Palestine Red Cresent Society

Vulnerability & Capacity Assessment

A Participatory Action Research Study of the Vulnerabilities and Capacities of the Palestinian Society in Disaster Preparedness
August 2000

INTERNATIONAL FEDERATION OF RED CROSS AND RED CRECSENT SOCIETIES

United Nations Children's Fund West Bank & Gaza

Vulnerability & Capacity Assessment
A Participatory Action Research Study of the Vulnerabilities and Capacities of the Palestinian Society in Disaster Preparedness

Palestine Red Crescent Society August 2000

Copyright © Palestine Red Crescent Society 2001 All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any electronic or mechanical means including photocopying, recording, or by any information storage and retrieval sysems without prior permission from The Palestine Red Crescent Society, Al-Bireh, Palestine.

For further infromation: Palestine Red Crescent Society Headquarters/ Al-Bireh P.O.Box 3637 Tel: ++972-2-2406515/6/7 Fax: ++972-2-2406518 e-mail: info@PalestineRCS.org Website: www.PalestineRCS.org

Thanks to technical support of UNICEF West Bank and Gaza to this study and to the financial contribution of UNICEF- Middle East and North Africa Regional office who made the design and printing of this publication possible.

Special thanks to the International Federation of the Red Cross and Red Crescent Societies for their technical and financial support to carrying this study.

Cover drawing and all drawings are by Palestinian Children randomly selected from Palestinian schools in the West Bank and Gaza.

The views expressed in this publication are those of the author (Palestine Red Crescent Society) and do not necessarily reflect the policies or views of UNICEF

Contents
LIST OF TABLES AND FIGURES LIST OF TABLES AND FIGURES LIST OF ABBREVIATIONS PREFACE VCA STUDY MANAGEMENT GROUP

Chapter 1: Introduction and Context of the Inquiry

13

Chapter 2: Literature Review Socio-Economic & Health Background of Palestine Demography Infrastructure and Transport Employment Education Health Morbidity Mortality Infrastructure and Hazards Water Sanitation & Pollution Desertification & Agriculture Regional Hazards in General Earthquakes Conflict Nuclear Installations

17 17 17 17 17 18 18 19 19 20 20 20 20 20 20 21 21

Chapter 3: Methodology Purpose of the Study Objectives Preparatory Stage: Task Group Steering Committee Workshops Research Methods Sources of Information Research Tools Validity and Reliability Qualitative Analysis Quantitative A.nalysis Measures of Spread

23 23 23 23 23 23 24 24 25 25 29 29 31 31

Chapter 4: Data Analysis and Findings of the Inquiry Major Findings Qualitative Findings Expected Hazards and Their Potential Locations

33 33 34 35

Vulnerable Groups Factors aiding the occurrence of Disaster The Influence of Disaster on the Palestinian Community Disaster Preparedness Local Community Preparedness and Capacities How to Respond to Disaster and the Basic Requirements Needed Analysing Roles and Capacities for Governmental/Non-Governmental Institutions Ministry of Interior Ministry of Environmental Affairs Ministry of Communication Ministry of Housing Ministry of Media Ministry of Education Ministry of Social Affairs Ministry of Supplies Ministry of Local Government Ministry of Public Labour Ministry of Labour Ministry of Health Ministry of Finance Ministry of Industry Ministry of Agriculture Civil Defence Palestinian Refugees Study Centre The Palestinian Board for Development & Rebuilding (Pecdar) Union of Medical Relief Committees Geography and Earthquake Engineering Centre International Movement for Defending Children Aneera Institute Universities Palestinian Water Authority Applied Research Institute ICRC (International Committee of Red Cross) Swedish Relief Institute UNRWA The Capacities of Governmental and Non-Governmental Organisations The Role, Capacities and Needs of the PRCS Community Training Volunteers Doctors Establishing voluntary committees Blood Bank Hospitals/PHC/Rehabilitation Contributions in Fire-fighting, Sheltering, Evacuation Contribution in assisting poor and vulnerable people Information Bank PRCS Role Requesting Assistance, organizing and distributing it. Quantitative Findings Relating to Perceived Hazards of the Local Community Focus Groups

36 36 36 38 40 42 43 43 43 43 43 43 43 43 43 43 44 44 44 44 44 44 44 44 44 44 45 45 45 45 45 45 45 45 45 45 46 46 46 46 46 48 48 48 48 49 49 49 50

Analysis of response distribution The Most Likely Occurring Events/Hazards Other Hazards Predicted by the Community Focus Groups

50 50 53

Chapter 5: Children and Youth Children's Drawings Children's Data Discussion

57 58 63 66

Chapter 6: Recommendations Projects Highlighted as Recommendations for Action Community Focus Groups The Institutes Recommendations The Local Community Recommendations: Task Group Recommendations Strategies Recommended Employees as Outcomes of the Pre-VCA Workshops in West Bank & Gaza Correlation o f Recommendations Categotries

69 69 70 71 71 72 72 73

Chapter 7: The Impact of the Study on Children, Local Community, Institutions, Task Group and PRCS Impact of the Study Impact of the Study on Children Influence of the Study on the Local Community Influence of the Study on Ministries and Institutions Influence of the Study on the PRCS

75 75 75 75 75 76

Chapter 8: Discussion and Outcomes The Role of the PRCS in Disaster Preparedness Advocating for a National Disaster Plan

79 79 80

References

81

Appendix 1: Consulted Ministries and Institutions Appendix 2: Persons Interviewed from Ministries and Institutions Appendix 3: Steering Committee Members Appendix 4: Community Focus Group Interview Guideline Questions Appendix 5: Record Sheet for Participant on Focus Group Discussions Appendix 6: Common Guidelines Agreed for Facilitators Working With a Focus Group Appendix 7: Summary Form for Completion by the Facilitator Immediately Followinh Focus Groups Interview Session Appendix 8: Locations of Focus Groups in the West Bank and Gaza Strip

83 84 85 86 87 88 89 91

Appendix 9: Number of Participants in the Focus Groups Appendix 10: Names & Numbers of Participants Within Focus Group Gaza Strip Appendix 11: Areas and Numbers of Participants Within Focus Group West Bank Appendix 12: Likert Scale Questionnaire Tool Relating to Hazards Appendix 13: D ata from the Quantitative Analysis Referring to Distribution of Questions Answered in the Likert Scale Appendix 14: Children and Youth Drawings Analysis Disaster Preparedness Depicted in Artwork by Children and Youth Appendix 15: Comparative Review of the Themes of Drawings Produced by the Children's Groups Appendix 16: Historical Data on Major Hazards Experienced in Nearby Countries

92 93 94 95 96 98 99 101 102

List of Tables and Figures
Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Figure 10 Figure 11 Figure 12 Figure 13 Figure 14 Figure 15 Figure 16 Figure 17 Figure 18 Figure 19 Figure 20 Figure 21 Figure 22 Figure 23 Figure 24 Table 1 Table 2 Table 3 Table 4 Table 5 Table 6 Table 7 Table 8 Table 9 Table 10 Table 11 Table 12 Table 13 Table 14 UNDP Crunch Model New View of Disaster Model of Community Focus Group Representation of the West Bank and Gaza Strip Photograph of Task Group conducting Analysis in Gaza Photograph: Wall-mounted Themes a data bits- Gaza Vulnerable groups in Palestine as defined by the community, ministries, & institutions36 Water Shortage - West Bank Political Events - West Bank Vehicles & Traffic Accidents - West Bank Water Shortage - Gaza Strip Politically Related Events - Gaza Strip Open Sewage - Gaza Strip Water and Sea Pollution - Gaza Strip Food Poisoning - Gaza strip Vehicle Accidents - Gaza Strip Violence and Conflict - Gaza Strip Children's Drawing - conflict and floods Children's Drawing - Air and Water Pollution Children's Drawing - Fire, Chemical Waste & Floods Children's Drawing - Natural Disaster Children's Drawing - Preparedness & Awareness Children's Drawing - Earthquake, Drought & Floods Children's Drawing - Preparedness Access to Medicines Potential Structure of a National Committee for Disaster Employment of the population by Industry types in percentages Numbers of students by Type of Educational Institution Distribution of health institutions by region and provider Morbidity in the West Bank and Gaza Mortality Statistics for Palestine Sample Distribution on VCA Methodologies Gender Distribution of Sample Groups by Location Strategy for analysing data, showing as an example, the Role of the PRCS Correlation of 5 DP Categories and 17 Major Hazards Comparison of current and expected hazards (Qual v Quant) Expected hazards and their location Influences of Disaster on the Palestinian People Preparedness Themes Prior to Disaster Emerging from Focus Group Interviews Preparedness Themes During Disaster Emerging from Focus Group Interviews 50 51 51 51 52 52 52 53 53 53 58 59 59 60 61 63 63 80 18 18 19 19 19 25 27 30 34 34 35 37 38 39 14 14 26 29 30

Table 15 Table 16 Table 17 Table 18 Table 19 Table 20 Table 21 Table 22 Table 23 Table 24 -32 Table 33 Table 34 Table 35 Table 36 Table 37 Table 38 Table 39 Table 40 Table 41

Preparedness Themes Post-Disaster Emerging from Community Focus group Interviews Local Capacities and Potential Capacities Identified by Community Focus Groups Community Ideas for Responding to Disaster Requirements for Rapid Interventions in Disaster by Institutions suggested by Community Focus Groups Capacities of Governmental Institutions & NGO's Capacities of the PRCS PRCS Roles and Capacities Main Hazards in the West Bank Main Hazards in Gaza Strip Children's Data Projects Proposed Through the Process of the Inquiry General Recommendations of the Community Focus groups Community Focus Group Recommendations for Pre-Disaster Phase Community Focus Group Recommendations for Disaster Phase Recommendations of Institutions Local Community Recommendations Task Group Recommendations Strategies Recommended by PRCS Employees During Pre-VCA Workshops A Comparison of the Main Categories of Various Group Recommendations and the Main Categories of the Study Findings

39 40 42 42 46 47 49 50 50 62-66 70 70 70 70 71 71 72 72 73

List of Abbreviations
EMS DP DR ERU PRCS VCA NGO UNDP OPT WB GS WHO PNA PHC MOH GNP IGCP IFRC ICRC CC RC SWOT UNICEF UNRWA Emergency Medical Services Disaster Preparedness Disaster Response Emergency Response Unit Palestine Red Crescent Society Vulnerability and Capacity Assessment Non-governmental Organisation United Nations Development Programme Occupied Palestinian Territories West bank Gaza Strip World Health Organisation Palestinian National Authority Primary Health Care/Clinic Ministry of Health Gross National Product International Geological Correlation Programme International Federation of the Red Cross and Red Crescent Societies International Committee of the Red Cross Comparative Criticality Red Cross / Red Crescent Strengths, Weaknesses, Opportunities and Threats United Nations Children's Fund United Nations Relief and Works Agency

VCA Study Management Group
President of the Palestine Red Crescent Society Younis Al Khatib VCA Team Leader & Study Coordinator Abdel Qader Abu Awad, Director of Rehabilitation Services, PRCS, Al Bireh Research Project Consultant Graham Betts-Symonds, Disaster Preparedness Delegate in Amman, International Federation of the Red Cross and Red Crescent Societies VCA Task Group Abdullah Abu Dayeh Hassan Khader Basharat Dr Mohamed Awaddeh Randa Hamed Magida Awashreh Mahmuda Ali Ad hoc Task Group Members Dr Haakon Aars Per Allen Olsen Technical Advisors Dr. Hossam Sharkawi Alexandra Galperin Bertrand Bainvel

Primary Health Care Administrator Director of Emergency Educational Centre Deputy Director of EMS Dept Assistant Director of Primary Health Care Department Planning Coordinator PRCS Administration

Health Delegate, IFRC Federation Office, Ramallah IFRC Representative in Palestine

Advisor & Emergency Response Unit Project Manager, PRCS, El Bireh Disaster Preparedness Department, Geneva VCA Pre-Study Coordination Programme Officer UNICEF, West Bank and Gaza

Research Assistants Amal Mahmoud Khalil Shamasneh AdbulGhafer Salawadeh Raba'a Atoum, IFRC (Amman) Steering Committee See Appendix 3

Preface
There are two important factors that PRCS perceives as emphasizing the objectives of this study on the vulnerabilities to disasters, the relative preparedness and the management capacities in Palestine launched to achieve them. The first is the time at which the study findings are being prepared for release. It coincides with breakout of further violent actions. These are characterized by intense and accelerated military activities carried out on a large scale on a daily basis. The events have caused much human suffering and destruction to the resources and economic life of Palestinian communities. During the last two months tolls have risen to 335 deaths and 10,858 injuries in addition to hundreds of millions of dollars lost to the Palestinian economy. There is no doubt that the outstanding national efforts for collective response to the increasing need in society for medical services, shelter, food and other life sustaining services requires more than collaboration and pooling of resources. A well formulated, scientifically informed preparedness plan that incorporates all potential actors is a step in the right direction. It is hoped that the findings and recommendations of this study will be of some assistance in realizing a National Disaster Plan. The second important fact is the overwhelmingly positive response with which this initiative was received both at official and community levels. Their contribution provided us with the necessary framework, widened our scope and enriched the analysis. Given the considerable importance of participation at the grassroots level, it is of similar importance that people's views and involvement become part of any future disaster preparedness planning. Indeed, the findings have indicated a significant role to be played by the community in utilizing their capacities in preventing, mitigating and recovering from disaster. The study was only made possible with the dedicated and committed cooperation of all involved. I would like to thank the many people who participated or helped carry out the group sessions. PRCS expresses its deep gratitude to the Steering Committee members for their ongoing guidance, and to all institutions for their assistance during the process of information collection in the field. I would like to thank all Palestinian children who participated in this study by expressing their views about expected disasters through drawings. This participation enriched this study massively. I would like also to thank the study team and PRCS staff members who undertook this tiresome endeavour and UNICEF for their sponsorship and encouragement with the involvement of children in the study. Finally, I would like to acknowledge the International Federation of the Red Cross Federation Office in Palestine, the Regional Delegation in Amman and the Disaster Preparedness Department in Geneva for their active support. The objectives of this study are important to all institutions in Palestine in order to define roles so that effective cooperation and coordination can be facilitated. The PRCS offers the study to form part of the background for a National Conference to function as an umbrella for all actors towards the realization of the National Disaster Plan. Meanwhile, this assessment will further serve as a basis for a provisional disaster preparedness programming for the Society in the communities it serves.

Younis Al-Khatib President Palestine Red Crescent Society- PRCS Al-Bireh- Palestine

Social Workers Participating in the Study as Community Focus Group Facilitators
Name of the participant 1. Amal Mahmoud Khalil Shamasneh 2. AbdulGhafer Salawadeh 3. Rehab Al-Salaymeh 4. Amal Al-Amleh 5. Jumanah Farooq Al- Dakak 6. Nebal Mahmoud Medrasee 7. Reema Kamel Enayeh 8. Intesar Mohamed Tayem 9. Maha Abu Ghoosh 10. Rana Waleed Al-Nagaar 11. Nagah Ali Aqel 12. Reem Tayseer Ghanam 13. Manal Qadoome 14. Azeezeh Odeh Al-Looh 15. Najwa Hassan Labad 16. Zoheerah Fares Al-Qadi 17. Fatmeh Abu Maraheel 18. Aishah Al- Abadleh 19. Ekram Al-Haqaqreh Occupation Social Worker Social Worker Social Worker Social Worker Social Worker Social Worker Social Worker Social Worker Social Worker Nurse Nurse Social Worker Social Worker Nurse Public Relations Social Worker Social Worker Social Worker Social Worker Place of Work Head Quarter Jericho Rehabilitation Head Quarters Taraqomyeh, Hebron Al-Khder PHC Center Bethlehem TubasNablus Salfeet + Kofer Hares Centers Tulkarem Bedouin Center+Qatneh Khan Younis Rafah Deer Al-Balah Deer Al-Balah Deer Al-Balah Gaza Selwad Center Deer Al-Balah Khan Younis Taraqomyeh- Hebron Notes West Bank West Bank West Bank West Bank West Bank West Bank West Bank West Bank West Bank Gaza Strip Gaza Strip Gaza Strip Gaza Strip Gaza Strip Gaza Strip West Bank Gaza Strip Gaza Strip West Bank

ABSTRACT
PRCS seeks to identify local community points of view in relation to real needs for disaster preparedness and ways of mitigating the impacts of disaster. In order to empower Ministries and Non-Governmental Organisations to plan and provide adequate services for the Palestinian community, practical roles need to be defined and a National Plan developed based on real available capacities. To meet these objectives we utilized several methodologies within a triangulation. We utilized community focus groups representing cities, villages and refugee camps within West Bank and Gaza. Twenty-two focus groups were facilitated involving the contribution of 429 in which males, females, elderly and handicapped were represented. In order to ensure that all age groups were consulted in this study, art workshops were facilitated for children ranging from the age of 6 years to 14 years. In these workshops children were invited to record their ideas of expected hazards, their effects and disaster preparedness in order to meet them.113 children from all governorates north and south of West bank and Gaza participated. Also, based on a triangulated methodology, semistructured interviews were conducted for Ministries and NGO's in which 44 representatives were interviewed. To support the qualitative information gathered from the local community through the focus groups, a quantitative checklist was designed relating to expected hazards and was based on a Likert Scale. Secondary data was also consulted collected from primary and secondary sources. Two information-gathering workshops were also conducted involving PRCS employees in West Bank and Gaza. The results of the study showed that political conflict, water shortages and environmental pollution were perceived to be the most significant disasters currently affecting the Palestinian people. The study also showed that earthquake was considered a significant potential threat. The most vulnerable groups in disaster were defined as women, children, and the elderly and disabled persons. The study also indicated that the Palestinian community has technical and human capacities to assist in the development of a National Disaster plan to meet the hazards through preparedness. This is supported by the fact that communities concentrated on preparedness now rather than dealing with events during disaster. Communities defined the roles of institutions based on the actual services that they are provided with by these organisations and therefore potentially more realistic. One of the obvious results of this study is the need to develop a National Plan based on the needs and aspirations of the local community. This may provide them with an effective role in the process of preparedness, prevention and mitigation of disaster. The clear message emerging from this study is that the optimum approach to meeting the hazards is cooperation and coordination. It acknowledges that no institution alone can meet the human and material capacities needed to deal effectively with disaster.

14

Chapter 1

Introduction and Context of the Inquiry

The context of this Inquiry lies within the PRCS' quest to identify realistic and effective disaster preparedness directions, which would enable it to provide appropriate services to the public and to clarify its own role, locally and nationally. This is important in the light of recent experiences in Turkey where the TRCS was left in a position of trying to live up to unrealistic expectations, with reference to its role and capacities in meeting them. Whilst a National Committee exists for Disaster, it became apparent, that each discipline was planning in isolation, and that an integrated National Plan did not exist. An integral part of preparing a National Plan is to first identify clearly the roles of each player, both locally and nationally. In order to begin this process, the PRCS decided to instigate a study aimed at defining its own role first, which may be helpful in providing direction for other participating agencies, to be able to review theirs. The beginning of this Inquiry started with a Pre-Study conducted by the PRCS together, with the Disaster preparedness Department in Geneva. This provided an excellent base for defining the objectives of the main study, and in the most useful directions that might be pursued. Recommendations from this work suggested, that information should be gathered from institutions and the community, along with secondary data sources. Of the numerous assessment tools available, the Vulnerability and Capacity Assessment (VCA) was selected, as it allows a comparison of the vulnerabilities existing capacities to highlight shortcomings, which might then be possible to be addressed. Different approaches to conducting VCA's have been used in various countries, and methods available may be described as either 'top-down' or 'bottom up',46 using quantitative, qualitative or a combination in a triangulated methodology. In this study, a participatory approach was designed, as outlined in the methodology section of this report, and was predominantly qualitative in nature. The VCA is said to require a basic model for interpreting relationships between important determinants, in the development of disaster-prone settings7. The meaning of this depends upon the definition of what disaster is. The approach in this study is uniquely different in that it is set around qualitative interactions, directly with community groups, throughout the West Bank and Gaza. It is also the first study in which information from a significant sample of children and youth, are also considered. The idea of 'disaster' has also been considered differently, where the idea of 'vulnerabilities of the community' have been viewed as: T those traditional sudden onset events, such as earthquakes, and floods described as Hazards, which are often the trigger events of disaster. T Vulnerabilities as Disaster 'per se', in terms of underlying determinants, such as poverty and the political environment, dynamic determinants and unsafe conditions such as pollution, health problems and infrastructural problems7.

15

The purpose of this is to create a 'new view' of what disaster is, in terms of the philosophy of the World Disaster Report 2000 and Strategy 2010. It is a change in emphasis from traditional ideas of preparing for the events that might come up to finding ways of dealing with the events that are already present that may also serve preparedness for sudden onset trigger events. This is an important context of this inquiry.

In terms of preparedness, this model creates opportunities to concentrate on initiatives that improve the lives of the most vulnerable, in the present and the future. It may do this by reducing the current problem and preventing it from getting worse, which in turn will affect the future. Initiatives may also mitigate the effects of expected events, and help with the response phases and in the rehabilitation stages. Response may also be seen as reacting to current problems, as well as sudden onset events. Responding to water, sanitation and shelter issues is the same model, as responding to the same problems in earthquakes or mass population movements. It is only the scale and the places that are different. Therefore, perhaps both can be dealt with, in imaginative and cooperative disaster preparedness initiatives. The major findings of this study are far-reaching and very much involve both the communities of Palestine- for whom disaster most affects - and the various disciplines, taking major roles in such events. Of particular originality, is the important contribution made by Palestinian children and youth, who show remarkable insight into how the situation might be improved. In terms of research reliability and validity, every effort has been made to include validity mechanisms, which are outlined in the methodology section.

