OVERVIEW OF THE CRISIS
In the Gaza Strip, after years of a relative absence of armed conflict there has been a sharp deterioration in the humanitarian, human rights, security and political situation in 2018, and an enormous rise in Palestinian casualties, as a result of the “Great March of Return” demonstrations. Between 30 March and end October, 228 Palestinians, including 43 children, have been killed by Israeli forces in the demonstrations and other circumstances. Over 24,000 Palestinians have been injured, including over 5,800 wounded by live ammunition, overwhelming the already overstretched health sector in Gaza.1 Patients referred outside for medical treatment unavailable in Gaza, especially those injured in the demonstrations, continue to face major access constraints through the Israeli-controlled Erez crossing, with only 59 per cent approved in the first half of 2018. Access restrictions in Gaza have only partly been alleviated by the re-opening of the Egyptian-controlled Rafah crossing almost continuously since May, where passengers are subject to unclear selection criteria, challenging crossing procedures and long delays. Although some participants in the demonstrations have launched incendiary and explosive devices and breached the perimeter fence into Israel, the large number of casualties among unarmed participants who pose no imminent threat of life or deadly injury to Israeli soldiers, has raised concerns about the excessive use of force and calls for an independent and transparent investigation into these incidents.2
For much of 2018, power cuts of 18-20 hours a day have impeded the delivery of basic services and crippled productive activity, with hospitals, water and sewage treatment facilities, and solid waste collection services almost completely reliant on UN-coordinated emergency fuel to maintain essential services: in October, the delivery of fuel funded by Qatar has provided a welcome, if temporary, improvement in the electricity supply. The coastal aquifer, Gaza’s sole water source, has been virtually depleted by over-extraction and the intrusion of seawater, forcing the impoverished population to buy trucked water, often of poor quality, at up to 20 times the expense of water from the network.3 Israel’s 11-year-long land, air and sea blockade, imposed following the violent takeover of Gaza by Hamas, has crippled the economy, resulting in high levels of unemployment, food insecurity and aid dependency. The Gaza economy is in ‘free fall’ according to the World Bank,4 with unemployment reaching 54 per cent in the second quarter of 2018, and over 70 per cent of young people and 78 per cent of women unemployed. Poverty has soared to 53 per cent and food insecurity to 68 per cent. Severely reduced purchasing power is compounded by the Palestinian Authority’s (PA) policy of withholding the payment of salaries and allowances to employees, alongside a cut in reconstruction and development aid, particularly by the US government, with the real income of a Palestinian in Gaza now about 30 per cent less than it was in 1999.5 There is a palpable loss of hope and rising desperation among the population in Gaza, which is eroding coping mechanisms and resilience, while rising violence and tension are fuelling concerns of a renewed escalation of hostilities.