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==Operations== UNRWA provides a wide variety of social and humanitarian services, as determined by resolutions of the UN General Assembly. Since its initial establishment in 1949, its operations have expanded beyond immediate relief and social services; as of 2019, the bulk of its budget is spent on education (58 percent), followed by health care (15 percent), and general support services (13 percent).<ref>{{Cite web|title=How We Spend Funds|url=https://www.unrwa.org/how-you-can-help/how-we-spend-funds|access-date=2020-08-13|website=UNRWA|language=en|archive-date=17 December 2020|archive-url=https://web.archive.org/web/20201217092243/https://www.unrwa.org/how-you-can-help/how-we-spend-funds|url-status=live}}</ref> === Education programme === Education is UNRWA's largest area of activity, accounting for more than half its regular budget and the majority of its staff.<ref name=":4">{{Cite web|title=Education|url=https://www.unrwa.org/what-we-do/education|access-date=2020-08-13|website=UNRWA|language=en|archive-date=5 August 2020|archive-url=https://web.archive.org/web/20200805170547/https://www.unrwa.org/what-we-do/education|url-status=live}}</ref> It operates one of the largest school systems in the Middle East, spanning 711 elementary and preparatory schools, eight vocational and technical schools, and two teacher training institutes.<ref name=":4" /><ref>[http://www.unrwa.org/what-we-do/education From UNRWAs page and sub-pages about its educational programmes and sub-pages ] {{Webarchive|url=https://web.archive.org/web/20140902043535/http://www.unrwa.org/what-we-do/education |date=2 September 2014 }}; no update date shown, accessed 2014-08-25. [http://www.unrwa.org/what-we-do/knowledge-and-skills Within the pages on education programmes, UNRWA tells about special knowledge and skills] {{Webarchive|url=https://web.archive.org/web/20140719215937/http://www.unrwa.org/what-we-do/knowledge-and-skills |date=19 July 2014 }}; no update date shown, accessed 2014-08-25</ref> It has been the main provider of basic education to Palestinian refugee children since 1950. Free basic education is available to all registered refugee children, currently numbering 526,000.<ref name=":4"/> In the 1960s, UNRWA schools became the first in the region to achieve full gender equality,<ref>{{Cite web|title=gender equity|url=https://www.unrwa.org/content/gender-equity|access-date=2020-08-13|website=UNRWA|language=en|archive-date=25 February 2021|archive-url=https://web.archive.org/web/20210225102653/https://www.unrwa.org/content/gender-equity|url-status=live}}</ref> and a slight majority of enrolled students are female.<ref name=":4" /> Half the Palestine refugee population is under 25. Overcrowded classrooms containing 40 or even 50 pupils are common. Almost three-quarters run on a double-shift system, where two separate groups of pupils and teachers share the same buildings, thus reducing teaching time. The school year is often interrupted by conflicts, prompting UNRWA to develop a special programme that provides education in emergency situations.<ref>{{Cite web|title=Education in emergencies|url=https://www.unrwa.org/what-we-do/education-emergencies|access-date=2020-08-13|website=UNRWA|language=en|archive-date=28 July 2020|archive-url=https://web.archive.org/web/20200728165846/https://www.unrwa.org/what-we-do/education-emergencies|url-status=live}}</ref> Per the longstanding agreement, UNRWA schools follow the curriculum of their host countries. This allows UNRWA pupils to progress to further education or employment holding locally recognised qualifications and complies with the sovereignty requirements of countries hosting refugees. Wherever possible, UNRWA students take national exams conducted by the host governments. ===Relief and social services programme=== UNRWA provides food aid, cash assistance, and help with shelter repairs to these families. In addition, children from special hardship case families are given preferential access to the Agency's vocational training centres, while women in such families are encouraged to join UNRWA's women's programme centres. In these centres, training, advice, and childcare are available to encourage female refugees' social development. In Palestinian refugee society, families without a male head of household are often vulnerable. Those headed by a widow, a divorcee, or a disabled father often live in dire poverty.<ref>{{Cite web|url=https://www.unrwa.org/what-we-do/relief-social-services|title=Relief & Social Services|website=UNRWA|access-date=8 April 2021|archive-date=14 April 2021|archive-url=https://web.archive.org/web/20210414205940/https://www.unrwa.org/what-we-do/relief-social-services|url-status=live}}</ref> These families are considered "hardship cases" and constitute less than 6% of UNRWA beneficiaries. UNRWA has created community-based organizations (CBOs) to target women, refugees with disabilities, and to look after the needs of children. The CBOs now have their own management committees staffed by volunteers from the community. UNRWA provides them with technical and small sums of targeted financial assistance, but many have formed links of their own with local and international NGOs. ===Health program=== Since 1950, UNRWA has been the main healthcare provider for Palestinian refugees.