Palestine Refugees Research Articles

Surviving Seemingly Endless Refugeeship—Social Representations and Strategies of Palestinian Refugees in Ein El Hilweh

Abstract Today, about 470,000 Palestinian refugees are registered with the United Nations Relief and Works Agency for Palestine Refugees in the Near East in Lebanon, with 45 per cent of them living in the 12 official Palestinian refugee camps. Previous research identified several socio-economic problems facing the Palestinian refugees in Lebanon. The refugee camps have generally been very poor and relatively dangerous places to live. Moreover, all the Palestinian camps suffer from overcrowding, unemployment, poor housing conditions, inadequate infrastructure, as well as a lack of access to justice. Although previous research has identified several difficulties with living in a Palestinian refugee camp, this study takes a fresh look at life in the largest camp in Lebanon—Ein El Hilweh. In addition to identifying such problems and difficulties, it also explores the various strategies adopted by Palestinian refugees to handle them. While acknowledging that not all problems can be resolved, these problem-solving strategies of refugees is a significant gap in the literature on refugees that warrants further investigation. The study is grounded in Serge Moscovici’s theory of social representations, analyzing Palestinian refugees’ shared experiences in facing difficult situations as well as their strategies for solving them.

La UNRWA en Gaza y Cisjordania. 70 años de estrategias de humanitarismo y desarrollo para los refugiados de Palestina

La Agencia de las Naciones Unidas para los refugiados de Palestina, la UNRWA, fue creada por las Naciones Unidas a raíz de la declaración 302 (IV) de la Asamblea General en diciembre de 1949 y entró en funcionamiento en mayo de 1950. Durante 70 años la UNRWA ha desarrollado programas y acciones que van desde una perspectiva inicial centrada en el socorro y las obras públicas hasta una estrategia de desarrollo humano y protección de los derechos humanos en sus cinco áreas de operaciones: Gaza, Cisjordania, Líbano, Siria y Jordania. El presente artículo estudia —a partir del análisis de los informes y la documentación de la UNRWA— la evolución de los programas de soco- rro, servicios sociales y emergencias de la Agencia en Gaza y Cisjordania desde sus inicios hasta la actualidad para analizar cómo se ha enfrentado a los retos, las amenazas y las ten- siones del conflicto en Israel-Palestina, con el objetivo de entender desde una perspectiva histórica como a pesar de las continuas tensiones a la que se encuentra sometida ha devenido en un instrumento esencial de la comunidad internacional en la asistencia, el desarrollo y el bienestar de la población palestina.

Evaluation of Mathematics Teachers’ Knowledge at UNRWA Schools in Gaza Strip about the Action Research Concepts and Process

In this study, the availability of action research knowledge was measured among teachers of mathematics in schools belongs to Relief and Works Agency for Palestine Refugees (UNRWA) in Gaza Strip. The study sample consisted of 241 male and female teachers, where the study sample contained (25%) of the total study population, which consists of (972) active teacher during the current study time (second semester- 2019/2020). It was found that the sample has a strong knowledge about the action research concepts. Moreover, it was confirmed that there are no significant differences attributed to the variables of gender, training programs, and educational qualification. Meanwhile, the results showed that there is a significant effect by the teacher’s age and cumulative experience on the teachers’ knowledge of action research. Based on the findings, the challenges and obstacles that prevent teachers or limit their ability to perform action research must be studied and thus an attempt should be made to overcome those obstacles in order to push the teacher to perform the action research.

Dietary Inadequacy, Micronutrient Deficiencies, and Approaches to Preventing Poor Nutrition in the Gaza Strip.

Palestine refugees comprise the largest refugee population in the world, most of whom are encamped in Middle Eastern countries. In the Gaza Strip, where ∼1.4 million Palestinians reside, there are high prevalences of anemia and multiple micronutrient deficiencies (MNDs), including those of iron, zinc, vitamins A, B12, D, and E, ranging from 11.4% to 84.7% among pregnant women and 2.9% to 70.9% among preschool children. Dietary diversification and adequate food fortification are framed in policies but remain aspirational goals. Alternative, effective, targeted preventive approaches include, for women, replacement of antenatal iron-folic acid with multiple micronutrient supplementation, and for young children, point-of-use multiple micronutrient powder fortification to prevent anemia, both of which can reduce other MNDs and may bring additional health benefits. These interventions coupled with monitoring of dietary intakes, periodic assessment of MNDs, and implementation research to improve existing nutrition interventions are warranted to protect the health of the Middle East Palestinian diaspora.

