This is the fourth brief statistical report focusing on the daily life and environmental conditions of families living under curfew and in fear and danger during the latest Israeli invasion of the West Bank. The towns included in these series are Ramallah/Bireh, Nablus, Jenin, Tulkarm and Bethlehem. While these reports are being dispatched separately, ideally they should be considered together. A final report will follow the individual town reports and will focus on the summary results for all the towns combined. This report pertains specifically to Tulkarm, with a population estimated by the Palestinian Central Bureau of Statistics (PCBS) in 1997 to be around 33,949 and 6,141 households.
At the time of writing this report, a damage assessment had already been conducted by a group of international donors, including the World Bank, the European Union, the United Nations and others. This damage assessment focused on physical damage to infrastructure, property and homes. It placed the highest level of this type of damage as having been incurred in Nablus. According to this assessment, the town of Tulkarm suffered damages amounting to 8,881,493 US dollars, the lowest of our surveyed towns. In our previous report on the town of Jenin, which did not include Jenin refugee camp, we demonstrated that social and humanitarian costs were perhaps highest in Jenin among the surveyed towns. This survey hopes to address at least to some extent the humanitarian and social costs paid by the people of Tulkarm during the invasion. It focuses on households and individuals, offering quantitative indicators of their situation generalizable to all of the population, and confirming to a good extent impressions and observations made during rapid appraisals and through interviews by journalists, researchers and institutions. The invasion of Tulkarm began on 29 March and ended on 22 April 2002. However, periodic invasions and curfews placed on the town where the Israeli army comes in, destroys homes and infrastructure, arrests or kills selected individuals then leaves, continue up until the time this report was written.
While this was being written, news of a new Israeli control regime leading to long-term "bantustanization" of the West Bank was beginning to appear in the local press, with territorial divisions expected to have even more severe effects on the Palestinian economy and humanitarian situation than during the first 19 months of the current intifadah, or uprising. The Tulkarm area, already disadvantaged by virtue of its distance from the centre of the West Bank, its proximity to the borders with Israel and its previous dependence on work inside Israel, is expected to be more hard hit than other regions of the West Bank. That is, some of the difficulties faced in living in Tulkarm town that will be outlined in this report are expected to continue, and perhaps become even more severe, even if the invasion is now "technically" completed, as it has been replaced instead by a serious intensification of closures and siege, making it impossible for people to earn livelihoods and seek services in places other than their town of domicile.
A sample of 154 households was selected utilizing stratified cluster sampling techniques. The city was divided into five strata, whereby two to three random starting points were selected. From each starting point a systematic sample of every 10th household was selected. In this survey, the expected maximum margin of error at the city level is:
E= 1.96*DE*sqrt((P)*(Q)/(n)).
P= The percentage of a certain attribute.
Q=1-P.
DE=Design Effect due to clustering.
The estimated value of DE=1.1.
E= 1.96*sqrt((0.5)(0.5)(1.1)/(150))=8.8%.
Data entry was completed using the Access database. Proper control structure was defined on closed questions. Data was transferred to SPSS using StatTransfer software. Double entry was conducted for a sample of the questionnaire to check for errors that could not be detected by the control structure defined in Access. One out of 50 questionnaires experienced swapping values like 1 entered instead of 2 or vice-versa.
One hundred and fifty-five adult household heads or family members were interviewed. The mean age of respondents was 38 years, slightly less than the mean age for the other surveyed communities. Forty-six per cent of the respondents were females and the rest were males. Of the total, 2 per cent were illiterate, 7 per cent had elementary schooling, 17 per cent had primary schooling, 32 per cent had secondary schooling, 8 per cent had postgraduate diplomas, 30 per cent had Bachelor's degrees and 4 per cent had Master's degrees or above. These results indicate a higher level of educational attainment for Tulkarm's population (Census 1977), notably in the high levels of post-secondary education: in the census, 9.3 per cent were found to be illiterate, 13.2 per cent could read and write, 24.4 per cent had elementary schooling, 22.9 per cent had preparatory education and 15.1 per cent had secondary schooling; 6.9 per cent were reported to have associate diplomas, 6.8 per cent Bachelor's degrees and 1 per cent an educational level higher than the Bachelor's degree. Caution should be made, however, when comparing with PCBS figures, as those pertain to a population 10 years or over. The differences may also be due to a bias in favour of educated respondents in our survey.
