This record is a partial extract of the original cable. The full text of the original cable is not available.

UNCLAS SECTION 01 OF 03 TEL AVIV 001546 
 
SIPDIS 
 
NEA FOR SATTERFIELD 
 
E.O. 12958: N/A 
TAGS: ECON KWBG IS ISRAELI PALESTINIAN AFFAIRS ECONOMY AND FINANCE HUMANITARIAN AID
SUBJECT: HUMANITARIAN CONDITIONS IN WEST BANK AND 
GAZA: NOT GETTING ANY BETTER 
 
This cable has been cleared by ConGen Jerusalem. 
 
¶1.  Summary: Overall, the humanitarian situation in 
West Bank and Gaza (WB/G) has not improved.  Despite 
some minor improvements in mobility, the range of 
socio-economic indicators remain dismal.  Over 60 
percent of the WB/G population live below the poverty 
line; Unemployment rates as of fourth quarter 2003, 
under ILO standards, were 20.7 percent for West Bank 
and 31.9 percent for Gaza.  If we include "discouraged 
workers", the rates climb to 27.8 percent for the West 
Bank and 37.2 percent for Gaza, according to the World 
Bank.  According to a recent WFP/FAO survey, 41 
percent of Gazans and 39 percent of West Bankers 
suffer from food insecurity.  The GOI has allowed 
Gazans to work in Israel, despite a series of recent 
terrorist attacks at Erez crossing and has 
consistently re-opened the crossing to laborers after 
very brief closings following these incidents.  Access 
to agricultural lands, however, remains problematic, 
despite some recent minor improvements in the West 
Bank.  In Gaza, however, farmers have reported more, 
not fewer, problems in accessing their fields. 
 
¶2.  In the realm of health, there has been a positive 
trend of improved access for ambulances and emergency 
medical teams.  However, there still are far too many 
delays.  The lack of financial resources means that 
many families forego routine and preventative medical 
care.  In general, international staff members of 
relief agencies have been able to travel to and from 
the West Bank and Gaza.  Due to recent attacks at 
Erez, there are however, serious delays in gaining 
access to Gaza.  However, there have been no 
improvements in the ability of these agencies to 
deliver services to enclosed communities in Gaza and 
the GOI has yet to fullfill its long outstanding 
committment to allow direct food delivery into El- 
Mowassi.  End Summary. 
 
--------------------------------------------- --------- 
Checkpoints/ General Movement: Too Many and Not Enough 
--------------------------------------------- --------- 
 
¶3.  In general, there has been a marginal improvement 
in mobility in the West Bank and Gaza for people and 
goods, including workers.  However, these modest 
improvements have not been enough to impact socio- 
economic conditions, and are unlikely to positively 
influence any of the broad health and humanitarian 
indicators - acute and chronic nutrition, food 
security, unemployment, poverty levels.  The GOI has 
claimed it has removed 22 internal manned West Bank 
checkpoints, while the Office of Coordination of 
Humanitarian Assistance (OCHA) could only confirm 
nine.  OCHA reported that nearly 600 concrete road 
barriers and earth mounds continue to restrict travel 
on internal West Bank roads.  Flying-checkpoints in 
the West Bank are an almost daily occurrence.  In 
Gaza, North-South travel has in general been possible 
with fewer delays at Abu Khouli checkpoint.  Travel, 
however, to and from enclosed communities such as El- 
Mowassi and Seafa remains extremely restricted. 
 
--------------------------------------- 
Land Confiscations/Demolitions Continue 
--------------------------------------- 
 
¶4.  Land confiscations, leveling, and demolitions all 
continue in both the West Bank and Gaza.  These 
actions are associated mostly with construction of the 
separation barrier in the West Bank; while in Gaza 
they are prompted by enhancement to security 
perimeters and infrastructure near settlements. 
 
--------------------------------------------- --------- 
High but Stabilized Unemployment/ Improved Access to 
Agricultural Lands 
--------------------------------------------- --------- 
 
¶5.  As of fourth quarter 2003, unemployment rates (ILO 
definition) stood at 20.7 percent for the West Bank 
and 31.9 percent for Gaza.  While this is an 
improvement over the peak Intifada unemployment rates 
registered in second quarter of 2002 (WB 31.4 percent; 
Gaza 42 percent), the numbers are still drastically 
higher than pre-Intifada numbers of 7.5 percent for 
the West Bank and 15.4 percent for Gaza.  With 
population growth at 4.3 percent per year, dependency 
ratios - the total population divided by the number of 
employed persons - have increased significantly over 
the Intifada period.  In the third quarter of 2000, 
each job holder in the West Bank was supporting 4.3 
persons, by the fourth quarter of 2003, each employed 
person was supporting 5.4 persons.  In Gaza, the 
dependency ratio increased more dramatically, from 5.9 
to 7.7. 
 
