This is the fifth and final 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 the subject of this report, Bethlehem. Dispatched separately, these reports should ideally be considered together. A final report will follow the individual town reports and will focus on the summary results for all the towns combined. In this report, we will review the responses obtained from the Bethlehem households. The surveyed households include Bethlehem town and its three refugee camps (Dheisheh, lying at the outskirts of town; Aida, joining Bethlehem with Beit Jala town; and Azza, inside Bethlehem proper). The responses obtained in this survey are generalizable to the entire population of Bethlehem and its refugee camps, estimated by the Palestinian Central Bureau of Statistics (PCBS) in 1997 to be around 32,510 persons and 6,157 households.
Bethlehem was invaded more than once during the recent period. The first invasion took place on 8 March 2002 and continued until the 15th of the same month. The second invasion, the subject of this report, began on 29 March and continued until 11 May 2002, placing Bethlehem in first place, compared to the other towns that we have studied, in relation to the number of days it has suffered under curfew and occupation (44 continuous days). The third invasion began on 27 May 2002, with curfew, arrests and destruction taking place as usual, and continues as we write this report. The impact of long periods of occupation and curfew, as well as repeated experiences of such events for shorter periods of time, can only translate into a heavy toll paid by the people of Bethlehem in social and humanitarian terms, perhaps heavier than the other towns that we have reviewed so far.
This house to house survey was conducted during the third week of May 2002. A stratified random sample of households was chosen, primarily based on locale, and representative of all of the households in the town.
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 10 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 per cent.
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 visa-versa.
One hundred and forty-eight adult household heads or family
members were interviewed. The mean age of respondents was 38 years,
comparable to the mean age of respondents for Tulkarm, but slightly
less than for the four other surveyed towns. Forty-seven per cent
of the respondents were females and the rest were males. Of the
total, 8 per cent were illiterate, 10 per cent with elementary
schooling, 16 per cent with primary education, 27 per cent with
secondary schooling; 10 per cent reported having post-high-school
diplomas, a high of 25 per cent had Bachelor's degrees and 3 per
cent had
Master's degrees or above. The educational picture for the town
as a whole and for those above the age of 10 years produced by
the PCBS for 1997 include 8 per cent illiterates, 14 per cent
able to read and write, 67 per cent with secondary schooling or
below, 4 per cent with associate diplomas and 8 per cent with
Bachelor's degrees or above.
The average family size in this survey was found to be high at 6.81 persons per family, higher than that reported by the PCBS for 1997 (5.3 for town and camps combined) but close to the family size reported in this survey for Ramallah (6.84) and lower than that of Tulkarm (6.94). In Bethlehem, we found that the smallest household was composed of one person, and the largest a very high of 40 persons/household, the highest family size of all the towns included in this survey. Of the total, 77 per cent were composed of nuclear families and the rest were extended one, results that are comparable to those obtained by the PCBS for Bethlehem (1997).
The higher-than-expected average household size found in this survey seems to be related to families housing other families during the siege, results that have been noted for all the towns included in this survey without exception. In Bethlehem, we found that 28 per cent of respondents reported housing others during the period of invasion and curfew, a rate that is comparable to those obtained for Ramallah and Nablus, but higher than in Tulkarm (23 per cent) and lower than in Jenin (37 per cent). These results are indicative of population movements away from dangerous areas into perceived less dangerous ones, probably pertaining to severity of onslaught directed at homes, as opposed to infrastructure, and leading to the internal migration of families within the town during the invasion period. Over two-thirds reported that the live-in guests were relatives, and the rest a mix of neighbours, friends or even stranded people who could not reach their homes either because of the curfew or because they were used as human shields then dropped away from home, necessitating seeking shelter elsewhere.
When asked about why these guests moved out of their homes and sought shelter in the surveyed household, almost a third reported fear of danger as the main reason for people seeking shelter in their home, four-tenths reported that the home of the guests was located in very dangerous areas, surrounded by soldiers and shelling, and the rest reported the usual "home was taken over by soldiers", "fear of being arrested" and the unusual "the guests were internationals who were in Bethlehem during the period to assist in our protection and in solidarity with our family".
