Environmental and Public Health
Crisis Emerging in The
Western Ramallah Villages


Rita Giacaman and Anita Abdullah
Institute of Community and Public Health, Birzeit University

This is a current appraisal of living conditions in 29 communities,1 located to the west of Ramallah, that have been separated from the main town center by the IDF’s checkpoint closure system and the recurrent Israeli invasions of the town. The current population of these communities is estimated to be 70,170 (PCBS)—approximately 37 percent are children under the age of 15 years, 20 percent are women of childbearing age, and 5 percent are over 65 years.

These villages have suffered the consequences of the Israeli siege and closures since the beginning of this current uprising (September 2000), plus severe deterioration of living conditions following the killing of six Israeli soldiers at the Ein Arik checkpoint on February 19, 2002. In particular, villagers have suffered serious constraints to normal life since the March 29 invasion with absolute closure lasting up to 45 days in some areas. This report corroborates reports that damage not only occurred in towns but also villages that depend on services from main population centers.

The information contained in this report was obtained by telephone during the second and third week of May 2002 from the mukhtars (heads) of village councils and confirmed by an additional person with village responsibility, usually a teacher or headmaster. These communities cannot be reached in person because of the very strict siege and closure.

Curfews:

During the March 29 invasion: Curfews ranging from several hours to 15 consecutive days (25 villages); no curfews (4 villages).

Before and during the invasion: The village of Deir Ibzi’ reported 40 consecutive days of curfew before and up to the invasion, after which the curfew was sporadic.

After the invasion: As of this report, some curfews are still in force for short periods (6 villages).

Fences: New fences on village land (2 communities); fencing around previously confiscated land (1 village); fencing around land that has evidently been confiscated, but without the village’s knowledge (5–10 dunums of land owned by one village).

Arrests: People arrested and not returned to the village (1 to 6 people in over half of the villages); people arrested but later released (1 to 11 people in one-third of the villages). Those arrested were police officers serving in the national security forces, as well as men on their way to work outside the village, and one health worker.

Deaths and Injuries: 1 or 2 deaths in one-fourth of the communities, mostly occurring outside the communities either in Ramallah or other towns; 1 to 8 injuries in 19 villages—on roads, settler attacks, and during imposed curfew episodes.

Problems with settlers: Serious problems (7 communities)—mainly with the settlers stationing themselves on the main road and blocking access to water or to reaching roads; vandalism, and cut electricity and water lines (1 village); reaching fields to work the land (2 communities); no problems (12 communities), as settlers use separate roads and villagers are not near lands surrounding the settlements.

Other reports pertain to uprooting trees, damaging communal cars, shooting at homes, attacking boys playing in the field, attacking teachers in village schools. In two cases, settlers and/or army tanks attacked the school, creating such fears that some students dropped out.

Food Shortages: Severe food shortages (8 villages); moderate food shortages(5 villages).

The communities have adjusted with mutual support of family and shop owners who allowed purchase of food on account. These services may be ending because of overall depletion of food and the spiraling costs of the new stock caused by road closures necessitating longer hours and alternative routes to reach communities.
There are reports that some truck drivers are refusing to reach the more remote villages because they have been refused entry to the area or their vehicles attacked and damaged (slashed tires, sand in motor) by army patrols. Even goods carried by pedestrians are destroyed. For example, Israeli soldiers ripped open sacks of sugar a man was taking to his village by donkey, spilling the contents on the ground.

Cash Shortages: Prolonged unemployment (29 villages).

Secondary Health Care Services: Emergencies requiring secondary care are taken to the hospital in Ramallah. Cases that could not reach hospitals included accidents and acute illness with children, heart attacks, renal failure, and scorpion bites. Many births occurred at home with the assistance of a nurse, relative, or with professional assistance via telephone. A health worker in Aboud village reported the death of a newborn baby because neither Ramallah nor Jerusalem hospitals could be reached due to the multiple disruptions of connecting roads, harassment by army patrols between the villages, and general lack of ambulances.
- Extreme difficulty reaching secondary medical services including maternity delivery (29 communities).

Primary Health Care Services (governmental and nongovernmental): Some services are located in villages; others require physicians, nurses, and immunization teams to travel to these centers. Since February 19th, 2002, medical teams could not reach villages and there was no medical service at all (18 communities); rare service available (2 communities); some service available (6 communities), and no problems with service (3 communities).

