MAP IN ACTION 2016

As we approach the fiftieth anniversary of Israel’s occupation of the West Bank and Gaza, 2016 was one of the most troubling years for the Palestinian people, and expectations for 2017 are no better.

In 2016, the West Bank saw the highest number of demolitions of Palestinian homes and buildings since records began. Bedouin communities in the Jordan Valley are among those worst affected, suffering frequent displacement and the loss of livelihoods.

In Gaza, the health system has been depleted by a decade of blockade. In 2016, the rate of permit approvals from Israel for patients needing urgent medical treatment outside Gaza dropped to its lowest level in seven years.

The Syrian crisis also continues unabated, with Palestinian refugees displaced across the border now sharing the poverty and exclusion of Palestinians already living in Lebanon’s overcrowded camps.

And yet, against this bleak backdrop, MAP’s projects are helping to provide a reassuring lifeline to Palestinians living at the sharp end of occupation, deprivation and displacement. In this review, we report on nine months of MAP’s activities from April to December 2016, adjusting to a new financial year.

In the West Bank, we have celebrated 10 years of support to the mobile clinic which brings vital medical care to marginalised Bedouin communities.

Our teams in Gaza continue to deliver training to hospital staff so that they can provide effective, high quality and sustainable care to people who live under very difficult conditions.

Our programmes in Lebanon provide essential relief to Palestinian refugees from both Syria and Lebanon, facilitating lifesaving operations, maternity care and safe spaces for children to play, free from the stresses and trauma of life in the camps.

MAP’s resolve to meet the coming challenges is as strong as ever. Our vision is for a future where all Palestinians can access an effective, sustainable and locally led system of healthcare, and see the full realisation of their rights to health and dignity.

Through the inspiring work of our teams and partners, we are helping to make this a reality.

I must say that all our work is only possible through the generous support we receive from you.

Alan Waddams, Chair of Trustees

What we do

MAP was established by medical professionals and humanitarians in Lebanon after the Sabra and Shatila massacre in 1982.

Since then MAP has been reaching out to the most vulnerable Palestinian communities, striving to achieve the highest attainable standard of healthcare in hostile and difficult conditions.

Today we have offices in the West Bank, Gaza, Jerusalem and Lebanon, as well as London. With extensive local knowledge and experience, we work closely with partners and communities, providing care and medical aid even where there are severe access restrictions.

MAP works in six programmatic areas:

  • Essential primary and public health care
  • Women and children’s health
  • Emergency preparedness and response
  • Mental health and psychosocial support
  • Disability
  • Campaigns

Training and capacity building runs through everything we do: MAP ensures that training for frontline staff on a range of topics is at the heart of our work.

2016 in brief

A challenging year

Lebanon continued to report the highest percentage of Palestinian refugees living in abject poverty anywhere in the world. Over 65% of Palestinian refugees from Lebanon and 89% of Palestinian refugees from Syria are living in poverty.

2016 saw the highest number of demolitions of Palestinian property in the occupied West Bank since 2009: 1,089 homes and other structures were demolished and 1,593 people displaced.

Permit approvals for Palestinian patients leaving Gaza for medical treatment dropped to the lowest rate in seven years.

Lebanon: achievements in 2016

In Lebanon, breast and cervical cancer awareness campaigns (pictured) provided hundreds of women with free diagnostic testing.

MAP’s team of community midwives received the Shield of the Order of Lebanese Midwives in recognition of their contribution and exceptional work.

MAP’s emergency treatment fund for refugees from Syria was expanded to cover multiple sclerosis and cancer patients.

West Bank: achievements in 2016

MAP’s mobile health clinic team distributed 1,260 kits containing vital hygiene and sanitary items to 630 families in Bedouin communities.

The Dunya Women’s Cancer Centre, MAP’s local partner in the West Bank, launched a hair collection campaign, succeeding in making 10 wigs for cancer survivors (pictured).

MAP launched the Oncology Nursing High Diploma programme with Bethlehem university – the first and only programme training nurses to be specialists in cancer care in Palestine.

Gaza: achievements in 2016

The launch of a pioneering infection control programme in Gaza’s neonatal wards means that the hospitals can monitor and prevent neonatal deaths caused by sepsis or infection.

