PALESTINE RED CRESCENT SOCIETY

STRATEGIC DIRECTION

2003 – 2006

Draft VI- Dec. 26, 2002 TABLE OF CONTENTS (Back to Appeal 2004)

ABBREVIATIONS...... 3 PALESTINIAN CONTEXT ...... 4 BACKGROUND ON THE PALESTINE RED CRESCENT SOCIETY...... 7 THE PRCS INTERNAL CONDITIONS...... 7 REVENUES ...... 7 EXPENSES ...... 8 HUMAN RESOURCE DEVELOPMENT ...... 8 CAPITAL...... 9 COORDINATION AND COOPERATION WITH INTERNATIONAL AND LOCAL INSTITUTIONS.... 9 ROLE OF PRCS DURING AL-AQSA UPRISING SINCE SEPTEMBER 2000 .... 10 PRCS SYSTEMS: STRENGTHS & WEAKNESSES...... 12 CHALLENGES...... 13 AIM ...... 14 GENERAL OBJECTIVES ...... 14 PRIMARY HEALTH CARE...... 14 EMERGENCY MEDICAL SERVICES (EMS) ...... 14 HOSPITAL CARE...... 15 BLOOD BANK...... 15 PSYCHOSOCIAL SERVICES (MENTAL HEALTH WELL-BEING)...... 15 REHABILITATION SERVICES...... 16 SOCIAL WELFARE ...... 16 YOUTH AND VOLUNTEERS ...... 17 INFORMATION AND DISSEMINATION ...... 17 DISASTER PREPAREDNESS AND RESPONSE...... 18 ORGANIZATIONAL DEVELOPMENT ...... 18 ORGANIZATION OF PRCS SERVICES ...... 20 IMPLEMENTATION ...... 21 EVALUATION OF PROGRAMS...... 23 ANNEX 1: ORGANIZATIONAL STRUCTURE OF PRCS DECISION-MAKING BODIES ...... 24 ANNEX 2: PRCS BRANCHES AND SUB-BRANCHES ...... 25 ANNEX 3: DISTRIBUTION OF PRCS LOCATIONS IN PALESTINE BY DISTRICT AND BY TYPE OF FACILITY ...... 26

Palestine Red Crescent Society strategic direction 2003-2006 2 Abbreviations

BTC Basic Training Course CBR Community Based Rehabilitation CHC Community Health Committee Diaspora Refers to the Palestinian Population living in Lebanon, Syria, Egypt & Iraq DPR Disaster Preparedness and Response Unit EEC Emergency Educational Center EMS Emergency Medical Services EMT Emergency Medical Technician ERU Emergency Response Unit HELP Health Emergencies in Large Populations HQ PRCS Headquarters HRD Human Resource Development ICRC International Committee of the Red Cross IFRC International Federation of Red Cross and Red Crescent Societies IHL International Humanitarian Law Intifada Refers to Al-Aqsa Uprising, which started in September 29th, 2000 MCH Mother and Child Health MIS Management Information System MOH Ministry of Health NGO Non-governmental Organization PA Palestinian Authority PCBS Palestinian Central Bureau of Statistics PHC Primary Health Care PRCS Palestine Red Crescent Society

Palestine Red Crescent Society strategic direction 2003-2006 3

Palestinian Context In 2000, the Palestinian population size was estimated at 8,797,333 persons, of which 3,150,056 persons resided in the West Bank and Gaza. Around 1,138,126 persons lived in Gaza Strip in an area of 360km2, and 2,011,930 persons lived in the West Bank in an area of 5,800km2. Accordingly, the population density rate in Gaza Strip was estimated at 3,161 inhabitants/km2, and 347 inhabitants/km2 in the West Bank. (PCBS, 2000) According to UNRWA statistics in June 2001, there were 382,000 registered Palestinian refugees living in Lebanon, of whom 215,000 resided in 12 refugee camps. This is in addition to an unknown number of unregistered refugees. In Syria, there are 400,000 registered Palestinian refugees. About 30% inhabit 10 refugee camps recognized by UNRWA. Palestinians in Syria enjoy living conditions that are similar to that of the Syrian population. Both populations have equal rights in all aspects of life. (see http://www.badil.org/Publications/Majdal/1999/4_12.htm ) Yet, in Egypt the status of the Palestinian population differs from that in Syria and Lebanon. Palestinians in Egypt are not living in camps, but scattered within the Egyptian population, mainly located in poor neighborhoods. While there are no accurate statistics about the Palestinian population in Egypt, it is estimated that their number exceeds 80,000 persons. The Palestinian population in Iraq is living outside the UNRWA area. They come within the remit of the UN High Commissioner for Refugees (UNHCR). According to the PCBS, the Palestinian population in Iraq is estimated at 62,000 persons. The Palestinian population in Palestine is young with 46.9% under 15 years of age. The population growth rate is 3%. The MOH reported in 2001 that the Infant Mortality Rate was 22 and the Neonatal Mortality Rate was 15.5. Cardiovascular and heart diseases were leading causes of mortality, whereby 35.1% of total deaths were caused by cardiovascular diseases and 20% caused by heart diseases. (Health Indicators in Palestine, HMIS, July 2001) Information about the health and social situation of the Palestinian population in the Diaspora is lacking, as no recent assessments were sited. UNRWA provides demographic data about the registered refugee population only, whereby, the unregistered refugee population gets slight consideration. According to UNRWA (1999), the Infant Mortality Rate for the Palestinian Refugees in Lebanon is 35/1000 live births, which higher than that for the Palestinian Refugee population in Jordan, Gaza and Syria. Since the beginning of Al-Aqsa uprising in September 29th, 2000, the Palestinian population in Gaza and the West Bank are living through a difficult situation that affected all aspects of life. Politically, the atmosphere is changing rapidly and indicators point to a more intense and prolonged conflict. PRCS scenario planning includes provisions for further isolation of towns and villages, possibility of inter-Palestinian military clashes, and/or cantonization of West Bank. Socially, local communities are isolated due to strict siege and prolonged day and night curfews. There is a general feel of insecurity and helplessness as a result of the current political environment. The severe damage to the infrastructures, private property and educational and social systems is leading to psychological distress. This agony is bigger among families experiencing grief from loss of life or from having a member wounded or disabled as a result of the current conflict. Many families lost their homes, thus left homeless and now staying in mosques or schools, or hosted by other relative families, which is increasing the economic burden on the hosting families.

