Challenges

The Agency faces enormous challenges in delivering its health services, including:

• access to health care
• protecting victims of violence

Access to health services

Ensuring equity in access to health care can be particularly difficult where UNRWA works, because of violent conflict, restrictions on movement and refugees’ entitlements under the different host governments.

UNRWA now has 137 health centres across all fields, significantly reducing the physical and economic barriers to health care for Palestine refugees.

Since February 2003, five mobile health teams have operated in the West Bank in those areas affected by closures, checkpoints and the Barrier. The teams offer a full range of essential medical services to around 13,000 patients per month, in over 150 isolated locations.

Protecting victims of violence

As an organisation working in a chronically unstable environment, UNRWA is continuously challenged by upsurges of violence, such as in Lebanon and more recently in the Gaza Strip.

New services such as mental health care, physiotherapy and rehabilitation have been established. These deal specifically with the consequences of protracted violence and insecurity. UNRWA also provides counselling and referral services to help victims of gender-based violence.

UNRWA’s health programme is decentralised and able to adapt rapidly to different security concerns and logistical problems.

Gaza Strip
Almost 1,500 people were killed during the Israeli military operation known as Operation Cast Lead, launched in the Gaza Strip between 27 December 2008 and 18 January 2009.

Fifty-two UNRWA installations were damaged in the fighting, including seven health centres and the Agency’s Gaza field office. As a result of severe shelling, some of UNRWA’s warehouses were destroyed. The estimated cost of repairs was more than US$3 million. The cost of replacing supplies, of which medicines were a substantial part, required an extra US$3.6 million.

In the Gaza Strip, movement restrictions continue to hinder patient referrals to Israel for medical treatment.

During the conflict, UNRWA provided temporary shelter to over 50,000 Palestinians who sought refuge in the Agency’s schools. Although security constraints severely limited the movement of staff, UNRWA continued delivery of its health services, adjusting to the needs of displaced people and to a deterioration in local environmental health standards.

The Agency also continued its high levels of disease surveillance after the conflict, making sure that no outbreaks took place among refugees in the Gaza Strip, who make up 70 per cent of the population.

Read about the life-cycle approach to health

More on healthcare in the five fields