MAP’s local partner provided 163 breast cancer survivors with breast prosthesis and specialist bras to help them retain their sense of dignity.

MAP has procured $1.2m worth of essential medical supplies and equipment for hospitals across Gaza.

UK: achievements in 2016

In September 2016, a group of 24 cyclists took on Cycle Palestine, a 230km ride through the West Bank. The event was a huge success and raised over £116,000.

Rahma Barclay took on a self-organised, five-week cycling adventure from London to Jerusalem. Rahma cycled 3,500 km across 13 countries and has raised over £13,000.

A Celtic FC supporter group set up the #MatchTheFineForPalestine campaign, raising over £176,000 which was split between MAP and the Lajee Centre, Bethlehem.

Programme areas

Essential Primary and Public Healthcare

Programme spend: £1.1m

A nurse working with MAP's mobile health clinic delivers a health education session in a Bedouin community, Jordan Valley, occupied West Bank

Challenges

Primary healthcare in the West Bank is fragmented, overburdened and ill-equipped to deal with the aging population and management of chronic disease. This results in poor quality treatment, lack of continuity of care and increased pressure on secondary and tertiary care services. Access to health services continues to be a problem for communities isolated and cut off by the separation wall and settlements. In Lebanon and Gaza, where dire living conditions contribute to poor health, public health campaigns are especially important.

Achievements

In 2016, working with An Najah medical school and the Ministry of Health, MAP launched a ground-breaking project to reform the primary healthcare system in Palestine by introducing the specialism of family medicine. By providing patients with unhindered access to quality primary health care at a family practice, we free up specialist hospital services to treat those most in need. This year we equipped two training and treatment centres with a combined catchment population of 140,000 people, and 15 doctors have started training to become specialists.

We have also continued our provision of healthcare services to Bedouin communities cut off from health facilities, providing 6,807 consultations in 2016 (pictured above). We have brought vital eye health and ophthalmic services to over 7,000 patients in the West Bank and have seen 450 surgeries performed in Gaza through our partnership with St John Eye Hospital’s mobile clinic.

Essential Primary and Public Healthcare: 2016 in figures

Women and Children's Health

Programme spend: £766,000

A group of mothers, with their babies, chat with MAP’s maternal and child health coordinator in Lebanon

Challenges

Women and children’s health remains a concern for Palestinians in the occupied Palestinian territory and Lebanon. They continue to be among most vulnerable groups during conflict and long-term displacement. Rates of maternal and child mortality and morbidity remain high, while insufficient access to reproductive and sexual health services mean that women’s specific health needs risk going unmet. MAP is supporting a range of women and children’s health projects to improve disease awareness and prevention and ensure access to treatment.

Achievements

In Lebanon, our pioneering home-visiting midwifery programme for at-risk women and infants has seen significant improvements in anaemia levels, rates of exclusive breastfeeding and healthy birth weight, with a caseload of 3,210 women and infants in 2016.

In Gaza, we supported a partner centre to support 800 survivors of gender-based violence with counselling and legal protection services.

Also in Gaza, our support for a specialist malnutrition clinic (pictured) has seen 430 children treated for malnutrition related illnesses with fantastic results: 100% of children diagnosed with wasting achieved a healthy weight, 96% of those with weight faltering gained weight each month, and 98% of anaemic children’s haemoglobin levels increased.

In the West Bank, MAP has continued to support the Dunya Women’s Cancer Centre to provide diagnostic services to 1,261 women, and to conduct awareness raising activities: 1,694 people attended lectures across the West Bank. Breast cancer in particular still carries a stigma among many communities, so encouraging self-examination and screening are key to survival.

Women and Children's Health: 2016 in figures

Emergency Preparedness and Response

Programme Spend: £567,000

MAP staff member, Mohammed Askari, delivers emergency hygiene kits in Gaza

Challenges

Palestinians in Lebanon and the occupied Palestinian territory continue to live in a vulnerable and precarious state. The war in Syria and the resulting flow of refugees into Lebanon continue to put pressure on communities already living in poverty, while the ongoing military occupation and the risk of further escalations of violence threaten Palestinians living in occupied Palestine.