On the whole, the observed major temporary shift in household composition through in-town migration during invasion appears to be an important phenomenon that affected all the towns during this period. These results once again call for future investigations of possible changes in family dynamics, perhaps focusing on power relations and the division of labour between men and women during these trying times, especially as anecdotal evidence indicates an increase in the burden of women as caretakers to even higher proportions that what is observed normally. Likewise, a closer look at the impact of seeming incapacitation, loss of work, inability to protect or provide for family and practical imprisonment at home on men's perceptions of themselves and their self esteem is also an important question to raise for future research.
Of the female respondents, only 53 per cent reported that they were housewives, with the rest reporting themselves as working, again denoting a strong bias in our survey in favour of the working women at home, and contrasting to the PCBS reports on the labour force participation of women for 1977, placed at a low of 14 per cent. The PCBS reports, however, pertain to all women over the age of 10, while our sample is composed of adults, making it difficult to ascertain the cause and level of bias here and precludes the possibility of further comparison.
Of the male respondents, one-sixth engaged in private work, either owning a shop or running a private operation, a high of a third reported working in white collar jobs, such as office workers, technicians and Palestinian National Authority functionaries, another third reported that they were working as semi-skilled and unskilled worked, while others reported themselves as professionals and farmers. Of the total males, one-tenth reported themselves as having been unemployed immediately prior to the invasion.
When asked if they were still holding their jobs after the invasion, of the respondents who were working prior to the invasion a high of 29 per cent reported that they no longer work, results that are comparable to those of Tulkarm (28 per cent) and Nablus (27 per cent), and higher than those of Jenin (24 per cent) and Ramallah (23 per cent). Of those reporting job loss, almost half pointed to the closures and siege as a main cause of their unemployment, about one-fifth reported problems pertaining to the collapse of the market and the rest provided varying types of reports, such as "conditions are still abnormal" or "place of work destroyed during the invasion", or even "laid off from work because of the situation". These results, combined with the results for the other town reports, point to the need to investigate the problem of unemployment, especially in relation to the siege and the collapse of the market. Furthermore, these results also point to the need for household assistance through the generation of employment in their area of domicile as perhaps one of main priorities for action at the economic, social and humanitarian levels.
While Bethlehem seems to have suffered the longest period of invasion and curfew of all the towns included in this survey, reports from households indicate that power cuts were perhaps not as severe as elsewhere. In this survey, we found that only 3 per cent of respondents reported living without electricity all of the time, an additional 10 per cent most of the time and 45 per cent only some of the time, and a high of 42 per cent not facing this problem at all. This contrasts with experiences of households in the other towns, with 20 per cent for Ramallah households, 44 per cent for Tulkarm, 47 per cent for Nablus and a very high of 96 per cent for Jenin reporting power shortages most or all of the time. Why Bethlehem's electricity network was possibly spared is beyond the scope of this rapid survey. However, it may be that the substantial difference in the length of curfew and invasion between Bethlehem and the other towns does not allow for an appropriate comparison in relation to severity of service interruptions and that, ultimately, the length of curfew and invasion may be determinant.
The water shortage during the invasion and curfew appears to have been more serious that the power shortage, with 6 per cent reporting no tap water most or all of the time, 17 per cent reporting no tap water some of the time and 77 per cent reporting having no problem with running water at all. Again, these results contrast with those obtained for the other towns, with 23 per cent for Tulkarm with no water supply most of the time, 37 per cent for Ramallah, 39 per cent for Nablus and a very high of 96 per cent for Jenin. The length of curfew and invasion as well as the neighbourhood where the household is located may explain these apparently lower rates in Bethlehem. According to the Water Supply and Sewerage Authority of Bethlehem, the water shortage was severest in the Nativity Church area and around the Old City, with water cuts ranging from five and up to 20 days, including a period of 40 days in the areas within the immediate vicinity of the church. Telephone line cuts were also found to be a problem, with 15 per cent of those having phones reporting that the lines were cut most or all of the time, and 21 per cent some of the time.