Palestine Red Crescent Society strategic direction 2003-2006 4 Economically, there is a continuous decline since September 29th, 2000, which is getting worse with the recurrent Israeli incursions of the West Bank major cities and towns. This situation is leading to increasing unemployment rates accompanied by an increasing cost of living. Trade activities are difficult to carry out. In general, the GNP is declining. The consequences on health are having severe implications for pre-hospital emergency care and access to medical teams and/or patients to care. Though the impact of the situation on health cannot be adequately assessed at the time being for a number of critical reasons, including denied access of rescue teams and other professionals to the areas under siege, the immediate effects on the health status are expected to be critical: ƒ Increasing morbidity, mortality and complications resulting from inability to tend to the sick, the wounded and other critical emergencies requiring medical interventions (e.g. women in labor, elderly suffering from chronic diseases…etc.) ƒ Public Health Disaster Zones: resulting from inadequate and/or complete lack of sanitation measures from garbage collection to lack or unavailability of clean water sources (destroyed mains or cut off systems). ƒ Paralysis of national functions: resulting from the massive total destruction of the Palestinian infrastructure, including medical services networks, access to supplies, and movement of medical professionals. ƒ Threat of infectious diseases outbreaks/epidemics resulting from the environmental threats listed above in addition to halted immunization efforts, poor nutrition and contamination of drinking water from various sources, where available, in addition to the lack of or denied access to appropriate medical care and related treatment. ƒ In July 2002, the PCBS published the results of a nutritional survey, which aimed at determining the overall rate of malnutrition among children based on three indicators: wasting, underweight and stunting. Results indicated that 49.5% of children (274,600) aged 6-59 months in the Palestinian Territory are suffering from anemia (below the mean of hemoglobin level), 43.9% in the West Bank and 54.7% in Gaza Strip. In August 2002, Care International (Humanitarian organization) published results of another nutritional assessment carried out in Gaza and West Bank. Results indicated high rates of malnutrition and anemia. About 22.5% of children under 5 suffered from acute (9.3%) or chronic (13.2%) malnutrition. Additionally, Care reported that a market survey revealed shortages of high protein foods such as fish, chicken and dairy products among wholesalers and retailers in Gaza and West Bank, which most probably is due to borders closures that seal Gaza Strip off from Egypt, Israel and West Bank. Effect on agriculture was drastic. Since the start of Al-Aqsa uprising, the Israeli army is being engaged in a systematic destruction to the fields and farms in Gaza and West Bank. Farmers are also denied access to their fields which affected all farming activities including harvesting. As a result, food stocks and agricultural products are diminishing, which is affecting the most vulnerable groups. On the other hand, Israeli agricultural food products are sometimes available in the market but at much higher prices, which the regular Palestinian family considers unaffordable. It is expected that this situation will affect the general health in the rural areas of Palestine, maybe leading to chronic malnutrition among the most vulnerable and economic hardships to all farmers. On the other hand, in Lebanon the Palestinian refugee population suffers from crowded and unhealthy living conditions and a decline in the medical services and medicines. This is accompanied by diminishing donations from the Arab countries since the Gulf war in 1991. And,

Palestine Red Crescent Society strategic direction 2003-2006 5 according to UNRWA, one-tenth of the refugees are considered hardship cases. The unemployment rate among the Palestinian working population in Lebanon is estimated at 65%.

As a result, the following needs are concluded:

In Palestine, ƒ Palestine should have a strong disaster preparedness and response program. ƒ Emergency educational and training programs need to be developed at different levels. ƒ Hospitals in Gaza Strip and West Bank need to be prepared to deal with mass casualties. Emergency units and theaters should be assessed and up-graded accordingly, staff should maintain their skills in emergency care, and adequate stocks of medicines and supplies should be preserved. ƒ The unique health needs of the internally displaced/homeless persons both in Gaza and West Bank should be addressed. ƒ There is a need to strengthen programs that promote the health of mothers, children and youth. ƒ The needs of all vulnerable groups should be addressed in order to reduce their suffering during the prevailing difficult situation. For example: the need for transport provision to vulnerable groups (women, children, elderly, disabled) to attend programs, services and activities. ƒ The rehabilitation programs for the disabled should be promoted, to enable the provision of rehabilitation services to the victims of the current situation. ƒ The effect of the current conflict on the mental health status of the entire population in Palestine should be addressed. Recreational programs for all sectors of the community need to be established to promote personal growth and health, and to contribute to the development of coping mechanisms needed to deal with stress. ƒ Environmental health programs should be initiated. ƒ There is a need to promote the awareness of local communities to current health and environmental problems. Community groups of youth and volunteers need to be trained on Community-Based First Aid and mobilized in time during emergency situations.

In Diaspora, ƒ There is a need to improve the living conditions of the refugee population in Lebanon. ƒ There is a need to strengthen programs that promote the health of mothers, children and youth among the Palestinian population. ƒ The needs of all vulnerable groups should be addressed among registered and unregistered refugees. ƒ Hospitals serving the Palestinian population in the Diaspora need to be maintained to continue meeting the growing needs emerging from the difficult living conditions. Hospitals need to maintain adequate stocks of medicines and supplies, upgrade essential equipment and renovate buildings.

Palestine Red Crescent Society strategic direction 2003-2006 6 Background on the Palestine Red Crescent Society (Back to Appeal 2004) The Palestine Red Crescent Society (PRCS) is a humanitarian national society established in December 1968. Since its establishment, it was mandated by the Palestine National Council to provide a wide range of health, social, cultural and other humanitarian services to the Palestinian people both in Palestine and Diaspora. Following the 1993 Oslo peace accord and the formal establishment of a MOH by the PA, the PRCS took the role of an auxiliary body to the public authorities targeting at the needs of the most vulnerable and disadvantaged groups of the Palestinian population. Since then, PRCS has become one of the main non-profit providers of medical and social services in Palestine. Despite obstacles and hindrances the society persisted in providing its ongoing services and support to the Palestinian people, through its branches in Palestine and Arab Countries. PRCS is affiliated to the international Red Cross Red Crescent movement. The decision-making bodies of PRCS are: ƒ The Congress, which is responsible for planning and policy-making, and elects the Administrative Council and the Executive Committee. ƒ The Administrative Council, which is responsible for following up the adopted plans, and can play the role of the Congress in case the congress is not capable of convening meetings. ƒ The Executive Committee which is responsible for the implementation of plans and activities that are carried out by the Society’ branches and departments. PRCS provides its services through its branches and facilities. It directly operates and manages hospitals, primary health care centers, dental units, rehabilitation centers, rehabilitation and nursing educational program, emergency medical services, emergency educational center, vocational training centers, elderly shelters, orphanages, nurseries and kindergartens. There are 19 PRCS branches and 4 sub-branches in Palestine. This is in addition to the branches in Lebanon, Syria, Egypt and Iraq. Currently, there are 6 sub-branches under establishment. (See annex 1 for organizational structure of PRCS decision-making bodies) (See annex 2 for list of PRCS Branches & Sub-branches) (Also visit our website http://www.palestinercs.org/branches/ & http://www.palestinercs.org/prcsdiaspora/Diaspora.htm)