Achievements

In 2016, MAP successfully developed and expanded medical training projects in Gaza and the West Bank to build hospital teams’ capacities to respond to emergencies and to reduce the number of patients having to travel outside to receive treatment. With 200 patients operated on by the new Gaza Limb Reconstruction team over the past two years, the Ministry of Health has saved £1m in referral bills. Pictured are the MAP-trained burns unit team in Nablus, West Bank.

We continued to support hospitals with essential supplies, dispensing $80,000 worth of medicines and supporting blood banks to collect 7,734 units in 2016.

In Lebanon, MAP’s support for life-saving hospital treatment for Palestinians displaced from Syria was expanded to cover the cost of vital medication for multiple sclerosis and cancer patients. 106 patients including 15 children received lifesaving treatment.

Emergency Preparedness and Response: 2016 in figures

Mental Health and Psychosocial Support

Programme Spend: £920,000

Children displaced from Syria take part in play therapy in Burj el Barajneh Palestinian refugee camp, Beirut

Challenges

With the war in Syria now entering its seventh year and Palestinian families from Syria suffering long-term displacement in Lebanon, mental health and psychological support services are needed more than ever. In the West Bank and Gaza, the occupation has been ongoing for almost 50 years, and the accompanying policies, including house demolitions, forced displacement and checkpoints which restrict movement continue to cause immense mental and psychological stress in the population.

Achievements

In the old city of East Jerusalem, the effects of the occupation are felt particularly acutely. MAP is supporting the Saraya Centre to provide activities for children (pictured) and support for teachers which aim to strengthen the community’s resilience in the face of massive pressure. 400 children took part in activities in 2016.

In Lebanon, we continued our partnership with UNICEF and local Palestinian community organisations to bring mental health and psychosocial support to 24,192 children and 13,588 caregivers affected by the Syria crisis. We aim to mitigate the impact of war and displacement and protect children from exploitation, abuse and neglect.

Mental Health and Psychosocial Support: 2016 in figures

Disability

Programme spend: £159,000

Children participate in activities in the MAP-supported Early Intervention Centre for children with disabilities, south Lebanon

Challenges

People with disabilities are among the most marginalised individuals MAP serves and there is a strong correlation between disability and poverty. In low-resource environments such as Gaza, there are few dedicated health services, and discrimination, social isolation and marginalisation are all too common. In Lebanon, the Syrian crisis has only served to divert funds away from disability services towards emergency response, resulting in the emergence of a critical gap which MAP is working hard to bridge.

Achievements

MAP takes a social and rights-based approach to removing the barriers which stand in the way of people with disabilities participating fully in society.

In Lebanon, MAP’s work has focused on providing early intervention, rehabilitative services and educational support, reaching over 300 children with physical, mental and learning disabilities (pictured). In Gaza, MAP supports local organisations to empower people with disabilities to claim their rights and become leaders advocating for schange within their communities. 30 people with disabilities carried out on the job training and four were offered employment as a result.

Campaigns and Community Action

Programme spend: £149,000

Dr Philippa Whitford MP launches MAP's breast cancer campaign at the SNP conference

Our Impact

As well as tackling the medical needs of Palestinian communities, MAP is committed to addressing the root causes of these needs.

2016 saw significant challenges to Palestinians’ rights, with the acceleration of the demolition of Palestinian homes and livelihoods in the West Bank, tightening restrictions on movement for those living in Gaza, and no end in sight for Syria’s devastating civil war.

This year we have expanded our partnerships with organisations in the UK, Palestine and Israel and across Europe working to highlight these issues and drive political and diplomatic action to address them.

As Palestinians mark the 50th anniversary of the occupation of Palestinian territory and the 10th anniversary of the blockade and closure of Gaza in 2017, MAP will continue to campaign in the UK and internationally for the removal of the political and social impediments to Palestinian health and dignity.

“Is now not the time, more than ever, for the United Kingdom Government to be entirely consistent and to remind the world, without any qualification, that settlements in the Occupied Palestinian Territories are illegal?”

William Wragg MP (Con), who visited the West Bank with MAP and Caabu in April 2016, speaking in a debate on Israeli Settlements in February 2017.