Of the total households, 11 per cent reported that sewage pipes were blown off, with households facing a problem in disposing of sewage, while 1 per cent reported difficulties in dealing with emptying cesspools. In contrast, a high of 95 per cent reported difficulties in getting rid of household waste, attesting to the severity of the curfew. Of those reporting this difficulty, 57 per cent stated that municipal services came to a halt during the curfew, 25 per cent reported that the curfew was so severe they were unable to move the waste outside the house, resorting to storing it at home, and the rest reported varied answers such as "the tank was right next to the waste container", "the army destroyed the container" and "the army was stationed right in front of the house".
The results pertaining to difficulties faced because of the shortage of food and cash demonstrate a pattern that is different from the pattern observed for the previous findings: Bethlehem households seem to have suffered food and cash shortages to a larger extent than in the other towns, presumably the effect of the longer period of invasion and curfew. Here, we find that 54 per cent of households reported problems with food availability at home, compared to 50 per cent in Tulkarm, 43 per cent in Ramallah, 37 per cent for Nablus and a higher 64 per cent for Jenin. That is, it seems that Jenin may have been the hardest hit in relation to such problems, followed by Bethlehem, then Tulkarm, Ramallah and Nablus respectively.
Of those who reported food shortages at home in Bethlehem, a high of about one-third reported that they tried to eat less, rationing what they had to manage the extended curfew situation, almost one-fifth reported that they got by with what they had and managed that way, another fifth reported cooperating with neighbours and relatives to feed their families and the rest resorted to home production, relied on food aid or managed with food substitution, with a reliance on canned foods. Likewise, shortages of food items in the market were noted when the curfew was lifted, with a high of 50 per cent of respondents reporting problems with these shortages, compared to a high of 74 per cent for Tulkarm, 69 per cent for Ramallah, 43 per cent for Nablus and a very high 89 per cent for Jenin.
Unavailability of cash was also a problem in Bethlehem, with a high of 65 per cent reporting difficulties in this area, compared to 54 per cent for Ramallah, 39 per cent for Tulkarm, 34 per cent for Jenin and 33 per cent for Nablus. It is not clear why Bethlehem and secondarily Ramallah households suffered especially from this problem, but this may have to do with a possible greater reliance of Bethlehem households on banks or the fact that the invasion first began in both Ramallah and Bethlehem, providing other towns with advance warning and prompting families to prepare for the onslaught, as well as the length of the curfew and siege, which created the conditions of more serious shortages of both essential items as well as cash. Clearly, these results call for further field investigation of this particular question. As with the other towns, these results also call for the need to examine in more detail the impact of these events on the health and nutritional status of the population, especially younger children.
Thirty-five per cent of respondents reported having heard a lot of shooting and explosions throughout all the period of invasion and curfew, 51 per cent most of the time, 14 per cent a little and only 1 per cent did not hear anything at all. When asked how they coped, a high of 65 per cent reported that the family hid in fear, lacked sleep and sufered mental distress as a result, 18 per cent reported that they carried on with their life normally, as the family was by now accustomed to the situation or that there was nothing that anyone could do. Only 5 per cent focused on dealing with the children's physical and mental health, and the rest gave a range of reports, such as "leaving our house and seeking shelter elsewhere", "quite bothered by the army next door", "sleeping in the safest place at home and hoping that God can protect us", and "family gathered in one room waiting for the army to come in".
Of the total respondents, 31 per cent reported considerable destruction in the neighbourhood where they live, in contrast to a very high 87 per cent for Tulkarm, 78 per cent for Jenin, 67 per cent for Nablus and 52 per cent for Ramallah. Evidently, and judging by these responses alone, the level of destruction around the residents of Bethlehem was considerably less than elsewhere, perhaps denoting a generally lesser level of physical destruction overall, or perhaps a concentration of destruction only in specific areas, such as the Church of the Nativity area and the Old City. Of those reporting witnessing destruction, almost half reported considerable destruction of retaining walls, telephone and electrical poles, sewerage, pavements, cars and even traffic signs, almost one-third reported the destruction of homes, doors, the breaking of furniture and windows, and the rest reported destruction of public buildings, commercial enterprises and the blowing up of closed homes. It is interesting to note that none reported the destruction of institutions that took place in Ramallah or the rampant destruction of homes that took place in Jenin and also Nablus's Old City area.