Figure 1: UNDP Crunch Model in which Disaster is a progressive event

Disaster is the whole of many parts contributing to the event, and of individual families and small parts of the infrastructure, usually "in a short period of time"47, which suddenly overwhelms. The essence of this approach is that underlying and dynamic determinants, along with unsafe conditions create what is described by communities, as disaster for them. Furthermore, any of these groups of vulnerabilities for one family multiplied by hundreds or thousands of families in terms of water shortage, infection with AIDS or Tuberculosis, constitutes a disaster in itself. In this sense it does not require one of the traditional trigger events to create what is generally known as Disaster.

Recommendations are based on the data, major findings and feedback from all concerned agencies, fulfilling the objectives of this study.

Figure 2: New View of Disaster in which vulnerabilities and trigger events can produce Disaster now and the future

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Vulnerability & Capacity Assessment

Introduction and Context of the Inquiry

17

18

Chapter 2

Literature Review
Socio-Economic & Health Background of Palestine
Demography
The total Palestinian population in 1998 worldwide was 7.7 million with 21.2% living in the West Bank and 13.4% in the Gaza Strip. In 1999 the total population of the West Bank8 was 1,810,309 and in Gaza7, 1,039,580. Refugee Camp population is 310, 772 in Gaza and 110,837 in West Bank, whilst the total refugee population in Palestine is 1,074,71813. The average household number of males per household in Gaza is 3.51 and that of females is 3.41. In the West Bank, the figures are 3.09 and 2.99 respectively7. The three main households locations in the West Bank and Gaza are divided into 36% urban, 50% Rural and 14%12 Camps. Poverty in Palestinian households in the Palestinian territories is 20% as of 1998, based on samples of six member families.

Infrastructure and Transport
Electricity supplies are mostly imported from Israel, though there are small power plants in Jenin and Nablus that supply their own. All electricity in Gaza is supplied from Israel. Palestinians pay 15-40% more for electricity than their Israeli counterparts, and 40% of the rural population has power for only a few hours per day. 138 villages have no electricity, with only part-time supplies from diesel generators16. 82% of Palestinian households own radios and 54% have televisions. Only 3.1% of Palestinian households have telephones14. The existing transportation services are inadequate and road networks have deteriorated in the OPT since occupation, due to weakening of local government. Road transportation is the only form of passenger services, and is served by private taxis and franchised bus services. 75% of the OPT has no regular bus services17. 3.2.4 Social services facilities are mostly funded by charitable organizations and NGO's. Due to the occupation, the major components of national systems such as mortgage, social welfare programmes, probation, and aftercare of offenders and child protection, are absent.17

Employment
The total working population in 1996 was 1,226,859 with a total labour force of 525,746 and about 65% are fully employed. The total number of unemployed labourers was 101,469. Between 1980 and 1995, the unemployment rate in the West Bank and Gaza rose from 5% to 20%14.

19

The employment of people in the West Bank and Gaza is shown in percentages in table 1 Table 1: Employment of the population by Industry types in percentages Industry Agriculture, Hunting, Forestry and Fishing Mining, Quarrying and Manufacturing Construction Commerce, Hotels and restaurants Transportation, Storage and Communications Services and other branches
(Source: World Fact Book 1999)14

West Bank 14.9 16.6 19.5 20.0 5.0 24.0

Gaza 6.4 13.6 14.3 19.4 4.6 41.7

Education
Education in Palestine is regarded as compulsory from age 6 - 15 years though it is not enforced by law. The literacy rate in the West Bank and Gaza is 86.1% equating with 86% in above average income countries39. Gross school enrolment rates are 98% in primary stages 1-6, 79% in preparatory stages 7-10 and 50% in secondary stages. The number of students and types of educational institution are shown in table 2.

Table 2: Numbers of students by Type of educational Institution West Bank Type of Education Kindergarten (ages 4-5) Basic schooling (First 10 years) Secondary schooling (Years 11 and 12) College University Gaza Kindergarten (ages 4-5) Basic schooling (First 10 years) Secondary schooling (Years 11 and 12) College University Number of students 49,020 422,891 36,190 3,069 26,896 26,012 279,491 24,895 1,225 23,338

Health
The PNA is the main provider of health services in Palestine through the Ministry of Health, with assistance from UNRWA and various other NGO's. The PRCS operates 28 Primary Health Care Centres and 5 hospitals (4 in the West bank and 1 in Gaza). A well organized Emergency Medical Services infrastructure is in place through PRCS ambulance stations. All ambulance personnel are qualified Emergency Medical Technicians. The distribution of all health facilities in Gaza and the West Bank is shown in table 3. The total hospital beds available in the West Bank is 2,286 and 893 in Gaza with bed occupancy rates of 77% and 84% respectively17.

Immunization programmes are in line with WHO recommendations for protection against Diphtheria, Pertussis, Tetanus, Polio, Measles and Tuberculosis. Coverage of the population is about 90%1. In addition, immunization is provided for German Measles, hepatitis and mumps. Comprehensive services are operated through the PRCS community health programmes. School Health is taken seriously with efforts by the MOH, PRCS and UNRWA. Health education, medical and dental examination and registration are provided and there is a link-up with immunization programmes. Psychological services are also provided. PRCS primary care nurses have programme inputs into local schools, which include health education. The number and type of health facilities within Palestine are shown in table 3.

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Vulnerability & Capacity Assessment

Table 3: Distribution of health institutions by region and provider Area Gaza WB Total Governmental PHC Hosp 35 5 300 9 335 14 UNRWA PHC 17 34 51 NGO's & Private PHC Hosp 40 7 104 28 144 35

Rehab 1 0 1

Hosp O 1 1

Rehab 0 0 0

Rehab 27 3 30

(Source: Ministry of Health Annual Report 1998)

Morbidity
The morbidity rate in Gaza and the West bank is shown in Table 4. It is significant for disaster preparedness,

response and rehabilitation in the sense that the state of health, with reference to prevalent diseases impacts upon any disaster.

Table 4: Morbidity in the West Bank and Gaza Diphtheria Pertussis Tetanus Polio Pulmonary TB Extra pulmonary TB Measles Gastro-enteritis Parasitic disease Meningitis Hepatitis B Hepatitis C Brucellosis AIDS Increasing control and elimination Increasing control and elimination Increasing control and elimination Increasing control and elimination Incidence declined Generally declined through occasional outbreaks 93.64% vaccination coverage Prevalent in refugee areas due to sanitary conditions Prevalent in Gaza Strip in refugee areas Incidences seen Increases Steady increase in the number of carriers Prevalent disease in Palestine with substantial under-reporting Reports show low incidence rates

(Source: Ministry of Health Annual Report 1998)

Mortality
Life expectancy at birth in the West bank and Gaza Strip in 1995 was 68.7 years compared with 69% for above average income countries 39. In 1996, 54% of the West Bank population and 73% of the one in Gaza Strip, had health insurance. Some mortality statistics are shown in Table 5.

Table 5: Mortality Statistics for Palestine Infant Mortality Rates 15/1000 live births Pre-School (Ages 1-4) 16.5% of total deaths mainly due to congenital abnormalities School Ages 5-14| 17.3% of total deaths mainly due to malignancy Adolescents Adults Elderly

25.15% due to malignancy 13.8% due to accidents

21.3% due to malignancy 10.6% due to CVA

12.8% due to CVA and 11.2 due to malignancy

(Source: Ministry of Health Annual Report 1998)

Literature Review

21

Infrastructure and Hazards
Water
Water is a vital commodity and its short supply is highlighted in this study as a cause of disaster to the community. Palestinian municipalities have to supply the West Bank with water and sewage services under the control of the Israeli Civil Administration. 200,000 individuals in 200 locations lack a water supply network3. Those who are connected only receive water for 3-5 days per week and 25-60% of the water does not reach the taps1,4. The daily consumption of water is low at 60l/c/d compared to Israeli consumptions of 250-300 l/c/d4. There is only one permanent river that can be used as a source of surface water, which is the river Jordan. Gaza has a water shortage of 61m3 /year which is projected to become bigger. The total water demand is 122m3 /year. In Gaza, there is a water deficit of 61Mn3/year where the only natural source is ground water (MOPIC 1998)2. Deficits are covered by importing water from Israel. Studies have been done in which the treatment of wastewater could assist in supplying 20-30% of the water deficits there. All wells in the occupied Palestinian Territories are drilled by an Israeli company which sells it to the Palestinian agencies at higher prices than it would cost if the Palestinians produced their own. There are 7 main water agencies in the West Bank. The Palestinians, however, only have access to 15% of these water resources, due to occupation. In the Gaza Strip, there are 77 wells of which 65% are below WHO standards1. There are 40 functional wells in the West Bank for potable water and 316 for agricultural irrigation use5.

the distribution system allowed dissipation, creating the effect of non-disinfected water.

Desertification & Agriculture
Desertification has become a progressively serious problem in both the West Bank and Gaza through various contributing factors. In the West Bank, rainfall depth in 1998/9 was the lowest over the entire record period9. The relative rainfall deficit ranged from 50-70%. The operation of water wells for agricultural use in the West Bank is unsatisfactory, and deteriorating over time. Expansion of the desert is reported as one of the gravest problems facing the country and is due to a combination of natural long-term variations in weather, climatic destabilization, and human intervention in the environment11. The bare land of the West Bank was once covered by Mediterranean-type forests and the Judean desert is almost devoid of vegetation. Agriculture is an important part of the Palestinian economy and a significant employer contributes between 25 and 30% of the Gross National Product (GNP). Agricultural decline has occurred since the occupation in 1967 with the confiscation of water and land. The closure policy has resulted in uprooting of thousands of trees and the gradual decline of cultivated areas10.

Regional Hazards in General
The hazards reported in this study are gathered from community and institutional groups who describe these as both current and potential seeing all of them as a 'disaster to them' and is related to the model in figure 2. Historical data, sourced from EMDAT18 that indicate types of sudden onset hazards in the region, are shown in appendix 16.

Sanitation & Pollution
Water sanitation is a serious problem in the majority of populated areas. Septic tanks are used to dispose of wastewater, if a sewage network is not available1. Sewage may be disposed of in the nearest Wadi, and industrial wastewater is not separated from domestic wastewater. Only 30% of the population is connected to a public sewer and the other 70% dispose of waste in cesspits and the streets, creating serious potential health hazards3,15. The environmental hazards of Palestine can be summed up as being due to uncontrolled wastewater disposal, salinity and depletion of the aquifer. In addition, unplanned solid waste disposal is available in only 33% of West bank households. A further significant environmental hazard is the indiscriminate use of pesticides15. In Gaza, studies showed the biological safety of ground water sources to be hygienically safe to drink6. However,

Earthquakes
In view of the major earthquake in Turkey, Palestine along with other regional countries are concerned about this hazard. The country is affected by two fault lines. The first affects the areas around the Dead Sea, Jericho, Nablus and the north of Palestine. The second one affects Hebron, the Negev desert and the south. This constitutes part of the Eastern Mediterranean sector of the International Geological Correlation Programme (IGCP) 20. This organization has been coordinating activities in the last two years towards a unified hazard mapping for the region. A study conducted by the Earth Sciences Centre in Nablus identified that 20% of all building would suffer total damage and 25% partial damage, in the event of an earthquake in Palestine20. The mortality would be caused mostly by fire after the event, rather than during the earthquake itself. The major impacts would be upon the economy and would have a negative influence on development that may be felt for 5 to 10 years later.

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Vulnerability & Capacity Assessment

Among the suggested of the centre, it is recommended that buildings and infrastructure are not developed in the Dead Sea and Jordan Valley areas. Advocacy is made for national cooperative planning and coordination efforts.

Conflict
Conflict has been a part of Palestinian life since occupation, and there have been numerous difficulties that equate with disaster. In 1996 the Four Day War resulted in serious clashes between Israelis and Palestinians. During this incident, there was unprecedented exchange of fire between Palestinian Police and Israeli Military, resulting in 70 Palestinian and 16 Israelis deaths24. Israelis used Cobra helicopters with heavy automatic weapons whereby 1,600 were injured in addition to those who were killed25. There were further, though less serious, significant incidents in 1997, 1998 and 2000.

The potential for very serious conflict in the area is strong with the difficulties in reaching a peace agreement. The potential difficulties for the Palestinian community is grave, considering the degree of control exercised over all essential infrastructure and services21. The potential for conflict over water is a regional problem, but in Palestine, the Israelis have put water as a nationally significant resource, under military control.

Nuclear Installations
The potential for nuclear accidents exists, given the number of special weapons facilities in Israel. These include 12 nuclear and one Chemical/Biological Warfare facilities, which are sited in 13 different locations throughout Israel22. Cases of cancer have been attributed to nuclear radiation in the desert town of Dimona23.

Literature Review

23

24

Chapter 3

Methodology
Purpose of the Study

The purpose of this inquiry is to address the objectives defined, and the results to be used as a basis for a National Conference on Disaster Preparedness, advocating for an effective National Disaster plan. The IFRC supported a VCA Study to be undertaken in Palestine by the PRCS. The PRCS took the initiative to make the study national society-driven, and set up a Task Group to be the engine of the work.

Objectives
1. To clearly position and define roles and responsibilities of the Palestinian Red Crescent Society in the national framework, while looking at prevention and mitigation as well as disaster response. 2. To advocate for the establishment of a national disaster plan

Preparatory Stage:
A Preliminary Assessment was undertaken by the Society with a representative from the Disaster Preparedness Department IFRC, Geneva, who reviewed secondary data and interviewed a number of key personnel in relation to disaster preparedness. The outcome and recommendations by the Society and the IFRC were that a VCA Study should be undertaken with reference to the following objectives: T To clarify the role of the PRCS in relation to Disaster preparedness T To promote activities for a National Meeting, for the consolidation of a National Plan of action.

Task Group
A task group was appointed by the President of the PRCS to plan, facilitate and report to a Steering Committee, with reference to the objectives of the study. The Group consisted of seven members representing PRCS in: T Emergency Medical Services T Primary Health Care T Planning T Rehabilitation In addition, a Statistician outside the PRCS was consulted. The purpose of the multidisciplinary approach was to ensure comprehensive and representative results.

Steering Committee
A Steering committee was formed of Ministry level representatives, with interests in Disaster preparedness. It included: T Ministry of Health T Ministry of Local Government T Civil Defence

25

T T T T T T

UNRWA UNICEF IFRC PRCS Ministry of Social Welfare ICRC 4.

The purpose of forming the Steering Committee: T Enhance the cooperation and coordination in Disaster Preparedness. T Cooperate with the Task Group to achieve the objectives and own the outcomes. T Participate in regular meetings to facilitate ongoing evaluation and redirection. T Allow the specific methodology to be approved. The role of the steering committee: T Approve the methodology of the VCA study T Facilitate the Task Group in gaining access for interviews with key agencies, by gathering names and contacting experts in the field. T Devise indicators and strategies to prepare for a National Conference for Disaster Preparedness. T Review the first draft of the VCA report and provide feedback. T Promote activities in support of developing a National Plan. T Evaluate the study and implement the recommendations. T Monitor the development of the study and direct it. Other Ministries were not included at this time, to ensure a manageable group of key disciplines. A National forum of all concerned parties would be formulated through the National Conference.

5. 6.

7. 8.

T Preparedness T Management T Coordination and cooperation with other organisations T Capacities T Human Resources Brainstorming of PRCS strategies based on vulnerable groups, expected hazards and analysis of the current situation. Define roles of PRCS, NGO's and governmental institutions within the strategies Define three strategies and priorities that concern each participant, which is based on democratic processes, to ensure the consensus and acceptance of the participants for these strategies. Choose projects to implement these strategies Define the needs and available capacities for each strategy and project.

Results of the Workshop 1. Participation of branches and workers from different departments 2. Definition of vulnerable groups 3. Definition of expected hazards in Palestine 4. Definition of priorities and strategies for PRCS 5. Selection of group of projects for implementation

Research Methods
A framework of Action Research was chosen as it is designed to address organization and community problem solving (Patton 1990)26,27. A triangulation was chosen which best suited the nature of the study, which sought to gather information from various sources, using multiple researchers and methods. Triangulation is related to the notion of 'multiple operationalism' and suggests that validity of findings can be enhanced by the use of more than one approach to data collection.43 Action research is also consistent with the participatory nature of this inquiry and Reason & Heron's (1996)28 statement that such inquiry is 'action in the service of human flourishing'. Therefore, whilst predominantly qualitative in nature, the study also used quantitative approaches, where numerical computations assisted in adding to the total picture.

Workshops
Two workshops were conducted in the West bank and Gaza Strip as part of this study. The purpose of these workshops were to: T introduce the study and its importance to PRCS staff. T involve the staff in facilitating the work of the Task Group. T Assess the current situation of the PRCS in relation to PRCS capacities and the role of other organisations. T Define the PRCS strategies in dealing with hazards and disasters. T Define projects to deal with the hazards. Mechanism and Structure of the Workshops. 1. Define the expected disasters 2. Define the vulnerable groups 3. Assess the current situation by using the SWOT method in six different areas: T Prevention

26

Vulnerability & Capacity Assessment

Table 6: Sample Distribution on VCA Methodologies
 





Sources of Information

T Qualitative interviews of key people at ministerial/ organizational level T Qualitative Focus Group interview of a cross section of community level and service provider people T Quantitative questionnaire data form a cross section of community level people T Qualitative Focus Group interview of groups of children and young people T Paintings and drawings from the groups of children and young people reflecting their ideas of disaster and disaster preparedness. T Secondary data from a review of relevant books, articles, reports, maps and Internet information.

T T T T T

Climate Water & Sanitation Infrastructure Historical perspectives Hazard identification to develop the quantitative tool

Quantitative Likert Scale Questionnaire The Likert Scale questionnaire to elicit community opinions about expected hazards. This is shown in Appendix 12. These were formulated through literature review, to identify the relevant hazards to Palestine, and they were found to be twenty-one in total. The participant was required to indicate a simple response to the likelihood of the named hazard or relevant disaster. The scale was given six gradations as follows: T T T T T T Cannot predict Unlikely Likely More Likely Most likely Sudden/unpredictable

Research Tools
Secondary Data Secondary Data was collected by the Task Group members in the preparatory stages of the study and sourceful textbooks, journals, reports, and Internet websites, in order to "understand the situations arising in practice"45. It was conducted at the beginning of the study, to provide an in-depth background for the Task Group, and be an information bank as the research process unfolded. It was used to build upon secondary information sources provided by the Pre-Study, conducted by PRCS and the IFRC. In addition, it was designed to provide supportive information to explain primary qualitative data. Merriam & Simpson (1995)44 confirm that such literature provides the basis for building knowledge. The information was used for the following additional purposes: T Developing the research methodology T Developing data analysis methods T Geography and maps

Since the twenty-one hazards were identified from literary sources, it was not necessary to pilot the questionnaire. It was simply designed with no sophisticated language, so that it required little direction to participants. In spite of this, the field researchers were ready to facilitate reading of the questionnaire among the participants.

Methodology

27

Qualitative Interviews of Key Ministry/Organisations The steering committee recommended names for interview from governmental and NGO institutions which appear in appendix 2. The purpose of interviewing these institutional representatives was to identify their capacities and preparedness to meet hazards and disaster. Interview guidelines were prepared in order to facilitate the semi-structured interview of these people. Process for Arrangement of Interviews Letters were sent to all government and NGO's to identify one or two nominated persons for interview and confirm dates to undertake them. The interview guidelines were enclosed with the letter to ensure that the most appropriate people were selected for interview. Where Ministries/NGO's did not respond, it was necessary to follow up requests by telephone to ensure that the interviews were conducted. For the purpose of validity, a workshop on interview skills was facilitated with the Task Group to allow them gain confidence and calibrate techniques, before conducting the Ministry/Institution interviews. The Task Group was successful in interviewing 44 persons from different organisations, and the list of agencies consulted is shown in Appendix 1. Community Focus Groups To represent the geographical area in Palestine, and to ensure the specific information was incorporated with community capacities, a convenience sample was used for villages, cities and refugee camps. This was because

it was necessary to consider the actual circumstances for these communities. Convenience sampling is used where purposeful sampling is logistically difficult or impracticable26. In this study, samples of given numbers were selected from the desired geographical areas, but selection of individual participants within the groups was based on convenience of accessibility. In order to select a representative sample, three main criteria were chosen: T Geography T Climate T Demography of Palestinian communities. To meet these three criteria, it was necessary to choose samples from North, Middle and South of the West Bank and North and South of the Gaza Strip (figure 3). This adds to the essence of 'combination' or 'mixed purposeful' sampling to meet multiple needs and interests26. In relation to the refugee camps, UNRWA provides educational, health and social services in a uniform manner with reference to financial, managerial and organisational administration of the camps. The choice of five camps could therefore be generalised to any of the camps within the West bank and Gaza. For this reason, random sampling technique was appropriate to identify the groups of community refugees to be interviewed.

Figure 3: Model of Community Focus Group Representation of the West Bank and Gaza Strip

28

Vulnerability & Capacity Assessment

Pilot Studies To assist the validity of the methodology of the focus group interviews and the information gathered, the Task Group conducted two pilot focus groups. These were in Silwad (Central West bank) and Merka village in the north of the West Bank. The information gathered by the task force was reviewed by the steering committee and it was decided to use this method for the purpose of gathering data. The focus group interview guidelines are shown in appendix 4, and guidelines for the conduct of groups in appendix 6. The interviews were conducted by PRCS social workers practising throughout the West Bank and Gaza. These social workers were employed in Primary Health Care and rehabilitation Centres. For the purpose of validity, a training session was conducted with these social workers on how to facilitate and manage the community focus groups. The Process of Conducting Focus Groups The social workers carried out preliminary meetings with key persons in the selected communities, to explain the purpose of the study, and to facilitate the conduct of the focus group interviews.