The PRCS internal conditions Revenues Usually PRCS services are offered at minimal charge. The revenues of PRCS from the different services has been declining since the start of Al-Aqsa uprising on September 29th, 2000, and with the latest Israeli incursions of the West Bank major cities, there have been no revenues due to the economic hardships of all families. For example, PRCS have been subsidizing the cost of medicines for many families since the start of Intifada, and since April 2002, medicines and treatments were given free of charge to many families in Ramallah, Nablus and Jenin in order to encourage poor families to seek health care and not to neglect "a disease" due to lack of money. In addition, there is an increasing public demand on ambulance services which are being provided free of charge. It is foreseen that recovery from the above-described current situation will take time, therefore revenues from services will continue to decline.

Palestine Red Crescent Society strategic direction 2003-2006 7 At the same time, PRCS is enjoying project support from many sister national societies, ICRC, IFRC, UNDP, UNICEF and international non-governmental organizations like PAZ (Spanish NGO), CISP (Italian NGO), NORWAC (Norwegian NGO), and MAP Canada (see http://www.palestinercs.org/aid/humanitarian_support_to_prcs.htm). Yet, most of those projects are short-term emergency assistance. In fact, most come to an end by end of 2002 or by first quarter of 2003, which threatens the continuity of several vital programs. In conclusion, the society is in need to a cash flow that allows for the sustainability and the development of the existing programs in order to meet the needs of the Palestinian people in Palestine and Diaspora.

Expenses PRCS currently operates 14 Emergency Medical Services (EMS) stations and 17 sub-stations in West Bank and Gaza, with a fleet of 105 ambulances and 250 fulltime emergency medical technicians. Each station may have 2 to 8 vehicles attached for dispatch when and where needed. The EMS stations are now required to hold higher stock levels, accommodate more staff and volunteers, as well as cope with information and reporting demands. Furthermore, PRCS operates the national 101-telephone number dispatch system. And in situation of mass casualties it deploys First Aid Triage posts at the scene to evacuate, treat and transport the injured. Additionally, PRCS operates 25 primary health care (PHC) centers in Gaza Strip and West Bank that need to be upgraded to perform advanced medical care including childbirth and trauma care, as the civilian population in many regions is often not reachable by ambulance. The need to supply and re-supply many of those EMS stations, PHC centers, and major non- PRCS medical facilities with medicines, disposables, consumables and Oxygen is presenting a real logistical and financial challenge. Moreover, the increasing demand on PRCS services, coupled with constraints in terms of staffing levels, infrastructure (power, telephone, water), and limited mobility is requiring a matching increase in capacity in terms of ambulance dispatches, staff numbers, tele-communications, power generation, fuel supplies, and higher levels of preparedness. In Lebanon, PRCS is operating four district hospitals, one referral hospital and nine health centers. The health centers provide primary health care services, dental care and maternity services. Most of those facilities are located within or next to the refugee camps. The branch is Syria is operating three general hospitals and nine health centers that provide PHC services, dental care and specialized health services. In Egypt, PRCS is operating a 110-bed referral hospital. The branch in Cairo also coordinates the treatment of patients referred from Palestine for treatment abroad. While in Iraq, the PRCS branch continues to provide vital health services to the Palestinian community mainly at the primary health care level. See also www.palestinercs.org/prcsindepth/prcs.htm

Human Resource Development In facing the current challenges, the PRCS need for a powerfully built volunteer network was never as important. Volunteers are continuously recruited and trained in first aid and humanitarian values. Proper placement and follow-up are fundamental issues in building this network. PRCS youth and volunteers committees are geographically located. PRCS employs over 3,600 employees in its different locations in Palestine and Diaspora. However, a human resource development policy is yet to be developed. Many selected staff

Palestine Red Crescent Society strategic direction 2003-2006 8 members participated and will participate in the years to come in courses, workshops and seminars, such as HELP, BTC and ERU. PRCS operates the only Emergency Educational Center (EEC) in Palestine with its two branches in Ramallah and Khan Younis. The purpose of this center is to supply the national EMS system with well-trained Emergency Medical Technicians at different levels. This is in addition to the provision of Community Based First Aid training to local communities. In Khan Younis, PRCS established the Ability Development Educational program to make available trained rehabilitation workers to all rehabilitation facilities in Palestine. This program was established in Cairo in 1984 and moved to Khan Younis in 1994. And, in Gaza city PRCS is in the process of establishing Al-Falouja Nursing Education program to become affiliated to the two PRCS hospitals in Gaza city and in Khan Younis. This is in addition to the nursing education program in Lebanon with its two locations in Al-Hamshari Hospital and Al-Buss. PRCS training needs include all aspects of logistics, English language, rapid assessments, project development and reporting, appraisal systems, planning for human resource development, computer skills and other short-term continuous training.

Capital The PRCS is currently constructing its new headquarters in Al-Bireh- Ramallah province. Besides the Headquarters offices, this building will also include the Total Communications Center for the deaf, warehouses, the blood bank and the Emergency Education Center. There are several construction plans and projects for PRCS Branches, which are aiming at establishing Community Centers within branch facilities in an attempt to strengthen branches and to increase community support to PRCS. Those community centers will include services like PHC, EMS, nurseries, rehabilitation centers, work space for the youth and volunteers and multi- purpose halls. Additionally, PRCS is in the process of expanding its ambulance services to improve coverage. Therefore, new EMS stations will be established and new ambulances will be needed. Moreover, there is an increasing demand for expanding the PRCS transport system for the delivery of medicines, supplies and relief items to the PRCS facilities in Gaza and West Bank.

Coordination and cooperation with International and local institutions The power of PRCS stems from its being part of the International Red Cross Red Crescent Movement. The continuous support and assistance that PRCS is getting from its sister national societies and from both the ICRC and IFRC gives it strength, while facing the current situation. This support is financial, logistical and technical, as well as support in human resource development. In difficult times when PRCS staff was unable to move due to enforced mobility restrictions, ICRC and IFRC were there to assist and coordinate. On the other hand, the IFRC 2010 strategy provided essential guiding principles to PRCS that directed the development of a strong primary health care (PHC) program and assisted in identifying the future priorities.

