Demographic and Health Prospects in the Occupied Palestinian Territory (oPt)

Allan G. Hill PhD Andelot Professor of Demography

Harvard School of Public Health

Main points…

Everywhere there are close links between population and politics but these reach extreme levels in Israel and the Occupied Palestinian Territory (oPt)

Special features of the demography of the oPt include a) relative high fertility and hence growth rates and b) high density and thus propensities to migrate high

Intense competition for resources in crowded, rapidly growing communities exacerbated by absence of a strong state and institutions able to referee attempts by sub-groups to seize power/resources by force

The area of Israel & the oPt is very small…

CountryArea in sq

miles

Washington DC 68

US Virgin Islands 135

Gaza 141

Singapore 247

Rhode Island 1545

West Bank 2183

oPt 2324

Delaware 2489

Connecticut 5544

El Salvador 8124

Israel 8463

New Jersey 8722

New Hampshire 9351

Vermont 9615

Politics and population Rights to the small territory of pre-

1948 Palestine has been disputed for generations

Israel’s growth and security has been built on immigration, never more rapid than in the 1990s

Longer term displacement of the Palestinian population well established but now more recently replaced by enclosure

Immigration to Israel was very high in 1990-91, sustaining growth in many “development towns” putting pressure on resources for all

0

50,000

100,000

150,000

200,000

250,000

1948

1952

1956

1960

1964

1968

1972

1976

1980

1984

1988

1992

1996

2000

2004

Period

Nu

mb

ers

of

imm

igra

nts

Total Olim

FSU

Source: Aliya and Klita Dept, Jewish Agency for Israel; Ministry of Immigration Absorption.

Population in Thousands

Country or area 2005 2015

Israel 6,725 7,838

Occupied Palestinian Territory 3,702 4,996

Total 10,427 12,834

Of which: West Bank 2,372 3,110

Gaza 1,390 1,980

Source: S DellaPergola American Jewish Year Book, 103, 2003, 3-68 and Statistical Abstract of Palestine no. 6

Palestinians in the World 2004: estimates

oPt 3,637,529

Israel 1,084,918

Jordan 2,839,639

Syria 442,699

Lebanon 421,292

Saudi Arabia 314,226

Kuwait and the Gulf 166,086

Other Arab countries 186,743

USA 238,721

Other foreign countries 303,987

Total 9,635,840

Source: Statistical Abstract of Palestine 2005

Population density in the oPt is already much higher than elsewhere in the region…

Source: UN World Population Prospects: 2004 Revision

0

200

400

600

800

1000

1200

Mortality levels in the oPt are good as measured by the under 5 mortality rate

Source: UN World Population Prospects: 2004 Revision

0

20

40

60

80

100

120

140

Unde

r 5 m

orta

lity

rate

per

100

0

Fertility trends and projections for the oPt are higher than neighboring Arab countries

0

1

2

3

4

5

6

7

8

9

1950-

1955

1960-

1965

1970-

1975

1980-

1985

1990-

1995

2000-

2005

2010-

2015

2020-

2025

2030-

2035

2040-

2045

oPt

Saudi Arabia

Iraq

Egypt

Source: UN World Population Prospects: 2004 Revision

The percentage of the population under age 15 is second only to Yemen

Source: UN World Population Prospects: 2004 Revision

0

5

10

15

20

25

30

35

40

45

50

% u

nd

er

ag

e 1

5

Balkanisation of the oPt prevents development

Bethlehem and Jerusalem cut off from each other by the Wall, new settlement in background

15

Gaza Strip: Shrinking Resources

Environment 50% land habitable 38.5% agricultural Security zone: 17%

Primary Water Source Coastal aquifer wasted in next 10

years Net annual deficit = 31 million m3 Three wastewater treatment

plants Two functioning partly 70-80% domestic wastewater

discharged into environment untreated

Projected wastewater to increase fourfold between by 2025

Sources: OCHA (2006). The Humanitarian Monitor; PCBS (2006). Labour Force Survey: 2006 Q3

16

Gaza Strip: Increasing pressure on employment and poverty

159,000 new jobs required by 2010Assuming current labor force participation rate 36.5%

Household poverty increasing

75% (2001) – 79% (2006)Definition: % Below the poverty line

based onreported income taking into

consideration family size

Unemployment increasing 17% (1999) – 36% (2006)ILO Definition

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Special Challenges for Gaza Strip

Lack of clarity of the residual status of the Gaza Strip: ‘disputed territory,’ ‘foreign territory,’ ‘entity,’ ‘occupied territory’, treated as international border by Israeli domestic law

Question of the status of the Oslo agreements and its impact on the unity of the Gaza Strip and West Bank

Lack of clarity within international donor community and humanitarian organizations (efforts by international community to increase passage of goods and people through Rafah Crossing and Karni Crossing)

Proliferation of agreements and coordination mechanisms

Lack of clear legal framework for governance, internal security, donor development schemes, trade and foreign relations

Absence of clarity of the responsibilities of the international community for the welfare of the population of Gaza

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The Population & Politics Framework

Constant deterioration Human security undermined further by population pressure Key rules disputed, consistent policies lacking Legitimacy of authority contested Constant low-level violence

Competing frames of reference Multiplicity and simultaneity of different initiatives & ambitions Obstruction by local, regional, and international actors

Breakdown of conflict resolution efforts Paralysis of local policy practice and initiatives Self-imposed constraints on international and multilateral action Denial of the socio-economic impact of demographic challenges

Conclusions and recommendations Given past growth, even with a sudden drop in

fertility, rapid rates of natural increase for years to come

Immigration to Israel and possible return migration of Palestinian exiles only adds to these pressures

Closure and other barriers to emigration and migration exacerbate already dire situation

No amount of development assistance can create development without addressing basic human security issues and normal pre-conditions for development

Absence of clear boundaries for both Israel and Palestine with communication between them produces instability

State monopoly of power the missing essential precursor for development

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Program on Humanitarian Policy and Conflict Research, Harvard University www.hpcr.org

UN Office for the Co-Ordination of Humanitarian Affairs www.ochaopt.org

AG Hill, CJ Clark, I Lubbad, C Bruderlein. Hope and despair over health in Gaza. BMJ  2006;333:845-846 (21 October)

S DellaPergola. Demographic Trends in Israel and Palestine: Prospects and Policy Implications. American Jewish Year Book, 103, 2003, 3-68.

J Pederson, S Randall and M Khawaja. Growing fast: the Palestinian population in the West Bank and Gaza Strip. Oslo: FAFO, 2001.

Roy, Sara M. Failing peace: Gaza and the Palestinian-Israeli conflict. Ann Arbor, MI : Pluto, 2007.

Some useful sources: