Anemia rates and high infant mortality among children in Gaza are cited by NGOs and UN agencies as evidence of a humanitarian crisis caused by the "Gaza siege." Examination of the actual data however shows that anemia rates have probably not changed much in Gaza and the West Bank since 1990, that childhood anemia is endemic among Palestinians outside of the occupied territories, and that higher anemia rates are found in other parts of the world. Infant mortality rates have declined slightly since 2000 and are less than infant mortality rates in Turkey, Syria and Egypt.
A UNICEF announcement of April 2008 which has been widely cited as evidence of the humanitarian crisis caused by the Israeli "siege," actually states that the situation is little changed since 2000. This suggests that there is no acute humanitarian crisis at all in Gaza as regards child health care and nutrition, relative to other parts of the world, and certainly no crisis caused by Israeli measures taken in recent years. Judging from these data, the Gaza "humanitarian crisis" appears to be a hoax. Health statistics have been deliberately and cynically manipulated for political purposes.
In 2002, widely quoted and quite alarming figures supposedly showed that about 19% of Gaza and West Bank children suffered from anemia, attributed to the malevolence of the cruel Zionists by diverse sources (for example see electronicintifada.net/v2/article616.shtml and lutheranworld.org/What_We_Do/OIAHR/Documentation/ELCJ-Newsletter_August-2002.pdf). By 2008, headlines were claiming anemia rates of 50% or more.
The following accusation appeared in a letter to Barack Obama circulated on many Web logs and Web sites, as well as by World Vision and other charities:
Last April, UNICEF reported that more than 50% of children under five in Gaza are anemic...(one of many sources on the Web: pjoris.blogspot.com/2009/02/to-president-obama-re-gaza.html)
Another report from 2008 gives a similar estimate of anemia in Gaza:
A Palestinian human rights commission has warned that 46% of Gaza children were suffering from anemia due to their parents' inability to feed them properly as a result of the brutal siege imposed on Gaza by the Israeli occupation government, which deprived those parents of work. (cited here
Not only do they offer a number, but they offer an opinion as to the etiology of the epidemic.
It seems from the above as though all the children in Gaza are doomed to die by Zionist cruelty, but is it really so?
"Anemia" is measured in gram/dl, and norms are determined for different age groups. For children, mild anemia is defined as less than 11 grams/deciliter (g/dl) of hemoglobin by the World Health Organization (WHO), moderate anemia is defined as 7.0-10.9 g/dl of hemoglobin. while severe anemia is defined as less than 7 g/dl of hemoglobin. A careful study of anemia in Gaza and the West Bank in children aged 6 months to 5 years done by Al Quds and Johns Hopkins university scientists in 2002 found that 18.8% of Gaza children were anemic by the criterion of less than 10 g/dl of hemoglobin (moderate to severe anemia by WHO standards) (Table 13 in the study). That is similar to the 19% figure quoted by Electronic Intifada for 2002. But by the criterion of 11 g/dl of hemoglobin (mild, moderate and severe anemia by WHO standards), the study found that 44% of the subjects fall below the norm in Gaza, about the same as the 2008 figures cited above.
Was this deficiency due to the Intifada? Evidently not. The study also noted:
Previous studies using a hemoglobin of < 11.0 gm/dl to define anemia suggest that the prevalence of anemia in preschool aged children, and specifically iron deficiency anemia, by far the most common type, is endemic in the Palestinian population:
* UNRWA/CDC, 1990, West Bank: 57.8%
* UNRWA/CDC, 1998, Gaza Strip: 52.8%
* UNRWA, 1998, West Bank: 49.7%
* UNRWA, 2000 birth year cohort, West Bank: 29.7%
* UNRWA, 2001 birth year cohort, West Bank: 39.0%
A study by Birzeit and Case Western university researchers that was reported in 2005 showed anemia (less than 11 g/dl) rates of 41.6% in Gaza children versus 35.5% in West Bank children. Anemia decreased monotonically with age. For age 6-11 months, it affected 56.7% of the children overall, 53.4% in of those 12-23 months old, 24-35 months: 37.6%, 36-47: 30.4% and 48-59: 19.8%.
The various studies seem to show that by criterion of less than 11 g/dl Hemoglobin, anemia rates have remained at about 50% depending on age group in the Gaza strip. Different sampling methods and assays are inevitably going to produce different results, but it is probably safe to conclude that that the 52.8% of 1998 is not much different from the figures quoted for the present decade, up to and including 2008.
This in itself would be seem to be a severe indictment of Israel, if not an indication of a "crisis" in Gaza, until we examine childhood anemia rates outside the Gaza strip and West Bank. A study by Hassan et all reported:
A nutrition survey was performed in 1990 among children 6 through 35 mo of age living in Palestinian refugee camps in Syria, Jordan, the West Bank, Gaza Strip and Lebanon. Overall, 67% [95% confidence interval (CI): 66, 68] were anemic (hemoglobin < 110 g/L), ranging from 54% in the West Bank to 75% in Syria.
The Israeli occupied territories had the lowest childhood anemia levels in that study.
Still, it would seem from the above that there is a chronic, if not urgent problem of anemia among Palestinian children in general. That may be true, but it is a problem that is common to large parts of the world, using the criterion of less than 11 g/dl of Hemoglobin. In oil rich Saudi Arabia for example, the WHO database lists a 1988-9 study showing child anemia rates of 37%.
In fact, it seems that childhood anemia seems to go hand in hand with poverty and poor medical and is highly prevalent. Many countries have rates as high or higher than those Gaza. Yet in no case has their been an international outcry comparable in any way to the alarm raised regarding the supposed humanitarian crisis in the Gaza strip. For Egypt, the WHO database has several studies showing anemia rates of 55% to 79% among children in the relevant ages. In India anemia rates are reported as 68.9 to 85% for children. In the Russian Federation Republic of Ingushetia, a 2001 study in the WHO database found that 58% of 1-3 year olds were anemic. A 1999 study of anemia in Tibetan children found anemia rates of about 90%. 90% anemia in occupied Tibet, but nobody is suggesting boycotting China, and nobody is writing letters to President Obama about it!
How come all these children are not dying en masse around the world? Remember that deficiencies between 11 g/dl and 10 g/dl are "mild anemia." They constitute the major part of the "anemic" children in Gaza according to this WHO criterion. This level of anemia is relatively harmless and is usually greatly ameliorated after age 5. The statistic is used by WHO as a warning of a possible problem.
And what about the claim that UNICEF found in April 2008 that half the children in Gaza are anemic because of the Israeli "siege"? What UNICEF actually claims in its report of April 4, 2008 is this:
Infant and under five mortality rates have seen little changes since 2000...Iron deficiency anemia affects more than 50 per cent of under-fives.
As suggested by the other data, UNICEF notes that the situation is unchanged since 2000. The anemia and infant mortality are not due to anything that Israel did in the last two years.
In fact, the one year infant mortality rate in Gaza has evidently gone down steadily. It is now listed as about 20 per thousand live births for males, compared, for example, to 27 per thousand in Syria, 30 per thousand in Egypt and 40 per thousand in Turkey.
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