Medications: Severe shortages of medications, especially those for the management of chronic diseases such as diabetes and hypertension (20 communities); moderate shortages of medication (6 communities); mild or no shortages (3 communities).

The major problem is the unavailability of free and low cost medications available from governmental and NGO health services due to prevention of access to the villages of supplies and medical personnel. Some drugs are available from private practitioners and pharmacies but there is no cash to purchase them, especially expensive drugs such as insulin.

Garbage: Serious problems (12 communities), especially among those who use Ramallah’s dumpsite; no problems (17 communities), presumably because the garbage is dumped locally. For those communities unable to reach organized sites, garbage is being burned, increasing the problem of air and soil pollution.

Animals: Some villages with large chicken businesses could not receive chicken feed causing the loss of scores of chickens.

Sewage: Severe difficulties (9 villages), including sewage spilling onto streets and between houses; no problems (20 villages). Dis-infection services from Ramallah can no longer reach these communities.

Electricity: Cuts from a few hours up to 10 days (28 villages), often resulting in spoiled food.

Water: Water cuts ranging from 2 to 60 days (11 villages), of these, piped water cut by settlers (1 village); no problems (18 villages) probably because villages were using spring rainwater stored in cisterns (water wells). No tests are taken of bacterial and chemical quality. In one village, it took two weeks to fix the broken water pump because of the Israeli army blockade.

Telephones: No link to the land telephone network (8 villages); lines cut (one to twenty days in 7 villages); no problems (14 villages).

The main problem is inability to pay utility bills, either because of unemployment or inability to reach Ramallah to make payments.

Fuel: Severe fuel shortages (6 communities), forcing families to collect and use firewood instead of bottled gas for cooking; a range of problems, from mild to severe (10 communities); no fuel shortage (13 communities).

Education: Problems with education (29 communities); as severe at time of interview as during invasion (25 communities).

During the 23-day period when the Israeli Army occupied Ramallah, all schools were closed. The majority of communities noticed that this long period of interruption has led students, especially younger ones, to forget much of what they had learned. The tawjihi (national high school leaving examination) students have fallen far behind. Students cannot concentrate, having lost interest because of psychological distress, because teachers cannot reach schools, grades have merged and classrooms are overcrowded, and high school and university students cannot commute to town to continue their education. Some students stay in town as a temporary but costly way out, and some students have dropped out of school altogether.

Summary: The main problem is unavailability of income (25 communities), already a serious problem, as a large number of males worked in Israel before September 29, 2000 have been unemployed for nearly 19 months. Prolonged unemployment because of road closures is the major cause of the upcoming life crisis.

The second major problem is healthcare (24 communities) with road conditions, the political problems, military attacks, the problems with settlers as issues of concern and worry. Immunization services, care of chronic patients, the elderly, and those with acute and communicable diseases has almost halted among the 70,000 people in the 29 villages. As a result, an emerging health crisis may soon arise.

Humanitarian and aid organizations can offer food and similar emergency aid, but they must address the underlying problems and advocate for the lifting of the closure, the only ultimate solution to this crisis.

References:
UN Office for the Coordination of Humanitarian Affairs (OCHA), Occupied Palestinian Territory crisis update, 18-20 February, 2002.
PCBS, 1999. Population, Housing and Establishment Census, 1997: Final Results, Population Report, Palestinian Territory, First Part.
PCBS, 1999. Small Area Population, 1997-2010. Ramallah – Palestine.

1The following is a list of communities that were included in this appraisal:
Aboud, al-Janieh, al-Midia, al-Tireh, Beit Liqia, Beit Sira, Beit Ur al-Foqa, Beit Ur al-Tahta, Bilin, Budrus, Deir Abu Mash’al, Deir Ammar, Deir Ammar refugee camp, Deir Ibzi’, Deir Qiddis, Ein Arik (where the military checkpoint is located), Ein Qinia, Jammala, Kharbathat Bani Harith, Kharbathat Misbah, Kufr Ni’meh, Libban al-Gharbieh, Nilin, Qibia, Rantis, Ras Karkar, Saffa, Shibtin, and Shuqba.

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