Specific dates were decided to conduct the focus groups in villages, cities and camps. The importance of gender sensitivity was recognised as important in representing the whole community (table 7). Cultural problems in some areas precluded the use of mixed focus groups. Therefore, in these areas, separate male/female groups were facilitated, thereby safeguarding cultural and religious sensitivity. Membership of Community Focus Groups In order to ensure a full cross-section of the communities, representatives of the following were incorporated: T T T T T T T T T Women Men The disabled The elderly Members of village councils Educationalists Religious persons Volunteers Health professionals

Table 7: Gender Distribution of Sample Groups by Location

          

&LW\

9LOODJH

&DPS

Methodology

29

To facilitate the collection of data from the groups, the social worker facilitators wrote down the information on flip charts, in order to share emerging information with the groups, and to maintain the discussion as the purpose of conducting the focus group. The flip charts were also used to summarise the discussions and responses to the guidelines and the results of brainstorming, in order to maintain the consensus of the group, about the issues and suggestions related to the study. In order to commence the initial data analysis at an early stage, because this is qualitative data collection, a data summary form (Appendix 7) was devised prior to the interviews and the social workers were orientated to use it. The procedure adopted by the facilitators was to immediately summarise and cluster information, so that in the event of having to return to participants, this could be done in a timely manner. Follow-up interviewing adds credibility in 'checking out' questions related to primary interviews42. The participants were informed at this stage that the data would be analysed and that it might be necessary to consult back with them on specific issues which were not understood by the researchers. All social workers participating in the focus group interviews met together, to discuss their experiences, the impact of the study on them, and to provide their own recommendations. In addition, feedback on experienced problems and constraints was allowed to be shared. Children and Youth Focus Groups Eight Focus Groups were held in this group, five in the West Bank and 3 in Gaza, and they consisted of 113 children and youth. The geographical location was determined through convenience, situated at the sites of Youth Summer Camps in the West bank and Gaza. Convenience samples26 were recruited from the summer camp participants with the consent of their parents and themselves, in order to fulfil ethical requirements of research26. Particular care was taken to deal sensitively with young people with no applied pressure to participate, and the consent of parents was obtained. The purpose of the children's/youth focus groups was to ensure that representation of all age groups was addressed in this study. Preparation for Children's Groups T Contact was made with organisations working with children's programmes in the West bank and Gaza T An invitation letter regarding the purpose of the focus groups with children and youth was sent. T The informed consent of parents and children was secured. T Dates on which focus groups could be facilitated were agreed.

T Request was made to them to use a suitable venue for the conduct of the workshops. T Artwork materials of the focus group meetings were provided and prepared in advance.

Method of Facilitating the Children/Youth Groups
The same methodology as in the adult community groups, in terms of the interview guidelines, was employed. Brainstorming of ideas relating to each of the guideline points and information, was recorded on a flipchart. The same procedure for initial data analysis was followed by the facilitators, immediately following the session, as feedback sought from participants as required. Each child within the focus group was given painting materials and was asked to paint or draw two pictures: 1. What disaster means to you 2. What disaster preparedness means to you Following this, each child was interviewed individually by the social worker/facilitator and was asked to explain each of these statements through the pictures they had drawn. The rationale for using the artwork was to capture their interest and allow expression of ideas through drawing. It is accepted that children can express ideas more usefully through this medium, rather than language alone. Examples of some of this artwork can be seen in chapter 5. The process of conducting Children's and Youth Focus Groups In a similar informal setting, the children and youth groups were facilitated by a Social Worker. A separate table was supplied with drawing and painting materials, and the children were informed that they would be able to use them after the discussion. Each question in the guideline was introduced in simple format. Following each question, discussion and ideageneration were encouraged. The main emerging issues were recorded on a flip chart. Following the focus group discussion, each child was invited to use the drawing/painting materials to draw two pictures: the first was to represent disaster to them and the second to represent preparedness. The name, age and address of each child were recorded on the pictures. Children were then interviewed individually by the social worker, to gather information about what the picture meant to them. A record of each interview was kept. The purpose of using the drawings as a basis for interviewing, was to allow expression of cognitive processes to be represented in picture form, around which the child could describe perceptions. Community Focus Groups Interviews were facilitated by a Social Worker from the concerned area, in a setting within the community such as a youth club, clinic, school, village hall etc. Informal

30

Vulnerability & Capacity Assessment

groups were convened and the questionnaire guidelines were used. Each question was posed to the group who then engaged in discussion and brainstorming. Main issues relating to each question were recorded on a flip chart. Interviews ranged from 90 to 120 minutes. Immediately following these interviews, the interviewer began analysis of the data onto a pre-designed form, that allowed for initial sorting, and timely return to participants for clarification (see appendix 7). Following the discussion each participant was asked to complete the Likert Scale questionnaire tool shown in Appendix 12.Conducting Interviews: Ministry and Institution Interviews Task Group members facilitated these. The rationale for this choice was so that interviewers had credibility with 'high-level players' by having an in-depth understanding of the methodologies used within the VCA.

T Return to participants for validation of unclear or ambiguous information collected. T Interviews with social workers during the interview process was facilitated to highlight obstacles, problems, implications, and to monitor process. T Experts were consulted at strategic points in the research process to gather feedback regarding methodology, natural disasters, Emergency Response Units and analysis. T Principal researchers undertaking this VCA study have appropriate research methods, knowledge and experience.

Method of Analysis of Data Qualitative Analysis
A Data Analysis Retreat was organized for the Task Group to meet in another town, away from the day-to-day interruptions of office life (Figure 4 & 5). The objective for this week was to complete the bulk of the analysis work and plan the first draft of the report. Experience of the mass of emerging qualitative data indicated that this objective was unrealistic. This bears out the findings of Phillips & Pugh (1996)29 who maintain that in research, short and long-term goals may need to be adjusted. Therefore, it was redefined to achieve 'sorting' of main categories and begin the reduction process by clustering, making notes of obvious features emerging from the data, for further discussion. This was then addressed in a further data analysis retreat in Amman. Data from ministry, community focus group and children's groups was transferred to data collection sheets, with initial sorting completed. The initial sorting of the qualitative data indicated a number of categories that occurred in all three groups and these were used as the starting point. It was decided to use the walls of a large room to mount data bits on them. The value of this method allows for sorting and seeing which may be ideal for focus group approaches. In this, discussion is important to think through the complexities of relationships between categories (Dey 1996)30.

Validity and Reliability

T All stages of the research process were developed by Participatory approach, involving all members of the Task Group. T Analysis was an integral part of an Action-Research approach that began from the start, with constant evaluation-redirection- action-evaluation. T Analysis stages of the study included the involvement of other experts such as the Disaster Preparedness teams of both the Syrian and Jordanian Red Crescent Societies. T Pilot studies were conducted to establish the validity of the interview guidelines T Community Focus Group approach was piloted in which the strategy was tested. This was valuable in identifying problems in the use of videotape, which was intended to give explanatory information about the nature of disasters. Findings indicated that this biased the children's' view away from other potentially-significant categories of disaster. T Community Focus Group Interviewers were given training, prior to conducting the Focus Groups. T Task Group members were given training in personal interview techniques, prior to interviewing key ministry people. T Sampling was determined according to the purpose of the inquiry and documented with rationales. T Sampling included consideration of geography and community types such as village, city and refugee camps. It also represented gender, age and special needs groups. T Information to children's groups was presented in a simplified form allowing for the special needs of dealing with children in research. T Validation included research methodology auditing by experts, such as Federation DP Department Researchers.

Figure 4: The Task Group in Data Analysis in Gaza using the wall as a field to theme and cluster. The methods allowed a panoramic view for discussion and connection.

Methodology

31

Principle categories were mounted, and the data bits derived from the interviews were attached under the appropriate category. This was done for each of the three main groups using one wall for each, and labelling them Figure 5: Wall mounted Themes and Wall A, B & C Data bits in Arabic and English (figure 5). Such a strategy allowed the data to be able to be viewed by all participants in the analysis process. Each 'data bit' was also given a reference number for identification and referencing as evidence during the analysis and report writing. For example, on the children's wall 'C', a data bit on the third row and fifth in the column would be referenced C3/5. The method facilitated comparison and theory generation (Gregory 1998)31 and gave efficient access to information during the sorting processes. When all data was mounted in categories, a process of data reduction through clustering was commenced. The three sets of wall-mounted data were considered in relation to each of the interview guideline questions and the objectives of the study. Connections were made; noting

similarities and differences in gathered information relating to each of the categories. As a continuous process, groups were asked to consider 'what is the data saying to us' noting the obvious features for further discussion. The Focus Group reached a period of confusion in looking for further direction in analysis. It was important to return to the objectives of the study, to clerify, that it was about 'the role of the PRCS', and accordingly, to 'advocate for a National plan'. Confusion and learning may be related. Thelan (1960)32 maintains that significant learning is often accompanied by discomfort and Joyce & Weill (1986)33 postulate that a student does not learn unless he is faced by not knowing how to respond. Focus Group learning emerged to formulate a plan, which allowed the objectives to be met. An example is shown in table 8. The evidence required was cross-referenced from wall-mounted data from all three sources. This would enable both the PRCS and other players to realize what realistic roles each can perform. In addition, it acts as a basis for negotiating how to get the identified needs into the disaster preparedness and response function. It may be through partnerships with the PRCS, in providing appropriate training for community-based volunteer responders, or the ownership of different functions. It is important to understand that this is a basis for discussion with the Steering Committee and National Conference. Data is presented as information gathered from various sources, which may need clarification through the wider view of the 'whole of the picture' by connecting the findings to the experience of the Steering Committee.

Table 8: Strategy for analysing data, showing here, as an example, the Role of the PRCS PRCS PRCS Role Capacity Awareness Can be provided by PRCS staff & volunteers in areas where there are clinics Can be provided as long as there is access to the concerned communities Trained staff Identified Needs to achieve capacity The PRCS cannot provide awareness in the remote communities not close to a clinic PRCS cannot give assistance tance in communities where access becomes impossible Trained staff are needed in their clinics Who can provide The needs? Volunteers if given appropriate training What evidence is there from the data? Cross references from the wall-mounted data bits

Awareness training in First Aid, Health Promotion

Volunteers if given Cross references appropriate training from the wallmounted data bits Volunteers if given Cross references from appropriate training the wall-mounted data bits Field First Aid (NonEMS training Cross references from equipment orientated) Field Medicine the wall-mounted Water & sanitation training Specialist data bits Shelter Water/Sanitation Basic rescue Department MOH/Civil Def Civil Defence

32

Vulnerability & Capacity Assessment

Quantitative Analysis
Purpose of the Quantitative Tool The primary aim of the Quantitative Tool was to solicit information, on how a representative sample of the Palestinian population, perceives the probability of each of the 21 hazards to occur. Aim of the Quantitative Analysis The aim of the data analysis is to interpret consensus on the level of the perceived probability of the occurrence of the twenty-one hazards listed in the questionnaire. To cope with the interpretation and identification process, statistical summaries of the responses were useful inputs. Method of Quantitative Analysis In performing statistical analysis, it is important that proper statistical techniques are used to avoid fallacious conclusions. Central to this selection process is the giving of due consideration to the level of measurement. The level of measurement of a variable is important because it limits the statistics that can be appropriately used on the variable (Weisberg, 1992 p5). Likert Scale data from the quantitative questionnaires was entered into an SPSS database and was analysed according to age groups 15-18, 19-34, 35-54, and >55 years. Analysis also included sorting to location such as the North & South West Bank and the Jerusalem area. Data was analysed by a professional statistician who used the Model Category Methodology. Data was ranked by expected crisis to show the incidence ratio between the modes and the index of diversity. Statistical tests were applied. The level of measurement used in this survey questionnaire is a 6-point scale with, cannot predict unlikely - likely - more likely - most likely - sudden, as categories. The Categories are ordered but non-numeric (that is, there is no indication of distance between them). Hence, metric analysis should be excluded. Integer scoring to assign numbers to the categories ( 1, 2, 3, 4, 5 and 6 respectively) is used simply to facilitate their storage and analysis on the computer. Before computing statistical summaries of the data, the organization of data into frequency distribution is useful. Each category is listed with its corresponding frequency (that is, the number of responses falling into that category). Frequency distribution can be portrayed effectively in tabular or graphic form, allowing examination and description on the pattern of the responses to be made. More importantly, frequency distribution has two outstanding features that make it an appropriate technique to use at this level of the investigation: it allows

the distribution of responses for a variable to be summarized by computing the typical value (point of central tendency) and it can be seen how typical that value is (measure of spread). Computing the center and spread will permit the objective identification of consensus and the quantitative comparison of probabilities of the occurrence of the hazards. There are three common methods of describing and locating the central tendency of a distribution, namely, mean, median and mode. However, some are only appropriate on certain occasions. It is, therefore, important that the method be appropriate to the problem (Hammond et al., 1970 p62). The measure of central tendency indicating the category that contains the largest number of responses is the mode. In the context of this investigation, the mode measures the most typical category and, therefore, objectively shows what the consensus on the probability of a hazard to occur is. For example a hazard having “most likely” as the modal category means more respondents agreeing to “most likely” than to “more likely” or “likely” or “sudden” or “unlikely” or “can not predict”. Given that identification of such a consensus is one of the focal points of the investigation, this makes the selection of the mode as the measure of central tendency appropriate for this investigation.

Measures of Spread
The organization of the data into frequency distribution and computing the central tendency is ordinarily not completely satisfactory to describe a set of response data. It is quite important to know their variability (or spread). The need arises mainly from the fact that distributions may have similar centres but differ widely in the amount of variation present. Measuring the centre finds the typical value for a variable, while measuring the variability or spread of the response distribution tells how typical that value is. It is important to put this in the perspective of the primary aim of this investigation. The mode identifies what the consensus on the probability of a hazard to occur is. It permits the organization of the hazards as most likely to occur or otherwise. In addition, measuring how typical 'most likely' is, will permit the interpretation of the extent of the consensus and the exact comparisons of the probability of the most likely hazards to occur. There is no single agreed-upon frequency-based measure of spread (Weisberg, 1992 p74). We have used two measures for the purpose, namely, the variation ratio and the index of diversity. Information relating to this analysis is given in Appendix 13, whilst pie chart representation of the main results is shown in figures 7 - 16.

Methodology

33

34

Chapter 4

Data Analysis and Findings of the Inquiry
The findings of this inquiry are based upon a comparison of qualitative data from interviews with the following three main groups: T Ministry/Institution representatives T Community Focus Gr oups T Children and Youth Focus Groups To support this information, quantitative data from the Likert scale questionnaire tool has been analysed to support qualitative findings about hazards in this study. A statistician conducted analysis and the pie chart representation of results is shown in this chapter in figures (7 - 16). Specific data related to distribution of questions answered by participants is presented in appendix 13. The major findings emerging from the inquiry are listed below.

Major Findings
1. There is a need to integrate local community in identifying needs. They need to participate in the planning process in order to mitigate the impact of disaster and facilitate meeting their own needs. 2. Volunteers are a major capacity in the area of Disaster Preparedness. 3. Coordination and cooperation between ministries/institutions is the most effective means of preparedness through identifying roles and authorities. There is no clear plan for the country, as a whole, and coordinated National Planning does not currently exist. 4. There is a lack of specialized personnel, coordination, money and materials. 5. There are capacities in materials, information and human resources that could be utilized and benefited from. 6. Disaster Preparedness as a concept or plan is not on the agenda for national organizations because of the political situation, which creates different priorities. 7. The main vulnerabilities identified by all groups were Drought, Earthquakes, Political conditions, environmental problems and lack of water. 8. The Palestinian community are suffering from lack of water, water pollution and Drought that needs urgent attention. 9. Children, women and the elderly were classed as the most vulnerable in a society in disaster. 10. The geographical distribution of Palestine has led to a gap in managing programmes, especially in preventive and tracing programmes. 11. The expectations of the local community for the role of Ministries and NGO's, based on their experiences of their needs, appears realistic. 12. Through the VCA study, Ministries and NGO's need to develop specific programmes for disaster preparedness-identifying responsible sections of their organization and implementing them. 13. Ministries and NGO's are very willing to cooperate in defining their roles in developing future programmes. 14. The centralized planning and cooperation involved in conducting the VCA, identified a large gap in not having a national DP plan. 15. A large communication gap is formed between the local community and ministries/ institutions in the mechanism of preparedness, in terms of expected hazards for disaster. 16. Local community capacities could be utilized for prevention and preparedness. 17. Direct intervention by communities, institutions and the community is required, to reduce water shortages and pollution. The main findings emerging from the study relate to five main categories of disaster preparedness: T Communities T Coordination & Cooperation T Hazards and disaster T Capacities and Preparedness T Vulnerabilities

35

These are shown correlated to the 17 major findings in Table 9 below. Table 9: Correlation of the five DP categories with the 17 major study findings Findings (identified by number) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Vulnerabilities Communities Coordination & Cooperation x x x x x x x x x x x x x Hazards & Disaster Capacities & Preparedness x x x x x x x x

x

x x

x x x x x x x

x x x x x x

x x

From this table it can be seen that the focus of DP development should be through addressing coordination and cooperation, increasing capacities and preparedness through vulnerability study and involvement of the community itself. These findings are useful in relation to the objectives of the study, which included advocating for a National Disaster Plan.

Qualitative Findings
Expected Hazards The analysis the qualitative data in this area of the inquiry shows correlation between whole study group (local community, children's community, governmental and non-governmental institutes) and the quantitative results derived from analysis of the questionnaire tool in table 10.

Table 10: Comparison of Current and Expected Hazards Qualitative Quantitative (Rank Order) (Perceived to becurrently being experienced) West Bank Gaza 1. Water Shortage 2. Political Conflict 3. Car accidents 1. Water shortage 2. Political conflict 3. Open sewage Quantitative (Rank Order) (Expected Hazards) West Bank and Gaza 1. Floods 2. Snow 3. Epidemics 4. Water Pollution 4. Famine 5. Electrical shocks 6. Forest fires 7. Nuclear accidents

West Bank and Gaza Strip 1. Drought 2. Conflict 3. Environmental 4. Air Pollution 5. Pollution 6. Fires 7. Earthquake 8. Disease 9. Epidemics 10.Floods

5. Food poisoning 6. Car accidents 7. Social conflict 8. Technical/labour accident 9. Landslide 10. Environmental pollution 11. Animal diseases 12. Insecticides 13. Drought

36

Vulnerability & Capacity Assessment

Predisposing & Exacerbating Factors In addition, the following were identified as factors that would impact upon the events identified above: T Electricity supplies T Building collapse T Sewage and sanitation T Poverty

T T T T T T

Animal diseases Nuclear accidents Food poisoning Overpopulation Family violence Desertification

Expected Hazards and Their Potential Locations
Table 11:Expected Hazards and Their Location Expected Hazards Environmental disasters including pollution Earthquakes, landslides, cracks in the earth surface Asia, Wars, confrontation with the occupied troops, settlements Explosions and fires Water problems (drought, pollution, salty water) Location in Palestine Near settlements, industrialized areas (Selfeet, Tulkarem, Agriculturalareas, crushing plants, Gaza beaches, crowded areas (Gaza) Jordan river course until the Arab valley, Jericho and Dead Sea,Tiberias, the fault line between Africa and Hebron and the south, 1948 areas, Nablus, AlFare'h, camps and high towers All the time Wood Areas, Factories, Sewage, Wastes, Gaza towers, Camps and over populated areas. Bethlehem, Hebron, Southern areas of the West Bank, Gaza, Tulkarem, Eastern heights, Agricultural areas. Exposed sewage places, Environmental pollution in agricultural areas, Gaza, Camps Low areas, beaches, valleys, Jericho, plain area, desert areas, heights that are more than 850 meters (Ramallah, Bethlehem, Hebron) Hebron, areas close to Demona reactor and to the border with Israel situated in the south Gaza, Ramallah Ramallah, Nablus, Hebron, Building sector, establishments, public areas. West Bank and Gaza generally West Bank, Jericho, Jenin All over Ramallah, Khoor All over Refugee camps, particularly in Gaza West bank, Al-Akhwar Refugee camps in the West Bank. Khan Younis City and refugee camps in Gaza. Gaza

Epidemics and contagious diseases Floods, snow

Nuclear radiations Building Collapse Work accidents, Industrialized accidents Road accidents Mines Food pollution Over population Weather Conditions Domestic Violence Desertification Open sewage/sanitation Water Pollution

Recommendations

37

Vulnerable Group
An important factor in assessing the vulnerability and capacities of a given community is to define the vulnerable groups. Within this study, the vulnerable groups emerged through the interview of the communities, Ministries and Institutions and are shown in figure 6. Children The fact that children cannot make decisions for themselves, renders them dependent upon the adult community through parents, family members, teachers and community/religious leaders. They are exposed in this society to specific fears and may not understand the global events causing these fears. The nature of the events relating to the political situation makes it likely that unpleasant occurrences will touch them through incidents involving family or extended family members. It is also significant that children form the majority of Palestinian society, and by their sheer number are vulnerable. The impressionable nature of children also makes them dependent upon older people as role models. The current troubles are significant psychological effects for their development.
Figure 6: Vulnerable Groups in Palestine as defined by the Community, Ministries and Institutions
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addition, unemployment is a serious problem affecting young people resulting in potential loss of morale.