Anaemia prevalence in children newly registered at UNRWA schools: a cross-sectional study.

ObjectiveChildren entering first grade at the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) schools in West Bank, Gaza, Lebanon, Jordan and Syria complete a comprehensive medical examination at UNRWA health centres (HCs) as a requirement for their acceptance. Our study aimed to assess anaemia prevalence and undernutrition indicators among new entrant school children during their preschool medical examination.SettingsIn 2017, we conducted a cross-sectional study in 59 UNRWA HCs, targeting children entering first grade at UNRWA schools in four of UNRWA’s countries of operation (known as fields), namely Gaza, West Bank, Syria and Lebanon.Participants2419 completed the study. Boys and girls living inside or outside Palestine refugee camps were included. Verbal consent was obtained from their parents.Primary and secondary outcome measuresSociodemographic and anthropometric data on each child were collected. Underweight (weight-for-age z-score <−2 SD), stunting (height-for-age z-score <−2 SD), thinness (body mass index-for-age z-score <−2 SD) and obesity (body mass index-for-age z-score >+2 SD) were examined according to WHO growth indicators (5–10 years).Results2419 students (1278 girls and 1141 boys) aged 6.1±0.4 years were examined. The prevalence of anaemia (haemoglobin (Hb) <11.5 g/L) was 25.0% (Gaza: 29.3%; West Bank: 22.0%; Syria: 30.0%; Lebanon: 18.3%). The mean Hb level was 12.0±0.9 g/L. The overall prevalence of stunting, thinness and underweight was 3.2%, 3.5% and 5.6%, respectively, with the highest levels found in Syria (4.3%, 6.3% and 10.1%, respectively). The highest prevalence of overweight was in Lebanon (8.6%), and the lowest was in Gaza (2.6%). Significant differences were found among fields with regard to undernutrition indicators (p=0.001). Also, children with anaemia had significantly higher prevalence of being underweight (5.2%) in comparison with those without anaemia (p=0.001).ConclusionsThe prevalence of anaemia among the surveyed children increased to 25.0%, compared with the previous study conducted by UNRWA in 2005 (19.5%). Thus, it is recommended that Hb testing be included in the medical examination of new entrant school children attending UNRWA schools.

Times of change in complex environments - Evaluating hospital co-payments in Palestine refugee camps

Abstract We measure the impact introducing a of 10% co-payment component on hospitalisation costs for Palestine refugees from Lebanon in public and private hospitals. This ex-post analysis provides a detailed insight on the direction and magnitude of the policy impact in terms of demand and supply for healthcare. The data was collected by the United Nations Relief and Works Agency for Palestine Refugees in the Near East and include episode level information from all public, private and Red Crescent Hospitals in Lebanon, between April 2016 and October 2017. This is a complete population episode level dataset with information from before and after the policy change. We use multinomial logit, negative binomial and linear models to estimate the policy impact on demand by type of hospital, average length of stay and treatment costs for the patient and the provider. After the new policy was implemented patients were 18% more likely to choose a (free-of-charge) PRCS hospital for secondary care, instead of a Private or Public hospital, where the co-payment was introduced. This impact was stronger for episodes with longer stays, which are also the more severe and more expensive cases. Average length of stay decreased in general for all hospitals and we could not find a statistically significant impact on costs for the provider nor the patient. We find evidence that the introduction of co-payments is hospital costs led to a shift in demand, but it is not clear to what extent the hospitals receiving this demand shift were prepared for having more patients than before, also because these are typically of less quality then the others. Regarding costs, there is no evidence that the provider managed to contain costs with the new policy, as the demand adapted to the changes. Our findings provide important information on hospitalisation expenses and the consequences of a policy change from a lessons learned perspective that should be taken into account for future policy decision making. Key messages We show that in a context of poverty, the introduction of payment for specific hospital types can be efficient for shifting demand, but has doubtable impact on costs containment for the provider. The co-payment policy can have a negative impact on patients' health since after its implementation demand increased at free-of-charge hospitals, which typically have less resources to treat patients.

