), population size and ability to obtain the relevant information from reliable sources. Nur Shams Camp was included in this survey because of its location, not in direct proximity to Tulkarm town, and consequently, resembling villages in terms of isolation from the main town centre. Information was obtained from the mukhtars or other responsible persons in each of the locales, and double checked for accuracy with other informants. Interviews were conducted by mobile phone.
The total population included in this survey is in the order of 120,000 persons. Of those, about 52,000 are children under the age of 15 (43 per cent of the population), an additional 6,000 (5 per cent) are elderly (65 years or over), and 22,000 (18 per cent) are women of childbearing age. These vulnerable and priority groups for health care are usually affected first by deteriorating living environments and constitute 65 per cent of the total population surveyed (PCBS, 1997).
Only about a quarter (eight) of the locales surveyed were not placed under curfew during the period. The remaining locales went through periods of curfew ranging from one day or less, and up to 30 days (Attil, al-Nazlet al-Wusta, al-Jaroushieh), 27 days (Far'oun), 26 days (Irtah), 24 days (Shuweikeh and Kufr Zibad), and 23 days (Deir al-Ghusoun). There were eight locales that reported the continuation of curfew at the time of the survey. Those included Qiffin, Kufr Jammal, Attil, Kufr Zibad, Deir-al-Ghusoun, Khirbet Jabara, al-Jaroushieh and al-Nazlete al-Gharbieh. The communities that were most affected by curfew conditions were Attil, Kufr Zibad, Deir al-Ghusoun and al-Jaroushieh, which experienced almost a continuous period of extended curfew, even up till today.
All locales reported being under strict and continuing siege for 30 days, that is, from the beginning of this current invasion and reoccupation and up till the time the survey was completed and this report written. Eight locales reported that barbed wire had been placed just at the edge of locales, six in one direction only, and two both in the east and the west of their locale. It is probably important to note that barbed wire seems to be placed in areas adjoining our locales with settlements or with military posts.
This siege has translated into an almost total inability of the labour force of these communities to get to work. Reports from only one community (Kirbet Kafa) indicated otherwise, with the labour force able to reach the workplace in the main. Reports from 30 communities indicated a total inability to get to work, and an additional four communities reported that some labour force members (such as teachers who attend school in the community) were able to get to work because their work is located inside their community, but that most workers were unable to access their workplace. Inability to reach work adds further burdens to an already existing economic and family financial crisis, the consequence of 19 months of siege and difficult road conditions. Should these circumstances continue to affect these communities, there is no doubt that they will be facing a humanitarian crisis shaped by want.
The vast majority of villages (28) reported serious or moderate food shortages, with seven reporting no food shortages so far. We were told by informants that community members had taken precautions (Arabic: ihtatu) just before the current onslaught began, meaning that households stocked up on food items in preparation for an expected invasion, curfew and hermetically sealed siege. The other factor that may be important here is that some of these communities continue to engage in agricultural activity as a secondary means of earning livelihood, with the primary means being wage labour, either in Israel or in West Bank towns. Despite these observations, however, these results indicate that, already, these communities are becoming nutritionally vulnerable, especially young children and infants, as well as pregnant and lactating women. Should the siege conditions continue, there seems to be no doubt that these communities would be facing a nutritional/food shortage crisis in the near future.
Three-quarters of these communities (26) reported that medical personnel have not been able to reach their locales with essential medical and primary care services. Twenty-nine communities reported severe medication shortages, four reported some shortages and only one reported no shortages to date. Of special importance is the problem of child vaccination, especially against tetanus, hepatitis, diphtheria, mumps and measles. With some of these diseases, even missing a dose or a booster for a few days can lead to serious untoward effects. Another main concern is women in labour, without access to medical or nursing help, having to deliver children at home under very difficult conditions and without the needed assistance, risking their live and the live of their new-born. The longer the strict siege is maintained, the higher the risks of labour and childbirth complications, which can lead to death, disability and much human suffering, and the higher the possibilities of infectious diseases spreading in these communities, and those know no political boundaries.