Achievements

Parliament work and delegation

In 2016 MAP continued to work together with the Council for Arab-British Understanding (Caabu) to support two cross-party delegations of UK Parliamentarians to visit Israel and the occupied Palestinian territory. On return, these MPs have been actively promoting an informed political debate on issues affecting Palestinians, tabling parliamentary questions and speaking out in support of Palestinian rights, including the right to health, during debates.

Breast Cancer

In October, MAP marked Breast Cancer Awareness Month with the launch of a campaign to expose the damaging impact of the occupation on access to breast cancer treatment. In partnership with Physicians for Human Rights – Israel we published a fact sheet and infographic highlighting these issues. This was launched by MP and breast cancer surgeon Dr Philippa Whitford, recently returned from a visit to the West Bank and Gaza with MAP, at a side event at the Sottish National Party (SNP) annual conference.

Cycle Palestine 2016

Last September, a group of 24 intrepid cyclists braved the heat and hills of the West Bank for the Cycle Palestine 2016 (pictured). The trip covered 230 km from the northern most point of the West Bank, Jenin, to the lowest point on dry land, The Dead Sea, and raised over £116,000.

“So pleased to have had the privilege of cycling with you and sharing unforgettable experiences. Appreciating all our freedoms and hoping that our friends in Palestine will one day be free from occupation.”

Celia Richardson, Cycle Palestine 2016 participant

Meet MAP's Partners

Through our offices in occupied Palestine and Lebanon, we work with trusted and experienced local partners to achieve our vision of a future where all Palestinians can access an effective, sustainable and locally-led system of healthcare.

Hashem Hashem

Health Educator in MAP’s Reproductive Health project in partnership with Naba’a, Ein el Helweh Camp, Lebanon

Tell us about the work you do

I work for Naba’a, a local organisation, to conduct health education sessions for young people, men and women, on topics including drugs, smoking, nutrition, and sexually transmitted diseases.

What were the biggest challenges you faced in this work in 2016?

We are facing increasing challenges in our work with young people – many are becoming involved in armed conflict. When a young person graduates from school and doesn’t find work (the case of most Palestinian refugees in Lebanon), armed factions try to lure them by offering them money. Young people see this as an opportunity to get an income, but they are not aware of the risks they face as a result. This is an issue we will be working on more and more in the next year.

What was your highlight of 2016?

We do see lots of successes in our work: I also conduct awareness sessions for men - mainly with refugees from Syria that live in collective gatherings. I see what they ask for and then prepare a session. Most often, the participants ask for sessions on the topic of drugs; addiction is a common problem in the camp. After attending the sessions, many people come to the centre to ask for help. We run a programme that specifically works with drugs users and facilitates access to treatment for them. We have seen good results over the years.

It can be difficult to engage men in these ‘taboo’ topics, but I find that by meeting men where they are comfortable, they become more responsive and collaborative.

Mohamad Aslan

Nurse in the MAP-supported Limb Reconstruction Unit, in partnership with Al Shifa Hospital, Gaza

Tell us about the work you do

I work as a nurse in the first Limb Reconstruction team in Gaza, which is a unique job. I believe that my profession is of crucial importance because of the role nurses play in ensuring the highest standards of care despite big gaps in resources at the Ministry of Health.

What were the biggest challenges you faced in this work in 2016?

This year, as part of my role in the new Limb Reconstruction unit, I was supposed to travel to the UK for a fellowship at King’s College Hospital to advance my skills, but my visa was rejected three times. This had a really negative effect on me psychologically. However, in the end, and with the help of MAP and IDEALS, I was able to finally visit King’s College Hospital in late 2016 to finish my fellowship.

What was your highlight of 2016?

A huge highlight of the year for me was being able to finally complete my fellowship. This really advanced my career and I’m now at the top of my peers when it comes to Limb Reconstruction care. Despite the difficult journey reaching my destination; I really enjoyed visiting the UK for the first time in my life.

I am very glad to have been able to work in a field which I am fascinated by. Thanks to my training, I have been able to deal with highly complex cases that I could never have dealt with previously. I have learned new dressing techniques, and more sterile methods of dealing with patients.

