ec.europa.euec.europa.eu/echo/files/evaluation/watsan2005/annex_file… · Web viewPumping...

EUROPEAN COMMISSIONHUMANITARIAN AID DEPARTMENT (ECHO)

UNIT COSTS OF HUMANITARIAN ACTIVITIES IN THE MIDDLE EAST

CLUSTER

Document is based on Johan Heffing mission from 20 November to 1 December 2004

Special thanks to the ECHO Regional Support Office in Amman (Robert Watkins, Olivier Rousselle, Alain Robyns and Sebastien Carliez)

And to the ECHO office in Jerusalem (Alberto Oggero and Bart Witteveen)

TABLE OF CONTENTS

1. INTRODUCTION AND OBJECTIVE OF THE MISSION.................................3

2. METHODOLOGY..............................................................................................4

3. RESULTS............................................................................................................ 4

3.1. Global overview of the annual ECHO budget in the Middle East...............4

3.2. Some statistics............................................................................................ 6

3.3. Health ..................................................................................................... 8

West Bank and Gaza................................................................................8

Lebanon.................................................................................................. 14

3.4. Food aid................................................................................................... 17

3.5. Food security............................................................................................ 21

3.6. Water and sanitation.................................................................................23

Cistern construction in the West Bank/Gaza Strip for rainwater harvesting..................................................................................23

Use of grey water treatment units in OPT (liquid waste disposal)......24

Results from Lebanon and Yemen programmes..................................25

3.7. Permanent shelter.....................................................................................35

3.8. Post emergency – semi permanent shelter................................................41

3.9. Psycho-social activities.............................................................................44

3.10. Activities for disabled..............................................................................53

3.11. Emergency job creation (income generation)...........................................58

2UNIT COSTS OF HUMANITARIAN ACTIVITIES in the MIDDLE EAST CLUSTER

DECEMBER 2004

1. Introduction and objective of the mission

The main purpose of the mission was to examine the possibilities to establish a data collection mechanism on unit costs in the cluster of the Middle East, similar as the exercise that was done in Sub Saharan Africa in 2001. The challenge was to get, in a short time, familiarised enough with the Middle East programme through documents and discussions with the ECHO and partner staff to make an assessment if and how this system could be established. The help from the RSO in Amman (and in particular Alain Robyns) and in Jerusalem (Bart Witteveen and Alberto Oggero) was therefore crucial.

The present document is only the beginning of a process. It tries to assembly some data on the different activities in the different sectors. Information is in many cases partial only and the subsequent additional data collection methods or the areas for which clarification from the partners is needed have been discussed with the two teams.

As a preliminary conclusion, I would say that without any doubt there are enough data available to have an initial estimation of the cost for the different activities established and therefore a unit cost data base is possible and can be useful. With additional effort and interested ECHO experts, in one year time there could be a serious and relatively complete databank existing in the cluster of the Middle East (containing OPT, Lebanon, Syria, Jordan and Yemen). Clearly Yemen is somehow an exception on the rule, but still has been included to make the comparison. Yemen seems to fall more in line with the results of the Sub Saharan Africa cluster.

The critical elements to lead to a full result are the following:

An interested RSO in Amman with a focal point who can continue to promote the idea of unit cost data as important elements in the cost efficiency evaluation and who can function as centralising and motivating factor. This focal point should be the guardian to work out further this document. The RSO staff should discuss who would be the best place person for this role.

Interested field experts who see the advantage of feeding data to the centralising focal point in the RSO because they get the feedback from other countries in the Middle East

A supportive group of partners who understand the importance for ECHO and for themselves to look at cost data (already UNRWA finds this exercise for shelter quite useful and cooperate fully)

A supportive ECHO 2 Headquarters who stimulate their experts to participate in the exercise and who also bring in data

Potential expansion into other areas or regions. Already, a link with the SSA data bank (which needs updating) could be established.

This document is far from finalised and can only be considered as a draft framework for further exploration. I hope it can already give some useful information but it should be further updated, verified, discussed and fine-tuned. I hope this will be possible.

Whether or not, this exercise can be duplicated in other areas (soon to be) covered by the RSO in Amman, remains to be discussed. It would be interesting to first assess the


DECEMBER 2004

usefulness of the data in the Middle Eastern cluster before other clusters are defined and examined (e.g. Chechnya, Tajikistan, Western Saharan refugees,…)

2. METHODOLOGY

The methodology as followed for this exercise is summarised below:

General briefing on ECHO’s programme in the countries of the Middle East

Standardisation of the typical set of ECHO financed activities following as much as possible the FPA structure and where necessary completing this structure.

Selection of sample projects covering these activities

Identify and define in detail a specific activity or a set of activities to which a specific part of the budget can be attached (this is sometimes taken from the proposal, from the final financial report, from interim reports or from appeal documents, etc) (1) Data from different sources are compared where possible.

Compare different unit costs between the different countries and try to see some consistencies.

In the long term, to update current data and to further develop the unit cost databank, a standard worksheet model can be used and filled in with standard information and then centralised on RSO level. The RSO should be responsible to issue regular updates of what is after all a dynamic document.

3. RESULTS

3.1. Global overview of the annual ECHO budget in the Middle East

Roughly, ECHO finances about 30 to 38 Million € in the Middle East and somewhere 2 to 3 M€ in Yemen per year. In the Middle East, the larger part of the budget goes to the West Bank/Gaza Programme (80 to 85% or 28 to 34M€). Second is Lebanon varying between 4 to 6 M€/year. Minor parts of the budget go to Syria and Jordan.

Budget Middle East ECHO2001 30 M€2002 35 M€2003 38 M€2004 35 M€2005 34 M€ (as planned)

For the sector and partner breakdown of the major part of the budget (West Bank/Gaza) see details below

ECHO WEST BANK + GAZA 2004 and 2003 budgets

1 We are aware that more consistency should be brought into the methodology to use the financial data. However, information is so sparse that sometimes any data that are more or less clearly stated is welcome in this stage of the exercise. It is at the same time remarkable that after so many years of ECHO’s existence we have not developed a better system to collect these financial data.


DECEMBER 2004

Sector Budget 2004 Budget 2003

Income generation 5,471,051 6,691,000

Protection 2,000,000 1,500,000

Health 4,814,387 4,755,058

Coordination 157,996 1,560,240

Food security 7,010,000 15,101,783

Watsan 5,567,752 3,557,400

Psycho social 1,031,406 1,170,000

Other 2,350,000 0

Total 28,402,592 34,335,481

Partner Budget 2004 Budget 2003

UN 10,285,096 16,655,298

INGO 16,117,496 11,680,183

ICRC 2,000,000 6,000,000

Total 28,402,592 34,335,481

ECHO WEST BANK AND GAZA 2004


DECEMBER 2004

Income19%

Protection7%

Health17%Coordination

1%Food Security

24%

Watsan20%

Psycho-social4%

Other:8%

ECHO WEST BANK + GAZA 2003

Income19%

Protection4%

Health14%

Coordination5%

Food Security45%

Watsan10%

Psycho-social3%

3.2. Some statistics

Refugee camp profiles (UNRWA figures for refugee data, as of 30 June 2004))

Field of operations

Official camps

Registered refugees

Registered refugees in camps

Total population in host country UNDP 2002

Jordan 10 1,758,274 281,211 5.3 MLebanon 12 396,890 192.557 3.6 MSyria 10 417,346 110,450 17.4 MWest Bank 19 675,670 177,920 2.4 M (est)Gaza Strip 8 938,531 464,075 1.2 M (est)UNRWA total 59 4,186,711 1.226,213 29.9 M

Plus approximately 200,000 settlers in West Bank and 7,000 settlers in Gaza Strip (verbal communication and pure estimates, currently these figures may change).


DECEMBER 2004

Mortality ratios (UNICEF “The State of the world’s children 2005”, figures mostly for 2003)

Country Under 5 MR (per 1000 live births

Infant MR(per 1000 live births)

Maternal MR (2000 adjusted)(per 100,000 live births)

Jordan 28 23 41Lebanon 31 27 150Syria 18 16 160OPT 29.1 25.2 100Israel 6 5 17Least developed countries

155 98 890

Sub Saharan Africa 175 104 940

The UNRWA agency has a total general fund budget (special appeals are to be added) of approximately 351 Million U$ annually (2004) or a per refugee budget of 84 U$ per year.

UNRWA spends these funds as follows:

54% in education (189 MU$)

18% in health (62 MU$)

10% in relief and social services (34 MU$)

6.5 % in operational services (23 MU$)

12.3 % in common services (43 MU$)


DECEMBER 2004

3.3. Health

West Bank and Gaza The health sector financial data from the MOH in the WB/GS are unclear and different reports show different results and sometimes contradict each other.