Twenty-one per cent of respondents reported that their homes were directly exposed to shooting, bombing and/or destruction, compared to 28 per cent for each of Tulkarm and Ramallah, and a higher level of home destruction noted for Nablus (34 per cent) and Jenin (59 per cent). Of the total, 15 per cent reported that their cars were directly exposed to shooting, bombing or destruction, while 18 per cent reported the exposure of their workplace to shooting, bombing and/or destruction, slightly higher that in Tulkarm (13 per cent) and Nablus (12 per cent), but lower than in Jenin (29 per cent) and Ramallah (41 per cent).
Thirty-eight per cent of respondents reported that their homes were searched by the Israeli army, compared to a lower 30 per cent for Jenin, a higher of 41 per cent for Ramallah, Tulkarm (45 per cent) and Nablus (50 per cent). Of the total respondents, 27 per cent reported the arrest of at least one family member during the period of invasion and curfew, a rate that is lower than reports from Ramallah (36 per cent), higher than the 12 per cent reported for Tulkarm or Jenin (21 per cent), but comparable to those of Nablus (24 per cent).
Taken together, these results demonstrate that, while the curfew and invasion continued for a longer period in Bethlehem, the physical damage there may have been less severe than in Jenin, at least in relation to the home destruction that took place during the period, and less in severity as well than the institutional damage reported for Ramallah. These results, combined with other results noted above, such as power and water supply interruptions, lead one to suggest that Bethlehem households were affected largely, but not solely, by the special problem of the long curfew and consequent inability to move around, buy what is needed, reach services and work, to a larger extent than in terms of the physical damage that took place in the town during the invasion.
In Bethlehem, reports of medication shortages stood at 34 per cent, the same level of shortage reported for Tulkarm and Jenin, leaving Ramallah with the highest level of medication shortages (49 per cent) and Nablus with the lowest (22 per cent). Given that the invasion in both Bethlehem and Ramallah took place at the same time, an understanding of why Ramallah residents reported a higher level of medication shortages than in Bethlehem, even though Bethlehem's curfew conditions continued for much longer than in Ramallah, is beyond the scope of this quick survey and may well be an interesting question to investigate in the future. However, given that Bethlehem residents were already exposed to the experience of invasions of long duration, it may also be that this experience is important as a conditioning factor determining patterns of shopping and the stocking up of homes with essentials, especially medications.
When asked about how they coped with medication shortages at home, a quarter contacted relief and humanitarian organizations for help, another fifth took the medication or its equivalent from the neighbours; one-sixth resorted to indigenous medical practices; another sixth did nothing and waited, and the rest either got help from friends, contacted ambulances for help, used sedatives instead of the medication that they needed, or relied on the "God-given immune system".
Of those reporting medication shortages during the period, over two-thirds reported the deterioration of the conditions of the patient, while others provided responses that included "lived with strong pain", "medical condition took longer to resolve", "disease was self-limiting anyway" and "bodily disruptions ensued".
As is the case with the other towns, a high of 87 per cent of respondents reported facing problems related to the mental health of one or more family members, results that are comparable to those obtained for the other towns and demonstrating considerable household psychological distress. A variety of conditions were reported, including great fear among children, uncontrolled shivering, lack of sleep, crying, lost appetites, exhaustion mixed with fear and worry, disagreements between the family and the neighbours (apparently seen as evidence of mental distress), and the feeling of insecurity and the inability to protect one's family.
When asked about how the family responded to such problems, the range of answers was quite wide, with one-sixth reporting focusing on relieving children of their fears, another fifth watching television, playing cards, computer games and entertaining themselves with others, a quarter reporting that they did nothing as nothing could be done, another sixth resorted to praying and the rest reporting just being bored and nervous, keeping the family in one room, seeking a counsellor's help, seeking the help of the ambulance services in town, taking medications to sleep, eating garlic (presumably because it is good for the nerves and calms people down) and screaming at the children in reaction to the stress that the family is experiencing.