¶6.  Gazans working in Israel continue to hover in the 
10,000/day range.  Recent terrorism attacks at Erez 
have resulted in the crossing being closed for only 
small periods of time - one or two days - before 
workers were allowed to resume crossing into Israel. 
Overall, according to a World Bank/PCBS study 
conducted over the past four months, Gazans who have 
jobs report "few" or "no" problems in accessing their 
places of employment.  (Note: It is not clear if Gazan 
respondents include both those employed in Israel and 
within Gaza, or just the latter.  End Note.)  West 
Bankers reported greater difficulties with the average 
falling between "few problems" and "difficult." 
Nablus has reported the most difficulty.  There, fully 
35 percent of those employed said they found it "very 
difficult" or "impossible" to reach their places of 
employment in the January survey. 
 
¶7.  Roughly one third of the households in the West 
Bank and 15 percent in Gaza have agricultural land 
that they cultivate.  In World Bank/PCBS surveys 
conducted over the past four months, West Bank 
households reported a slight improvement in access to 
that land, while in Gaza the trend was negative. 
Overall, West Bankers still report more difficulties 
in accessing farmland, than do Gazans. 
 
--------------------------------------------- --------- 
Food Security: International Assistance Averts a 
Catastrophe 
--------------------------------------------- --------- 
 
¶8.  The donor community has managed to reduce global 
acute malnutrition through massive amounts of food 
assistance, technical support and awareness raising 
with the Ministry of Health.  However, there have 
not/not been significant improvements in overall food 
security which exists when people have physical and 
economic access to sufficient, safe and nutritious 
food to meet their dietary needs and food preferences 
for an active and healthy life.  A recent FAO/WFP Food 
Security and Vulnerability Profiling Assessment 
concluded that 41 percent of Gazans and 39 percent of 
West Bankers suffer from food insecurity.  The 
majority of cases in the West Bank were reported along 
the route of the separation barrier.  In a pilot study 
examining coping strategies, WFP reported that 89 
percent of its beneficiaries said they frequently or 
always consume less quality and variety of food; 63 
percent limit the portions of meals; 56 percent forego 
health and education expenses; and 55 percent reduce 
the meals of adults in favor of children.  The survey 
also concluded that among WFP beneficiaries, 
humanitarian assistance is the main/main source of 
income in the Gaza Strip, whereas in the West Bank, it 
remains employment and casual labor. 
 
-------------------------------- 
Health Access: The Worst is Over 
-------------------------------- 
 
¶9.  OCHA reported that medical staff and patients 
continue to face checkpoint delays of up to four 
hours.  There have, however, been fewer cases of 
ambulances being denied access altogether, under 
"normal" conditions.  During periods of major clashes, 
OCHA reported that the coordination mechanisms between 
Israelis and Palestinians tend to break down, 
resulting in serious delays.  Since the beginning of 
the year, there have been 12 incidents where 
ambulances and medical teams have been denied access; 
and 45 incidents in which medical personnel were 
delayed from 40 minutes up to four hours. 
 
¶10.  Access to routine medical care is less 
problematic than access to emergency services.  In 
joint surveys carried out by the World Bank and PCBS 
over the past four months, for the approximately 70 
percent of households in Gaza reporting a need for 
medical attention, most said that access to that care 
posed "few problems."  In the West Bank, access was 
more problematic, with West Bank village residents 
reporting the most difficulty in accessing care; and 
camp residents reporting the least problems, probably 
due to the existence of UNRWA clinics in the camps. 
Financial wherewithal remains a key determinant to 
whether a family receives routine and preventative 
health care in both Gaza and the West Bank, but this 
factor is more pronounced in Gaza. 
 
--------------------------------------------- --------- 
Access for Relief Agencies: Okay in the West Bank - 
Problematic in Gaza 
--------------------------------------------- --------- 
 
¶11.  International organizations and NGOs are not 
generally encountering major obstacles delivering 
services in the West Bank.  Access to and from Gaza 
has been difficult lately as a result of a series of 
recent terrorist attacks at Erez crossing.  Currently, 
internationals are not allowed to bring cars into 
Gaza.  We have heard informally that access to 
vehicles will be restored by the end of the week. 
 
¶12.  However, NGOs and international organizations 
continue to face more systematic access problems in 
delivering services to enclosed communities in Gaza -- 
El-Mowassi and Seafa.  Despite numerous pledges, 
commitments, and meetings dating back over one year, 
the GOI has still failed to allow UNRWA and WFP to 
make direct food deliveries to El-Mowassi for example. 
 
¶13.  The GOI has recently issued some permits to local 
Palestinian staff members of UN organizations. 
However, there is still room for improvement in this 
regard. 
 
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