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Page last updated at 10:55 GMT, Friday, 30 January 2009

Gaza: Humanitarian situation

Palestinian woman looks at bags of food aid distributed by the Unrwa
Agencies say current aid supplies are far from sufficient

Aid agencies are battling to meet the urgent needs of tens and thousands of displaced, homeless and injured people in Gaza, as well as to get damaged water, power and sewage infrastructure back even to their ailing pre-war levels.

The UN has appealed for $613m for the initial recovery phase, but has estimated that long term reconstruction will run into the billions.

Two separate Palestinian surveys have put the cost of the damage just under $2bn.

One said it would take three to five years to rebuild even under normal conditions - never mind with the continued Israeli blockade which stops all but humanitarian basics entering the strip.

As well as killing more than 1,300, and leaving 5,300 injured, according to Palestinian figures, the UN says that the Israeli operation left two-thirds of Gaza's 1.5m residents without power, a third without running water and medical facilities overwhelmed and lacking basic supplies.

Even before the fighting, most Gazans lived a precarious existence, with half the population dependent on UN food aid and the economy at a virtual standstill. Israeli and international human rights groups also accuse Israel of using closures in the month before the assault to further drain supplies of food and fuel in Gaza.

Israel has stressed that it is working to speed the flow of aid into Gaza, and while more truckloads of supplies have entered Gaza than in the weeks preceding the operation, aid agencies say they are far from enough - and all border crossings must be opened if Gaza is to recover.

Israel tightened its blockade of the Hamas-controlled territory in November after rocket attacks by militants.

FOOD

Even before the Israeli assault, aid agencies were warning of malnutrition in Gaza, as the aid-reliant population struggled to afford and access dairy, meat and fresh vegetable products to supplement the bread, rice and oil that form the backbone of humanitarian aid.

Although food aid has entered the strip during and since the fighting, security problems hampered distribution, while damage to tunnels under the Egyptian border and agricultural fields have pushed up prices for other goods.

Two weeks after the ceasefire, the UN said food prices had doubled or tripled from before the fighting, and Gazans were struggling to access food because of a shortage of currency which means many have not received their wages.

The "acute shortage" of bread the UN reported in the immediate days after the ceasefire has been somewhat eased by increased grain deliveries, but the UN is still reporting long queues for bread. Bakeries have been plagued by shortages of cooking gas, as well as flour.

WATER AND SANITATION

Before the Israeli operation, Gaza's water and sewage system was already in dire need of maintenance and spare parts.

The fighting damaged water wells and pipes, and led to shortages in the fuel that powers them, leaving half a million Gazans without running water. Two weeks after the ceasefire, 70% of Gaza's water wells were functioning, but some localities and 10,000 people in Beit Hanoun were still without water.

Gaza's sewage and water body estimates it will cost $6m to repair the water and sewage network.

Officials have confirmed that all two million litres of wastewater at Gaza City's treatment plant, bombed on 10 January, leaked into surrounding agricultural land.

A pump that sends sewage from Beit Hanoun to the Beit Lahia wastewater treatment plant was also damaged, leaving sewage flowing onto the streets.

FUEL AND ELECTRICITY

At the height of the crisis, two-thirds of Gazans were without power. The strip's only power plant shut down on 30 December because of lack of fuel, and damage to power lines from Israel and Egypt, and to transformers and the distribution grid.

Five days after the Israeli ceasefire, the power plant was operating at a third of its capacity. About a week later, Gaza was receiving 84% of its electricity needs, although damage to power lines meant households in some hard-hit areas were without power.

Israel said 2.8m litres of fuel for the power plant was delivered in the 10 days following the ceasefire, which remains below the 2.2m litres a week the Israeli Supreme Court set as a minimum - itself less than the 3.5m litres for the plant to operate at full capacity.

The UN says 38 transformers needed for the repair of the electricity system are waiting for Israeli permission to enter Gaza.

Cooking gas has been in short supply for months. Shipments began entering Gaza in the days after the ceasefire - by 27 Jan they had averaged about a quarter of Gaza's daily needs, the UN said.

Israel has for about a year limited fuel supplies into Gaza in response to rocket attacks.

MEDICAL FACILITIES

Eight hospitals and 26 primary health care clinics were damaged during the fighting, according to the World Health Organisation.

The WHO says Gaza's hospitals were "completely overwhelmed" during the Israeli assault, with only a total of 2,000 hospital beds in Gaza, but more than 5,000 people injured.

Hospitals suffered shortages of basic supplies - even when these were able to enter the strip, security problems hampered efforts to get them to where they were needed.

Medical facilities were also hit hard by power cuts and fuel shortages, being forced to rely on back-up generators and fuel for them delivered by Unrwa, with Israeli co-ordination.

Since the ceasefire, shortages of supplies and fuel improved. Two weeks after the ceasefire hospitals were receiving mains electricity "intermittently," the UN said, while the International Committee of the Red Cross said some heavy-duty painkillers and drugs for cancer patients were unavailable.

But shortages of skilled medical personnel and ailing equipment had brought the health infrastructure close to collapse before the Israeli operation, and the UN has said it remains under "enormous strain".

More than 50% of people surveyed by Care International just after the ceasefire said they faced difficulties accessing basic medicines such as antibiotics and drugs for diabetes, and heart disease - 60% of them said their health had worsened as a result.

Israel has evacuated a small number of injured Palestinians for treatment in Israel, and dozens of others have been sent to Egypt - partly because the strip lacks specialist medical facilities.

SHELTER

Some 55,000 people were sheltering in UN-run schools at the height of the fighting, but many thousands more moved to stay with friends and relatives in different areas.

More than half of the people surveyed by Care International were hosting displaced people in their homes.

A survey by local and international non-governmental organisations found that, in the week after the ceasefire, at least 66,000 people had still not returned to their homes.

While most were said to be staying with friends and relatives, journalists have found some families camping in makeshift shelters on the top of their destroyed homes.

Gazan officials have estimated some 4,000 residential and government buildings were severely damaged and another 20,000 destroyed.

An initial survey by the Palestinian Bureau of Statistics said 4,100 homes were totally destroyed and 17,000 others damaged during the conflict.

About 1,500 factories and workshops, 20 mosques, 31 security installations and 10 water or sewage pipes were also damaged, it said.

ACCESS

International agencies have said difficulties in getting humanitarian staff into Gaza were hampering aid affords.

Ten days after the ceasefires, the UN said 30 international humanitarian workers had been about to enter, but there were outstanding requests from the Israeli authorities for permits for another 140.

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