A high average family size was noted for Tulkarm, at 6.94, even higher than the highest report pertaining to our survey, that of Ramallah (6.84), and higher than that quoted by the PCBS (1997) for Tulkarm at 5.5 persons per household. Here, the smallest household was composed of one person and the largest a high of 30 persons/household. Of the total households, a high of 81 per cent was composed of nuclear families and 19 per cent extended. These results are very close to those of the PCBS (1997) that place the percentage of nuclear families at 79 per cent for Tulkarm town.
As is the case with the other towns surveyed so far, the higher-than-expected average household size found in this survey seems to be related to families housing other families during the siege, where families moved out of dangerous areas to perceived less dangerous locations for the duration of the Israeli invasion. In Tulkarm, 23 per cent of the households housed people other than those who normally live in their households during the invasion, a rate that is the lowest for the towns that we studied so far (Jenin - 37 per cent, Ramallah - 30 per cent and Nablus - 29 per cent). Of those taking in people, over half reported them as relatives, a quarter reported them as friends and the rest reported neighbours and other stranded people.
When asked why these people moved out of their homes and sought shelter in the surveyed household, a surprising almost half reported that the guests moved out because the army has taken over their homes, compared to one-tenth each in Ramallah and Nablus respectively and the half in Jenin who reported that guests had sought shelter because the Israeli army destroyed their homes. Over a quarter of Tulkarm houses sheltering guests denoted fear as the cause for this internal migration, around a fifth explained that their guests could not get home as the road was closed and curfew was imposed, and the rest provided for various answers mainly dealing with feeling safer where they moved. On the whole, judging from this set of data alone, it appears that Tulkarm homes were occupied by the army to a larger extent than the other towns, forcing them to seek shelter elsewhere and suddenly inflating household size in the sheltering households.
Again here, given generalizability for Tulkarm's population, these results are significant in that they indicate a major shift in household composition, as was the case in other towns, although temporarily, during the invasion, with a consistent pattern emerging for all the towns surveyed so far, leading us to strongly suspect that this was probably a generalized phenomenon, probably influencing family life and influencing the consciousness of household members, especially children, in important ways requiring further investigation.
Of the female respondents, only 55 per cent were housewives, and the rest working women. These results indicate the presence of a strong and unexplained bias in favour of working women respondents in our sample, and contrasts with the results obtained by the PCBS in 1997 for working women in Tulkarm (14 per cent). Given that the PCBS results are relevant to all females over 10, and our sample is composed of adults, these differences remain unexplained.
Of the male respondents, 21 per cent engaged in private work, either owning a shop or running a private operation, 7 per cent were professionals (academics, teachers, lawyers, doctors, nurses), 27 per cent where white collar workers (office workers, technicians, Palestinian National Authority functionaries) and 28 per cent were semi-skilled and unskilled workers. Thirteen per cent reported themselves as being unemployed just preceding the invasion, and only 1 per cent reported farming as a profession, in a once well-endowed agricultural area.
Of those working just before the invasion, a high of 28 per cent reported that they are no longer holding a job, compared to 23 per cent for Ramallah, 27 per cent for Nablus and 24 per cent for Jenin. In explaining why they are no longer working, over one quarter blamed the closures, a little less than half reported the collapse of the market and job unavailability as a cause, and the rest denoted injury, having been arrested, and the destruction of the workplace during the invasion as the main cause of unemployment.
While one has to be cautious against over-interpreting the available data, it may well be that the Tulkarm households will suffer from a higher level of unemployment as a result of the invasion and its aftermath combined with the strict closures and siege, especially as Tulkarm, unlike Nablus, for instance, is not able to generate employment within its district immediately and without substantial support because of the history of dependence on work in Israel. Indeed, Tulkarm has always suffered disproportionately from the impact of the political situation, being situated right at the border with Israel and relatively far away from the main centre of the West Bank, where work opportunities have been relatively more abundant than in other towns. On the whole, the loss of means of livelihood as a result of the latest events appears to be a consistent feature of our findings for all the towns that we have surveyed so far, and call for attention to be paid not only to infrastructural damage and rehabilitation, but perhaps, above all, assisting people, especially in the hinterland, through the generation of employment, to help themselves.