Palestine Red Crescent Society strategic direction 2003-2006 9 In addition, PRCS coordinates its primary health care services with the Ministry of Health (MOH). Today, PRCS and MOH have six merged PHC locations1. Cooperation with MOH also includes participation in standard development and training. In 1996, PRCS was mandated by the Palestinian Authority to provide Ambulance services in Palestine. Accordingly, PRCS coordinates with all relevant institutions in this field. During the present crisis, PRCS assisted many NGO health providers and governmental hospitals in meeting immediate needs in medicines and medical supplies especially during curfew2 days. This support to other health care providers is expected to increase with the ongoing development of the Disaster Preparedness and Response unit that was established in 2001 as a result of the current crisis and in response to the strategic direction of the ICRC & IFRC. Similarly, the ICRC supported the establishment of the International Humanitarian Law (IHL) unit in early 2002 aiming at increasing awareness of PRCS staff, volunteers and branches to the IHL principles, and at documenting violations of IHL principles relating to PRCS core activities to ensure protection of medical missions.

Role of PRCS during Al-Aqsa Uprising since September 2000 Since its establishment in 1968, PRCS has been developing a considerable network of branches, sub-branches, locations and facilities in all districts of Palestine and in the Diaspora in an attempt to target the most vulnerable. These locations and facilities consist of hospitals, PHC centers, EMS stations, rehabilitation centers, volunteers committees, Kindergartens, nurseries, mental health centers and cultural and heritage centers. This network proved to be a great asset during the last two years of continuous "chronic crisis or emergency" situation. Services of different programs/centers were integrated in the best possible ways for meeting the continuously increasing needs of local communities. Examples are many: 1. The Rehabilitation department is working with the PHC department on child development screening program aiming at identifying and managing disabilities as early as possible. 2. The PHC and the EMS services cooperate in emergency pre-hospital care. Casualties are admitted to PHC setup where they are stabilized while waiting for the ambulance.3 3. Several branches embarked on developing community centers that provide activities/programs for vulnerable groups. These programs include PHC, EMS, rehabilitation, hospital services, mental health services, theaters, heritage exhibitions, recreational activities to various age groups, and elderly day care. The community centers initiative aims at responding effectively to the needs of the community targeting the most vulnerable. 4. The Social Welfare, Youth and Volunteers and PHC departments carried out hundreds of home visits to the Intifada injured, families of the martyrs and families affected by the recurrent Israeli invasions. The purpose of these visits was to assess needs and provide home care and support to the wounded.

1 These locations are Silwad, Der Abu Mishaal, Biddo, Qatanneh, Arrabeh and Bedia. 2 A Curfew is defined as a complete house arrest forced on a population, whereby the mobility of the whole population is restricted to their homes. All activities and services are put on hold. This includes education, trade, garbage collection, municipality services, activities of repair crews, and mobility of health teams. Most importantly, the mobility of the ambulances is restricted. 3 There are over 100 road blocks and military check posts throughout the West Bank, which delay ambulances while trying to reach the wounded or sick.

Palestine Red Crescent Society strategic direction 2003-2006 10 5. PHC, EMS, rehabilitation and mental health programs utilized to a great extent the services of youth and volunteers. 6. The entire PRCS network participated in varying degrees in the relief operations in Jenin, Nablus, Ramallah, Bethlehem, Hebron, Khan Younis and Rafah. 7. An increasing attention to the detainees and tracing programs was highlighted, which is expected to develop in the coming years in coordination with all branches and the ICRC. It is expected that this kind of service integration will be maximized in the coming years. PRCS service programs shall develop in this direction in order to maintain comprehensive services and to develop a cost effective disaster preparedness and response program for Palestine. The mental health department developed at a greater pace after the outbreak of the Intifada. There were trainings of groups of volunteers and employees, employment of social workers and psychologists, and expansion to several districts4. The department developed a special Mental Health program for PRCS staff and their families to assist them in coping with the daily pressures of life resulting from extra working hours, risky duties and loss of colleagues. Additionally, the department is in the process of piloting a school-based program to provide psychological support to children affected by armed conflicts. It is expected that the mental health program will become an integral component of each PRCS community center targeting all age groups and assisting communities in their response to disaster situations. In disseminating health information, PRCS launched public awareness campaigns that aimed at minimizing risk and injury in the forms of TV spots and publications. Issues tackled in these health education materials included first aid, coping with bombardments, making home and work places safer and safe motherhood. During the past two years, PRCS has always been concerned about the availability of basic and essential health care services to isolated and remote local communities.5 In June-July 2002, the Disaster Preparedness and Response unit designed and piloted a Rapid Damage Assessment surveillance tool to trigger a response within 24-48 hrs. The surveillance results are to guide the PHC and EMS departments in identifying and providing urgently needed medical care (both trauma and/or clinical care) for isolated villages and towns. The survey is now active and tracks key health services, health status and environmental indicators. Additionally, PRCS has been involved with Norwegian Red Cross, IFRC, Spanish Red Cross, American Red Cross, and German Red Cross in training personnel to become part of the International Medical ERU and IRT systems. PRCS envisions both a regional and national role in initially support ERU deployments by experienced National Societies, and possibly a longer-term vision to set up a regional medical referral ERU and smaller advanced medical mobile posts. Based on the above-mentioned role and recent developments, PRCS is now embarking on long- term effort to set up a solid and realistic Disaster Preparedness & Response Program in the works to integrate vital functions from within and outside PRCS. This program will more formally link various PRCS departments and branches to become part and parcel of one plan, establish formal links with other stakeholders and providers, provider of highly skilled and motivated personnel for key functions, and possibly act as a model for others in the nation and region to replicate. PRCS is NOT the sole responsible agency for disaster response in Palestine. Other governmental and non-governmental agencies have vital roles to play. It is hoped however that through the

4Mental health program expanded to districts, which had witnessed severe violence acts & home demolitions that resulted in psychological traumas to the most vulnerable. These districts were Jenin, Nablus, Ramallah, Bethlehem, Hebron and Rafah. 5People face great obstacles in reaching the hospitals and clinics with road check points, curfews and closures impeding access.

Palestine Red Crescent Society strategic direction 2003-2006 11 program outlined above, others will follow and a truly National and Comprehensive Disaster Preparedness Plan will come together.