Factors aiding the occurrence of Disaster
A useful finding of the study identified the aiding factors, which could be contributory in the occurrence of a disaster and may have a large influence on the society The interviewed groups identified that whilst there are natural factors that the human being cannot interfere with, they can make some preventive procedures that can mitigate the effects. In this, there are initiatives which institutions and the community can develop to eliminate or reduce effects, if programmes and plans are introduced to mitigate them: Natural factors and the current situation: T Presence in the area on the active fault line. T Increase of the percentage of salt in water. T Weather changes T Lack of rain T Nuclear radiations T Geographical nature (mountains, hills) T Electrical towers T Difficulty of communication and interconnection between the governorates T Conflicts on water resources T Settlements T Political considerations in executing projects Factors which could be eliminated: T High populations especially in Gaza T Lack of awareness regarding disasters and preparedness for them. T Shortage of preventive disasters T Dependence on the Israeli economy T Infrastructure, Electricity, Roads, Sewage T Lack of experience for the Palestinians to face disasters and the shortage of qualified staff. T Absence of special legislations designed for disaster preparedness T Mine fields T Use of sewage in agriculture T Poisonous wastes and sewage water for the settlements. T Closeness of the factories form the populated areas

$JHG SHRSOH 

Elderly Old people have a special place in Palestinian society within the extended family related to cultural beliefs. They are dependent upon younger family members to house and provide for them. Poverty is likely to have a more severe effect on these members of society due to their frailty. The elderly are often sick and infirm or invalid rendering them vulnerable and dependent. Women In various parts of this society women may be dependent upon men to varying degrees. In many cases much time is spent within the home where they may be responsible for caring for large families of children and elderly relatives. This in itself can provide stress. Youth The youth are particularly at risk as they face most hazards on a daily basis and in the current troubles may be more likely to be exposed to dangerous situations. In

The Influence of Disaster on the Palestinian Community
The study showed that the effects of disaster on the Palestinian community would fall into the following five groups: T Clinical Health T Psychological T Social T Economic T Infrastructure

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Vulnerability & Capacity Assessment

Table 12: Influences of Disaster on the Palestinian People General Health Psychological -Severe injury-Physiological paralysis,mutilation, disorders burns, fractures -Increase of -Increased anxiety. mass percentage mortality rate Social -Increased illiteracy rate -Dispersion, homelessness, internal and external displacement -Child neglect Economical -Limited incomes Infrastructure -Destruction of streets cracks in the earth -Electricity net interruption

-Lack of employment and livelihood

-Abortion

-Spreading of diseases -Chemical food poisoning -Loss of immunity and physical abilities -Respiratory infections

-Concentration loss and poor decision-making -Suicide

-Lack of capacities to face the events -Lack of effective services -Absence of labour and staff -Lack of raw materials

-Child labour

-Amnesia

-Lack of entertainment

-Spread of fear

-Absence of social values

-Carelessness

-Absence of social awareness and belonging -Political detention and riots -Increased crime rate

-No harvests

-Reverting to alternative medicine -Absence of Primary Care (especially vaccination)

-Isolation and loss of security -Aggressive behaviour

- Loss of private belongings -Wastage of resources and energy

-Destruction of sewage/water network -Destruction of agricultural wealth -Destruction of education system -Destruction of hospitals and shortage of beds -Loss of strategic stores for medicines and food -Absence of communication infrastructure -Destruction of shelters

-Loss of confidence -Absence of rehabilitation

-Polygamy -Non-Marriage phenomena -Lack of endurance and patience -Neglect of handicapped groups -Increase in poverty -Dissipation of families and social structure -Overpopulation -Isolation of villages and cities from each other -Unfinished Schooling -Influence of professional morals -Lack of basic services

-Collapse of high buildings

Recommendations

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Disaster Preparedness
The subject of Disaster preparedness was approached in three parts with all groups in terms of “before”, “during” and “after” disaster.

The common themes identified for 'Before Disaster' were grouped into six categories and can be seen in table13.

Table 13: Preparedness Themes Prior to Disaster Emerging from Focus Group Interviews Social Levels -Community awareness brochures -Workshops -Professional safety -Guiding the consumption of natural resources -Professional specialized courses -Specialized Media Centre -Physiological social preparedness -Determining hazards -Arab solidarity Coordination -Training and organizing volunteer work -Forming special committees for work -Availing staff for preventive services -Direction and organization of staff -Availing needs for rescuers -Availing a fully equipped civil defence system -Establishing representative committees for the country -Exchanging experiences locally and internationally -Establishing organizing committees that link the Palestinian authorities, institutions and people -Cooperation and coordination through establishing studies and surveys Materialistic Levels -Completely equipped ambulances -Food and materialistic support -Water wells and tanks -Shelters and services to employees -Complete system for emergencies -Alarm system -Safety deposits Human Factors -Availing staff and specialized people -Training sectors of society -Using working groups for dealing with disaster -Field, professional and specialized surveys in all fields

Laws and Legislation -Generate a human concept from officials towards people -Giving legal standing for disaster preparedness committees -Special legislation for establishing an emergency rescue fund -Working on making legislation concerning public safety -Legislation for facilitating the work of the voluntary and charitable organizations -Working on establishing study and survey committees

Research & Surveys -Preventive research and social surveys -Identifying capacities and making statistics for it -Monitoring agriculture -Studying ways for better water use -Creating a guideline for the correct use of fertilizers and chemicals -Following up the implications of building criteria and implementation laws -Ensuring the selection of the right people for the right jobs -Establishing a specialized institute for DP

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Vulnerability & Capacity Assessment

During Disaster The groups divided this aspect of preparedness in to four groups, which are shown in table 14 below: Table 14: Preparedness Themes During Disaster Emerging from Focus Group Interviews Organizational Level -Fast thinking and action when disaster occurs -Considering professional safety in response to the event -Forming committees for follow-up and organization -Maintaining cooperation and coordination between different committees -Maintaining systems -Imposing quarantine in epidemicHuman Resources -Forming rescue teams for assistance -Conducting training for vulnerable people in the field of disease and First Aid -Calling for first abiders, police and institutes, which provide services Materialistic Level -Availing ambulances and equipment for work Building wells, water tanks and shelters

Level of Services -Announcing cases emergency -General mobilization and preparedness -Offering prompt service and intervention -Donating blood -Building field hospitals -Offering field hospitals, first aid and vaccination -Determining the size of disaster and damage -Establishing a National Board for Disasters

After Disaster Post-disaster themes were also divided into four categories and identified in table 15. Table 15: Preparedness Themes Post-Disaster Emerging from Community Focus group Interviews Level of Services -Conducting educational services Instruction and Awareness -Conducting different awareness and educational programmes to deal with the impact of the disaster -Applying communitybased programmes to assist people to integrate and accept the current situation -Providing consultation to the private sector to help them in reactivating their economic situation -Tracing missing persons in cooperation with IFRC Studies, surveys & projects -Investigating in accidents, which have happened due to technical reasons, and instituting applied programmes -Preparing and presenting comprehensive urban development projects -Planning projects to study the impact of disaster on buildings likely to fall -Applying projects for collecting water in response to water restrictions -Treating sewage and salty water Coordination -Coordinating between all concerned authorities in evaluating achieved work and making official reports -Coordinating internationally for the utilization of foreign resources and technical aid -Coordinating between marine police, Ministry of Industry and Environment at crossing points, to prevent smuggling -Coordination between Ministry of Education and Environment to conduct water network examination

-Organizing relief programmes for the most vulnerable through social affairs and NGO's -Rehabilitating roads

-Providing security for citizens and their properties -Offering assistance for the vulnerable -Conducting mobile clinics and rehabilitation for hospitals. -Reaching the needy and deprived in isolated places - Rehabilitating sewage -Rehabilitating water and electricity networks

Recommendations

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Local Community Preparedness and Capacities
Disaster preparedness, prevention and mitigation of the negative impacts of disaster require a great deal of effort from the Palestinian Community, government and NGO's. The study showed an awareness of the necessity to capitalize on the human and material capacities available in the community. Where such capacities can be found in villages, cities and camps, they can be mobilized in a participatory manner with institutes, Ministries and all community groups, if planned carefully. Table 16 shows the local capacities and potential uses identified by the community focus groups. This is an important realization that items and resources may be

utilized in many different ways other than their original intended use. For example, water tanks are intended to contain water supplies for households but could also be seen in the category "container" which immediately increases the potential capacities for this item in disaster. In like manner, mosques are places of prayer but if we change their category to "covered meeting places" then many other possibilities become apparent, such as shelter, first-aid centre, awareness mechanism, communications and information dissemination. This indicates that the processes involved in this inquiry facilitated the connections between actual capacities and disaster preparedness thinking, to increase PRCS capacity.

Table 16: Local Capacities and Potential Capacities Identified by Community Focus Groups Local community -Transporting people most affected by disaster -Rebuilding -Collecting donations -Offering assistance -Offering social aid Public Squares -Centres for sheltering and housing -Using them for farming -Awareness -Using them as field hospitals -To gather volunteers -Places of instruction -Using them as shopping and farming places -Collecting donations Charitable Societies -Awareness and guidance -Collecting donations -Education -Treatment services -Sheltering places -Evacuation Water Tanks -Storing water when it is cut off -Domestic farming -Extinguishing fires -Protecting tanks from pollution -Using rain water -Equity of distributing water

Mosques -Preaching religious lessons and prayer -Awareness -Making First aid and treatment centres -Informing people -Sheltering and housing -Gathering volunteers -Building shelters -Communicating Cars -Ambulances -Fire extinguishers -Police -Transporting the injured -Medium for communication

Clubs -Training the youth -Establishing First Aid Rooms -Awareness and promotion for children and youth -Assisting in rescue service -Source of Volunteers -Shelters -Shopping centres Volunteers -Collecting donations -Assisting people in disaster -Coordinating health work -Teaching community awareness -Evacuating casualties -Providing first-aid

Specialists and professionals -Coordinating the health and treatment work -Community awareness -Providing aid and services to citizens -Preserving the environment -Volunteering -Informing people about disaster -Re-building and rehabilitation, building dams -Giving psychological support -Monitoring events

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Vulnerability & Capacity Assessment

Kindergartens -Preparing places -Conducting awareness and training -Means of communication with people. -Shelters -Treatment areas

Schools -Setting educational curriculum for Palestinian children. -A source of community -Forming student based networks to assist specialists in DP programmes.

Health Clinics -Supplying medicines and equipment -Providing treatment for the injured. -Offering direct assistance

-Mother and child care -First Aid and Emergencies -Providing psychological support. -Community awareness -Vaccinations. Hospitals -Lending hospital equipment -Receiving patients -Making sheltering centers -Undergoing treatment and surgery -Providing medicines. -Raising awareness and promotion. -Providing health staff -Ensuring reasonable prices for treatment. Police -Defending the country -Preserving public security -Protecting property. -Preventing traffic and drowning accidents. -Resolving problems between people. -Registering and verifying information.

Municipalities and village councils -Building and repairing electricity networks -Availing volunteers -Informing concerned people -Providing fire extinguishers -Instructing awareness -Availing transportation -Building roads -Supplying people with the necessary equipment - Carry out sewage treatment -Building dams -Keeping levels of sanitation safe -Cleaning streets -Providing water sources -Building libraries for children -Knowing peoples' needs -Ensuring the rehabilitation of infrastructure -Assessing damage and needs -Assisting service providers, making shelters for disaster -Assisting affected people

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How to Respond to Disaster and the Basic Requirements Needed
Disaster is characterized by disorganization and randomness. There are casualties, people wandering from one place to another. Social perversions can be seen such as burglary, rape and a lack of social system. In addition, there is loss of family ties, people and buildings. In order to address some of these to the community and institutions, the local community focus groups communicated the ideas identified in table 17. Table 17: Community Ideas for Responding to Disaster
Organizational Level -Quick thinking in case of disaster -Considering professional safety -Cooperating and coordinating between different committees -Forming committees for follow -up and organization -Distributing tasks -Enforcing law -Enforcing quarantine in case of epidemic -Conducting an international council for Disasters Materialistic Level -Providing extinguishers -Providing equipment -Building wells and water tanks -Building shelters Human Resource Level -Organizing rescue teams for assistance -Calling first-aiders from Red Crescent, police and service institutes Service Level -Announcing emergencies -Calling for public mobilization -Offering quick and emergency services -Making blood donations -Field hospitals and vaccinations -Defining disaster and damages

The Palestinian community, through the focus groups, defined basic requirements for quick intervention in disaster to be provided by institutions and are shown in table 18.

Table 18: Requirements for Rapid Interventions in Disaster by Institutions suggested by Community Focus Groups
Social Level -Awareness brochures -Workshops -Professional safety -Consuming of natural resources in careful manner -Professional specialist courses Materialistic Level -Fully equipped ambulances -Food and material support -Water tanks and wells -Shelters -Fully equipped emergency departments -Alarm equipment-Safety deposits -Defining budgets Laws & Legislation -Human view of officials towards citizens -Making a law for DP committees -Making law for relief funds. -Executing laws designated for public safety -Laws for establishing voluntary, charitable institutes to help people in case of disasters -Activating the role of ministries and institutes for law formation -Forming committees to study and trace needs for people affected by disaster Human Resources -Providing staff and expertise -Training groups of society -Appointing working staff -Groups for dealing with psychological, social and economic problems -Specialized and professional surveys in all fields

Coordination -Organizing work of volunteers -Activating special committees to work in emergencies -Employing specialists -Providing preventive, service and therapeutic staff -Central operating units for instructions and organizations -Providing needs for rescuers -Forming committees representing communities -Benefiting from experiences, both local and international -Generalizing information between institutes -Forming committees to study and trace needs for people affected by disaster

Surveys and Research -Performing researchers and social surveys for different groups in society -Limiting capacities and conducting statistics continuously -Updated standards to monitor agriculture -Guides to use water wisely -Correct use of insecticides -Laws for monitoring building -Establishing a Department for DP in each national institute

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Vulnerability & Capacity Assessment

Analysing Roles and Capacities for Governmental/NonGovernmental Institutions
In considering roles and capacities, both focus groups within the community and Institutions themselves were interviewed. Whilst the Ministries have a leading role in planning, all ministries and institutions agreed during interview that this was one of the main roles designated to them. They all considered that some form of legal base was a necessity for them in the field of DP. An interesting factor was that the community focus groups identified the same roles for all ministries as the ministries themselves, with the addition of the material support for disasters. These organizations emphasized that community awareness regarding DP and DR lies with Government and NGO's equally, according to their specialties and the capacities available. The recruitment and development of human resources in DP and response was considered one of the main ways to enrich their specialist work and increase effectiveness. However, these human resource capacities were considered insufficient in all concerned institutes.

Ministry of Communication
The local community focus groups and children's' groups agreed on the important role of the ministry of communication in providing connections between areas in case of disaster, providing news about disasters and hazard mapping.

Ministry of Housing
Despite the fact that designed projects in reality have not yet been funded, the Ministry has a major role in issuing and policing building laws (codes). It also establishes reserve-housing units that can be used after the occurrence of a disaster.

Ministry of Media
Role of the ministry of media, agreed upon by societies and institutions in the occurrence of a disaster, is in coordination between working forces, awareness and instruction for citizens about how to act. It also has a role in preparing studies and research in awareness and dissemination, issuing brochures concerning natural phenomena, which may lead to a disaster.

Ministry of Education
It has a main role in putting the concept of DP in school curriculums and conducting DP awareness programmes inside schools. The resource of school social workers could be used in dealing with psychological traumas after disaster. The schools themselves could serve the purpose of temporary shelters.

Ministry of Interior
The responsibility lies on this ministry to establish a special system to secure good social and economic security standards in case of a disaster, which will protect people's lives and properties. In addition, they are responsible for establishing follow-up of fieldwork and information concerned with disasters. The ministry representatives considered one of the most important roles was population registration after a disaster. Also, it contributes in providing demographic information from the information base that it has, announcing the state of emergency and defining the roles of the participating institutes. It also has a role in providing plans for civil defence and the Palestinian security authorities.

Ministry of Social Affairs
It was clear from the children and local communities that the role of the ministry of social affairs lay in availing assistance in money and kind along with the protection of women, children, the elderly, and other vulnerable groups. Following disaster, its role lies in preparing special rehablitation programmes for the groups damaged by a disaster, fighting poverty, and perversions, and tracing missing people, in cooperation with other concerned institutes.

Ministry of Environmental Affairs
Capacities include the environmental emergency centre to define hazards and detect specific disasters and identify ways of dealing with them. It also has an important informative environmental system for planning and presents studies regarding mines and Israeli environmental violations. The ministry also conducts special procedures to prevent pollution and monitor waste materials (Chemical, nuclear). The ministry contributes in analysing the environmental situation and enforcing designated rules for the environment. In terms of Disaster Preparedness and Prevention, awareness is considered one of the most important roles that the ministry of environment can perform.

Ministry of Supplies
In the pre-disaster phase, its major role is in identifying stores and warehouses, to store food with a minimum reserve for six months. The post-disaster, role lies in monitoring shops, fighting monopolies, monitoring prices and corruption. In addition, it conducts awareness and promotion programmes for both suppliers and consumers.

Ministry of Local Government
The ministry provides basic services like water, electricity, waste disposal and sewage to local communities and rebuilds these services in case of damage.

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45

A pre-disaster role is in compelling building owners to build shelters in municipalities, following legal standards. It is also responsible for emergency alerts in cooperation with civil defence. It is responsible for conducting community-based awareness campaigns, through local councils. The ministry also ensures the benefit is made from local resources, specifying community needs and coordinating between village councils and municipalities.

for farmers after a disaster. It also facilitates law to compensate farmers through special funding to help them in rehabilitation and rebuilding, in case of a disaster. It is responsible for building dams to collect water for use in agriculture and treating salty water. The Ministry distributes seeds for fruit trees and through its capacity of a counselling board, fights desertification.

Ministry of Public Labour
The capacity of equipment, such as bulldozers, gives the ministry possibilities in intervention during and after a disaster, where its role would be in removing ruins, building temporary shelters, building dams and bridges. Its possession of a data network about roads repair status, helps in opening these roads after a disaster, in coordination with the ministry works and the civil defence.

Civil Defence
The Civil Defence is mandated to provide national fire response, search, and rescue services. They also operate a limited fleet of ambulances that accopmany fire response. The Civil Defence takes the leading role in availing the basic needs in case of disaster. It also supplies fire extinguishers, transportaion, and rapid intervention. Its role outside of disaster is an organizational one that includes issuing licenses for gas and fuel stations. The Civil Defence also works with institutes and different ministries to effect rapid intervention adn awareness. It also heads the Higher Council for Emergency to coordinate the work of different ministries during emergency interventions. In disaster, the Civil Defence has a key role in search and rescue operations with medical support in on-site stabilization of casualties. It has responsiblity for the estabishment of casualty clearing stations and casualty bureaus for inforamtion and communication. The Civil Defence is an important part of an integrated emergency management apprach to a whole range of disaster situations including fires, floods and similar major catastrophes. It is a specialised service with technical personnel and equipmnet.

Ministry of Labour
The main roles identified for the ministry of labour, as described by the ministry itself, is in identifying safety and professional health units in addition to dealing with dangerous wastes.

Ministry of Health
The ministry of health has a role in maintaining a database about the available capacities to face a disaster, designating a reserve budget for emergencies and disasters. In addition, it is also perceived by the local community and children to have a role in vaccinations, treatment services and coordination with other health institutions in Palestine. It also maintains rules and health legislation and performs awareness campaigns to limit the effects of disaster.

Palestinian Refugees Study Centre
Discussion with the centre showed potential to support a complete study about the hazards and capacities in refugee camps. Such a study was requested by people living in the camps as they have a bank of data regarding the status of the camps.

Ministry of Finance
The role of the ministry of finance is represented in finding a mechanism for disaster response, through an accounting system which covers emergencies financially, in preparing the public budget for the state. The ministry also monitors this mechanism in the spending of money that is presented to the authority to cover emergency cases and the collection of international donations.

The Palestinian Board for Development & Rebuilding (Pecdar)
Roles include availing budgets, building schools and hospitals, developing infrastructure, providing material support, and assisting local boards, in the rehabilitation of infrastructure, in addition to training local boards.

Ministry of Industry
The role of the ministry of industry is represented in promoting international industry standards. It is responsible for ensuring the treatment of industrial wastes and materials and, recycling. Post-disaster has a role in preparing plans to rebuild industries.

Union of Medical Relief Committees
In addition to other health institutes that are in the community, the Union of Medical Relief Committees provides various medical services to the community. It also supports a college for training health and First Aid workers.

Ministry of Agriculture
The ministry of agriculture has been highlighted by other institutes as providing service loans and compensation

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Vulnerability & Capacity Assessment

Geography and Earthquake Engineering Centre
Its role lies in formulating and promoting a Palestinian Code designated for earthquakes, and cooperates with local universities to come design a specialized academic programme.

ICRC (International Committee of Red Cross)
The role of ICRC during a disaster is in ensuring the compliance of the Geneva Conventions for human rights, and providing assistance. It provides donations in kind and supports people during a disaster. The ministries see these among its roles. The presence of a commission of ICRC in Jerusalem and Gaza has experience in dealing with disasters and assisting people, due to its easy movement. The cooperation and coordination that is possible with the Red Crescent, assists in availing immediate health services.

International Movement for Defending Children
The movement promotes physiological and social dimensions for children and victims of political violence before and after disaster, both individually and collectivelly. It does this through clearing minefields, mine awareness and preparing the community in dealing with the minefields, before an actual Israeli withdrawal from the concerned areas.