Dr Rohi Fityani

Doctor working with MAP’s Mobile Health Clinic in partnership with the Islah Charitable Society, occupied West Bank

Tell us about the work you do

I treat patients within Bedouin communities, conduct medical and clinical examinations and prescribe medicines for them. These communities are vulnerable and isolated, but they deserve the right to health just as much as all other patients in the world, regardless of their age, race, and ethnicity.

What were the biggest challenges you faced in this work in 2016?

The poor infrastructure and maintenance of the roads cause harm to the mobile clinic vehicle. These problems, and road closures by the Israeli authorities, sometimes mean that we can’t get close enough to the community we are visiting and have to conduct examinations quite far away. This causes problems for the elderly and children as they have to walk to meet the mobile clinic.

We also have a problem that men don’t always attend the medical examinations; they don’t show enough interest in their health. We are trying to counter this with health education.

What was your highlight of 2016?

My highlight has been to treat lots of patients and provide them with the medicines they need. We were also able to diagnose many people with hypertension. Hypertension is a silent disease and so we are especially glad to diagnose it at its early stages so they can get treated as soon as possible.

Finance and Accountability

Income & Expenditure

MAP has changed its financial year-end from March to December to align our financial year with our overseas offices. Our next reporting period will be for twelve months from 1st January to 31st December 2017.

Our income in the nine months to 31st December 2016 was £4.2m which was £0.7m ahead of budget. The majority of our income comes from our individual supporters. We also receive institutional and partnership income. Support from UNICEF for mental health and psychosocial support programmes in Lebanon, support from Muslim Aid for our work with malnourished children in Gaza, and from UN OCHA for our emergency hospital treatment fund in Lebanon, have all enabled us to continue in our mission working for the health and dignity of Palestinians.

Total expenditure in 2016 was £4.3m: £3.7m spent on programmes and £0.6m invested in fundraising for future programme sustainability.

Standards

Accountability

We ensure that funds are directed to appropriate projects and that we comply with international regulations and industry standards. MAP has a comprehensive project approval and control process which is implemented in line with best international practice.

Transparency

MAP works to be as transparent as possible about our governance, our activities and our finances. We publish the names of our trustees and directors, details about our programme activities, our annual review and fully audited annual accounts on our website.

Protection of vulnerable people

The protection of children and vulnerable adults is critical; we are committed to maintaining the highest standards within our organisation and partners’ and to the regular review of our policies and protocols and the training of all staff.

MAP is a member of the following alliances and membership bodies which aim to improve our own work as an NGO but also contribute to improving the sector as a whole.

MAP works in partnerships with Palestinian organisations and in co-ordination and collaboration with other humanitarian stakeholders.

MAP works with Bond, the UK membership body for NGOs working in international development, and its members to influence the policies and practice of governments and institutions.

Through AIDA, MAP works in cooperation with over 80 international NGOs working in occupied Palestine to ensure greater accountability within the donor community and increased aid effectiveness.

Future Plans

2017 anniversaries

In 2017, we will mark a series of significant anniversaries which serve to remind us just how much there is still to do. After almost 50 years of occupation, hundreds of checkpoints obstruct Palestinians’ access to clinics and hospitals. In occupied Gaza, nearly 10 years after the blockade was first imposed, it is tighter and more restrictive than ever. The 100th anniversary of the signing of the Balfour Declaration reminds us of Britain’s historic responsibility for its ongoing impact on Palestinians.

In 2018, we will mark 70 years since the Nakba, or ‘catastrophe’ in Arabic, when two thirds of the population of Palestine fled their homes during the 1948 war and the establishment of Israel. Since then these families have lived as refugees, mostly in neighbouring countries, prevented from returning to their family home that most of them have never seen.

With the help of our supporters, MAP will mark these anniversaries with community events, campaign actions and increased humanitarian support in occupied Palestine throughout the year.

Key Campaigns

Our Health and Dignity Campaign, running throughout 2017, sees our Palestinian partners and friends demand their basic rights, denied for too long by prolonged, manmade crises: the longest military occupation in the world today and a decade of blockade and closure in Gaza. Palestinians and people across Britain are calling on the UK government to take action to bring these humanitarian crises to an end. You can support this via our website: map.org.uk/actnow

New Programme Strategy

Last year, MAP developed a new three-year programme strategy: 2017-20. The new strategy sets out how we will improve the health of the Palestinians and the technical and professional capacities of our partners, as well as raising awareness of violations to the right to health.