PRCS Systems: Strengths & Weaknesses PRCS key strengths lie in the highly motivated and capable personnel and in its unique network of branches, centers and facilities. The systems established over the past 5 years including EMS, Emergency Education Center (EEC), Rehabilitation, PHC, Information systems, Volunteers networks and International networks confirm this. The support of ICRC, IFRC, sister national societies and other supporters had made these accomplishments possible. However, the systems are challenged by a variety of weaknesses that PRCS must overcome for they may hinder further development and/or curtail gains already made. Examples are: • The organization's chronic financial problems coupled with inadequate pay scales & benefits for professionals and support staff. • Inter-departmental communication and flow of information has not reached desired levels that promote efficiency and effectiveness. • The potential for harnessing and organizing volunteers, as well as the capacity of PRCS branches has not been utilized and followed through to realizable limits. • Computer and Internet literacy have improved but much remains to be done in this field. • The skills of various departments and personnel in administration, logistics, personnel management, communications systems, secretariat, and languages need to be strengthened in order to enable the provision of supporting services to core departments. • Lack of a "staff security policy" that directs workers in protecting their own lives while performing their duties.6 • Record keeping, forms and information flow within EMS and between EMS HQ and stations require further development. • Volunteers network management need to be strengthened to support various vital headquarters functions. • Dependency on outside funding, which is mostly short term. This is threatening the sustainability of PRCS programs.

6 Since September 2000, PRCS faced a huge problem in carrying out its missions. Ambulances were targeted by the settlers as well as by the Israeli military. About 200 ambulances were attacked, 180 staff members were injured, 3 EMS staff members were killed and a big number of staff and volunteers were arrested for different periods of time. This is in addition to several hundreds of staff members risking their lives daily while traveling to their workplaces and back to their homes.

Palestine Red Crescent Society strategic direction 2003-2006 12

Challenges Aside from the continued curfew, siege of cities, evident roadblocks, attacks on vehicles and personnel, difficulty in importing and clearing goods, etc. the following issues continue to challenge PRCS operations: 1. Mobility and access of ambulances and health teams to villages. 2. Relief operation mushrooming due to curfew, siege and poverty. 3. Communications system heavily dependent on Israeli wireless backbone, which can be cut. 4. Distribution of medical and other supplies halted on many occasions due to curfew. 5. Gaza-West Bank coordination & communications weak and irregular. 6. Branch-Branch coordination, cooperation & communications are weak and irregular. 7. Blood & patient transport ties up vehicles. 8. Systems responsibilities beyond capacity – relief operations, blood & patient transport, staff not able to get to work, etc. 9. Lack of national and international coordination & guidance in relief programs. 10. Inadequate spaces for desired functions. 11. Communications, coordination and cooperation with the Diaspora branches are weak and irregular. Back to Appeal 2004

Palestine Red Crescent Society strategic direction 2003-2006 13 Aim (Back to Appeal 2004) Contribute to community development by working with and through local communities and stakeholders to develop sustainable capacities and reduce vulnerabilities and working towards effective and efficient responses to disasters.

General objectives

Primary Health Care Reduce the vulnerability of local communities to diseases, in particular maternal and childhood diseases. Therefore, the PRCS will continue to develop and expand the following programs: 1. Safe motherhood program: Antenatal, postnatal and newborn care, family planning, nutrition, and management of childhood illnesses. 2. Home based care for vulnerable individuals. 3. School health education. 4. Health education to the public. 5. Preventive & curative dentistry and diagnostic services. 6. Community Based First Aid training to the public. 7. Programs emphasizing full participation of the local communities. 8. Medical hotline (to be expanded). 9. Establish mobile clinics (emergency, curative and preventive). 10. Community-based Continuing Education program for medical, nursing and administrative personnel in Primary Health Care facilities.

Emergency Medical Services (EMS) Ensure the continuity of pre-hospital care services, and emergency and first aid training to save lives and minimize the effects of accidents and diseases. Therefore, the PRCS will continue to: 1. Expand and promote quality ambulance services to the entire population in Palestine. 2. Develop, disseminate and maintain the EMS standards and protocols. 3. Strengthen the Emergency Education Center through review of curriculums, strengthening faculty and physical structure. 4. Develop a certificate program in Disaster Preparedness and Response. 5. Obtain accreditation of the Emergency Medical Technicians training programs of all levels. 6. Develop a Continuing Education program for the Emergency Medical Technicians that focus mainly on skills development. 7. Supervise the Community Based First Aid courses provided to groups of volunteers in local communities.

Palestine Red Crescent Society strategic direction 2003-2006 14

Hospital Care Provide quality hospital care services to the Palestinian population in the Diaspora, West Bank & Gaza. Therefore, PRCS will continue to: 1. Renovate and upgrade PRCS hospitals in Lebanon, Syria and Egypt in order to ensure Hospital Care provided to the Palestinian population in the Diaspora. 2. Focus on developing the maternity, neonatal, pediatric and emergency services in PRCS hospitals in Gaza and West Bank. 3. Establish a Continuing Education program for medical, nursing and administrative personnel in Hospital facilities. 4. Bridge the gap between hospital care, primary health care and pre-hospital emergency care.

Blood Bank Adopt, implement and maintain a blood service policy that ensures the highest possible standards of quality and safety. Therefore, PRCS will: 1. Establish a well-equipped blood bank in Ramallah city capable of serving the West Bank population. 2. Guarantee the availability of safe blood to save lives during disasters and large-scale accidents. 3. Recruit, retain and motivate voluntary potential blood donors. 4. Implement quality control systems throughout the blood collection and processing chain.

Psychosocial services (Mental Health Well-being) [For the sake of peace of mind] Strengthen the Palestinian community, not only to recover from current and past traumatic experiences, but also to live with the hope of building a society and to overcome the disbelief in human beings that resulted from the daily sufferings. Therefore, through preventive and developmental approach and following mainly a social model under thoughtful supervision of the Mental Health department, PRCS will: 1. Establish two Violence Impact Management Centers, one in the West Bank and one in Gaza to assist communities in developing healthy attitudes using a variety of tools such as media and educative cultural tools. 2. Work through the PRCS Community Centers to promote the mental well being of children, youth, and vulnerable groups through a variety of creative programs/services like child open studios, theaters, open gardens and cinemas. 3. Care for care givers, [emergency medical staff] will become part of the PRCS written internal policy.

Palestine Red Crescent Society strategic direction 2003-2006 15 4. Pilot a project on developing healthy attitudes among school children in Tubas (West Bank) for the next 3 years. 5. Crises intervention, i.e. disaster responsiveness, is another scope under establishment. Therefore, support groups of volunteers will be established within local communities to empower each community in caring for itself. This is in addition to the above-mentioned new approach of Caring for the Care Givers and their families.