Swedish Relief Institute
The institute is characterized by its clear capacities for recruiting material resources and its wide international connections along with emergency satellite equipment.

Anera Institute
Anera is characterized by its capacities in the facilitation of bringing in supplies and equipment and, providing loans to those whose property is damaged. It also supports social, cooperative, productive and economic programmes.

UNRWA
The role of UNRWA lies in providing relief and admitting refugees within Palestinian camps. Great capacities also exist in the camp community such as schools, clubs and clinics, which could be of benefit in case of disasters. These could be used as shelters, education and Relief centres. The large number of employees in UNRWA could be utilized in volunteerism and relief alongside other institutes.

Universities
The local community, ministries, and children perceive the role of the Palestinian universities as forming trained groups to work during a disaster. They also suggest that they could be used as shelters and ambulance centres during & after a disaster. In addition, they see Universities as having a role in conducting studies and research into disaster risks.

The Capacities of Governmental and NonGovernmental Organisations
The main efforts of these, since the beginning of the building of a Palestinian State, has been in rebuilding infrastructure, destroyed due to the Israeli occupation. Capacities in DP have been identified in this process in human resources, and technical and financial expertise. Legislation boards need to cooperate with the Civil Defence in order to facilitate public safety rules. In addition, available data as a capacity can assist in determining public capacities in DP and these have been grouped into four sections in this analysis: T Technical and Expertise Capacities T Human Resource Capacities T Rules and Legislation capacities T Informative Capacities.

Palestinian Water Authority
The role of the water authority is in managing the available water resources, to resolve the problem of drought in Palestine, building water networks and drilling wells for water resources. It is also responsible for purifying the sewage water for agriculture, as a solution for water shortage. The Authority acknowledges that it is not ready to face a water disaster. However, it has plans for the water authority and works according to it, executing water projects.

Applied Research Institute
The institute works on forming an International Disasters Fund in coordination with the ministry of agriculture, conducting studies and publishing them. It also contributes in securing equipment for institutes and supports other ministries in providing plans and evaluations in the environmental influence of some projects.

These categories are presented in detail in table 19 below.

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Table 19: Capacities of Governmental Institutions & NGO's Technical & Expertise Capacities T Availability of habitation centres T Availability of centres for the elderly T First Aid and Emergency experiences T Experiences in the research field T International Experiences T Experiences in the DP field T Administration hierarchy and an institutional system T Courses T Environmental projects T Water purifying projects T Maps for cities and villages T Scholarships abroad T Health and professional health programmes Materialistic capacities T Presence of Civil Defence T Branches for development and ministries T Professional training centre
T T T T T T T T T T

Human Resource Capacities T Various local resources T Civil Defence staff T Health Staff T Scout groups T Local expatriates T International and Institutional expatriates T First aid staff T Number of researchers T Health Committees T First aid teams T Volunteers

Food storage Equipped ambulances Funded projects Waste clearance stations Free industry zone School Power Stations Money donations Money assistance Equipment and machines Primary Health Centres

Informative Capacities T Guiding information for youth T Good communication network T Presence of libraries and documentation centres for information T Presence of studies regarding the environmental adjustments T Study regarding landmines T Presence of International relations. T Presence of educational curriculum. T Presence of awareness and instructing materials. T Presence of a database T Presence of a Statistics department T Presence of studies about refugees

Other Capacities: T The presence of the ICRC T Good relationships with the local community T Presence of the Red Crescent T Presence of International Institutes.

The Role, Capacities and Needs of the PRCS
Based on the study of available capacities and resources, there appears to be the need for an infrastructure to establish specialized training programmes supported by the Emergency Educational Center, trainers, first aid training equipment, and a curriculum taught in English. The joint cooperation of the Palestinian institutesand the PRCS is considered one of the unique capacities for the institute, as it has specialized trainers in rescue, from the civil defence.

In order to be effectively responsive to Disaster Preparedness for the expected disasters, the Red Crescent Society needs to conduct specialized training courses in Arabic, and prepare a specialized training manual for a continuous training process. This would best be accomplished through preparing specialized trainers around the state in participation with the civil defence. The PRCS has a number of specific capacities that are useful and are shown in Table 20.

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Vulnerability & Capacity Assessment

Table 20: Capacities of the PRCS Rehabilitation 11 Rehabilitation centres 178 Rehabilitation workers and specialists Physiotherapists Occupational Therapists Special Education Total Communication Prevention Community-based Rehab Volunteers 1,500 Volunteers distributed Throughout the West bank and Gaza PRCS branches Emergency Medical Services 17 EMS Centres 50 EMS Ambulances 230 Emergency Medical Technicians Primary Health Care 20 PHC Centres 32 Physicians 24 Social Workers 14 Nurses 15 Lab Technicians 4 Assistant Pharmacists

Social Services 17 Nurseries and Kindergartens

Hospitals 6 Hospitals

1 Elderly Care Home 2 Rehabilitation Centres for Girls 92 Social Workers

1 Emergency Response Unit Mental Health Care

Community Training
The society aims to reach to the largest number of beneficiaries in the local community through applying community programmes, First Aid and Primary Health Care centres, and training facilities, in cooperation with governmental and non governmental institutes. This cooperation is enhanced through resources in Arabic, the Balsam magazine and awareness leaflets in health & social education. Employing large numbers of youth Emergency Medical Technicians(EMTs) is considered one of the most important needs for Disaster preparedness for response. Older EMTs may have abilities and capacities that are limited in facing a disaster. However, their experiences can be used in directing and advising the youth technicians. Facing a disaster effectively requires great standards of fitness and ability in effective prevention.

but for the purpose of DP and response, the available numbers are not sufficient. Specialized doctors for First Aid in rescue operations and treatment services need to be developed.

Establishing voluntary committees
The Society works hard in facilitating volunteers to support the society programmes in facing disasters and mitigating their influences. However, its work depends largely on volunteers and the lack of sufficient trained volunteers limits the efficiency of the First Aid and emergency staff. To address this, the society must work on forming voluntary community-based committees in different geographical areas (villages, cities, camps). Supporting the different agencies in DP and organizing the performance of volunteers is considered one of the most important procedures, to increase the effectiveness of interventions and to assist the injured that are caused by disasters. Therefore, it is recognised that the Society needs to work on increasing the number of volunteers with the ministry of education and enhancing the profile of voluntary work for students and facilitating their commitment, in voluntary work. Cooperation should be fostered with universities and non-governmental institutes in joint programmes to recruit large numbers of volunteers who could contribute to Disaster Preparedness. Governmental organizations, like the ministry of health, could contribute in providing the Red Crescent with volunteers for training in First Aid and pre-hospital services, where the local community is prepared to provide the society with volunteers for Disaster Preparedness training.

Volunteers
Although there are some volunteers to support EMTs, the society needs to recruit larger numbers, especially in remote areas and large cities to facilitate rapid intervention and to assist in DP operations. In relation to this, training is required in first aid including the remote areas of Palestinian villages. In addition, information needs to be developed about their experience and location so that they can be contacted in emergencies and transferred from one site to another as required according to the nature of the emergency. The role of volunteers needs to be in training and preparation in these communities.

Doctors
There are large numbers of doctors who work in the RC

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49

The capacities of the local community are large when it comes to providing trained specialized volunteers like doctors, healthcare workers and administrators. In addition, there is a great potential capacity in the youth who can be utilized through establishing organized community-based groups in Disaster Preparedness programmes built on the local community.

capacities in DP through the Health Centres. In terms of drug stores, the Society has one which meets the needs for the ambulances and Health clinics for a period of 6 months only, based on the Society's plan of emergency adopted by the RC senior staff. However, the Society must develop more medical stores so that there are two in the north, two in the middle, and one in the south and two in Gaza. The one in the south would cover Bethlehem and Jerusalem. Dealing with Disasters requires specific practical experience from the Health centres. Currently, there are no specialists within the Society or other institutions and so there is a need to train personnel in the field medical components of DP, and give specialized courses to include prevention and mitigation, in cooperation with other ministries and institutes. Training is considered one of the most important capacities among institutes for dealing with disasters and mitigating their effects. An important point is that all current community-based training within the Society does not take into consideration DP. This suggests that Society must conduct appropriate periodical courses, in cooperation with International and local experts. These courses should target volunteers and be based on an instruction manual for use in community training. The society should develop its Internet resources to ensure up to date information in modern developments. In addition, it should embark upon studies in which analysis can be made of expected hazards, so that twoway sharing can be pursued with other institutes.

Blood Bank
Establishing the Blood Bank is considered one of the most important programmes that the Society can pursue. To this end, the Society has put a very ambitious plan into action, to found a Blood Bank based on a decision from the executive office in the Society. The building is under construction at present. The Society has resources in the Blood Transfusion operation for running this programme, in addition to volunteers and the support of various Departments. However, it needs the equipment for Disaster Preparedness, and lacks specialists for the blood bank laboratories. The role of the Blood Bank would be to provide blood for all the injured in the event of disaster. Cooperation with the Ministry of Health and other ministries in Blood services including database development for donors, is considered an important area for cooperation with ministries and non-governmental institutions. Related to the Blood Bank project, there is an important role in stimulating the local community, to participate through awareness campaigns in order to meet increased needs for blood donation in emergencies.

Hospitals/PHC/Rehabilitation
The National Society operates five hospitals in Palestine within the northern and southern governorates, in addition to twenty-eight PHC centres. Thirteen rehabilitation centres provide health, social, physiological, rehabilitation services and training programmes for members of the local community. However, these capacities need development in order to upgrade their preparedness for Disaster. In order to support other governmental Health institutes in Palestine, the Society needs to develop protocols and treatment regulations for workers in DP. In addition, attention needs to be made to develop emergency rooms which are equipped to manage multiple casualties, in addition to availing specialized staff from the local community as volunteers, such as doctors, assistants and nurses. Hospital systems management also needs to be developed to deal with disaster. Developing the National Plan, with the involvement of the RC Society, can complement other health programmes. The Society must develop their programmes further, by adding the community based DP programme within the PHC programmes, to build

Contributions in Fire-fighting, Sheltering, Evacuation
The buildings, which belong to the Society, can be used for sheltering the injured so as to assist hospitals and clinics. The society needs doctors, nurses and volunteers in these places and this is a capacity within the reach of the PRCS. The Society may best contribute to these functions in supplying ministries with trained volunteers for Disaster Preparedness. In addition, the International connection that the Society has with the IFRC can assist in facilitating communication, for availing assistance and support in intervention process.

Contribution in assisting poor and vulnerable people
Within the available programmes, the Society has the community development programmes, which can contribute in helping the poor and the needy. This role can be coordinated with the ministry of Social Affairs and non-governmental institutes specialized in this field, with more coordination and defining of roles between

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Vulnerability & Capacity Assessment

the Society & other ministries. The Society can also contribute in availing volunteers to support the ministry of Social Affairs in assisting the most vulnerable. This requires a coordinated joint plan, based on the local community needs and capacities of other ministries.

Information Bank
This is required to provide a detailed database about capacities in the PRCS including volunteers, and through

this base to conduct analytical studies in DP. In addition, the Emergency Response Unit (ERU) of PRCS maintains information regarding current hazards and needs both nationally and internationally. The PRCS ERU has been active in a programme with the Norwegian Red Cross in Kosovo. In this initiative, skilled manpower was provided by PRCS to work with health in the community. Qualitative data relating to roles and capacities is shown in table 21.

PRCS Role
Table 21: PRCS Roles and Capacities The PRCS Roles and Capacities T Specialised training is needed over and above the EMS because disasters are different types of emergency and it needs to be done in conjunction with other agencies. T The PRCS has a role in community training programmes to address disaster preparedness needs. T Blood Banks need developing. T The five PRCS hospitals and 28 PHC Clinics need developing in terms of emergency room staff development. T There is a role in participating in Fire incidents in terms of responding to on site casualty management, providing shelter and volunteers in cooperation with other agencies. T Assisting in providing help for victims in cooperation with social services. T PRCS has an important role in assessment of needs in disaster and liaising with the Federation for Appeals. T An Emergency Response Unit could provide personnel (including volunteers) to assist in the functions of other agencies.

Requesting Assistance, its organization and dissemination.
The RC society considers the information provided by the Palestinian Society, (requesting assitance and the organzation of their logistical operations) a major function, complementing the IFRC role. The ERU is based on this principle, which functions as a connecting chain between the International community and the RC Society on one hand, and between the RC and the other local institutes on the other. The Local community expects the RC Society to perform this role, because of its special International relations, and its network of centres in the west bank and Gaza strip. They also see the experiences in the Palestinian communities abroad, in such places as Lebanon, Syria and Jordan, as relevant here. The unique role that the Society has in dealing with Disasters supported by staff and volunteers, can be helpful in determining the assistance required, based on the actual needs of the local community. It is considered that the Society should establish communitybased groups in the different geographical areas, to assess needs, provide information about damage that a disaster can cause, and contribute in organizing intervention and prevention from the effects of disaster. Such communitybased groups need to be trained to do this in a coordinated

way that serves the varying interests of concerned institutions. The importance of volunteers in relief programmes and awareness regarding prevention from expected hazards is well recognized. It is important therefore, that organized community-based campaigns are conducted, to raise awareness in the community, about the hazards of expected disasters. It was also suggested that useful learning could be gained from evaluating experiences in rescue and DP from other countries. It is recognized that in the PRCS there is not a suitable plan for DP but that there is a rapid intervention plan. There is a need to provide a clear plan that is understood both by the Palestinian community and the local authorities. These need to be documented and publicized to ensure the credibility of information for all parties. Recommendations, that emerged were based on interviews of Ministries and Institutions and community focus groups. The Palestinian community made practical recommendations to be used as a reference in the DP process and prevention. It is divided into community-based recommendations, ministries and non-governmental institution recommendations.

Recommendations

51

Quantitative Findings Relating to Perceived Hazards of the Local Community Focus Groups
Analysis of response distribution
The vast majority of the hazards response distributions are unimodal. That is, the most frequently occurring responses appear on one category. Given this feature, the use of mode as the measure of central tendency for this investigation is appropriate. The top ranking hazards in the West Bank and Gaza are shown in Tables 22 and 23 with the detailed analysis of the distribution of questions answered included in appendix 13. Table 22: Major Hazards in West Bank Hazards Water Shortage Political Related Events Open Sewage Food Poisoning Soil Erosion Vehicles/Traffic Accidents Violence/Conflict CC Index 0.236 0.259 0.317 0.385 0.403 0.410 0.414 Probability of Occurrence Most Likely Most Likely Most Likely Most Likely Most Likely More Likely More Likely Rank 1 2 3 4 5 6 7

Table 23: Major hazards - Gaza Strip Hazards Water Shortage Political Related Events Vehicles/Traffic Accidents CC Index 0.407 0.392 0.419 Probability of occurrence Most Likely More Likely More Likely Rank 1 2 3

The Most Likely Occurring Events/Hazards
The findings of this study through the quantitative tool are shown in the following tables in which the most likely occurring events are sorted and presented in order of perceived probability to occur in the West Bank and Gaza Strip. The graded categories of 'most likely', 'more likely' and 'likely' are grouped together in discussion under the one group of 'likely' to occur by the communities concerned. ‘Unlikely’ and ‘cannot predict’ are also grouped together. Some connection of these quantitative findings is discussed in relation to information gathered in the qualitative interviews, focus groups, children's artwork and data collection.

West Bank In the above chart (figure 7) 82% of the community study predicted water shortage in Palestine, 4% didn't or couldn't predict its occurrence and 5% of the community predicted it to be a sudden occurrence. Palestinian cities are subjected to water shortage more than villages and camps. This is because the rural areas have wells, rain, ground water and springs whereas the cities are totally dependent upon mains water networks under the control of the Israeli authorities. The southern governorates are subjected to greater water shortages than the northern governorates. This is partly due to the fact that the Israeli controlled water nets distribute the largest amounts of water to the Israeli Settlements, with very little reaching the Palestinian areas. This results in insufficient supplies for the needs of the Palestinian community in the south. The Israeli authorities also cut off the mains supply in the event of other disasters, such as the threat of epidemic outbreak or famine. The current political events in the Middle East add to the water problem precisely because the Israeli authorities are in total control of it. This is supported by the literature presented in chapter 3.1,3,4,5 through the focus groups, the community considers water shortage the main hazard that threatens, first Gaza, and second, the West Bank.

Figure 7 Water Shortages - West Bank
    

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Vulnerability & Capacity Assessment

Figure 8 Political Events - West Bank
   

81% of the community study predicted the occurrence of traffic accidents in Palestine. 7% couldn't or didn't predict it and 13% considered sudden occurrences. This is shown in figure 9. The high proportion of the community considering road accidents likely, is supported by statistics which also indicate that 13.8% of deaths among adolescents is due to accidents.34 Predictability of this hazard in the Palestinian camps was much higher than in cities and villages. This may be due to geographical location in terms of limited space and overpopulation13, use of large cars through narrow roads, which are poorly visible to drivers. In addition, there is poor traffic lighting in the camp areas, identified by the local communities in these areas. Predictability was highest in the West Bank and it was ranked as the fourth main hazard there, due to the geographical layout of the northern governorates. Its open areas and wide spaces give motorists the opportunity of travelling at high speeds when travelling long distances, resulting in serious accidents. The roads of Jericho, Nablus, Jenin, Jerusalem and Tulkarem in particular, are at the risk of these accidents. This may also be exacerbated by the fact that the only form of public transportation is on the roads.17 The study of the communities in the southern governorates indicates that road accidents are greater than the north, through the results that showed a ranking of the sixth greatest hazard in these areas. The predictability of car crash occurrences in the Southern Governorates is due, among other reasons, to the lack of traffic lights and road signs, according to local opinion. Gaza Strip The results show that there are more events\hazards that are most likely to occur in the Gaza Strip, where seven are identified, than in the West Bank, where three are identified. Figures 10 to 16 present these seven ‘most likely’ hazards in order of perceived probability to be a problem, According to the Gaza community. Figure 10 Water Shortages - Gaza Strip
    

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VXGGHQXQSUHGL.WDEOH

Figure 8 shows that 68% of the study community predicted the occurrence of political events in Palestine. 14% did not or could not predict it and 12% opted for sudden occurrence of these events. It was considered that Palestinian cities were more subject to the occurrence of political events than the villages and camps, although there is not a great difference between them. This may be due of the fact that city communities are distinguished by their openness and strong opinions. The rise in the predictability of political events is in Palestinian areas is directly linked with the political problems surrounding the Israeli Occupation. In addition, the rise in predictability of the occurrence of political events, is linked to the reality of a high number of occurrences on a daily basis, in urban areas. The high number of people considering the likely is consistent with experience and is well documented in the literature.21,24,25 Predictability of occurrences is higher in the southern governorates than in the north. This is due to the greater political and economic restrictions in the south. These lead to fierce protests and strikes because the inhabitants are losing the requirements for living, they are loosing jobs and freedom of movement. Pressures and political provocations occur especially in the presence of difficulties at the Erez Crossing Point, which places a significant obstacle in the face of the Gaza inhabitants. Political events in the southern governorates are considered the second leading hazard after water shortage, and a primary hazard in the northern governorates. Figure 9 Vehicles & Traffic Accidents - West Bank
    

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In the above chart (figure 10), 90% of the community study predicted water shortage in Palestine, 4% didn't or couldn't predict its occurrence, and 5% of the community predicted it to be a sudden occurrence. There is a close correlation with the results in the West Bank with an 8% higher result for likelihood of occurrence. Similar commentary is appropriate for Gaza as it is for the West Bank, and qualitative findings are supported by the literature.1,3,4,5 Figure3 11 Politically Related Events - Gaza Strip
   

The danger is greater in the Palestinian camps than in cities or villages due to the collapse of the sewage network. In addition, this population depends on absorption holes, which weaken the constructions and the soil, which forms a serious risk to individuals6. Further hazards connected with open sewage are the risk of epidemics and the pollution of drinking water. These ideas are consistent with qualitative commentaries relating to food poisoning and pollution identified with figures 13 and 14. The situation is exacerbated by the increase in Palestinian camps and populations, which lack water and sanitation networks. In winter, inhabitants often dispose of sanitation in the camps and in case of drought, they use contaminated water for plant irrigation. Disaster related to open sewage ranked third most likely among the communities of the northern and southern governorates in Palestine and there is ample literature to support opinions1,3,5,6,15. Figure 13 Water and Sea Pollution - Gaza Strip
    

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VXGGHQXQSUHGL.WDEOH

As shown in figure 11 above, 83% of the community study predicted the occurrence of political events in Palestine. 8% did not or could not predict it, and 9% opted for sudden occurrence of these events. This represents a 15% higher community prediction of these events than in the West Bank and appears consistent with the dense population and potentially greater tensions. This is consistent with findings in Figure 12 and its commentary along with abundant literature.21,24,25 The commentary included for this hazard in the West Bank also applies in the Gaza area. Figure 12 Open Sewage - Gaza Strip
8% 46% 3% 1% 21%

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Figure 13 indicates that 88% of the community study predicted the occurrence of disaster related to water and sea pollution with only 7% who did not or could not predict it. 5% saw it as a sudden occurrence. The predictability of the occurrence of water and sea pollution was much higher in the camps than in the villages and cities. This is due to the lack of infrastructure within the camps with reference to health and hygiene. In addition, the shortage of water leads people to store water in wells and water tanks for long periods of time as well as use the same sources for drinking and household needs.1,3,15 This hazard is ranked sixth most likely by the Palestinian community. They suggested that such a hazard is increased by the fact that the sewage and waste from Israeli Settlements is disposed of in the western areas and in rivers and swamps, which surround the Palestinian, populated areas. Due to the location of high numbers of Settlements in the Southern areas, and the disposing of their wastes this way, pollution is much greater than in the north. Sewage wastes disposed of

21% can not predict likely most likely unlikely more likely sudden/unpredictable

In figure 12 above, 86% of the community study predicted the occurrence of a disaster from open sewage in Palestine. 4% did not or could not predict it and 8% expected a sudden occurrence of problems related to this.