If one takes into consideration the reports from Bethlehem in combination with the reports from the four other towns, one can be led to the conclusion that the impact of the invasion and curfew periods was felt by households not merely in physical terms, but also in mental health terms as well. The fact that mental health problems were also recognized by respondents, who were willing to report on such household problems, is also significant in that these reports indicate the presence of a generalized awareness of the importance of psychological distress for the general wellbeing of households, and perhaps the need to work to manage and resolve such problems. While these reports are proxy reports that cannot be analysed further, especially at the individual level, the information we obtained here suggests that the effects of the invasion and curfew may have manifested themselves through symptoms of psychological distress, both somatic and behavioural, perhaps exacerbating pre-existing conditions, both physical and mental.
Lastly, when prompted to express their views regarding the conditions in which they live, once again a high of 76 per cent reported views pointing to despair and misery over what is happening to their lives, results that are consistent with those obtained from the other four towns; 8 per cent focused on worries pertaining to the financial condition of the family and the rest gave a range of answers, such as "this is a natural consequence of the Oslo accords", "a wise leadership for the Palestinian people does not exist", "the game is being exposed", "the fear is over what will happen in the future" and "this is a political game, betrayal and complicity".
The responsibility for this deterioration in daily life was placed on the Palestinian leadership in not assessing the situation well, because of favouritism, corruption and other factors in 20 per cent of the responses; the blame was placed on occupation and its force, Sharon and his political failure in 34 per cent of the cases; the blame fell on both Israel and the Arab world leaders in 10 per cent of the cases, and on occupation combined with the failure of the Palestinian authority in another 10 per cent. The rest were mixed answers, including the standard Arab betrayal and American support responses that one hears commonly here, the absence of national unity, the presence of collaborators with Israel and Arab silence.
This initial statistical report focusing on Bethlehem town during the invasion of 29 March 2002 shares findings and observations made in the four other town reports that have been surveyed. In Bethlehem, however, the length of curfew and siege manifested themselves in more difficulties dpertaining to food shortages and cash, compared to the other towns. However, reports of power, water and telephone shortages indicate that those were less severe than elsewhere, although the duration of curfew and siege differences between Bethlehem and the other towns makes it difficult to come up with definitive results.
As with the other towns, the households of Bethlehem were subjected
to much violence and violation of basic human rights, including
the right to move around, to access health services, to work and
to have adequate nutrition. Yet, although Bethlehem may have taken
a larger share of media attention because of the specific events
that took place around the Nativity Church, and despite the fact
that the curfew and invasion were the longest of all five towns,
our data suggests that Bethlehem may have suffered less than other
towns in terms of physical destruction and damage. Perhaps the
presence of media coverage and international volunteers, combined
with the spiritual status of the town in the Christian civilization,
may have caused the Israelis to use a softer hand and may have
deterred some of the brutality demonstrated elsewhere, especially
in the Jenin refugee camp.
However, as is the case with the other towns, despair in Bethlehem
seems to be rampant and part of a generalized consciousness that
began to appear among the Palestinian population even before that
last invasion began. This despair is now being consolidated by
not only grave violations of human rights and the destruction
of the infrastructure needed for survival, but also by the continuation
of the episodes of invasion and curfew as well as closures and
siege, so strict that they preclude possibilities for rehabilitation
and reconstruction. Without the removal of closures and the state
of siege, without putting a stop to Israeli army invasions and
re-invasions, indeed, without the end of occupation, the people
of Bethlehem as well as the other towns and villages of Palestine
are likely to face even worse conditions than those they have
already witnessed.
In estimating the number of households and people that were affected by specific serious difficulties in dealing with daily life as a consequence of this invasion, and based on PCBS estimates, we find the following:
1. Family composition change during exceptional circumstances
2. Unavailability of basic services
3. Low on food and cash
4. Medications
5. Mental health
1. Bennet, James, "Bethlehem invaded again as Israelis extend control", New York Times, 27 May 2002.
2. Palestinian Central Bureau of Statistic (PCBS), Population of Palestinian Communities, 1997-2010 (Ramallah, Palestine, 1999)
3. Palestinian Central Bureau of Statistics, "Population, housing and establishment census - 1997 (City Reports Series. Final Results, Bethlehem City, 2000)
*Institute of Community and Public Health, Birzeit University