Rehabilitation services In recognition of international concepts of “full participation and equal opportunity for disabled people”, and the current “inclusive” policy in education; Work together with the community and the disabled people and their families in caring for the well being of disabled people and their families through the provision of opportunities for development of abilities, empowerment and integration. Therefore, PRCS will: 1. Promote public awareness of the situation and rights of people who are disabled and their families. 2. Facilitate “inclusive” experiences in education (all levels), vocational training and employment. 3. Sustain, develop and expand programs of prevention, early detection of disabilities, diagnosis and early intervention. 4. Sustain, develop and expand rehabilitation programs (educational, vocational, social and medical), targeting all age levels and all disabilities. 5. Evaluate, develop and expand programs of human resource development. 6. Strengthen communication systems within the department, with other departments, and with other related organizations.

Social Welfare Contribute to the community development process through programs that support the most vulnerable with special focus on children, poor families, elderly, the wounded and their families, the detainees in the Israeli prisons, and tracing the missing. Therefore PRCS will: 1. Assist branches in developing their social services to their respective communities. 2. Develop links with external agencies. 3. Develop the Social Welfare role in disaster preparedness and response, i.e. tracing, role in rapid damage assessment, follow-up of detainees and providing relief & support to families. 4. Support victims during and post disaster situations. 5. Supply kits to hospitalized casualties during crisis situations. 6. Develop international tracing services and networks with other national societies to help re- establish family links as a result of war, conflict, disaster or other family separation causes.

Palestine Red Crescent Society strategic direction 2003-2006 16 7. Develop a detainees program that embark upon following up the health needs of individual detainees and meeting the needs of detainees and their families through coordinated efforts with PRCS branches, ICRC and local NGOs. 8. Promote community awareness to social concerns like drug abuse, early marriage, child abuse and others through coordinated activities with PRCS departments and other organizations.

Youth and Volunteers The volunteers' network needed for the present and future operations will be expanded to include more health professionals. Therefore PRCS will: 1. Strengthen the Youth and Volunteers department through improved management, recruitment, training and closer involvement with the PRCS service programs and branches. 2. Train volunteers, staff and PRCS branches on disaster preparedness and response, International Humanitarian Law (IHL) principles, humanitarian values, leadership and community development issues. 3. Promote awareness of the Palestinian community to the principles of the International Red Cross Red Crescent movement and mission of PRCS. 4. Promote awareness of the Palestinian community to Disaster Preparedness & Response, first aid and principles of IHL.

Information and Dissemination Promote and support the dissemination of knowledge and awareness of the fundamental principles of PRCS and the International Red Cross and Red Crescent Movement, International Humanitarian Law, in addition to the services, plans and history of the PRCS. Therefore, PRCS will continue to: 1. Manage the collation, sorting, analysis and dissemination of general conflict related, and public interest information for both internal and external use. 2. Archive and document using multi-media modalities relevant activities and programs as required. 3. Establish, maintain and develop media relations at national, regional, Arab and international levels. 4. Raise awareness of the PRCS mission and services among the general public by producing publications and other informational and promotional material. 5. Initiate public awareness campaigns highlighting specific public health and humanitarian issues. 6. Initiate dissemination activities focusing on Palestinian youth and students. 7. Support training for PRCS volunteers and staff on Movement principles, emblem and International Humanitarian Law. 8. Monitor and record violations of IHL principles relating to PRCS core activities to ensure protection for medical missions, reintroduce fundamental rights of the movement for

Palestine Red Crescent Society strategic direction 2003-2006 17 ambulances and medical care to the wounded and sick in Gaza and West Bank in accordance with basics of the Geneva conventions. 9. Establish an IHL resource center to enforce the society’s work in the IHL field. 10. Ensure that PRCS obtains the appropriate legal advice on emblem issues, movement documents, security incidents concerning PRCS core activities and implementation of IHL into national legislation. 11. Continue to upgrade and expand the PRCS Homepage and Intranet, including international volunteer web recruitment, online donations, and media relations

Disaster Preparedness and Response Work with and through the community and stakeholders to ensure maximal efficiency and effectiveness while responding to the community needs in pre-during-post disaster and conflict phases. Therefore, PRCS will: 1. Develop its leadership role in Disaster Preparedness and Response in Palestine. 2. Develop the skills and experience of the PRCS departments and branches in professional response to disasters of different kinds. 3. Continue to integrate the PHC, EMS and Rehabilitation Programs into the PRCS Disaster Preparedness and Response program. Programs facilities will contribute to the Rapid Damage Assessment Surveillance. 4. Continue to integrate the psychosocial support and social welfare programs into the PRCS relief operations. 5. Expand the youth and volunteers’ networks to include skilled and general volunteers, and integrate those networks into the PRCS Disaster Preparedness and Response program. 6. Develop a surveillance system aiming at developing an early warning system. 7. All integrated programs will be capable of performing Rapid Damage Assessments during and post disaster phases. 8. Strengthen disaster preparedness and responses at the national level by building up PRCS resources and pre-positioning vital supplies, equipment and emergency kits in strategic locations with risk and population concentrations of vulnerable groups.

Organizational development Establish well-functioning systems that are efficient and effective and that contribute to the well being of the most vulnerable in the Palestinian population in Palestine and Diaspora. Therefore, PRCS will continue to: 1. Develop the role of the branches and sub-branches in the cities, villages and camps. There will be increasing communications, meetings, joint projects and activities between branches and the different departments. A branch coordinator will be appointed for that purpose. 2. Establish community centers to host all branch activities and programs that address the needs of the local communities. 3. Promote the public awareness towards the mission and programs of PRCS.

Palestine Red Crescent Society strategic direction 2003-2006 18 4. Strengthen the Planning Unit. Therefore, programming, reporting and follow-up on activities, projects and programs will improve. 5. Maximize interdepartmental cooperation, joint projects and activities. 6. Develop a Human Resource Development policy that will lead to better recruitment, placement, promotion and retaining of staff and volunteers. Continuous education and training of staff and volunteers will be an integral part of this policy. 7. Develop a "Staff Security Policy/Protocol" and carry out relevant training. 8. Expand the national and international networks. 9. Strengthen the financial systems aiming at reducing dependency on external financial support and generating new financial resources. 10. Promote the quality of services offered to the community, and develop & promote practice guidelines and standards. 11. Review of the administrative systems and policies aiming at increasing efficiency and cost containment. 12. There will be an extended logistics network of sub-warehouses, transport vehicles and telecommunications. 13. Enhance information flow both internal and external.