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Vulnerability & Capacity Assessment

from the Israeli sewage networks in the Gaza Sea also increases the pollution of water and sea, which also results in the death of fish. Figure 14 Food Poisoning - Gaza strip
    

Figure 15 indicates that 86% of the community study predicted traffic accidents and 7% did not or could not predict it. 5% predicted such events to occur suddenly. The commentary presented regarding the West Bank, is also applicable in Gaza, with the main north-south road being a hazard for high speeds and death rates among adolescents in particular. This is highlighted in literature34. Figure 16 Violence and Conflict - Gaza Strip
  



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In figure 14 above, 90% of the community predicted the occurrence of food poisoning. 6% did not or could not predict it, and 4% considered that it would occur suddenly. The predictability of food poisoning occurrence is higher in the cities than in villages and camps, because the study sample indicated, that food poisoning in the southern governorates is higher than in the northern ones. The complexity of the procedures for importing food products in the south, result in old foodstuffs being bought by the community. In addition to this, the collapse of the sewage system and prevalence of mosquitoes complicates this problem. There is also an absence of control for food storage and warehousing. The fact that local farmers also resort to using open sewage for irrigation, is another cause of potential food contamination. and high The high population density in cities dependence on canned food, is also a factor that may lead to food poisoning, and it is urged that the Ministry of Supplies takes a lead role in inspecting and controlling food materials, by the enforcement of laws for merchants and warehouses. Figure 15 Vehicle Accidents - Gaza Strip
    
7,8,12,13

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Relating to table 16 shown above, 72% of the community predicted the occurrence of violence accidents in Palestine and 16% did not or could not predict it. 12% predicted that such events would occur suddenly. Predictability of this was greater in the cities than in the villages, due to increasing internal migration to the cities by village inhabitants and camps in the north and south, for the purposes of finding work and study. The political, psychological and economical pressures imposed by the Israeli authorities on Palestinian areas, plays a significant part on the psychological state of the community. The frustration of being deprived of their rights leads to tension, whereby individuals may take their anger out on each other. Violence is predicted to be higher in the north due to overpopulation in the refugee camps, along with the psychological and economical pressures of occupation.

Other Hazards Predicted by the Community Focus Groups
Floods 44% of the community predicted the occurrence of floods and 56% did not or could not predict it. The communities study in the camps predicted a higher likelihood of occurrence, due to the geographical layout, and the lack of sanitation nets. It was predicted that such occurrences were more likely in the northern areas where there are plains rather than

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Recommendations

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in the south. There is also a lack of experience in dealing with floods. Snowstorms 34% of the community predicted the occurrence of snowstorms as a hazard, whereas 42% did not know or could not predict it. 14% predicted the sudden occurrence in the northern and southern governorates. 29% predicted sudden occurrence of these events. There is a higher predictability of occurrence of snowstorms in the West bank Camps than in the cities and villages. This can create a greater danger because of constructions, overpopulation and lack of health and social services. In addition, dangers exist from cars having difficulty in manoeuvring narrow internal streets in bad weather. The lack of occurrence of snowstorms in Gaza is due to the semi-desert geographical climate of the Strip, which prevents their occurrence. Epidemics 54% of the community predicted the occurrence of diseases and epidemics. 40% did not or could not predict it and 6% predicted sudden onset. The predictability of epidemics in camps is higher than in villages and cities of both the West bank and Gaza, due to the geographical nature of the area and overpopulation7,8,12,13, which facilitates the spreading of disease among people. The collapse of internal sewage networks and the tendency to dispose of waste in the streets, also adds to the risks in camps. The increase in numbers of camps, lack of health and social services17, is also a factor, along with the Israeli Settlements whose waste contaminates the camp areas. The social conditions also encourage disease-carrying hosts, such as mosquitoes and insects. This is supported by MOH literature, indicating a prevalence of gastroenteritis and parasitic disease in camps34. The closing down of access to areas in Gaza, also limits the availability and supply of medicines needed by the local community, in the event of disease outbreaks and prevention.

Famine 56% of the community predicted the occurrence of famine in Palestine, 33% did not know or was unable to predict it, and 11% predicted sudden onset. The groups most likely to famine in Palestinian camps, due to the limited geographical space and over-population. Few inhabitants own land, and water shortages lead to the damage and death of crops9,10,11. The occurrence is likely to affect the southern governorates more than the ones in the north, due to the sandy nature of the soil, which is not suitable for growing. The cutting off of water supplies for long periods and the predominantly salty water leads to the death of crops. Death of cultivated crops and trees is also caused by the waste and sewage disposal from the Israeli Settlements. Southern governorates are also more at risk due to political and economic restraints from all sides, which disrupts the importing and exporting process, resulting in damage and loss. Earthquakes 28% of the community predicted earthquake in Palestine, and 10% did not or could not predict it. 63% indicated that its occurrence would be sudden and difficult to predict. These results correlate well with the literature on locations of high risk, outside the Gaza area19,20. The risk to cities is considered higher than two villages and camps, due to the increasing construction of buildings and high-rise towers, which present greater damage potential and mortality. It is considered that the areas of greatest risk in this respect are Nablus, Jericho, Gaza and Jerusalem. Predictability of disaster is greater in the south than in the north, due to the geographical considerations. The likelihood of sudden occurrence provides great concern for human and material losses, due to lack of preparedness for the event. There is an increasing number of high buildings that are being constructed, and there is an urgent need to ensure that proper building codes are enforced. Earthquakes have an obvious correlation between unpredictability and the likelihood of sudden occurrence.

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Recommendations

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Chapter 5

Children and Youth

This study is the first to acknowledge the importance of consulting children and youth within disaster preparedness, by including them in the sample group of a vulnerability and capacity study. In September 2001, the United Nations General Assembly's Special Session on Children will meet, and the outcome is likely to shape the lives of children and adolescents throughout the world35. It is, therefore, fortuitous that the PRCS has pre-empted this with its VCA study, that truly seeks to include its young people within disaster preparedness for the future. Related to this, it is appropriate in this chapter to include a statement made by the Secretary-General of the United Nations, which epitomises the importance of involving young people in important decision-making: "I see the light in your eyes, the energy of your bodies and the hope that is in your spirit. I know it is you, and not I, who will make the future. It is you, not I, who will fix our wrongs and will carry forward all that is right with the world".35 Adults in a society may often not seriously consider the ideas of children and young people because they feel that they are to be 'controlled' and 'protected in such matters'. Additionally, their perceived lack of experience in the 'real world' may generate assumptions that they can't possibly understand. It is particularly interesting, therefore, to review the insightful ideas of young Palestinians, about how they consider disaster should be faced, when it occurs. The involvement of children within Palestinian society is supported by government policy in advocating children's rights. Information and awareness is stated to be based upon the principle that the child is a complete person and citizen with rights, duties and responsibilities39. Furthermore, the policy advocates for children to become involved in issues that are of relevance to their lives and well-being. This in itself supports the idea of Palestinian children being involved in planning, related to dealing with disaster in their community. Sixteen percent of the sample distribution within the methodology employed, was specifically from children and young people aged between 6 years and 19 years. Eight Focus Groups were held in this group, which consisted of five in the West Bank and 3 in Gaza, involving a total of 113 children and youth. The geographical location was determined through convenience situated at the sites of Youth Summer Camps in the West bank and Gaza. Participants were recruited from the summer camps, with the consent of their parents and the children themselves. Particular care was taken to deal sensitively with young people with no pressure applied to participate, and the consent of parents was obtained. Within this chapter the qualitative data emerging from the focus group interviews is presented in tables with some observations and commentary. Since the methodology with the children and youth included the use of drawings, these will also be considered. 83 drawings were reviewed in this study as a sample of ideas

59

about disaster and disaster preparedness, presented through pictures. The qualitative data relating to some of these drawings, can be reviewed in appendices 14 and 15. Some discussion of the data, along with examples of drawings, is included within this chapter. The sample of drawings commented upon in the appendices, originate primarily from the West Bank with the vast majority from children living in Nablus. Twelve out of thirty six drawings (33%) of Nablus children's

pictures depicted war or conflict as a disaster (figure 17). This correlates with the findings among adults in the West Bank, in the quantitative data, where conflict is seen as the second most important disaster. It may indicate a significant pre-occupation of children in Nablus and their frequent exposure to scenes of clashes. Drawings in the preparedness category also included ideas about preparedness relating to war, clashes and conflict. Interestingly, drawings from Ramallah children (although less of them) did not depict violence.

Nablus
Age 14 Years

Disaster & Preparedness
Conflict Floods

The drawing depicts three ideas, from top to bottom, of people fighting, floods and the things the child perceives that need to be done and to be prepared

Figure 17

Children's Drawings
Fifteen percent of Nablus children identified car accidents as disaster in the artwork, and whilst drawings relating to cars were not found in the preparedness categories, emergency and hospital services were. Within the adult results, car accidents were also identified as a current problem in the West Bank. In terms of preparedness in the Gaza Strip, hospitals and the EMS were identified.

Pollution was represented as a disaster with both Nablus and Ramallah children, particularly with reference to air pollution and the roles of factories (figure 18) in creating the problem. Destruction of the environment and the effects of chemical waste (figure 19) were also depicted. Disaster preparedness showed reference to pollution.

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Nablus
Age 17 years

Disaster
Air and Water Pollution The drawing describes what this adolescent considers a disaster, that affects society

Figure 18

Nablus
Age 19 Years

Disaster
Fires, Chemical Waste Floods

Destruction of the Environment

Figure 19

Natural disaster was well represented both in Nablus and Ramallah, though interestingly as Volcanoes, which are not a threat in this region (figure 20). None of the preparedness categories refers to such events. It would

appear that the internal representation of a volcano might generalize for natural events. Concern about the environment was identified in these drawings, about the environment.

Discussion and Outcomes

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Ramallah
Age 6 years Natural Disaster depicted in the form of a Volcano and the environment Figure 20

It is interesting that none of the drawings reviewed in this sample depicted water shortage or drought, though they depict floods and forest fires. Conversely, drought is considered the primary existing problem in the adult quantitative data results. There is, however, correlation with fire and floods.

Preparedness drawings depict opinions among children that awareness is an important component of preparing for disaster, including the use of schools, media and the community to do this (figure 21). In addition, the idea of cooperation, coordination, EMS and hospitals is also represented. Other areas identified for preparedness show floods, war pollution and drought.

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Ramallah
Age 12 years

Preparedness
Television, Local Council, School awareness campaigns, water wells Figure 21

Discussion and Outcomes

63

Table 24: Children's Data How will disaster affect children? -Unable to respond to the event -Kidnapping -Burns -Lack of education -Pain, fear and anxiety -Swallowing difficulties -Lack of immunity -Misbehaviour -Few capacities -Breakdown in health -Poisoning with medicines -Displacement of people -Deformity -Accidents -Unconsciousness -Paralysis -Disease -Fractures -Vaccinating against disease -Conducting first aid -Availing of medical supplies -Quick rescuing -Resolving problems -Making oxygen available -Training for rescue/ first aid -Meeting shortages in basic services -Supplying electricity and budgeting Children identify a range of effects of disaster 'on them' (Table 24), including physical problems and security. Of interest, particular, is the idea of not being able to respond appropriately. In educational theory, this relates to the fact that people do not learn, unless they have the realization of 'not knowing how to respond'33. Their ideas of the role of the community (Table 24) in the aftermath of disaster, are both comprehensive and insightful. They include themes of cooperation, coordination, problem solving and education. Cooperation, communication, awareness and training are the main themes, in ideas for prevention of disaster and very valid comments from any section of the society. Some ideas in the drawings of children with reference to natural disaster, imply an understanding of the cycle of events that may occur. It suggests an appreciation that there are not just sudden impact effects, but also associated consequences. In the picture below (figure 21), it is interesting that hospitals and emergency services are absent, and the environment is heavily depicted. This is consistent throughout the data, with an orientation wider than simply considering the immediate response to disaster. Role of the local community -Using the available possibilities -Building hospitals -Importing medicines -Planning and coordination between concerned parties -Collecting donations -Training youth and volunteers -Establishing earthquake-proof -Taking necessary precautions -Getting assistance -Building special centres for shelter -Making water available -Instructing people -Building shelters -Contacting institutions and media -Storing medicines -Increasing number of volunteers, engineers and labourers -Repairing demolished buildings -Monitoring the health situation How to prevent disaster after disaster -Setting rules -Making efforts to prevent life loss -Establishing a council in every city -Storing building materials -Awareness and instructing people -Training staff -Cooperating among individuals in facing disaster -Communicating with other countries -Collecting donations -Communicating with Chairman Arafat -Protecting children -Acquiring necessary equipment -Building shelters -Social monitoring -Finding substitute families for children -Communicating with media, sufficient doctors, medicines and supplies -Communicating with police, ambulance and fire services -Increasing social ties

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Ramallah
Age 13 Years

Disaster
Earthquake, Drought and Floods A representation in four stages ideas about the representation of these hazards to the child Figure 22 Table 25: Children's Data How will disaster affect the movement of people? -Breaking life routines -Confusion and fear -Death -Emigration -People not going out of homes -Poisoning people -Loss of family contact -Psychological shock -Lack of movement between people How will it affect the streets? -Soil cracking due to drought -Holes in the street -Remote areas -Lack of movement between people -No transportation -Unemployment How will it affect health services? -Spreading diseases -Demolishing hospitals -Lack of room for the injured -Lack of primary care -Shortage of medicines -Wounds -Fractures -Diseases -Psychological problems

Children's Data
The categories in table 25 indicate themes about psychosocial problems, the disruption of important family life with breakdown of local infrastructure. Health services are identified with a realization of primary care loss and psychological problems, in addition to acute injury. It suggests an awareness of the longer-term health problems of the community in which they live. Drawings in preparedness included the need to consider the supply of medical/ drug supplies ahead of disaster occurring (figure 22).

Ramallah
Age 13 Years

Preparedness
Need to ensure pharmacies have medicines accessible in all communities before disasters occur Figure 23

Discussion and Outcomes

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Table 26: Children's Data How will we face disaster when it occurs? -Coordinating between concerned parties using available capacities -Calling the police, fire, ambulance and municipality -Getting foodstuff -Resolving problems -Informing rescue service -Assisting the army -Being self dependent -Contacting media -Making building codes -Cooperating -Awareness campaigns -Finding shelters -Getting staff: health centres, doctors, nurses, shops etc -Giving Psychological support -Establishing committees to control crowds in disaster -Evacuating the injured -Using weapons correctly -Contacting organisations -Asking for help Role of local government ministry in disaster -Keeping people away from dangerous places -Making transport available Role of the Ministry of Health -Vaccinations

-Disseminating awareness -In the community -Forming committees to monitor chaos -Informing concerned parties -Assisting citizens -Solving problems -Facilitating individual movements -Training people -Supporting municipalities -Getting modern equipment -Collecting donations

-Availing hospitals, trained staff, health insurance, medicines -Increasing PHC's -Training in first aid -Availing food and shelter -Preparing sheltering places -Attending to the needs of elderly -Helping the homeless and injured -Rehabilitating orphanages

In table 26, the key themes identified include the importance of coordination, cooperation, communication and 'making do' with existing resources. A central theme in many of the

categories in the tables of this chapter also highlights awareness campaigns and education as important which is also reflected in a number of drawings (figure 22).

Table 27: Children's Data Role of Ministry of Social Affairs Coordination with other ministries Health awareness First aid for emergencies Prevention Role of the Civil Defence Availing water Supplies: clothes and transportation Being at the site of disasters Rescuing people in disaster Providing protection Role of the Red Crescent Courses in First aid emergencies Assisting in fire extinguishing Taking care of the handicapped and deaf Collecting donations Availing immediate service Performing surgery Transporting the injured Immediate treatment of casualties Helping the poorth through rescue service

Children's perceptions of the role of ministries and specialized services were amazingly accurate, and again placed the importance of training, awareness and prevention within their remit (Table 28). Feedback

suggests that useful ideas have been communicated back to various institutions, which may otherwise have remained unseen by them.

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Table 28: Children's Data Role of Specialities Health work coordination Working according to specialties Building dams Conducting awareness courses Giving courses to people before disaster Volunteer training Defining places of earthquakes Providing protection How will disaster affect people? Changing life routines Encouraging love between people Backwardness Death How it will affect Youth Developing the spirit of belonging Lack of motivation Not attending courses Family problems Unemployment Carelessness Lack of awareness Shortage in nurses Lack of housing Misusing time

Table 29: Children's Data How will disaster affect electricity? Material losses Fires Breakdown of networks Electric cuts How will disaster affect water? Pollution Crops Damaged water supplies Shortage of water No water Role of cars Fire engines Ambulances Police Hospital transportation

The effects of disaster on the community are well documented, and the categories of the most vulnerable (Tables 28, 30 and 31) are consistent with data from the adults in this area. Socio-economic welfare is highlighted, along with realistic predictions about the

effects on each category. The effect on their homes (Table 30) is reminiscent of disaster related to conflict, which is consistent with the pre-occupation of this subject in the drawings from Nablus children.

Table 30: Children's data How will it affect houses? Demolition Explosion Material losses Burns Cracking of the soil due to drought Breaking windows How will it affect school students? Not going to school Closure of schools How will it affect the elderly? Death Lethargy Handicapped Inability to walk Lack of medicines Lack of mobility Laziness

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Table 31: Children's Data How will it affect men? Breathing inability Drowning Unemployment Difficulty in getting jobs Death Sickness Homelessness Headache Fractures Poor living standards How will it affect women? Having diseases Fatigue Weakness in body structure Polygamy Little capacities Abortion due to decision-making Lack of awareness Death Limited abilities Lack of experience How will it affect the handicapped? Burns Inability to escape Paralysis Increase in family members Inability to face events Wounded Lack of services Death No one to take care of them

Table 32: Children's Data General Preparedness Training staff Availing electricity Agriculture fields Society awareness Storing energy Water Hospitals Not to throw garbage Plans Defining needs Mobile first aid centres in remote areas Defining hazards Communication Availing weapons Storing equipment Clothing Availing stores First aid training for children, youth and girls Meetings for planning General Preparedness Forming committees Helping Arab countries Abiding by traffic law Availing phones Peace between countries Good planning for buildings Give people professions: electricians, blacksmiths, plumbers Connecting with others Training volunteers Building houses Rescuing people Availing gas Availing medicines Police Availing equipment Cooperation between institutes Cars General Preparedness Storing food Building shelters Availing fire engines Spreading awareness in the streets Taking donations from the rich Psychological services Stairs Building dams and tents

Discussion
Whilst this is a relatively small sample of the young people of Palestine, it presents a significant indication of the value of their contribution as members of the society. The findings correlate well to the expected hazards identified among the adult groups in Table 11, and the main hazards shown in Table 10. Approximately 24% highlighted conflict in both Nablus and Ramallah as disasters, though only 12% of the preparedness group identified this as a priority. It is concerning that young people identified 'availing weapons' within the category

of general preparedness, but it may be related to the prominence of the political situation and the idea of self preservation in a situation of war and conflict. Children's' ideas about what can be generally done as disaster preparedness are abundant, diverse and creative, as indicated in Table 32. They contain elements that are defined as important, in the five core areas of the International Federation's 'Sphere Project'36, relating to International Standards for Disaster. These are health, shelter, water & sanitation, and food & nutrition.

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Key themes include the importance of communication, cooperation and coordination. Interestingly, they include regional cooperation in disaster preparedness, recognizing a world extending beyond the boundaries of Palestine. Planning with reference to infrastructure and services is represented, and the provision of adequate emergency and health services including, psychological health. Again, training and awareness in preparedness are of central importance. Review of some of the ideas presented in appendices 14 and 15 relating to the drawings, show quite young children being amazingly insightful in putting forward ideas for preparedness. This correlates well to qualitative findings from the children's focus group interview data, which indicated even more creative thinking than their adult counterparts. Important findings from the children's groups were awarness, of the threats of disaster and their desire to be included with adults in preparedness activities. This is important because fifty per cent of the current population

is children and they represent one hundred per cent of the future Palestinian society39. Common themes throughout the children's interview data included the perceived importance of prevention, training, awareness, problem solving and cooperating with others. These are clear, internationally accepted directions, which are reflected in the Strategy 201037 and the World Disaster Report 200038, which places emphasis on disaster in public health and the need for prevention. Furthermore, review of the qualitative data also shows a remarkably wide and intelligent understanding of many of the issues involved. This perhaps counters ideas that children should not be shielded from such subjects as disaster and catastrophe. Indeed, it indicates that their ideas should be taken seriously, and that adults should accept them as part of the community disaster preparedness group, in line with recognition of children’s rights.

