About Unrwa

8 Alaa Ghosheh/ UNRWA archiveslong andhealthy livesadopt new approaches through reforms that ensureaccess to quality care and an improved standardof medical services. As such, the Agency hasintroduced family health teams that are responsiblefor the health care of families. Teams are madeup of doctors, nurses and midwives who vices.The Agency’s network of 138 primary health-carecentres and mobile clinics provides the foundationof health assistance to refugees, offering costeffective preventive, general medicine and specialistcare services tailored to each stage of life. Guidedby the standards of the World Health Organization(WHO), the Agency also works to ensure a healthyliving environment for Palestine refugees in the 58official camps.This holistic approach promotes comprehensivecare for the whole family, focusing on improvinghealth over the long term by building doctor-patientrelationships, and with that, trust. It brings UNRWAhealth programming in line with global standardsof quality health care, and has been establishedtogether with an electronic medical record andappointment system, E-health.The health-care services provided to refugees haveevolved considerably over the years, from respondingto outbreaks of air- and waterborne infectionsfollowing the establishment of the first refugeecamps, to combating widespread malnutritionamong children and reducing instances of infant andmaternal mortality, to combating communicablediseases and responding tochronic non-communicabledisease such as diabetes,hypertension and cancerhealth stafftoday.Perinatal care3,000138primary healthcare facilitiesWith emergent health-careneeds, rising health-carecosts and limited financialresources, it has becomeincreasingly important toProviding regular health care for women duringpregnancy substantially reduces instances of infantand maternal mortality. On average, a pregnantwoman receives seven consultations prior to givingbirth from an UNRWA health care professional,beginning in the first trimester. This enables doctorsto recognize potential complications and associatedrisks at an early stage and provide a personalizedand appropriate medical response. Screening foranaemia, gestational diabetes and hypertensionis carried out as standard. To prevent congenitalmalformation in the newborn, folic acid supplementsare provided to all women of reproductive age.Pregnant women are also protected againstmicronutrient deficiencies through the provision ofiron supplements.

about unrwa9The Agency also promotes safe motherhood andthe prevention of perinatal deaths by subsidizinghospital deliveries. Mothers and newborns aresubsequently monitored after childbirth, either inthe UNRWA health facilities or through home visits.Infant and child careChildren, particularly infants and newborns,are vulnerable to malnutrition and infectiousdiseases. The Agency provides health educationand counselling for mothers on appropriate feedingpractices and newborn care. Infants up to 5 yearsof age benefit from a package of preventive care,which includes a thorough medical examination,growth monitoring and screening for disabilities.Micronutrient deficiencies are prevented throughiron and vitamins A and D supplements. Vaccinationservices provide immunization for ten diseases:tetanus, diphtheria, pertussis, tuberculosis,measles, rubella, mumps, polio, haemophilicinfluenza (Hib) and hepatitis.With school enrolment, a thorough medicalexamination is undertaken, focusing on diseasesand disabilities that can impair a child’s learningcapacity, such as hearing or visual impairment.Once identified, children with disabilities areassisted with the provision of eyeglasses, hearingaids and other prosthetic devices. Oral health,vitamin supplementation and health education arealso a priority.Adolescent and adult careAdolescence and young adulthood are uniqueperiods in the lifespan of an individual, representinga challenge but also an opportunity to pave theway towards a healthy and productive adult life.Preventive and curative health care includes:reproductive, mental and oral health care services;cervical and breast cancer screening; and outpatient,diagnostic and dispensary, physiotherapy andrehabilitation services. The Agency also providesmicrobiology services, either directly or throughhospital referral agreements with host countries,and prescribes medication free of charge.Active ageingAgeing is a challenge that impacts all aspects ofmodern society. The reductions of the incidencesof communicable diseases, combined withmodifications in lifestyle and longevity, have led to a Alaa Ghosheh/ UNRWA archives119dental clinics3 millionpeople regularly use unrwa health centreschange in Palestine refugees’ morbidity profile anda rise in cases of cardiovascular diseases, diabetesand cancer. Older refugees are supported thougha set of preventive and curative services to achieveactive and healthy ageing. This includes screeningfor and treatment of diabetes and hypertension, riskscoring and secondary prevention for cardiovasculardiseases.Healthy environmentThe environmental health component of arefugee’s life-cycle focuses on reducing bothmorbidity and risk of outbreaks associated withpoor environmental conditions and practices.This includes the provision of safe drinking waterwithin refugee camps, together with the provisionof sanitation, disease vector and rodent-controlservices.