No ordinary leaders - Analysing female-headed households in Palestine refugee camps

Abstract We explore the potential impacts of being a female head of household (FH) or a family member in a female-headed household (MFH) in terms of budget expenditures and socio-economic determinants. Female household leaders in Palestine Refugee Camps find themselves with more barriers to provide the basic needs to their families. However, there is yet no analysis on the different household typologies, nor whether these translate into differences in healthcare spending and well-being outcomes. We perform a cross section analysis using two-part models (probit and glm) to understand correlations between household composition and spending decisions, as well as healthcare indicators. The data are from AUB Socioeconomic Surveys from 2010 and 2015 with household and individual level information. Our preliminary results follow the evidence in the literature and show that expenditure in healthcare as a percentage of total spending is 2.3%*** higher in 2010 and 3.3%*** in 2015 in female headed households. This difference is higher in families headed by widows or single women. Comparing 2010 to 2015 female-headed households are better off financially and belonging to these families is a significant determinant of receiving remittances from family abroad or in Lebanon and being self-employed. Our results suggest that family remittances for female-headed households, heads of households having their own business and better budget management may be helping these families to cope with financial distress. These families are also target of special social support, but further research is needed to understand whether this support should target the gender of the household head or a more specific issue, that might be common to most of these households, but not the female leadership itself. Key messages Female-headed households are related to higher household budget spending on healthcare, are more likely to receive remittances from abroad and most of female heads of households are self-employed. We contribute to the discussion on whether special social support should target specifically female headed households or other specific poverty related issues.

Micronutrient status of Palestinian school children following salt and flour fortification: a cross-sectional study

BackgroundIn 1996 and in 2006, Palestine initiated salt iodization and multiple micronutrient fortification of wheat flour, respectively as a strategy to prevent deficiencies of these nutrients. In 2009, we assessed the impact of these interventions on the health and nutritional status of schoolchildren residing in the West Bank.MethodsWe surveyed a sample of 22 schools run by the UN Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) and the Palestinian Government. We randomly selected students from the first (mean age 6.7 years [SD 0.5]), sixth (11.8 years [0.6]), and ninth grades (14.8 years [0.6]). Data were obtained from 1484 (99%) of 1500 students planned for enrollment.ResultsOur results suggest that iodine intake appears adequate and there was essentially no iodine deficiency. As to the status of other micronutrients, the main nutritional micronutrient risks for schoolchildren in the West Bank continue to be low serum levels of iron, zinc, and vitamin B-12; folate levels were seemingly high. The overall prevalence of anemia was 9.6%, but there were pockets of anemia in certain districts. Almost 42% of the anemia in our sample was explained by iron deficiency. There were significant differences in iron deficiency between girls and boys, 29.5% vs. 15.7%, respectively (p = 0.0001). There were no cases of lead toxicity in the studied sample.ConclusionsWheat flour and salt fortification has had a major influence on improving the micronutrient status of Palestinian children, for some but not all micronutrients. The recommended key blood and biochemical parameters to be incorporated in the surveillance system are iron, zinc, and vitamin B12.

Assessment of the knowledge, attitudes, and practices (KAP) among UNRWA* health staff in Jordan concerning mental health programme pre-implementation: a cross-sectional study

BackgroundMental health is a major public health priority, especially among refugees. The United Nations Relief and Works Agency for Palestine Refugees (UNRWA) started to integrate mental health and psychosocial support (MHPSS) into its primary healthcare services in Jordan in late 2017. In this study, we aimed to assess of the knowledge, attitudes, and practices (KAP) among UNRWA health staff (HS) in Jordan concerning mental health programme pre-implementation, and their perceived barriers about this MHPSS programme.MethodsA cross-sectional study was conducted among doctors, dentists, nurses, and midwives who work at 16 of the 25 UNRWA health centres in Jordan. The assessment was made using a validated self-administered questionnaire. Data analysis was performed using SPSS (version 22).ResultsOf the participants, 73% (161 of 220) believed that their knowledge of MHPSS programmes was insufficient, with no significant difference (p = 0·116) between different categories of staff. Furthermore, 88% (194 of 220) said that they needed more training, 67% (147 of 220) reported that the number of mental health cases is increasing, and 50% (110 of 220) that dealing with these cases is difficult. Reflecting on the past 12 months, 31% of staff (69 out of 220) reported meeting between one and ten children, and 45% (100 out of 220) reported meeting between one and ten adults suspected of having mental illnesses. The most suspected condition was depression (84%; 150 of 220), followed by epilepsy (64%; 140 of 220). The main perceived barriers to implementation included the limited availability of MHPSS policies (87%; 192 of 220), MH professionals (86%; 190 of 220), resources (86%; 189 out of 220), and lack of privacy (14%; 31 out of 220).ConclusionsMost health staff had positive attitudes towards MHPSS programme implementation but felt they lacked the required knowledge. There is a need for training and clear technical guidelines. Perceived barriers to MHPSS programme implementation were consistent with the previous studies and need to be tackled with a structured plan of action.