Palestine Red Crescent Society strategic direction 2003-2006 19

Organization of PRCS services

Psychosocial Organizational well-being: development, crisis Capacity building intervention, & branch hotline, development counseling

Programs that address the needs Disaster relief of vulnerable operations groups: disabled, elderly & children Care in the Community Community Emergency medical organization: services: Volunteers, health Ambulance services, committees, triage posts, first aid dissemination training

Hospital Mother & services child health, & Health Blood promotion & protection, services Disease prevention

Palestine Red Crescent Society strategic direction 2003-2006 20 Implementation

The pace and scale of the implementation of the expected developments and service delivery are dependent on the following requirements: ƒ Financial stability: There is an increasingly high dependency on external funding for all PRCS operations. This is expected to continue as long as the current situation in Palestine prevails and as long as the general political situation in the region stays unstable. The PRCS foresees an expansion in its various service programs, which is necessary to meet the needs of the Palestinian population for ambulance services, health care, psychosocial services, disaster preparedness and response and rehabilitating the increasing numbers of disabled. These commitments are expected to increase the dependency on external funding and to threaten the financial stability of the society. ƒ Accessibility: There is an increasing difficulty in the accessibility of PRCS staff to the different locations. In order to adequately deliver its services, PRCS should be given complete access to all populations at risk without delays on checkpoints. ƒ Quality improvement: Until the present date, PRCS did not approach quality improvement of its services and managerial processes in a systematic way. Additionally, it is expected that in the past two years there was a decline in the quality of the services, which may be as a result of reduced on-site supervision and disrupted staffing levels due to inaccessibility, coupled with increasing demand on PRCS services. Also, human resource development was difficult to maintain and follow-up, in particular the trainings of field staff. On the other hand, PRCS believes that quality is a managed process that involves people and systems, and can be achieved through a cultural change. Quality is not a luxury but a necessity for best meeting the population’s needs, and if improved will lead to cost containment. Quality improvement should come from within the organization and cannot be imposed from the outside. Therefore, this challenging implementation requirement is the business of every employee at PRCS. The department heads will have the responsibility of promoting accountability of staff members for their own performance, increasing awareness through trainings and improved communications and supervision, focus on the results of the department as well as the results of individual performances, and review structures, roles and responsibilities. And most importantly, is the continuous commitment of all persons in key positions to quality improvement and their understanding of their role in steering & directing the process of quality improvement. ƒ Infrastructure: Satisfactory implementation will be accompanied with improvements/upgrading of the PRCS facilities, i.e. equipment, furniture, replacement of damaged ambulances and in some cases buildings. Also, the continuous development of communication systems, and information technology and networks will be required to minimize problems of inaccessibility and restricted mobility of technical and management staff. ƒ Integration of departmental functions: It was stated in this document as well as in other PRCS documents that departmental functions/services are to be integrated to enable the society in meeting its objectives in disaster management, organizational development, promoting humanitarian values and health of the community. Therefore, each service department will contribute to those objectives in a coordinated manner with the other departments. See the following matrix for illustrations.

Palestine Red Crescent Society strategic direction 2003-2006 21 Integration of departmental functions

THEME Organizational Disaster Management Humanitarian Values Care development In The PROGRAMS Community Promote quality of services Rapid damage assessment Promote public awareness MCH HRD Medical hotline to PRCS mission: Prevention of disease Joint projects/activities with Home care -Community events Promotion & protection of Primary branches Mobile clinics -Social gatherings health Backup EMS -May 8th activities First aid training Health Care Clinical care Home care Maintain stock levels Unity Community health Increased levels of trauma committees care School health Promote quality Emergency care Promote volunteers MCH- deliveries HRD Operating rooms Curative care Hospitals Upgrade facilities Specialized volunteers Improve communications with Links to EMS EMS, PHC & DPR Establish standards & Safe blood to save lives Spirit of giving Safe blood to save lives protocols Humanity Potential donors Blood bank Quality control Blood transport vehicles Promote quality of services Rehabilitation assessment Promote public awareness: CBR HRD Psychosocial support -To Role of disabled Child development Joint projects/activities with programs -To PRCS mission screening Rehabilitation branches Home care Unity Early diagnosis & Empower vulnerable treatment groups Special education programs Establish centers in districts Hotline Social gatherings Assist individuals, groups & Psychosocial Training of volunteers Victim support Empower vulnerable communities in crises Referrals groups Referrals Emergency standards & Triage posts Humanity Ambulance service protocols Maintain stock levels Volunteers First aid training Emergency Strengthen EMT school Transport of casualties Medical Quality control Integration with PHC Services Replace ambulances New stations Tele-communications Volunteer management Backup EMS, DP & ERU Summer camps Assist in community Expand volunteers network Support to most activities Publications events/activities Youth & Train volunteers Network of skilled & general IHL awareness Support activities Volunteers Leadership training persons HIV/Aids awareness Motivate volunteers Mines awareness campaigns campaigns Database Training of staff &volunteers Maintain operations room Volunteers Rapid interventions to Information system Relief items Humanity reduce suffering & loss of Disaster Staff security policy ERU Unity life Decentralize response Camp management Preparedness Increase logistical capacity Water & sanitation & Response Coordination with branches Surveillance Placement of Emergency kits in strategic places Links to external agencies Tracing Promote public awareness Child protection Links with other departments Victim support to PRCS mission Assist branches in Social welfare & branches Home visits Empower vulnerable operating nurseries, KG, Integration with EMS, PHC, Supply kits to hospitalized groups elderly homes & orphanage DPR casualties Community based health Food distribution education Rapid assessments Strengthen systems: Decentralized warehouses Volunteers Indirect effect on all of the -Financial Replenish stocks above -Warehouses Strategic supplies Support -Procurement Personnel mobilization & services -Information support -Personnel management & HRD -Maintenance systems