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Chapter 6

Recommendations

This chapter will review the recommendations emerging from this study, and propose projects for consideration to be undertaken by the PRCS. Recommendations, specifically raised by the Palestinian community, ministries, institutions and the Task Group, are shown in tables 34 - 39. The following list of recommendations is a general compilation of the opinions of all groups: T Promoting the role of PRCS and establishing centres for volunteering, especially among women and youth, in the field of community awareness. T Establishing community-based initiatives to strengthen infrastructures and DP in the home T Building confidence and bridging the gap between ministries, institutions and the communities that they serve. T Establishing disaster preparedness in the school curriculum, with creative learning strategies related to real life. T Creating trained human resources and developing existing capacities. T Utilizing Palestinian capacities within the state and abroad. T Establishing links and finding coordinating mechanisms, internationally. T Forming committees from all institutes and ministries, to work as an integrated team, to develop national disaster plans, and establish specialized legislation for disaster. T Defining roles and coordinating between agencies, sharing resources and expertise. T Establishing criteria for institutions, as indicators for action, before disaster occurs. T Defining the basic requirements for dealing with disasters, according to the type of events, before they happen. T Defining the role of the PRCS in Disaster preparedness, and response within refugee camps, and prepare the infrastructure. T Giving priority in development needs to remote and deprived areas, and to those that are on confrontation lines. T Providing centres for first aid and emergency institutes. T Strengthening the EMS system with more ambulance drivers. T Highlighting the role of the army and the media in disaster. T Highlighting the role of preventive health in the prevention of disease in disaster. T Ensuring the recommendations of this VCA study are followed up with action, by implementing projects addressed them.

Projects Highlighted as Recommendations for Action
Through the process of this research study, the combined input of all participants proposed Action Projects that could be considered, and which may assist in improving Disaster preparedness in Palestine. The projects that are presented in table 33 are divided into immediate and future implementation ones.

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Table 33 : Projects Proposed Through the Process of the Inquiry Project Training programmes in first-aid for local organisations Establishing a Disaster Management Department Building psychological Rehabilitation Centre Making community-Based Disaster Preparedness Volunteer Programme Developing Youth Volunteering in DP Developing Ambulances Providing mobile Field Hospitals Emergency Response Unit Development Improving Storage for Supplies and Equipment Increase available tents Devising children's clubs and DP child to child projects Organizing Summer and Winter Camps for DP Developing PHC's with disaster in mind Building Information, Media and Research Centre Launching community awareness campaigns Making Quality Improvement Programme Developing Communication Systems Now X X X X X X X X X X X X X X X Future X X X X X X X X X X X X

Table 34:General Recommendations of the Community Focus groups Community Focus Group Recommendations T Activating the role of the PRCS in the field of community awareness T Availing centres for first aid and emergency institutes T Promoting the establishment of emergency centres in the local community in the field of volunteering T Forming a committee from all institutes and ministries to work within one integrated team T Building confidence and bridging the gap between the official agencies and the people T Activating the role of the media in case of disaster T Paying attention to developing infrastructure projects in the home T Conducting, launching vaccination campaigns after disasters to prevent epidemics T Establishing national plans which enable people to handle and manage disasters T Following recommendations and delivering them to the concerned Table 35: Community Focus Group Recommendations for Pre-Disaster Phase Before Disaster T Forming national plans to enable people to deal with disasters and hazards T Activating the role of the Red Crescent and non-governmental institutes in community awareness T Working on activating the principle of voluntarism by governmental and non-governmental institutes T Forming a committee of all institutes and ministries to face a disaster and work as one Team T Establishing First Aid centres and emergency services in heavily populated areas Table 36: Community Focus Group Recommendations for Disaster Phase Disaster stage T Activating the role of the Media in case of disaster T Conducting vaccination campaigns after a disaster T Establishing emergency rooms in clubs and community institutes T Exchanging equipment between institutes T Coping with the prices of food and medications for the disaster needs

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Community Focus groups
Community recommendations concentrated their discussions on the stage before disaster, which focused on preparedness and the need to mitigate its severity. They also concentrated on the importance of coordination and cooperation at community and institutional levels considering it to be the best basis in preparedness for facing hazards and expected disaster. This correlates well with general preparedness ideas made by the children's groups, identified in table 32 of chapter 5. A significant realization of the community groups was that it is not possible for one party to face or overcome disasters. They concentrated on the capacities and

community resources that could be utilized during disaster. Furthermore, it was suggested that local community awareness and training could help in Disaster Preparedness, mitigating the effects, in addition to prevention. Again, these ideas are echoed in the children's section in chapter 5.

The Institutes recommendations
The institutes concentrated on the Disaster Preparedness process, because they realized that their individual infrastructure was not able to deal with disaster, and identified needs for cooperation and coordination at the highest levels. Some of their recommendations are summarized in table 37.

Table 37: Recommendations of Institutions Institution Recommendations T Establishing specialized legislation for disaster T Defining basic requirements for dealing with disaster according to the type of event T Coordinating between institutions and defining roles T Preparing infrastructure in refugee camps T Establishing criteria for institutions as indicators for action before the events occur. T Highlighting the role of the army in Disaster preparedness T Increasing the number of ambulance drivers T Sharing all resources in the various institutes for Disaster preparedness T Utilising State capacities and Palestinian capacities abroad. T Establishing trained human resources and developing the capacities of existing ones.

After studying the data it is apparent that the Palestinian institutions gave precedence in the area of Disaster preparedness. It also became clear that they do not have clear plans to deal with hazards, disaster and post disaster stages. They appear to be in a process of building infrastructure in terms of human and material resources,

and are, to some extent, related to the building of a Palestinian State. They recognize that they have limited experience in dealing with natural catastrophe, but acknowledge their experience in the difficulties of the political issues.

Table 38: Local Community Recommendations Community Recommendations T Putting DP within the school curriculums relating to the activities of every day life T Using other audio/visual mediums for children such as plays, drama and singing, which help in mitigating psychological traumas after a disaster. T Establishing an international coordination mechanism in case of disaster T Activating the role of volunteering in the society T Giving priority to the remote areas that lie on the lines of confrontation in conflict T Activating the role of The Palestine Red Crescent Society in case of community awareness

The Local community Recommendations:
Local community recommendations identified in table 28 are consistent with the ideas of coordination, cooperation and community awareness among others. They correlate well, as general themes, with the

information gathered from children's groups and the Task Groups themselves(table 39). The important DP directions suggested in the recommendations, relate well to the study of objectives and community-based initiatives, as one project emerging from this assessment.

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Table 39:Task Group Recommendations Task Group Team Recommendations T Defining the role of the PRCS in Camps before, during and after a disaster (reference to political situation) T Putting the remote and deprived areas that are situated on the confrontation line, as a priority for development T Finding an international coordination mechanism, in case of disasters T Activating the role of volunteering in the local community especially among women T Following the recommendations and delivering them to the concerned T Activating the role of the community in the field of community awareness T Sending notes of thanks to those helping in the focus groups

Strategies Recommended Employees as Outcomes of the Pre-VCA Workshops in the West Bank & Gaza
These strategies were developed from the workshops conducted for PRCS staff and were divided into the six main categories shown in table 40. Table 40: Strategies Recommended by PRCS Employees During Pre-VCA Workshops
Category Planning Suggested strategies
T Develop a special emergency plan for PRCS incorporated into a National Plan. T Establish and work with emergency committees in coordination with others concerned. T Participate in establishing an emergency committee in order to develop an emergency plan in which T T T T T T

Preparedness

T T T T T T T T T T T T T T T T T T T T T T T T

Training for Professionals

Establishment of Communication networks Awareness and Community Development

Emergency Unit (ERU)

T T

roles and responsibilities are defined. Prepare plans for each disaster. Establish working groups for each disaster. Provide necessary resources in order to meet the needs of emergency relief and infrastructure. Assess the existing needs, the current situation and capacities, in terms of materials, equipment and finance. Develop a specialized training initiative to train professionals in how to respond to hazards. Work and coordinate with specialized organizations to implement measures for safe earthquake buildings. Emergency and EMS: Provide necessary healthcare equipment to deal with the disaster. Add more ambulances to various parts of the country according to intensity of population. Build new healthcare centres to cover all parts of Palestine. Provide field hospitals and mobile clinics. Provide backup of medical supplies and storage. Provide backup of relief items and storage. Provide generators, tents and shelter. Establish training centres. Exchange scholarships with disaster experienced countries. Conduct training in first-aid, and training for women, children and the elderly in crisis situations. Provide mechanisms for psychological support to rescue teams. Develop existing communication networks. Train professionals in using communication systems. Establish centralised and de-centralised communication networks. PRCS participation in increasing the level of awareness in the community about disasters and their prevention. Organise and conduct promotional campaigns for the community, to meet the impact of disasters through brochures and information sheets about each disaster. Conduct an awareness campaign in the community to utilise the resources available. Establish a media plan in cooperation with other media organisations both internally and externally. Conduct a case study of injured people in a disaster, in order to conduct social and psychological programmes. Evaluate the socio-economic situation of the families in need. Cooperate and coordinate with "grass root" organisations based on the division of labour. Prepare a community guide on how local committees could be established in refugee camps, villages and cities. Establish community communication systems to evaluate the situation for the intervention and utilization of committee resources. Establish a group in each profession and specialization related to hazards and disasters, for rapid Response intervention. Prepare an on-going training programme for each ERU member.

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These strategies were developed prior to conducting the qualitative interviews of the main VCA study and indicate a correlation between the key issues in all

recommendations and the major findings categories. Such correlation adds to the validity of the findings of the study and is shown in Table 41.

Table 41: A Comparison of the Main Categories of Various Group Recommendations and the Main Categories of the Study Findings
Major Findings Categories Community Focus Groups Vulnerabilities, Hazards & Disaster Activating the role of the media in case of disaster Communities Develop DP through schools Coordination & Cooperation National coordination. Bridging the gap between the official agencies and the people. Following recommendations and delivering them to the concerned Capacities & Preparedness Increasing the diversity of learning media. Availing centres for first aid and emergency institutes Vaccination campaigns after disasters to prevent epidemics Giving priority to the remote areas that lie on the lines of confrontation in conflict.

Develop volunteering Developing infrastructure projects in the home. Promote role of PRCS in community awareness Institutions Legislation for DP Preparing infrastructure in refugee camps Develop role of PRCS in awareness Give priority to remote areas in development

Establishing indicators Coordinating between institutions and defining roles Sharing resources with others

Defining basic requirements Highlight the role of the army in DP

Utilizing state and international capacities Increase ambulance staff Human resource development

Task Group

Defining the roles of PRCS

Activating the role of volunteers

Activating the role of PRCS in community awareness Priority in development to remote areas

Finding an international coordinating mechanism in disaster. Recognise those helping in the focus groups by letters of thanks. Defining the role of the PRCS in Camps before during and after a disaster (reference to political situation)

Pre-VCA Workshops categories

Planning

Community Awareness & Development

Communications

PreparednessTraining & ERU

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Chapter 7

The Impact of the Study on Children, Local Community, Institutions, Task Group and PRCS

Impact of the Study
From the very beginning of the work of this study, there have been positive impacts. These include the interest of PRCS workers and the participation of the various departments such as ambulance, emergency, planning, rehabilitation and primary care. Externally, the interest and cooperation of the various ministries and institutions, such as IFRC and UNICEF, have had a very positive impact through relationships developed within the Steering Committee. Commitment and dedication have had a good deal to do with reaching realistic outcomes in the study.

understand the preconceived ideas of their communities.

Influence of the Study on Ministries and Institutions
Governmental and non-governmental organizations acknowledged the importance of the study and cooperated with the interviews conducted. Their cooperation and involvement throughout, has affected their own definition of their own roles, and has opened the way for future coordination and cooperation in programmes they may be implementing. Great interest was shown in evaluating the outcomes of this study and in joint participation in the National DP Conference that will follow on from it. There was complete readiness from all concerned to play their various roles in cooperation towards the goal of National Planning.

Impact of the Study on Children
The study has had an important impact on the children of the community through the interaction of the unstructured workshops. It has created a feeling that children have an important role in determining what the disasters are, and they are being involved in preventing and mitigating their effects. It has also given them a chance to talk about hazards in their own environments that may affect them in the future. Children's' participation in what is usually perceived as an adult subject is unique, and strengthens the outcomes of the study. It involves them in potential programmes of DP and Community-based initiatives. Whilst children are classed as a vulnerable group affected by most disasters, it has also identified them as an important resource in DP programme planning.

Influence of the Study on the PRCS
Great impact and value was borne out of this study. It made PRCS workers examine their capacities and those of other agencies in the field of Disaster Preparedness. The process of the study has facilitated support for the Society's strategy of cooperation and coordination, in all stages of disaster with local, government and nongovernmental establishments. Furthermore, the success in achieving cooperative working arrangements inside the country has indicated that the Society may also effectively participate in Regional DP Planning with SARCS and JRCS. To this end, a preparatory three Country Society meeting was held, in which the path was set for coordinating regional work, exchanging of experience and future planning. The interaction with Ministries and the community stimulated requests for first aid courses and communitybased training for disaster. The study spearheaded by the Society greatly raised its profile and standing in the National Interagency Palestinian Community, and is considered a start for strategic planning and an analysis for disaster studies. The PRCS has participated in a national achievement in disaster preparedness through this study, and it underlines the role and the importance of cooperative working with Ministries, Institutions and the community, in the field of Disaster Preparedness.

Influence of the Study on the Local Community
The involvement of wide cross sections of communities from cities, villages and refugee camps in the research work with the Task Group has had a great impact. It validates the assessment process by really showing what the Palestinian people think and it has identified the intense interest that they have, in being part of the DP process in their own country. The study has also raised awareness throughout the country, considerably about preparedness, and has llowed a review of available capacities. It has created a realization among the community that they may have direct coordination with various establishments and may be practically involved. A greater awareness of the role and function of the PRCS has been achieved along with the PRCS as being able to

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Chapter 8

Discussion and Outcomes

The Study in Palestine has facilitated much more than the product, which was to address the objectives of the research. It has provided an Action research study in the form of Participatory Learning and Action, in which a model has been crafted for potential use throughout the region. A flexible process model of Vulnerability and Capacity Assessment is now available, which can be refined into a shorter and more cost effective assessment framework, for other National Societies to use. Initial VCA Workshops that were designed and conducted as a preliminary part of this study and the data analysed incomplete. There is an interesting correlation between this and the main VCA study. Generally, there are similarities in the following categories: T Vulnerabilities T Expected hazards T Major Findings T Future projects for preparedness T Importance of volunteers T Recommendations The purpose of this study was to identify the role of the PRCS in disaster preparedness, to advocate for a National Disaster Plan. Some discussion is therefore appropriate, regarding the extent to which this study has addressed these issues.

The Role of the PRCS in Disaster Preparedness
The emergence of the role of the PRCS disaster preparedness has come out of an appreciation of the perceptions of the community, other agencies and above all, the National Society, through the important learning gained through its nominated Task Group. In the past, priorities in terms of emergencies were related more to dealing with major emergencies, through its EMS system and sudden onset disasters, such as earthquakes. The data and the resultant major findings have acknowledged, that disaster is far more varied. It very much includes current events, which also constitute disaster in the eyes of the Palestinian people. An important recommendation is related to this important new learning, in recognizing the Society's need to extend its own training in preparedness and response. This is necessary to develop capacities in rescue, first-aid, shelter, water & sanitation issues in a different way, because catastrophe is different to an emergency. Additionally, catastrophe has been found to be relative including slow and sudden-onset anomalies. This has been recognised in the Societie’s recommendation to create a Disaster Management Centre, which will coordinate disaster preparedness initiatives consistent with the findings of this study. In terms of developing this project, it is useful that there is an already well-established EMS network and community health programme, on which the new vision of disaster preparedness can be built.

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Perhaps the most important lesson learned in this study is that the greatest asset of the PRCS is the community itself, and that disaster preparedness initiatives need to be developed at community level. Linked with the primary health outlets, opportunities exist in which disaster preparedness and health in the community can become an integrated programme. Community-based DP focus groups need to be actively involved in the design and content of these, as the concept of vulnerability and capacity assessment, becomes part of the process rather than a completed product.

facilitated by the Steering Committee involvement, have also highlighted this. There is a National Committee for the management of Emergencies, which serves a mainly reactive rather than proactive role. It currently involves cooperation between the Civil Defence, the PRCS, Ministry of Health and military medical services. It does not involve many of the key facets, identified as important by all the people and organisations participating in this study. The serious interest of members of the Steering Committee of this VCA underpins the importance with which the study is perceived, and the will to create a national plan. The structure for a National Emergency Committee shown below in figure 24 appears to reflect the ideas of the Palestinian people for future directions in designing a national emergency committee. Whilst this incorporates the idea of cooperative and integrated operation, it will be for a National DP Forum to work together to agree upon the exact nature of a national committee, as part of the quest for the establishment of a National Disaster Plan.

Advocating for a National Disaster Plan
Perhaps the most difficult part in achieving this is in defining clear roles and responsibilities of all players, and then coordinating them in an efficient manner. The most significant role of the PRCS in disaster discovered vividly in this study, is the need to go forward in preparedness cooperatively, and in partnership with other agencies. This is borne out in data from all sections of the community. In addition, the working relationships

Figure 24: Potential Structure of a National Committee for Disaster

An interesting observation within this study was the 'gap' between the ideas generated from the communities and the Ministry/Institutions that can serve as useful baselines, from which the national plan can be developed. Of unique value the information from the children/youth group which provides such a planning group, with rich and interesting ideas. The impact of the study on all concerned sectors has facilitated enlightenment about each other's functions, and shared hitherto unrecognised possibilities for all, in developing future plans. This is powerful because it is

likely that the eventual national plan will now allow this 'new view of reality' to modify and integrate individual emergency plans, which might previously have not considered the important needs of the communities we serve. This VCA study has facilitated process of thinking as a philosophy for disaster preparedness in the PRCS. Importantly, it has empowered PRCS employees to become dynamic action researchers, where partners and community have become united in Participatory Learning and Action for the future.

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References
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32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47.

Thelan M (1960) "Education and the Human Quest", Harper Row. Joyce & Weill M (1986) "Models of Teaching", London: Prentice Hall. Ministry of Health (1998) "Annual Report", Palestinian National Authority UNICEF(2000) "The State of the World's Children 200, United Nations Children's Fund, New York McConnon I (2000) (Ed), "Humanitarian Charter and Minimum Standards in Disaster Response", The Sphere Project, Oxfam Publishing: England IFRC (1999) "Strategy 2010", International Federation of the Red Cross & Red Crescent Societies, Geneva. IFRC (2000) "World Disasters report 2000", International Federation of the Red Cross & Red Crescent Societies, Geneva Ministry of Planning & International Cooperation (1999) "National Plan of Action for Palestinian Children", Secretariat for the NPAPC, El Bireh, Weisberg Hammond et al Rubin H & Rubin I (1995) "Qualitative Interviewing: the Art of Hearing Data", Sage: England Brennan J (1992) "Mixing Methods: Qualitative and Quantitative Research", Avebury: England Merriam S B & Simpson E (1995) "A Guide to Research for Educators and Trainers of Adults", Malabar: Florida Jarvis P (1999) "The Practitioner-Researcher: Developing Theory for Practice", Jossey Bass: California IFRC (1999) "Vulnerability and Capacity Assessment" International Federation of the Red Cross & Red Crescent Societies, Geneva Baskett P & Weller R (1988) "Medicine for Disasters", Butterworth Ltd: England

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Appendix 1
Consulted Ministries and Institutions
T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T Water Resources Department Electricity Generating Department Public Labour Department Pecdar Institute Ministry of Supplies Ministry of Social Affairs Radio & Television Board Ramallah & El-Bireh Governorate Ministry of Education Ministry of Interior Ministry of Labour Ministry of Industry Ministry of Local Governance Palestinian Health Council Red Crescent Society Minstry of Education Ministry of Agriculture Ministry of Finance Research Institute Earth and Earthquakes Sciences Saving the Land institute International Movement for Defending Children UNRAWA Rescue Ministry of Industry Ministry of Environmental Affairs ICRC Swiss Rescue Agency Anera Institute Civil Defence Ministry of Industry Governance Ministry of Supplies Ministry of Energy

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Appendix 2
Persons Interviewed from Ministries and Institutions
No 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 Name Omer Awwad Ghaleb Al-Shanti Faisel Farahat Mutasem Amoose Mohammed Eshteetah Waleed Al- Tameemi Abdullah Al- Horanee Ena'm Sha'ban Mu'en Ansawi Fawaz Droobe Tameem AbdulRahem Safe Seed Ghazi Atone Housein Al Natoor Hekmat Al Agourie Hussar Tarawa Mohammed Al- Remain Walled Hawaii Adulate Al- Afire Dr. Jade Shaw Jalap Al-Dabbed Ali Al She'd Masher Abu Dinah Eyed Abu Quotes Mohammed Al Ode Mohammed Safe Ream Meddle Manhood Halide Mohammed Al Thumbnail Nasser Al Behaves Martin Hahn Nadir Fran sees Ameerah Barham Adnan Obeedat Saleh Zeedan Mahmoud Khalid Dr. Ezat Ayoob Basheer Shaban Dr. Fawzi Hasooneh Hossam Al Sharkawi Greta Van Leche Dr Ali Shah Faritaz Forliq Faisal Freehat Motassim Amouse Occupation/Institute Manager/ Water and Planning Resources Department Manager/ Electricity Generating Department, Ramallah Ministry of Transportation Ministry of Public Labour Manager/Pecdar Manager/ Ministry of Supplies, Ramallah Manager/ Ministry of Affairs Manager/ Radio & Television Relations Ramallah & El-Bireh Governorate Ministry and Education Director Manager/Ministry of Interior Manager/Ministry of Labour Manager/Ministry of Industry Ministry of Local Governance Palestinian Health Council PRCS/Media Unit Ministry of Education Ministry of Agriculture Manager/ Finance Department Manager/ Research Institute Earth and Earthquakes Sciences Centre Saving the Land Institute Refugees Studies Centre International Movement for Defending Children UNRAWA Medical Relief Services Medical Relief Services Manager/ Ministry of industry Ministry of Environmental Affairs Ministry of Environmental Affairs ICRC Swiss Rescue Agency Swiss Rescue Agency Manager/ Anera Institute Civil Defence Ministry of Industry, Industrial Security Manager/ Ramallah Governorate Ministry of Supplies Ministry of Power PRCS Save the Children Save the Children Swedish Organisation for Cooperation and Development Ministry of Works Ministry of Works

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Appendix 3
Steering Committee Members
No 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Name Dr Baseem Remawi Sami Mustaklin Graham Betts-Symonds Dr Haakon Aars Per Allen Olsen Siri Guy Mohamed Bertrand Bainnvel Younis Al Khatib AbdelQader Abu Awad Randa Hamed Magida Awashreh Khowla Abu Khaleel Laila Moqdaadi Mohamed Abu Eishah Dr Mohamed Oddeh Dr Mohamed Awadeh Hassan Basharat Peter Bult Organisation Ministry of Health Civil Defence DP Consultant IFRC Health Delegate IFRC Federation Representative IFRC UNRWA UNICEF PRCS President Task Group Leader, PRCS Task Group Member Planning Department Ministry of Local Government Ministry of Local Government Ministry of Social Welfare UNRWA Task Group Member Task Group Member UNICEF

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Appendix 4
Community Focus Group Interview Guideline Questions
1. Arrange the hazards that are in the attached list (appendix 6), which according to your point of view may threaten the safety of you, others and the community in general (Property, Economy, Agriculture, infrastructure). What are the expected hazards? 2. Who is the most vulnerable to these disasters in your opinion? 3. How can disaster influence the Local Community as a whole? 4. What are the available capacities and resources in the community for Disaster Preparedness when it occurs? 5. How would you face the disaster if it happened? 6. In your opinion, - What are the main requirements for DP prior to the occurrence? - What needs to be done to avoid its occurrence? 7. How do you perceive the role of the local community in rebuilding after the event of disaster in the long term? 8. What is the role of Ministries and NGO'S in Disaster Preparedness?