G.A. Res. 73/95, Palestine Refugees’ Properties and Their Revenues (Dec. 7, 2018)

G.A. Res. 73/95, Palestine Refugees’ Properties and Their Revenues (Dec. 7, 2018)

G.A. Res. 73/92, Assistance to Palestine Refugees (Dec. 7, 2018)

G.A. Res. 73/92, Assistance to Palestine Refugees (Dec. 7, 2018)

G.A. Res. 73/94, Operations of the United Nations Relief and Works Agency for Palestine Refugees in the Near East (Dec. 7, 2018)

G.A. Res. 73/94, Operations of the United Nations Relief and Works Agency for Palestine Refugees in the Near East (Dec. 7, 2018)

Dissemination and implementation of the e-MCHHandbook, UNRWA’s newly released maternal and child health mobile application: a cross-sectional study

ObjectivesIn April 2017, the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) released the electronic Maternal andChildHealth Handbook, the e-MCH Handbook application. One of...

Serin Alheto v. Zamestnik-Predsedatel Na Darzhavna Agentsia Za Bezhantsite (C.J.E.U.)

On July 25, 2018, the EU Court of Justice (CJEU) released its judgment on the case of Alheto, concerning an application for international protection lodged in a European Union (EU) member state by a distinct category of refugees, namely Palestinians registered with the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA). In dealing with the particular status accorded to such persons, the Court opined that a Palestinian who is registered with UNRWA is excluded from refugee status in the EU, so long as the protection from the UN ad hoc agency is effective, which is ascertained through a full and ex nunc examination of the facts and points of law.

Palestine at the UN: The PLO and UNRWA in the 1970s

This article examines the relationship of the Palestine Liberation Organization (PLO) to the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) during the 1970s, the period when the PLO reached the zenith of its power in Palestinian refugee camps throughout the Levant. Based on archival United Nations (UN) and UNRWA documents, as well as the PLO's own communications and publications, the article argues that the organization approached its relationship with UNRWA as part of a broader strategy to gain international legitimacy at the UN. That approach resulted in a complex set of tensions, specifically over which of the two institutions truly served and represented Palestinian refugees. In exploring these tensions, this article also demonstrates how the “question of Palestine” was in many ways an international issue.

“Incredibly Difficult, Tragically Needed, and Absorbingly Interesting”: Lessons from the AFSC School Program for Palestinian Refugees in Gaza, 1949 to 1950

This article examines a school program operated by the American Friends Service Committee (AFSC) for Palestinian refugees in Gaza in 1949 and 1950. Drawing on historical records from organizations involved in the broader relief effort, it examines why the school program was set up and how it operated, and considers the lessons it offers for contemporary refugee education efforts. I argue that, while AFSC adopted an atypical approach to humanitarian relief that prioritized education from the outset of the crisis, the school program it developed was invariably constrained by the overarching humanitarian paradigm within which it operated. Funding for education was limited, which left the schools vulnerable to competing political objectives. This article underscores the importance of understanding the history of the United Nations Relief and Works Agency for Palestine Refugees in the Near East in order to understand its present, and to inform contemporary education efforts for other refugee populations. The article also highlights the need for a critical appraisal of attempts to align refugee education programs with the generally accepted principles of humanitarianism.