As with the other towns, reports of power cuts during the invasion were widespread for Tulkarm. Here, respondents indicated that 44 per cent of households faced power supply shortages largely most of the time, 54 per cent some of the time and the rest did not have a problem in this area. These results indicate that the power cuts were more severe than in Ramallah (20 per cent most or all of the time), but less severe than in Nablus (47 per cent) or Jenin (at a high of 96 per cent). This may have been due to various factors, including the severity of the curfew, initiation and success of coordination efforts with the Red Cross to allow for the fixing of damage, and perhaps the insufficient infrastructure and human resources required to fix damages in the Tulkarm area. Note also that power cuts have affected not only the people of Tulkarm town, but also the surrounding villages and camp that are served by the Tulkarm Electricity Company, a population estimate based on the PCBS census figures of 1997 to be around 27,000 persons.
The tap water situation seems to have also been less severe than elsewhere, with 23 per cent reporting no water supply most of the time, and 68 per cent some of the time, compared to Ramallah with 37 per cent reporting cuts most or all of the time, 39 per cent for Nablus and Jenin at a high of 92 per cent. Again, however, the clean water shortage did not only affect the residents of the town, but also the villages and camp that are served by the Tulkarm Water Company, estimated on the basis of the PCBS census of 1997 to be around 21,000 persons. Only very few faced the problem of telephone lines being cut, with 8 per cent most or all of the time and 24 per cent only some of the time, again denoting that the services situation in Tulkarm during the invasion was less severe than elsewhere.
In Tulkarm, the vast majority did not have a problem in disposing of sewage, with 92 per cent reporting no problems and the rest reporting problems with blown up pipes or cesspools not emptied because the municipal services came to a halt during the invasion and curfew. Once again, waste disposal was an important problem, with 70 per cent reporting having difficulties in getting rid of the household waste, a situation somewhat less severe than in the other towns. Here, over three-quarters of the respondents reported not being able to dump their waste outside the home, with waste piling up inside, apparently because the curfew was quite severe, and the rest reported waste collection by the municipality as being the problem.
The food availability problem at home seems to have been serious in Tulkarm, with 50 per cent reporting this problem, compared to 43 per cent in Ramallah, 37 per cent for Nablus and a high 64 per cent for Jenin. Likewise, a very high 74 per cent reported food shortages in the market, that is, when the curfew was lifted and they tried to purchase basic provisions, higher than the 69 per cent reported for Ramallah and the 43 per cent for Nablus, but lower than reports from Jenin (89 per cent), once again, reinforcing the emerging picture of Tulkarm as harder hit than an assessment of physical damages can show.
In response to this food availability problem, families coped in similar ways to the other towns, with one twentieth resorting to baking and other traditional methods of making food, about a quarter receiving help from neighbours and friends, another quarter reporting that they in fact ate less, one-fifth relied on substitution, using tinned foods and eating more rice and lentils than usual, and an additional fifth reported that they did nothing and waited for the curfew to be lifted, with the rest relying on food distribution and buying on account from stores that they know.
Reports of cash shortages stood at 39 per cent in Tulkarm, compared to a higher 54 per cent for Ramallah, 33 per cent in Nablus and 34 per cent for Jenin. Coping with situation, we find that over half borrowed money from relatives and friends, about one-quarter economized and spent less, and some even began to request payment of loans they had given to others previously, as well as other answers such as using money that was saved for other purposes.
When asked about shootings, explosions and destruction in their area, a high of 85 per cent heard shooting either all or most of the time, 12 per cent a little and only 3 per cent not at all. In response, 49 per cent of households coped by hiding in fear and suffering lack of sleep and mental distress; 33 per cent reported specifically paying attention to children who were in great fear, crying and needing comfort, 8 per cent reported that the family hid in one room at times, and the rest either reported that they took sedatives, wished to die, waited in anguish until the army came to the house or encouraged themselves by saying that they should have patience and perseverance.