10 Alaa Ghosheh/ UNRWA archivesa decentstandard oflivingFood aid and cash transfersRelief and social servicesCommunity empowermentUNRWA provides a range of social services thatrespond to the needs of the poorest of the pooramong the Palestine refugee population. UNRWAestimates that 1.2 million of the 5 million Palestinerefugees it serves are in absolute poverty, while700,000 are abject poor, unable to meet even theirbasic food needs.The Agency’s support to the most vulnerable hasevolved over time from the emergency provision ofbasic humanitarian reliefthrough the distributionof food aid, towardsprogrammes that aim torefugees supported by socialfurther the socioeconomicsafety netempowermentofthemost vulnerable Palestinerefugees and safeguardtheir rights.Assistanceincludesfoodaid, ationsand rehabilitation services.283,000101At present, food rations are provided to familiessuffering from severe economic hardship, unableto meet their basic dietary needs. Families facingspecial hardships - like those lacking an ablebodied male head of household - benefit fromquarterly cash transfers. While reducing poverty,this financial support also promotes economicdevelopment through the stimulation of the localeconomy.Partnership with the community is a vital aspect ofthe Agency’s commitment to protecting the rightsof Palestine refugees. Since 1989, the Agency haspartnered with community-based organizationsto respond to the needs of the most vulnerable,including women and children, the disabled,and elderly. A wide range of social, cultural andrecreational activities, as well as skills training andrehabilitation services, promote self-reliance andan empowered response to socioeconomic needsand priorities.Refugee registrationThe Agency maintains the records of all registeredindividuals who fit the legal definition of Palestinerefugees. Records are updated through acentralized and secure system so that refugees canhave amendments and changes made by qualifiedUNRWA staff to registration documents to reflect

about s, deaths, marriages, divorces and physicalmovement. An estimated 17.5 million historicaldocuments contained in family files are alsopreserved within a digital archive.MicrofinanceUNRWA provides income-generating opportunitiesfor Palestine refugees, as well as other poor ormarginal groups who live and work near them.It extends credit and complementary financialservices to families, women and youth, and smallbusiness owners. These investments sustain andcreate jobs, reduce poverty and empower refugeesto be the drivers of their own development.The Agency’s financial services operate inaccordance with the global standards and bestpractices of the microfinance industry. Outreachactivities focus on poor urban areas, which arecentres of commercial and industrial activity andhost a high concentration of Palestine refugees.The provision of financial services is intended to besustainable, while charging rates of interest thatare affordable and in line with other microfinanceproviders. A range of loans aim to address refugees’diverse needs.FamiliesConsumer loan product (CLP) – This is a personalloan for working-class families who have no accessto bank credit. It is intended to help them recoverhousehold assets sold to cope with unemployment,ill health or other social expenses, like weddingsand funerals. The loan ceiling is three times theborrower’s monthly salary.Housing loan product (HLP) – A loan to help familieswith no access to mortgage facilities to improve,expand or acquire housing. Loan values range fromUS 3,000 to US 15,000. UNRWA archivesWomen and youthMubadarati – youth start-up loan (YSL) - Availableto young men and women aged 18-30 to startnew businesses that create self-employment andemployment for others, Mubadarati is the first youthstart-up loan product of its kind in the region.Solidarity group lending (SGL) – This loan isintended for groups of women entrepreneurs whoare collectively responsible for repayment. Rangingfrom US 400 to US 5,000, the SGL sustainsenterprise, as well as household spending oneducation, health and basic needs.Women’s household credit (WHC) – This loanaccommodates home-based enterprise by women,allowing them to build up household assets forbusiness use.Small businessMicroenterprise credit (MEC) – This product targetsthe overwhelming majority of regional businessesthat employ fewer than five workers, most of whomhave no access to formal credit and are vulnerableto shocks. MEC loans range from US 300 to US 8,500, and help businesses build up and maintainreserves of short-term working capital.

12325,000small loans awarded since 1991Microenterprise credit plus (MEC ) – As successfulsmall businesses mature, they often require largerloans with extended repayment periods to continueexpanding their capital and increase employment. Tomeet this demand, the Agency provides MEC loansto borrowers who have demonstrated repaymentability over three loan cycles, and to more formalenterprises.Small and medium enterprise business training(SMET) – UNRWA runs a training programme forsmall business owners in the Gaza Strip, offeringthem customized training in subjects such as bookkeeping, taxation, computing and e-commerce. Thedirect costs of each course are paid by the participants,with donor grants covering remaining overheads.Small-scale enterprise lending (SSE) - The loansare relatively large, ranging from US 3,000 to US 75,000, and typically support capital investment,modernisation, and market expansion.72,000overrefugees benefited from a loaneveryone—the right to an adequate standard ofliving, including housing, without prejudice to otherrights they enjoy as refugees.The development of comprehensive campimprovement plans follows a holistic andparticipatory approach to sustainable campdevelopment that reflects both the social andphysical aspects of camps. The active participationof refugee communities in prioritizing needs tomake improvements strengthens their ownershipover the development process. It also contributesto building skills and capacities in the constructionsector and associated professional trades.The UNRWA camp improvement programme is notfunded by the Agency’s core budget, and as such,it is dependent on specific grants from donors tocontinue its work.School and health facilitiesInfrastructure and campimprovementOf some 5 million Palestine refugees registeredwith UNRWA, roughly one third live within the 58recognized refugee camps in Jordan, Lebanon,Syria, the West Bank and the Gaza Strip. Over theyears, the camps have transformed from temporary‘tent cities’ into hyper-congested masses of multistorey buildings characterized by concentrationsof poverty and extreme overcrowding. Some of thecamps are considered to be among the densesturban environments in the world.While the Agency does not administer the camps,it does have a clear interest in improving theconditions of Palestine refugees living in them. Ascamp structures were built for temporary use, overthe decades the buildings have fallen into disrepair.Under international law, refugees have - as does21,675entrepreneurs have participated in nearly 1,000courses since 1995The Agency oversees the construction andmaintenance of UNRWA schools, health care centresand clinics that endeavour to meet the evolvingneeds of both the Agency’s package of education andhealth services and Palestine refugees themselves.All newly constructed facilities are built to complywith international standards and provide universalaccess for people with disabilities.Environmental infrastructureIn order to promote a safe and healthy urbanenvironment for Palestine refugees and controloutbreaks of waterborne diseases such asdiarrhoea, cholera and hepatitis, the Agency works incollaboration with host authorities to assure accessto safe drinking water through comprehensivewater-supply networks. The provision of seweragesystems, waste-removal services, storm-water 368,187,157worth of loans awarded since 1991