To achieve these objectives, we will implement and support projects under the following programme areas which have been identified as the most pressing needs:

  1. Essential primary and public health care (previously primary healthcare)
  2. Women and Child healthcare (previously maternal and child health)#
  3. Mental Health and Psychosocial Support
  4. Disability
  5. Emergency Preparedness and Response

The strategy also outlines a set of cross-cutting issues that all our projects should take account of and integrate sufficiently into their design, implementation and evaluation: capacity building and training, gender mainstreaming, protection, access for marginalised groups, and evidence-based need and design.

Thank you!

The achievements reported in this review would not have been possible without the generous support of our Patrons, Trustees and Key Supporters. Our thanks to all!

President

The Baroness Morris of Bolton OBE DL

Patrons

Honorary

  • Dr Swee Chai Ang FRCS
  • Sir Terence English KBE, FRCS, FRCP
  • The Baroness Kennedy of the Shaws QC
  • Isaac Nusseibeh MBCHB, LMSSA, FRCS
  • The Rt Hon Lord Steel Of Aikwood KT KBE PC

President's Circle

  • Dr Peter Barham & Dr Jennie Metaxa-Barham
  • Magdi Jameel
  • Fadi Kassis
  • Bernard Lo & Anne McGhee
  • John Payne
  • Alistair and Dale Thomson
  • Heba Zaphiriou-Zarifi

Chairman's Circle

  • Mazen Arafat Nomura and Sophie Tremolet
  • Mr & Mrs Roderick Cooke
  • Mr & Mrs Mayassi
  • Anthea Norman-Taylor
  • Kirkland and Patrick Smulders

Board of Trustees

Alan Waddams (Chair)

Siham Bortcosh (Treasurer)

  • Alan Philps
  • Laith Almasri
  • Johnny Rizq
  • Andrew Karney
  • Phyllis Starkey
  • Ezzidin Gouta
  • Steven James
  • Peter Coleridge
  • Jean Bowyer Brown
  • Sir Vincent Fean
  • Lina Nashef

Partners and Donors

ABC International Bank PLC | The B & P Glasser Charitable Trust | Bank of Palestine | Gareth Beynon | The Bryan Guinness Charitable Trust | Cambridge Applied Physics | The CB & HH Taylor 1984 Trust | Professor Tony Davies | Professor Joseph Farrell | Hugh Symons Charitable Trust | Islamic Relief | The John Swire 1989 Charitable Trust | The Mactaggart Third Fund | The McLain 8 Strands Foundation Ltd | The Mirianog Trust | Muslim Charity | Muslim Aid | The P&W Webster Trust | The Pilkington Charities Fund |Mr & Mrs Pountain | The Pump House Trust | The Ridgeback Charitable Trust | Thomas Norman Franklin’s Charitable Trust | John Trythall | UK Islamic Mission |UN OCHA | UNICEF | Lawrence Waterman

Raising MAP's Profile

Yasmin Alibhai-Brown | Bill Bailey | Caryl Churchill | Bella Freud | Jeremy Hardy | David Morrissey | Camilla Rutherford | Juliet Stevenson

Senior Management Team

  • Tony Laurance CBE, CEO (until December 2016)
  • Iain McSeveny, Finance
  • James Denselow, Media and Campaigns (until November 2016)
  • Jo O’Neill, Marketing
  • Dr Andrew Ferguson, Programmes
  • Mira Al Mukarker, West Bank
  • Marta Petagna (until October 2016), Lebanon
  • Dr Ali Dakwar (acting from November 2016), Lebanon
  • Fikr Shalltoot, Gaza

In March 2017, we were delighted to welcome Aimee Shalan as CEO and Neil Sammonds as Director of Advocacy and Campaigns.

Key Relationships

Paul Julien and Kate Mason

33a Islington Park Street, London, N1 1QB, United Kingdom +44 (0)20 7226 4114 info@map.org.uk

Follow MAP on Twitter and facebook

MAP is a Charitable Company Limited by Guarantee. Registered Number 3038352 England. Charity Registration No. 1045315.

Credits:

Richard Gray

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