Regarding hearing or seeing destruction in their neighbourhood, 87 per cent reported witnessing such events, compared to a lower 78 per cent in Jenin, 67 per cent in Nablus and a lower 52 per cent in Ramallah. It is not clear why this in, given the severity of home destruction in Jenin, but this could be due to Jenin's destruction being more concentrated around the camp area, and Nablus's around the old city, while in Tulkarm it may have been more widespread, including more neighbourhoods, even though perhaps less severe than in both Jenin and Nablus.
In reporting types of destruction, three-quarters reported rampant destruction of retaining walls, telephone and electricity poles, shops, pavements and traffic signs, 13 per cent reported the destruction of homes, doors, the breaking of furniture and windows as well as water pipes; 10 per cent the destruction of institutions around them such as public centres, schools and police stations. The rest reported minimal levels of destruction of cars and other public property.
Of the total, 28 per cent reported that their homes were directly exposed to shooting, bombing and destruction. This is the same as that in Ramallah (28 per cent), but lower than that of Nablus (34 per cent) and Jenin (59 per cent). Of those, over half reported that the shooting was directed at their home's walls, glass, home entrances and retaining walls, with an additional fifth reporting that bullets reached the walls of their homes only, but did not penetrate inside; less than one-twentieth reported that the army occupied the building and broke into and damaged the home and its interior property, and others provided reports pertaining to some destruction in their homes because the homes were searched. Of the total who have cars, 12 per cent reported that their cars were directly exposed to shooting, bombing or total destruction.
Forty-five per cent of respondents reported that their home were searched, a rate that is higher than that of Jenin (30 per cent) or Ramallah (41 per cent) but lower than in Nablus (50 per cent). Searching homes is quite a terrifying experience, not only because of the usual destruction of property that ensues, but also because usually families are all placed in one room and locked up as the army searches, while families experience worry and fear not only in relation to their property, but also in relation to the potential arrest of a family member. Of those reporting army searches of their homes, over a quarter reported that the army made a mess in the house, almost one-fifth reported that the army broke things inside the house, and almost one-sixth reported that the army stole their belongings as they searched, again confirming the consistency of the stealing episodes and contradicting Israeli army claims of incidental occurrences. Overall, 12 per cent reported that one or more members of their families were arrested.
The place of work of respondents was not spared, with 13 per cent reporting that their places of work were destroyed or damaged during the invasion, a rate that is lower than in Ramallah (41 per cent) and Jenin (29 per cent) but higher than in Nablus (12 per cent). Of those reporting such events, over one-third reported the destruction of doors, windows, offices, files and computers in their workplace, a quarter reported shooting directed at their place of work and the destruction of the materials inside, including the stealing of items inside, one-tenth reported the total destruction of their workplace and the rest reported the invasion of schools, theft of various items, the destruction of agricultural land and the use of premises as barracks, destroying or damaging them in the process. These results indicate that perhaps Ramallah was most hard hit in terms of institutional infrastructure and that, in this particular type of destruction, Tulkarm and Nablus were the least affected.
Of the total respondents, 34 per cent reported a medication availability problem at home, exactly as in Jenin, but lower than in Ramallah (49 per cent) and higher than in Nablus (22 per cent). Again, it is difficult to explain these variations in need for medication as possible explanations include a variety of answers, ranging from the severity of the curfew, availability of medications in stores, ambulance services as well as the relative dependence on medications as a way of life that we suggested as a possible explanation for the high Ramallah results, which are interesting in view of the fact that ambulance services providing medications to the people that needed them were certainly more active in Ramallah than elsewhere. How they reacted to this need included the following: about one-fifth resorted to indigenous medical practices, over one-quarter did nothing and just waited until the curfew was lifted and the medication was available, about one-tenth substituted one medication with another or reduced the dose of the needed medication in an attempt to stretch what was remaining, and the rest managed to transport the person affected to hospital, called ambulances which reached them with the medications, and in one case, the person in need received the medication from the Israeli army!