about unrwadrainage and rodent-control services combats thespread of sanitation- and hygiene-related diseases.Electrical infrastructure, access roads and footpathnetworks are also maintained.HousingSubstandard and overcrowded housing is an acuteproblem in Lebanon, Syria, Jordan and the GazaStrip due to financial constraints and the needsof a growing refugee population. In response, the Isabel de la Cruz/ UNRWA archives13highest priority is given to improving the criticallysubstandard shelters of the most vulnerablerefugees. In Jordan alone, 500 substandard sheltershave been earmarked for urgent upgrading.The UNRWA response to basic housing needs iscoordinated with host governments in line with theirnational, regional and municipal plans.Shelter rehabilitation is not funded by the Agency’score budget, and as such, it is dependent onspecific grants from donors to continue its work.

14 John Torday/ UNRWA archiveshuman rights enjoyed to thefullestThe services UNRWA provides through itsfive main programmes – education, health,relief and social services, microfinanceand infrastructure and camp improvement– mean that it has direct responsibilitiesfor ensuring the well-being of Palestinerefugees in a variety of sectors. Addressingprotection needs is an essential dimensionof UNRWA humanitarian and humandevelopment work, ensuring that thechallenges Palestine refugees face arecomprehensively addressed.Protection is an integral part of the UNRWAholistic approach to meeting refugeeneeds and to obtaining full respect forthe rights of refugees, which are grantedto them under international law. Moresimply, protection is what the Agency doesto safeguard and advance the rights ofPalestine refugees.By providing quality services to vulnerablebeneficiary communities and individuals,UNRWA delivers essential support wherethese needs may otherwise not be met.There are four components to UNRWAprotection work. Two components arecentred on UNRWA programmes and staff(and therefore have an internal dimension),and two are directed to entities externalto UNRWA and depend primarily on themfor their realization (and therefore havemore of an external dimension). Thesefour components of the UNRWA protectionframework are as follows:Internal1.2.Protection in programming – Ensuringthat protection needs are addressedin all aspects of programming,project design, policies, protocols andprocedures, as well as in staff training.Protection in and through servicedelivery – Delivering services in amanner that promotes and respectsthe rights of beneficiaries and ensuresthe security and dignity of beneficiariesand of UNRWA personnel.External1.2.International protection – Promotingrespect for Palestine refugee rightsthrough monitoring, reporting andintervention.A just and durable solution –Highlighting to the internationalcommunity the urgent need for a justand durable solution to the plight ofthe Palestinian people and helpingto ensure that in its elaboration therights and interests of the refugeesare safeguarded.Partnership with the community is avital aspect of the Agency’s approach toprotection and the perspective of UNRWAbeneficiaries is taken into account in theplanning and implementation of all of itsservices.

about unrwa15 UNRWA archivesemergenciesThe UNRWA operational context is challenging,ranging from relative stability in some host countriesto more complex environments with sporadic flareups of intense violence and instability.The Agency works closely with UN country teams inhost countries to develop contingency and emergencyresponse plans through phases of prevention,preparedness, response and recovery. Normally,these operations are of short duration. However,protracted humanitarian emergencies may require asustained relief effort.UNRWA first began supporting refugees after theirdispossession in 1948, in the aftermath of the 1967war, and in subsequent conflicts. In the 1980s, aspecial emergency programme helped the Agencyrespond to the Lebanese civil war and then the firstintifada, which began in West Bank and Gaza in 1987.The second intifada of 2000 and the ever-tighteningrestrictions of the Israeli occupation, includingthe Gaza blockade, have meant a need for ongoing emergency assistance to address the severesocial, economic and rights-related deprivationsexperienced by Palestinians. In 2007, the destructionof the Nahr el-Bared refugee camp by the LebaneseArmy caused the displacement of nearly 27,000refugees. Since then, the Agency has been rebuildingthe camp. In Gaza, UNRWA responds to urgent needscreated by the military operations of 2008-2009 and2012. Now, as a result of the devastating conflictin Syria, UNRWA i

plight, pending the just resolution of the question of the Palestine refugees. The operational definition of Palestine refugees is people whose normal place of residence was Palestine between June 1946 and May 1948, who lost both their homes and means of livelihood as a result of the 1948 Arab-Israeli conflict. Descendants