USAID Report Says Malnutrition in Palestinian Areas Serious

By Julie Stahl | July 7, 2008 | 8:12 PM EDT

Jerusalem ( - Malnutrition and a shortage of some foods in the West Bank and Gaza Strip are at serious levels and are being attributed at least in part to Israeli policies there, according to the preliminary findings of a report funded by the United States Agency for International Development.

Tens of thousands of Palestinians, who formerly worked in Israel, have been unable to work there for much of the last 22 months since the eruption of the Palestinian uprising. Plagued by the constant threat of terror attacks, Israel has said it has kept them out for security reasons.

For nearly the last two months, Palestinians in most West Bank towns have been under curfew in their cities, with periodic breaks to stock up on food.

But Israeli experts say the general health situation in the Palestinian areas has been declining since 1995, following the Palestinian Authority take over in those areas.

The results of the USAID study, conducted jointly by John Hopkins University, Al Quds University in Jerusalem, Global Management Consulting Group and CARE, were released at a press conference in Jerusalem on Monday.

"For the last year, we have been monitoring the situation in the West Bank and Gaza with respect to the issue of nutrition," said Larry Garber, director of USAID here.

"As a result of a number of conversations with Palestinian health experts and others we decided that it would be useful to have [this] type of assessment," Garber said.

The study includes four different surveys, of which two are as yet incomplete. Using internationally accepted measurements and terms, a household survey looked at nutrition and anemia in children from six months to five years of age and women in the reproductive age 15-49.

According to Dr. Mohammad Shahin, dean of School of Public Health at Al Quds University in Jerusalem, the study showed that 4.3 percent of Palestinian children in the West Bank are suffering from severe and moderate "wasting" or acute (short-term) malnutrition, while 3.5 percent are suffering from severe and moderate "stunting" or chronic (long-term) malnutrition.

In the Gaza Strip, the numbers are much higher, with 13.2 percent suffering from "wasting" and 17.5 percent suffering from "stunting." The cumulative average is 9.3 percent for the wasting and 13.2 percent for stunting.

In the West Bank and Gaza Strip, nearly 20 percent of children until the age of five and approximately 11 percent of non-pregnant women aged 15-49 are suffering from anemia.

According to general information on the USAID website, not connected with the survey, more than 40 percent of Palestinian women "have some degree of iron deficiency anemia."

A clinical survey of Palestinian health facilities' ability to recognize and treat malnutrition and anemia is not yet complete.

A market survey of 800 retailers and wholesalers in the West Bank and Gaza Strip examined the availability of food on the market and price fluctuations during the month of June.

"The mission [was] to see [if] when Palestinians want to go to the market...the food is available," said Nael Shabaro, of the Global Management Consulting Group in Ramallah, which conducted the survey.

"The most severe shortages were found in the most nutritional items or food products such as the powdered milk," Shabaro said.

More than 54 percent of vendors reported "major shortages" - defined as unavailable for three days or more - in powdered milk; 48 percent reported major shortages in baby formula; and 55.5 percent reported major shortages in meat and poultry supplies, he said.

"As for the reasons for these shortages, they were mainly attributed to Israeli policies in the West Bank and Gaza," Shabaro added.

An ongoing "Sentinel Surveillance," which began in May 2002 and will continue for another year until August 2003, visits 1280 households every two weeks to examine whether food is available and affordable, what the quality and quantity of water is and what kind of access there is to health care.

Dr. Gregg Greenough, from the John Hopkins University Schools of Medicine and Public Health in Baltimore, Md., said the kinds of questions asked in this survey are important.

Some 56 percent of the heads of households said they had decreased food purchases during the last two weeks. Some 65 percent said it was because of lack of money, while approximately one-third blamed the lack on curfews.

More than half the people, 53 percent said they were forced to borrow money to buy food and nearly 17 percent said they had sold unspecified "assets" in order to buy food.

"Those are important questions because eventually people run out of places to borrow money and they run out of assets to sell. We're seeing acute malnutrition and rates that are unacceptably high," said Greenough, linking the studies together.

"We are not politicians. We are scientists. We don't make political statements," he said. "Hopefully [the numbers] speak for themselves. But I think we all need to think about the terms of the marketplace and in terms of what the households can do to feed their families."

Greenough admitted that there was no "baseline" or previous figures against which they could check their findings.

Israeli experts said that the context is much broader than the last few months or two years.

According to Dr. Jakov Adler, medical advisor to the coordinator of activities in the territories, various nutritional surveys in the territories from 1984 to 2002 (USAID) indicate that the situation of the Palestinians has been on the decline for the last seven years.

"The nutritional status of children (6 months to 5 years) improved until 1995 and since then deteriorated gradually until 2002," he said in a press conference prior to the release of the USAID report.

Adler concluded that there are "marked differences" between the populations in the West Bank and Gaza Strip.

The Gaza Strip, he said, requires "blanket supplementary and therapeutic feeding programs" while in the West Bank the status is "acceptable" according to World Health Organization levels.

Dr. Dorit Nitzan Kaluski, director of nutritional services at the Ministry of Health, said that Israel was more than willing to provide advice and assistance to Palestinian health professionals but they had not been asked for help.

Kaluski charged that in the past, supplies of antibiotics had been offered to the Palestinians, but the offers were refused. Because the offers of essential medicines were rejected, Israel has not offered food, he said.

"During the military activities in the West Bank in April...the State of Israel offered blood donations for the Palestinians...and these blood donations were rejected," said Adler. "We received an answer that blood from Israeli donors was not acceptable."

E-mail a news tip to Julie Stahl.

Send a Letter to the Editor about this article.