Consequences of the lack of medication from those who suffered it included: about one tenth reported the deterioration of a diabetic or hypertensive case, about a quarter reported that in consequences, the illness episode was extended beyond its normal course, an additional tenth reported the condition began to affect others in the family presumably, it was communicated to others, and the rest reported a deterioration in the health of children, fainting as a result, eventual transfer to hospital or living with pain.
Respondents were asked to report any problems they observed in their family relating to mental health during the period. Of the total, only 10 per cent reported no mental health problems at all in their households, results that are comparable to the reports from the other towns, and again clearly denoting the need for family assistance on a large scale in these communities. Reports pertaining to symptom of psychological distress management were also interesting. Among those who reported mental health problems in their families, we found that only 9 per cent reported that they tried to entertain themselves with playing cards, watching television and playing computer games and entertainment with the neighbours, in contrast to the 24 per cent in Ramallah. On the other hand, only 2 per cent resorted to praying, in contrast to 22 per cent in Nablus. For the rest, a high of 23 per cent reported that they used sedatives or used sedating indigenous herbs as tea, 22 per cent reported lack of sleep and waiting and attempting to control one's fear, 9 per cent focused on dealing with and helping children cope, and the rest gave a range of answers: sleeping at the neighbours, nervousness and boredom, trying to forget, sleeping early, helping each other cope and other such answers.
As is the case with the other towns, a high of 77 per cent reported their views on the current conditions that have damaged their lives in terms of despair and misery, and the rest reported their feelings in terms of "grave violations of human rights", the need to go back to God, the need to persevere as this is a war, it is getting worse all the time, and there will be no peace. Of the total, 53 per cent directly blamed Israel for what is happening, explaining events in terms of an attempt to destroy Palestinian life, 11 per cent pointed to America and Israel as the cause of what is taking place around them and in the country, 5 per cent blamed Israel and the Arab leaders, and the rest pointed to the Oslo accords, the Palestinian leaders, and that this is a reaction to resistance and suicide bombing incidents.
This report helps to consolidate an image of household and personal tension, fear, danger and damage that accompanied the Israeli invasion of the towns of the West Bank during April 2002. By examining responses in relation to social, human and health conditions, we observe that Tulkarm residents were seriously affected, even though the physical damage in their area was reported as being less severe than in other towns. While more analytical work is required to demonstrate this point further, as it stands now it seems to be that Tulkarm may be the second hardest hit, after Jenin, in humanitarian and social terms, while Ramallah was hardest hit in relation to the destruction of the institutional and cultural infrastructure, and Nablus the physical infrastructure. What remains now is an initial analysis of Bethlehem town to be completed in order to confirm these observations. These results once again call for the construction of more than one definition of the scale of damage severity, important for understanding the impact and damage of these recent events on the population, and equally important for the formulation of future policies.
In estimating the numbers of households and people that were affected by specific serious difficulties in dealing with daily life as a consequence of this invasion, we can note the following based on the 1997 PCBS census data of 6,141 households and 33,949 persons living in Tulkarm town:
1. Family composition: change during exceptional circumstances
2. Unavailability of basic services
3. Shortage of food and cash
4. Shootings, explosions and destruction of property and institutions
5. Medications
6. Metal health
1. Local Aid Coordination Committee, "Damage to civilian infrastructure and institutions in the West Bank estimated at 361 million" (Press release, Jerusalem, 15 May 2002)
2. Hass, Amira, "Israel forces internal movement permits on Palestinians", Palestine Monitor, 19 May 2002
3. Information brief, "Israel imposes new control regime leading to long-term Bantustanization of the West Bank", Palestine Monitor, 21 May 2000
4. Palestinian Central Bureau of Statistic (PCBS), Population of Palestinian Communities, 1997-2010. (Ramallah, Palestine, 1999)
5. Palestinian Central Bureau of Statistic (PCBS), Census for population, housing and establishments-1997: city report series, final results, Tulkarm city, (Ramallah, Palestine, 2000)
*Institute of Community and Public Health, Birzeit University