Palestine Red Crescent Society strategic direction 2003-2006 22 Evaluation of programs The improvement of PRCS service delivery systems to become more efficient and less costly requires systematic program evaluation. Only then, the status of the programs’ progress towards achieving the goals is identified, the impact of services on the community is verified and increased, and the adequacy of resources to achieve the stated goals is identified. Strong comparisons between programs are also needed to decide which programs are to be retained and which are to be eliminated in case of budget limitations. Currently, PRCS departments and branches produce annual reports that provide information about achievements, challenges and significant role during the current crisis and various statistics on service components. However, this reporting system is not leading to bottom-line recommendations or summary of findings or issues that assist the governing bodies in making the necessary decisions about the programs. Moreover, departments report steadily on achievement of project objectives. This reporting includes technical and financial components. External project evaluation is sometimes carried out upon the donor’s request. Usually these evaluation reports lead to further development of the designated program. In late 2002, PRCS embarked on developing its management information system (MIS) to facilitate monitoring of performance indicators. In its initial stages, the MIS will be launched in several programs, namely disaster management, ambulance services, rapid damage assessment and project management. It is expected that this development will become an important evaluation tool, thus, leading to an improvement in the information flow, improvement in the quality of decision-making at the operational level, and efficient and in-time reporting on processes and achievements. Accordingly, the PRCS is taking the following approaches for improving its performance: ƒ The strategic objectives are to be continuously reviewed. ƒ These objectives are to be translated to subordinate objectives. ƒ The accomplishment of objectives by each department and or branch is to be tracked/directed. ƒ The departments and branches continue to report annually on achievements or accomplishment of objectives in a structured standardized manner. ƒ Departmental annual reports are then processed to produce an executive annual report that guide decision-making regarding program development and resource allocation. ƒ The development of the MIS system will continue to include all programs. As a result, during the coming years, PRCS will be able to build in clear outcome indicators that determine the success of each program. ƒ Departments, assisted by the financial department, will annually identify resources needed to carry out programs’ processes (i.e. salaries, benefits, training, rent, supplies, equipment purchases & maintenance, travel, communications, etc.). This process will lead to developing projected budgets for programs by estimating the cost for each identified resource. ƒ Financial department provides quarterly financial reports for each department with alerts whenever allocated budgets are exceeded for the reported period. ƒ Finally, there is a possibility of utilizing external evaluation for all programs.

Palestine Red Crescent Society strategic direction 2003-2006 23 ANNEX 1: Organizational Structure of PRCS decision-making bodies

Administrative Elected Branch Council Representatives Members

Congress Executive Experts Committee

Members

Elected Administrative

Council

Elected Executive Committee

Executive

Body

Palestine Red Crescent Society strategic direction 2003-2006 24 ANNEX 2: PRCS Branches and Sub-Branches

DISTRICT BRANCH SUB BRANCH WEST BANK Jerusalem Jerusalem Ramallah Ramallah El-Bireh Nablus Nablus Salfeet Der Istia (under establishment) Qalqilia Qalqilia Hableh (under establishment) Hajjeh (under establishment) Jenin Al-Yamun Qabatia Yabad (under establishment) Jenin Tubas Jaba’ (under establishment) Arrabeh Tulkarem Tulkarem Anabta Jericho Jericho

Bethlehem Bethlehem Hebron Halhoul Hebron Bani Naim (under establishment) Idna GAZA Gaza Gaza Jabalia Der El-Balah Der El-Balah

Khan Younis Khan Younis

Rafah Rafah Lebanon Beirut Lebanon Syria Damascus Syria Egypt Cairo Egypt Iraq Baghdad Iraq For complete information about PRCS branches and Sub-Branches, please visit PRCS web site: http://www.palestinercs.org/branches/

Palestine Red Crescent Society strategic direction 2003-2006 25 ANNEX 3: Distribution of PRCS locations in Palestine by district and by type of facility District EMS PHC Secondary Rehabilitation Mental Social Welfare Youth & Care Health Volunteers Station Sub- EMT Hospital Center Nurser KG Orphanag Elderly Vocati station school Center y e onal Jenin 1. Jenin 1. Arrabeh 1. Tubas 1. Jenin PT 1. Jenin 1. Jenin 1. Jenin 1. Jenin 2. Tubas 2. Qabatia 2. Tubas ability 2. 2. Qabatai A 2. Arrabeh 3. Selet El- 3. Arrabeh-PHC development Qabatia 3. Qabatia B 3. Kfereet Dhaher 4. Jaba’ 3. Qabatia rehabilitation 4. Qabatia C 4. Yabad 5. Arrabeh 5. Al-Yamoun 6. Tubas 7. Qabatia Nablus 2. Nablus 4. Betta 5. Azmout 4. Special education Nablus 8. Nablus 5. Der Istia 6. Salfit 5. Total communication 6. Salfit 7. Bedia 6. Physiotherapy 7. Bedia 8. Kifel Hares 7. Counseling unit Tulkarem 3. Tulkarem 8. Atteel 9. Anabta 1. Tulkarem 8. Tulkarem PT 3.Tulkar 1. Child 9. Tulkarem em Protection 10. Anabta Qalqilia 4. Qalqilia 9. Azoun 10. Habla 9. Physiotherapy 11. Qalqilia Ramallah 5. Ramallah 10. Sinjel 1. Ramallah 11. Ramallah 2. Al-Bireh 10 Al-Maqdisiyah 1. Ramallah 12. Al-Bireh 12. Silwad 11. Total mental 13. Silwad 13. Der Abu Mishal communication health prog. Jerusalem 14. Biddo 3. Jerusalem 14. Jerusalem 15. Qatanneh 6.Bethlehem 11. El- 16. Al-Khader 2. Child & 15. Al-Khader Bethlehem Izariyeh 17. Beit Fajar community 16. Beit Fajar center Jericho 7. Jericho 12.Ability development 17. Jericho Hebron 8. Hebron 12. Halhoul 18. Halhoul 4. Al-Muhtaseh 13. Physiotherapy 6.Al-Shaaba 18. Hebron 13. Idna 19. Tarqumia 14. Al-Raja’ special 7. Khallet 19. Tarqumia 14. Bani 20. Idna education Hadour 20. Al-Shyoukh Naim 21. Bani Naim 8. Khalil Al- 21. Halhoul 15. Saeer Rahman 22. Beit Kahel 16. Yatta 9. Al-Saraya 23. Idna 10. Biron 24. Bani Naim 11. KG A 25. Yatta 26. Al-Samou’ 27. Der Samet 28. Dura Gaza 9. Jabalia 22. Jabalia 29. Jabalia North Gaza City 10. Gaza 23. Khalil El-Wazir 5. Al-Quds 30. Gaza Der El- 11. Der El- 31. Der El-Balah Balah Balah Khan 12. Khan 17. Al- 2. Khan 24. Al-Amal City 6. Al-Amal 15. Al-Amal city 3. Gaza 4.Ghous 12. Ghousn 32. Khan Younis Younis Mawasi Younis 25. Al-Mawasi 16. Ability development mental n Al- Al-Zaitoon Younis 26. Ma’n educ. program health Zaitoon Rafah 13. Rafah 33. Rafah 14. Airport TOTAL 14 17 2 25 6 15 3 4 12 1 1 1 33

Palestine Red Crescent Society strategic direction 2003-2006 26 For more details on the PRCS facilities, refer to the PRCS intranet (http://intranet.palestinercs.org)

Palestine Red Crescent Society strategic direction 2003-2006 27