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Appendix 5
Record Sheet for Participant in Focus Group Discussions
Facilitator: Date: Group: Local Community No Name Service Providers Occupation Age Sex Male/Female

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87

Appendix 6
Common Guidelines Agreed For Facilitators Working With a Focus Group
T T T T T T T T T T T Session timing: an hour and a half (90 minutes mostly) One facilitator runs the session The reporter writes down the notes by using the assigned form Number of participants ranges from 10-15 Seating has to be in a semi-circle shape (open circle) The room has to be closed, no photos or smoking is allowed No exit or entrance after the beginning of the session Involving every body in the discussions in a friendly atmosphere Neutrality, not to show opinion of what is being discussed Facilitating the discussion to ensure all guideline points are covered Focus group attendance record form, to be filled by the participants in the end of the session.

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Appendix 7
Summary Form for Completion by the Facilitator Immediately Following Focus Group Interview Session
Date: _______________ Governorate: _______________

Working Team Names: 1. ________________ 2. _______________

Name of the Village/City/Camp________

Number of Participants: Males_____________ Females___________

Q1. In your opinion, what are the expected hazards that may happen in your area? 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

Q2. In your opinion, who is most vulnerable to these disasters? 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

Q3. How can disasters influence the Local Community as a whole? T T T T T T T Population Children Men Handicapped Elderly School Children Workers

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89

T T T T T T T T T T T

Youth Infra structure Houses Sewage Electricity Water Telephones Health Services Streets Schools People Movement Others

Q4. What are the available capacities and resources in the community for Disaster Preparedness at its occurrence? T T T T T T T T T T T T T T T T T Schools Health Clinics Hospitals Municipality Clubs Public Squares Religious Places Water Tanks Cars Specialist Vocational Persons Volunteers The area inhabitants Kindergarten Nurseries Women/Youth/Cooperativeness/charity Others

Q5.A In your opinion, what are the main requirements for DP before its occurrence? Q6.B What has to be done before disaster occurs? Q7. How would you face the disaster in case it occurred? Q8. How do you perceive the role of the Local Community in rebuilding and facing the influence of the disaster on the long term? Q9. What is the role of Ministries and NGO's in Disaster Preparedness? Ministries Ministry of Local Governance Civil Defence Ministry of Environment Ministry of Transportation Ministry of Agriculture Ministry of Communication Others

Ministry of Affairs Ministry of Health Ministry of Interior Ministry of Labour Ministry of Industry Ministry of Supplies

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Appendix 8
Locations of Focus groups in the West Bank and Gaza Strip
No 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 Focus Group location Hebron City Al- Fawar Camp El-O'beidiyyah Village Nablus City Tayaseer Village Fasayel Village Jenin City Bethlehem City Budrus Village Al-Jalazone Camp Noor Al- Shams Camp Jerusalem Al-Zawideh Village Al- Mawasee Village Beet Lahia Deer Al- Balah Khan Younis Gaza Rafah Jabaleh Camp Al- Nasserat Camp Beteen Camp Al- Fara' Camp Nablus City Askar Camp Khan Younis Area Hebron/WB Hebron/WB Bethlehem/WB Nablus/WB Nablus/WB Jericho/WB Jenin/WB Bethlehem/WB Ramallah/WB Ramallah/WB Tulkarem/WB Jerusalem/WB Gaza Gaza Gaza Gaza Gaza Gaza Gaza Gaza Gaza Ramallah/WB Nablus/WB Nablus/WB Nablus/WB Gaza Notes Service Area Local Community Local Community Services Local Local Local Local Local Local Local Local

Children Children Children Children Children

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Appendix 9
Number of Participants in the Focus Groups (Villages & Camps & Children's Groups)

Villages
No 1 2 3 4 Total Village Name El- O'beidiyyeh Village Tayaseer Village Fasayel Village Budrus Village 4 Villages Male Participants 7 14 17 15 Female Participants 10 17 27 Total 17 31 17 42 107 Notes Local Community Local Community Local Community Local Community

Camps
No 1 2 3 Total Village Name Noor Al-Shams Camp Al-Fawwar Camp Al-Jalazone Camp Male Participants 10 13 14 Female Participants 2 11 24 Total 12 24 38 74 Notes Local Community Local Community Local Community

Children's Focus Group Workshops
Location Betten Village Al-Fara' Camp (two workshops) Nablus City Askar Camp Khan Younis (3 workshops) Total Number 22 22 22 23 24 113

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Appendix 10
Names & Numbers of Participants within Focus Group Gaza Strip
No 1 2 3 4 5 6 7 8 9 10 Total Area Name Al-Zawideh Village Al-Mawasee Village Beet Lahia Deer Al-Baleh City Khan Younis City Gaza City Rafah City Jabaleh Camp Al-Nseerat camp Jabaleh camp Males 5 1 12 19 10 12 11 2 4 1 Females 8 11 4 14 17 3 8 20 9 Total 13 12 12 23 24 29 14 10 24 10 171

Total of participants from villages = 37 Total of participants from cities = 90 Total of participants from camps = 44 West Bank + Gaza = 429

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Appendix 11
Areas and Numbers of Participants within Focus Groups West Bank
No 1 2 3 4 5 6 7 8 9 10 11 12 Total Name of area Hebron City Al- Fawwar Camp El-O'beidiyyeh Village Nablus city Tayaseer Village Fasayel Village Jenin City Bethlehem City Budrus Village El- Jalazone Camp Noor Al-Shams Camp Jerusalem Males 4 13 7 15 14 17 12 8 15 14 10 8 Females 7 11 10 10 17 Total 11 24 17 25 31 17 12 12 42 38 12 17 258 Notes Service Area Local Community Local Community Service Providers Local Community Local Community Local Community Local Community Local Community Local Community Local Community Local Community

4 27 24 2 9

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Appendix 12
Likert Scale Questionnaire Tool Relating to Hazards
Instructions to Participants: Arrange the hazards that are in the attached list, which according to your point of view may threaten yours and the others safety and the area in general (of properties, Economy, Agriculture, Infrastructure, others) No Hazards (Identified from the Secondary Data review) Floods/Heavy Rain Snow/ Snow Storms Epidemics Famine High Tension Cables Chemical Pollution Political Events Water Shortage Open Sewage Earthquakes Violence accidents Forest Fires Nuclear Radiation Work Accidents Insecticide/ herbicide Traffic Accidents/Car Crashes Drought/ Desertification Animal & Poultry Diseases Water & Sea Pollution Soil Erosion and Land Slides Food poisoning Cannot Predict Unlikely Likely More Likely Most Likely Sudden/ Unpredictable

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21

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Appendix 13
Data from the Quantitative Analysis Referring to Distribution of Questions answered in the Likert Scale
(see appendix 12) The modal approach showing Hazards as either likely, more likely or most likely events Most Likely q7, q8, q9 More Likely q16 Others q1, q2, q3, q4, q5, q6, q10, q11, q12, q13, q14, q15, q17, q18, q19, q20, q21

Respondents Consensus in the Most Likely Occurring Hazards - Palestine Consensus in returning Hazards as most likely Majority No majority Hazard q7 q8 q9 q16 Variation Ratio 0.50 0.50 0.58 0.62 Probability Most Likely Most Likely Most Likely More Likely

Index of comparative criticality (CC Index) Hazards Political Related Events Water Shortage Open Sewage Vehicles/Traffic Accidents CC Index 0.33 0.33 0.38 0.41 Probability of occurrence Most Likely Most Likely Most Likely More Likely Rank 1 1 2 3

West Bank
The modal approach showing Hazards as either likely, more likely or most likely events Most Likely q8 More Likely q7, q16 Others q1, q2, q3, q4, q5, q6,q9, q10, q11, q12, q13, q14, q15, q17, q18, q19, q20, q21

Respondents Consensus in the most likely occurring hazards - West Bank Consensus in returning Hazards as most likely majority no majority Hazard None q8 q7 q16 Variation Ratio

0.610 0.589 0.628

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Gaza Strip
The modal approach showing Hazards as either likely, more likely or most likely events Most Likely q7, q8, q9, q19, q21 More Likely q11, q16 Others q1, q2, q3, q4, q5, q6, q10, q12, q13, q14, q15, q17, q18, q20

Respondents’ Consensus in the most likely occurring hazards - Gaza Strip Consensus in returning Hazards as most likely majority Hazard q8 q7 q9 q21 q19 q16 q11 Variation Ratio 0.35 0.39 0.48 0.58 0.60 0.61 0.62 Probability Most Likely Most Likely Most Likely Most Likely Most Likely More Likely More Likely

no majority

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97

Appendix 14
Children and Youth Drawings Analysis

Disasters Perceived by Children and Youth through Artwork and Interview
Location Ramallah Ramallah Comments on drawing from participants Volcano erupting Volcano erupting. Volcanoes cause poisoning of the air and throw fire to burn trees. Pollution Ramallah 9 Picture of a volcano erupting and children crying Ramallah 13 Volcano erupting Ramallah 12 Volcano erupting Ramallah 13 Volcano erupting Ramallah 6 Volcano erupting Ramallah 12 Volcano erupting. Volcanoes have poisonous gas and melted materials and they cause burning of houses. Ramallah 11 Air Pollution. The picture shows a 'no' for pollution and a 'yes' for fresh air. Pollution causes birds to be destroyed. It comes from factories and cars. Ramallah 13 Drought. The picture is divided into two; on one side depicting dark colours and no vegetation, on the other showing green colourful vegetation and water. Ramallah 9 Conflict/war in a typical clash scene. Nablus 11 Conflict/war Nablus 10 Conflict/war Nablus 10 Conflict/war. Ambulances and medical tents shown Nablus 8 Conflict/war Nablus 11 Conflict/war Nablus 10 Conflict/war Nablus 10 Conflict/war Nablus 12 Conflict/war Nablus 10 Conflict/war Nablus 11 Conflict/war Nablus 12 War. The drawing depicts the bombing of cities with rockets. Tanks are firing at airplanes. There are house, schools and mosques on fire. People are injured and ambulances/fire engines are rescuing people. Nablus 12 Conflict/war. A lot of action is shown in the picture. Israeli planes are firing rockets at people. Palestinians are firing back and one plane is shot down. An aeroplane shoots a Palestinian dead. A child calls for help. Israeli jeeps are depicted getting ready to enter a mosque. Gaza airport is represented. This means that we can have airplanes to help the Palestinians. Nablus 10 Volcanoes. These can cause trees to be destroyed and people to be wounded and die. Natural volcanoes are always far away from people. If they are close to you, you will get injured. Nablus 13 Volcano erupting. It causes the killing of people and the burning of forests Nablus 11 Volcanoes erupting Nablus 9 Volcanoes erupting Nablus 8 Volcanoes erupting Nablus 10 Earthquake. Picture showing fires, damage to houses, cars broken downand people injured. Ambulance is evacuating the injured. A child runs into the street. Fire engines bring water. Helicopters are shown to evacuate people. The helicopters are very busy Nablus 11 Forest Fires showing the Fire service called to help. Nablus 7 Fires. Picture shows houses with flames coming from the roof. Age 10 13

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Nablus

Floods. Picture coloured blue in its entirety with two single trees being swept away. Families will be displaced. Nablus 7 Floods Nablus 12 Floods Nablus 9 Pollution. The picture shows a factory emitting smoke blowing over a house. Nablus 11 Pollution. There is a picture of a factory emitting smoke and an ambulance. It represents people asking the PRCS to help people. Nablus 11 Pollution. Picture depicts smoke Nablus 18 Pollution. Shows a factory with smoke emerging. Pollution comes from factories, which affects the ozone layer, causes disease and rises in temperature. Also depicted in the drawing:In case of fire we lose lots of trees and there are not enough materials for feeding. It affects carpenters and touristic areas.Leaking of chemicals into the sea causes water pollution and epidemics.Industrial waste also pollutes the environment and people cannot survive. Nablus 17 Pollution of air and water.. The picture represents both types of pollution of the environment through factories and cars Nablus 9 Car accidents depicted Nablus 8 Car accidents depicted Nablus 9 Car accidents depicted Nablus 9 Car accidents depicted Nablus 7 Car accidents depicted Nablus 13 Car Accidents depicted. Picture shows a sudden car accident. We live in an environment that has mountains, and suddenly the car slides off the road, and down the mountain, because its winter and there is lightning. I was watching the car falling down, and calling people and the ambulance for help. Nablus 9 Non specific disaster depicting non-specific objects Nablus 11 Non specific disaster depicting non-specific objects Khan Younis 10 Car accidents depicted Khan Younis 12 Floods. There is water and two ambulances. Two people are holding a child who is injured.

10

Disaster Preparedness Depicted in Artwork by Children and Youth
Location Ramallah Ramallah Ramallah Ramallah Ramallah Ramallah Ramallah Ramallah Ramallah Age 7 14 13 13 11 12 11 11 13 Comments Awareness and schools. The picture denotes preparedness through schools. Guidance and counselling as a means to create awareness in children Awareness Campaign. Drawing records a lecture that took place in the village council. It shows a TV talking about pollution and disaster. Praying to God for help. Preparedness and Capacities. The picture shows an ambulance, health centre, and shelter. The ambulance can assist in transporting people as there is no transportation. Preparedness in supplies and storage. Preparing for floods. The picture shows sand blocks in a village to protect against floods. Preparing for floods. The picture shows sand blocks in a village to protect against floods. Preparing for floods. The drawing shows a house and trees. A light is on in the house. He wants to go into it but people have closed it up with wood to protect it from floods. Preparing for floods. The picture shows houses, trees and a river. There are floods and people go into their houses. Preparedness for floods. Floods causing damage to houses. The drawing is divided into four frames, with each one progressing from a normal rural scene, to clouds forming rain and then damaged trees. An ambulance is shown coming to assist. Fire preparedness. The scene shows a child in a house playing with fire and catches fire. His father comes home, takes the child out and saves him.

Ramallah

11

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99

Ramallah

11

Ramallah

12

Ramallah

13

Ramallah Ramallah Ramallah Nablus

7 12 13 9

Nablus Nablus Nablus Nablus Nablus Nablus Nablus Nablus Nablus Nablus Nablus Nablus Nablus Nablus

8 11 12 8 6 8 6 9 7 11 15 13 14 18

Khan Younis 10 Khan Younis 10 Khan Younis 10

Preparedness for drought. The picture is divided into two frames. Drought is shown on one side with a scene of poor vegetation. On the other side is a colourful scene showing good soil, rain and plants. Preparedness for pollution. Picture shows full water wells and food storage for disasters. The picture shows a meeting of people discussing how to keep the village clean. Shows a school with awareness campaign regarding pollution. There is a TV screen with programmes about awareness and the utilization of different things for awareness. Preparedness by providing services to the villages. The picture shows a pharmacy. This provides necessary medicines and time will be saved if there is a pharmacy in each village. Pharmacies. Picture shows a cause-effect relationship Factory = pollution War = death Floods = death and damage to trees Industrial waste in the sea = killing of sea life Hospital and ambulance. Preparedness for war. The picture shows field hospitals, ambulances, stretchers and specialised people. Cooperation and coordination. The picture is a football pitch in which two sides are playing together. The political situation is like a football match and there should be coordination between the two teams. The reason for carrying out this game is so that they can coordinate with each other in case of disaster. (Metaphor) Preparedness. The picture shows a helicopter coming down to assist in floods. Preparedness for volcanoes. Every year volcanoes will erupt. (Indicating prior warning). The picture shows a TV and radio (indicating early warning) Preparedness for floods and mixed disasters. Hospitals and ambulances. Preparedness showing a hospital Preparedness showing a hospital Preparedness showing a hospital Preparedness showing a hospital and ambulances Preparedness. The picture shows evacuation teams Flood preparedness. Picture shows water, ambulance and Federation Emblem. Preparedness for war. Preparedness for war. Preparedness for war. Preparedness in general. A hospital, and people fighting. There is a flood scene and volcanoes damaging houses. Shows damage to agriculture. Preparedness for pollution. Water pollution can lead to disaster. Drawing of a boiler system to demonstrate water pollution. We need a boiler system because the water is so polluted. The water system needs maintenance so we can get fresh water. (Metaphor) Preparedness for drowning. Shows a child drowning in the sea and other children swimming. There is a boat in the sea with other people watching. Preparedness with ambulances and EMS Preparedness with ambulances and EMS

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Appendix 15
Comparative Review of the Themes of Drawings
Produced by the Children's Groups Disaster Volcano Pollution Drought Conflict Ramallah 8 1 1 1 Ages 6,9,10,12,12, 13,13,13 18 13 9 Nablus 5 5 12 Ages 8,9,10,11,13 9,11,11,17,18 8,10,10,10, 10, 10,11,11, 11,12,12,12 10 7,11 7,10,12,12 7,8,9,9,9,13 9,11 KhanYounis Age Total 13 6 1 13

Earthquake Fires Floods Car Accidents Mixed 11

1 2 4 6 2 37

1 1 2

12 10

1 2 5 7 2 50

Disaster Type, ages of participants and location of children doing artwork (Sample Group reviewed = 50) Preparedness Ideas Awareness in schools & Community Floods Supplies, storage & equipment Fire Drought Pollution Conflict EMS, Hospital & Helicopters Volcanoes Drowning Mixed Ramallah 2 Ages 7,14 Nablus Ages K.Younis Ages Total 2

5 4

11,11,11, 12,13 7,13,13,13

1

7

6 4

1 1 1 1

11 11 18 13

1 3 7 1

18 11,13,15 6,6,8,8,8,9,12 2 11 1

10,10

1 1 2 4 9 1 1 2 33

10

1 16

12

1 14

14 3

Ideas in Disaster preparedness referred to in artwork, showing the ages and locations (Sample Group = 33)

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Appendix 16
Historical Data on Major Hazards Experienced in Nearby Countries
Source: EM-DAT (OFDA/CRED International Disaster Database)19 Country Israel Israel Israel Israel Israel Israel Israel Israel Israel Israel Jordan Jordan Jordan Jordan Jordan Jordan Jordan Jordan Jordan Jordan Jordan Jordan Jordan Jordan Kuwait Lebanon Lebanon Lebanon Lebanon Lebanon Lebanon Lebanon Turkey Yemen Year 1970 1983 1983 1983 1991 1992 1995 1995 1997 1998 1927 1963 1965 1966 1970 1981 1982 1983 1987 1989 1991 1991 1992 1995 1997 1955 1956 1983 1983 1987 1992 1992 1990-1998 1991 Event Landslide Flood Storm Wildfire Cold wave Cold wave Wildfire Earthquake Flood Flood Earthquake Flood Flood Flood Drought Epidemic Flood Storm Flood Insect Infest Flood Cold wave Cold wave Earthquake Flood Flood Earthquake Storm Landslide Flood Storm Cold wave Earthquakes x 5 Earthquake Region W.Asia W.Asia W.Asia W.Asia W.Asia W.Asia W.Asia W.Asia W.Asia W.Asia W.Asia W.Asia W.Asia W.Asia W.Asia W.Asia W.Asia W.Asia W.Asia W.Asia W.Asia W.Asia W.Asia W.Asia W.Asia W.Asia W.Asia W.Asia W.Asia W.Asia W.Asia W.Asia W.Asia W.Asia Continent Asia Asia Asia Asia Asia Asia Asia Asia Asia Asia Asia Asia Asia Asia Asia Asia Asia Asia Asia Asia Asia Asia Asia Asia Asia Asia Asia Asia Asia Asia Asia Asia Asia Asia

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Palestine Red Cresent Society
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