<ref>[http://www.unrwa.org/what-we-do/health From UNRWAs page and sub-pages about health services] {{Webarchive|url=https://web.archive.org/web/20140901133851/http://www.unrwa.org/what-we-do/health |date=1 September 2014 }}; no update date shown, accessed 2014-08-25</ref> Basic health needs are met through a network of primary care clinics, providing access to secondary treatment in hospitals, food aid to vulnerable groups, and environmental health in refugee camps. Key figures for 2014 are: * 139 primary health facilities based in or near UNRWA settlements/camps * 3,107 health staff * 3,134,732 refugees accessing health services * 9,290,197 annual patient visits The health of Palestine refugees has long resembled that of many populations in the transition from [[developing world]] to [[developed world]] status. However, there is now a demographic transition. <blockquote>People are living longer and developing different needs, particularly those related to non-communicable diseases (NCDs) and chronic conditions that require lifelong care, such as diabetes, hypertension, and cancer. A healthy life is a continuum of phases from infancy to old age, each of which has unique, specific needs, and our programme therefore takes a 'life-cycle approach' to providing its package of preventive and curative health services. To address the changing needs of Palestine refugees, we undertook a major reform initiative in 2011. We introduced the Family Health Team (FHT) approach, based on the [[World Health Organization]]-indicated values of primary health care, in our primary health facilities (PHFs). The FHT offers comprehensive primary health care services based on wholistic care of the entire family, emphasizing long-term provider-patient relationships and ensuring person-centeredness, comprehensiveness, and continuity. Moreover, the FHT helps address intersectional issues that impact health, such as diet and physical activity, education, gender-based violence, child protection, poverty, and community development.</blockquote> Medical services include outpatient care, dental treatment, and rehabilitation for the physically disabled. Maternal and child healthcare is a priority for UNRWA's health program. School health teams and camp medical officers visit UNRWA schools to examine new pupils to aid early detection of childhood diseases. All UNRWA clinics offer family planning services with counselling that emphasises the importance of birth spacing as a factor in maternal and child health. Agency clinics also supervise the provision of food aid to nursing and pregnant mothers who need it, and six clinics in the Gaza Strip have their own maternity units. Infant mortality rates have for some time been lower among refugees than the [[World Health Organization]]'s benchmark for the developing world. UNRWA provides refugees with assistance in meeting the costs of hospitalisation either by partially reimbursing them, or by negotiating contracts with government, NGOs, and private hospitals. UNRWA's environmental health services program "controls the quality of drinking water, provides sanitation, and carries out vector and rodent control in refugee camps, thus reducing the risk of epidemics." ===Microfinance Department=== UNRWA's [[Microfinance]] Department (MD) aims to alleviate poverty and support economic development in the refugee community by providing capital investment and working capital loans at commercial rates. The programme seeks to be as close to self-supporting as possible. It has a strong record of creating employment, generating income, and empowering refugees. The MD is an autonomous financial unit within UNRWA, established in 1991 to provide microfinance services to Palestine refugees, as well as poor or marginal groups living and working in close proximity to them. With operations in three countries, the MD currently has the broadest regional coverage of any microfinance institution in the Middle East. Having begun its operations in the Palestinian territories, it remains the largest non-bank financial intermediary in the West Bank and Gaza. Key figures, cumulative as of 2023 are:<ref>{{Cite web |title=What we do - Microfinance |url=https://www.unrwa.org/what-we-do/microfinance |website=UNRWA - united nations relied and works agency for palestine refugees in the near east |access-date=3 February 2024 |archive-date=10 October 2023 |archive-url=https://web.archive.org/web/20231010235409/https://www.unrwa.org/what-we-do/microfinance |url-status=live }}</ref> * 29,000 number of loans awarded * US$531.41 million value of loans awarded * 25% youth outreach * 48% women outreach ===Emergency operations=== {{unreferenced section|date=January 2024}} UNRWA takes a wide variety of actions to mitigate the effects of emergencies on the lives of Palestine refugees. Particularly in the [[West Bank]] and the Gaza Strip (occupied Palestinian territory) there has been ongoing intervention made necessary by, e.g., the 1967 War as well as the [[First Intifada|first]] and [[Second Intifada|second]] intifadas, and the 2014 Gaza War. The reconstruction work at [[Nahr el-Bared]] Palestine refugee camp in Lebanon has been the largest reconstruction project ever undertaken by UNRWA. This work began in 2009 and was made necessary when the camp was destroyed in the fighting between the Lebanese Armed Forces and [[Fatah al-Islam]] in 2007. Services range from supplying temporary shelter, water, food, clothing, and blankets to temporary job-creation and help for rebuilding. There is extensive cooperation with other international NGOs and local actors. ===Infrastructure and camp/settlement improvement=== As of 2023, there are [[Palestinian refugee camps|58 official refugee camps]] for Palestininans, of which nine are undergoing active improvement.<ref name="UNRWA 2023 report">{{cite report|title=Annual operational report, 2023 |url=https://www.unrwa.org/sites/default/files/content/resources/aor_2023_-_english_-_final.pdf |website=UNRWA |publisher=UN |date=2024|access-date=30 August 2024}}</ref>{{rp|62}} 6 million refugees were registered with UNRWA,<ref name="UNRWA 2023 report" />{{rp|5}} with 1.37 million in Gaza using a UNRWA camp.<ref name="UNRWA 2023 report" />{{rp|12}} The camps are neither owned nor administered by the Agency; host governments are responsible for allocating land (mostly of which is privately owned) and providing security and order.<ref>[https://www.unrwa.org/who-we-are/frequently-asked-questions Frequently asked questions β Who Owns The Land The Camps Are Built On?] | UNRWA</ref> Rather, UNRWA is responsible for operating education, health, relief and social services, microfinance, and emergency assistance programmes, some of which may be located outside the camps.<ref>[https://www.unrwa.org/who-we-are/frequently-asked-questions Frequently asked questions β Does UNRWA Run The Refugee Camps?] | UNRWA</ref> However, as the camps have gradually transformed from temporary [[Tent city|"tent" cities]] to semi-permanent and dense urban environments, UNRWA has characterized them as "hyper-congested" and "overcrowded" with "critically substandard and in many cases life-threatening" infrastructure.<ref name="WhatWeDo">[https://www.unrwa.org/what-we-do/infrastructure-camp-improvement What We Do - Infrastructure & Camp Improvement] | UNRWA</ref> In response, in 2007 the Agency launched the Infrastructure and Camp Improvement Programme (ICIP) to improve spatial and environmental conditions through comprehensive urban planning methods and community engagement.<ref name="WhatWeDo" /> ICIP is implemented differently in each host country based on local needs, resources, and priorities, albeit with a broader focus on rehabilitating or reconstructing existing shelters, building new housing or service centers, providing maintenance, and improving public infrastructure such as sanitation and water drainage. Following the destruction of much of the [[Nahr al-Bared refugee camp]] in northern Lebanon in 2007, resulting from months of fighting between Fatah al-Islam militants and the Lebanese Armed Forces,<ref>{{Cite web |date=2019-02-08 |title=Revisited - The challenge of rebuilding Lebanon's Nahr al-Bared refugee camp |url=https://www.france24.com/en/20190208-revisited-challenge-rebuilding-lebanon-nahr-al-bared-palestinian-refugee-camp-unrwa |access-date=2024-08-15 |website=France 24 |language=en}}</ref> UNRWA led the initiative to rebuild the camp, in what has become the largest project in its history.<ref>[https://www.unrwa.org/content/fighting-breaks-out-nahr-el-bared Fighting breaks out in Nahr el-Bared] | UNRWA</ref><ref>{{Cite web |title=What We Do - Infrastructure & Camp Improvement |url=https://www.unrwa.org/department-infrastructure-and-camp-improvement-amman |website=UNRWA}}</ref> As of April 2021, nearly two-thirds (72 percent) of the camp has been reconstructed, including 386 shops and businesses, enabling 3,550 families to return.<ref>[https://www.unrwa.org/where-we-work/lebanon/nahr-el-bared-camp Nahr el-Bared Camp] | UNRWA</ref> Special funding has been provided by Saudi Arabia, Japan, the Netherlands, and the United Arab Emirates.<ref>[https://www.unrwa.org/newsroom/press-releases/saudi-arabia-donates-us-10-million-nahr-el-bared Saudi Arabia donates US$ 10 million for Nahr el-Bared] | UNRWA</ref>
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