Siege and curfew conditions have also contributed to problematic sanitary conditions in these communities. Twenty-six of these locales reported interrupted garbage collection and transport to dump sites, one community reported being able to sometimes get rid of refuse and sometimes not, and eight communities reported the continuation of this activity despite the siege. This may be related to where the dumping site is located, whether within community boundaries or outside. Sewage disposal, normally pumped out of cesspits and dumped outside community boundaries, also seems to be a serious problem, with 26 communities reporting not being able to dispose of sewage and nine reporting no problems in that area. Clearly, the combination of garbage, sewage, the rising temperature and the incoming mosquitos, together call for urgent attentions to be paid to environmental conditions known to contribute to the spread of disease in the area.
Fuel shortages, especially cooking gas and electrical generator fuel, were reported by 29 communities, with six seeming not to suffer from this problem. Fourteen of the communities reported no interruption in power supplies during the period of the survey, with the others (21) reporting electrical cuts ranging from a few hours and up to 30 days! The water problem seems to be less acute, with 21 communities reporting a continuation of the service and 14 reporting water cuts varying from a few hours and up to seven days. In these communities, however, the large majority still store winter water in wells, accessing those when needed. However, the bacterial quality of this water, along with other quality problems in well water, raises a concern here in that, combined with power cuts, garbage and sewage disposal problems, food shortages, lack of access to medical care, they produce an emerging picture of fertile grounds for the spread of infectious and parasitic diseases. And those usually attack the vulnerable first, especially young children, the elderly, and the disabled.
We asked our respondents whether new land had been confiscated during this period. Of the total, 29 communities reported no confiscation of land, while five responded positively. In other words, one in seven villages experienced land confiscation. In one case, the report indicated that the land was confiscated to become a military buffer zone; in another, the apparent purpose was road building, but Israeli construction happened to have destroyed the village's precious water wells in the process. What is striking is that these five villages are all located very close to the borders with Israel (Nazlet Issa, Qiffin, Khirbet Kafa, Far'oun and Khirbet Jabara) and that reports indicate that confiscated land, at least partially, is being used to build a very large road, suggesting that Israel's new policy of buffer zones may well affect Palestinian rural livelihoods and lives. Unconfirmed reports also indicate a possible re-emergence of the Israeli Civil Administration that was responsible for managing local Palestinian affairs prior to the Oslo accords.
Six of the communities reported problems and harassment by settlers, especially in reaching their fields, which they need to till in order to live (Nazlet Issa, Qiffin, Khirbet Kaffa, Saida, Anabta and Isbet Shofah). That is, even agriculture as a mode of sustaining families is being compromised in these trying times.
Although the invasion at first affected towns in particular, villages were not spared. Curfew with periodic invasions and arrests, as well as injury and death, have been reported. Eighteen of these communities reported no temporary arrests at all, with the remaining villages reporting the temporary arrest and then release of their village members, and with these arrests ranging from one and up to 180 persons (Allar), followed by Nur Shams Camp (130), Nazlet Issa (110), Saida, Anabta and Kufr al-Lubbad with 25 arrests each, and Bal'a with 30 such arrests. Continuous arrests up till the time of the survey were reported by half of these villages, with a total of 17 persons affected that way. One-third (12) of these villages also reported the injury of village members, with the total reported as injured in such incursions being 12 persons and four martyrs.
Given the information at hand, there is certainly cause for alarm. Sealed off completely, these communities are beginning to gradually fall, perhaps without the notice of many, into the abyss of misery. Already deprived, and out of sight in the backwaters of the West Bank, these communities are in need of immediate assistance now, in order to prevent an emerging humanitarian crisis. While currently in need of food, medications and fuel, a far more important need is the lifting of the curfew and state of siege, and the end of occupation. It is only then that these villagers would be able to pick up the pieces, get back to work and help themselves into better living conditions.
*Institute of Community and Public Health, Birzeit University