Child-Reported Food Insecurity Is Negatively Associated with Household Food Security, Socioeconomic Status, Diet Diversity, and School Performance among Children Attending UN Relief and Works Agency for Palestine Refugees Schools in Lebanon

Recent studies have shown that children are able to accurately describe their own experiences of food insecurity; however, few studies have quantified this experience. We aimed to develop and validate a child food security scale to be used in Arabic-speaking countries. As part of the Healthy Kitchens Healthy Children study on food security and nutrition in schools, 14 questions were administered to 5-15-y-old children (n=1433) attending 4 UN Relief and Works Agency for Palestine refugees schools. We used statistical methods based on Item Response Theory to assess the internal validity of a proposed food security scale using these items. Further validation of the scale was conducted by examining associations with sociodemographic, economic, household food security, and diet diversity variables through logistic regression models adjusted for age, sex, and school of the children. A total of 1287 children (89.8%) provided complete responses to the questionnaire. Four items were dropped from the scale because of high infit statistics (>1.3) and high residual correlation with other items. The resulting 10-item scale had acceptable reliability (Cronbach α coefficient=0.89). Children who reported food insecurity were more likely to be from food-insecure households (OR: 2.3; P<0.001). Food-insecure children came from households with lower expenditures per capita (OR: 0.80; P=0.007) and higher household crowding (OR: 1.70; P=0.001), and had less educated mothers (OR: 0.89; P=0.009), lower household diet diversity (OR: 0.85; P<0.001), and lower household consumption of meat (OR: 0.89; P<0.001) and fruit (OR: 0.95; P=0.001). Child food insecurity was also associated with higher school absenteeism (OR: 1.64; P=0.01) and lower academic grades in languages and science (P<0.05). Child food security was accurately measured through a 10-item scale. This tool is appropriate to assess child food insecurity experience directly with children, and can be used in school-based interventions, where obtaining data from parents may be cumbersome.

The Global Compact on Refugees: A Historic Achievement

The Global Compact on Refugees: A Historic Achievement

Health system resilience in the face of crisis: analysing the challenges, strategies and capacities for UNRWA in Syria.

Health system resilience reflects the ability to continue service delivery in the face of extraordinary shocks. We examined the case of the United Nations Relief and Works Agency (UNRWA) and its delivery of services to Palestine refugees in Syria during the ongoing crisis to identify factors enabling system resilience. The study is a retrospective qualitative case study utilizing diverse methods. We conducted 35 semi-structured interviews with UNRWA clinical and administrative professionals engaged in health service delivery over the period of the Syria conflict. Through a group model building session with a sub-group of eight of these participants, we then elicited a causal loop diagram of health system functioning over the course of the war, identifying pathways of threat and mitigating resilience strategies. We triangulated analysis with data from UNRWA annual reports and routine health management information. The UNRWA health system generally sustained service provision despite individual, community and system challenges that arose during the conflict. We distinguish absorptive, adaptive and transformative capacities of the system facilitating this resilience. Absorptive capacities enabled immediate crisis response, drawing on available human and organizational resources. Adaptive capacities sustained service delivery through revised logistical arrangements, enhanced collaborative mechanisms and organizational flexibility. Transformative capacity was evidenced by the creation of new services in response to changing community needs. Analysis suggests factors such as staff commitment, organizational flexibility and availability of collaboration mechanisms were important assets in maintaining service continuity and quality. This evidence regarding alternative strategies adopted to sustain service delivery in Syria is of clear relevance to other actors seeking organizational resilience in crisis contexts.

Moving towards Inclusive Education for All: Examining Stakeholder Perceptions of Educating Students with Special Needs in Schools Operated by the Jordan Field of the UNRWA

ABSTRACT Perceptions of inclusive education in schools operated by the Jordan field of the United Nations Relief and Works Agency for Palestine Refugees in the Near East were explored through multiple embedded case studies. Each of the three schools examined included a student with a special educational need. The study was framed by a theoretical model of inclusive education and guided by theoretical propositions, an empirical hypothesis developed using previous research. Findings from interviews, classroom observations, and document reviews suggest that all stakeholders believe education for students with special educational needs is a human right. However, perceptions of inclusion differed based on several factors including the student’s level of need and the perceived severity of the disability, the teacher’s self-efficacy and feeling of preparedness towards meeting the needs of students, and the impact of overcrowded classrooms and limited instructional time.