Maybe the most comprehensive and trustworthy (and certainly worthy of reading) report is the “Health sector Review in West Bank and Gaza Strip”, (October 2003 draft report) by HERA (Health research for action) & Alter (Santé Internationale & développement) & Health Partners International. This report provides the following information (figures for 2002): TOTAL EXPENDITURE IN 2002 BY THE DIFFERENT HEALTH PROVIDERS AMOUNTS TO 256 MU$ or (assuming 3.6 Million people in WB/GS), 71 U$/INHABITANT.

Expenditure in Primary Health Care (most relevant aspect of the health providing system for ECHO): approximately 74 Million U$ or (assuming 3.6 Million inhabitants) 20.5 U$ per inhabitant, broken down as follows

o MOH: 38 MU$o Local NGO’s (from donors): 20 MU$o UNRWA: 15 MU$

Expenditure for hospital care : approximately 126 Million U$ or 35 U$/inhabitant

Other expenditure (administrative expenditures and centrally procured drugs): approximately 56 MU$ or 16 U$/inhabitant

Comments:

This amount per inhabitant is higher compared to the average in Sub Saharan Africa (SSA) (24 U$/inhabitant) but quite low compared to Industrialised countries (1860 U$/inhabitant). In SSA, ECHO traditionally invest an amount varying from 1 to 12 € into the health of one inhabitant. The 12 € is rather preserved for situations like refugee camps or a settled IDP camp population with a high attendance rate of up to 4 new cases/person/year.

See also World health report 2003 for a broader reference framework:

Country rank Annual per capita income in U$

Annual health spending in U$

High-income > 8,000 1000 – 4000

Middle-income 1,000 to 8,000 75 – 550

Low-income < 1,000 2 – 50

UNRWA regional 12.8 per refugee

17.3 per user


DECEMBER 2004

Proportionally too much funds go to hospital care and the primary care is receiving only a minor part of the total (49% compared to 29% for PHC). The health system in the OPT is suffering from the fact that a very significant proportion of the funds are spent on referrals abroad of a limited group of privileged politicians or their families for often less than live saving situations (e.g. in vitro fertilisation)

The health delivery system suffers from lack of access (security related), duplication of services without proper coordination between the different health providers and from the lack of a general regulatory framework normally established by the governmental health authorities. Also amongst the partners (international and local NGO’s), it is difficult to find any clear country health strategy. Most NGO’s have an individualistic approach and overlap geographically with their programmes and duplicate with the MOH services.

As the access problem is crucial and an otherwise relatively dense health delivery system is not used in a very practical and cost efficient way, a large part of the health expenditures is lost, resulting in gaps in geographic coverage, financial gaps and a deficient emergency health service.

To mitigate the access problem, local and international NGO’s and UNRWA have established the system of mobile emergency teams. This system is quite expensive and is usually considered as the solution of the last resort. In this situation, it seems however justified. Some cost evaluation:


DECEMBER 2004

Cost per beneficiary

Emergency mobile teams (MEDICO International Germany)

Based on project

ECHO/ME/BUD/2004/01016

Per person covered (real contact) 5.08 €/new contact

Per year and per inhabitant in the catchment area

3.02 €/inhabitant

Includes: 1 team includes 2 physicians, 2 village health workers, 1 lab

technician, 1 driver (4 teams in this case) Vehicle running costs standard medical equipment drugs, disposables and lab material coverage of approximately 0.6 New cases/inhabitant/year

Emergency mobile teams UNRWA

Based on the appeal document: UNRWA emergency appeal 2005

Per person covered (real contact)

4.15 U$/new contact

Includes a medical officer, practical nurse, lab technician, pharmacist and lab

technician driver visits on a weekly or bi weekly schedule offers a full range of essential medical services including Maternal

and Child health services, immunisation, control of communicable and non communicable diseases and first aid for conflict related injuries

11 % Programme Support Costs one team covers approximately 2000 new cases/month


DECEMBER 2004

Case study of ECHO’s health sector approach in OPT as a practical application of the unit cost approach

Approximate total investment in the health sector per year: 5.3 M€ (ECHO)

Via 7 NGO partners

Increased streamlining by introducing a model intervention based on the following criteria:

Based on the health District approach (clearly delineated geographic area covered by a defined set of health facilities and with a certain degree of autonomy)

Equitable access by all Palestinians (physical and economic) Improved quality and efficiency of services provided by different actors (MOH

and NGO’s mainly) Closer cooperation with the MOH (global discussion needed) to avoid overlap and

increased complementation Clearer definition of what the MOH as an institution and the MOH primary health

structures as service providers can contribute: assessment per cluster needed of MOH structures and available personnel, stocks of drugs and medical supplies, solid mapping of health facilities of MOH and other providers (UNRWA and NGO’s), coverage surveys

Full integration of all activities (no separate interventions) Sharing of the total cost of the PHC according to a model that is to some extent

flexible and adapted to the situation (note no investment in the secondary health care structures = hospitals)

Combination of o Support to the MOH structures in the clustero Support to local NGOs structures in the clustero Reinforcement of outreach via emergency mobile teams to areas that have

difficulties to reach the health structures Combination of curative and preventive activities:

o Curative care of common acute and chronic diseases: provision of essential medicines and diagnostic lab tests (via fixed structures or mobile clinics)

o Integrated immunisation serviceso Screening for acute malnutrition (weight for height) and micronutrient

deficiencies (in particular iron deficiency anaemia) o Treatment of malnutrition cases and iron supplementso Screening of pregnant women at risk for problem deliveries, antenatal careo Refreshment courses or training of medical personnel including village

health workers and traditional birth attendants.o Health education with carefully chosen and culturally appropriate key

health messageso Establishment of transparent fee collecting system with community

involvement (funds remaining at the peripheral level) (also including criteria and procedures for exemptions)

o Emergency evacuation of problem cases (e.g. pregnancies at risk): communication system and logistic back-up)


DECEMBER 2004

Suggested model for application throughout the 7? Clusters in the WB (a similar exercise will be needed for the GS)

Available funds per cluster (indicative): 750,000 € Indicative catchment population per cluster: 150,000 inhabitants Total population covered by ECHO funds: 1,050,000 inhabitants (more than 40% of

WB population) Potential criteria for the choice of the clusters can e.g. be the proximity to the wall as

this is probably the area mostly suffering from reduced access to health facilities. Contribution from the MOH:

o Use of the available primary health care facilities in the cluster (inventory needed)

o Availability of health personnel and payment of salaries o Partial provision of drugs and medical supplies to the MOH facilities

(complemented by project where needed and indicated – see further)o Secondary health care facility

Contribution from project (ECHO funded) o Establishment of mobile teams to cover entire cluster area and increase access,

guarantee emergency evacuation for problem cases and emergency referral to secondary health facilities: logistics, medicines, lab tests, iron and vitamin complements, diagnostic equipment and materials to screen for malnutrition and pregnancies at risk

o Complement of drugs and medical supplies to the MOH structures with as condition a “droit de regard” on the management of the drugs in PHC facility with as final goal the rationalisation of the drug management system

o Support to the local NGO who implements the project: salaries and running costs, technical assistance in two areas (management skills and public health)

o Incentives ?? where needed and indicated for MOH personnel (incentive not greater than 1/3 of salary)

o Organisation with the MOH and local NGO of refresher and training courseso Organisation of health education sessions during waiting hours for mobile

clinics and MoH/NGOs permanent facilities Contribution of WFP and UNICEF

o Supplementary food packages for families with malnourished under fives from WFP

o Vaccines and immunisation materials and equipment from UNICEF Contribution from the population via the fees collected

o Minor running costs of the MOH facilities and temporary accommodation in the areas where mobile teams are visiting

Coverage and financial contribution from ECHO (total cost and contribution from other actors to be investigated further)


DECEMBER 2004

Coverage of 1 new case/person/year>>>150,000 new cases in curative care, leading to a unit cost of 750,000 €/150,000 inhabitants or new cases = 5 € per inhabitant or per new case as contribution from ECHO (2).

2 This contribution will then further be complemented by other donors or by the MOH, NGO, UNRWA or population. Note that this is only covering the primary health care. As a reminder, the total expenditure on primary health care was estimated above at 18.5 U$/inhabitant. Therefore, ECHO would contribute about 35% (6.5 U$/18.5U$) of the total expenditure for PHC for 44% of the WB population with a budget of 5.25 M € (which seems like a balanced policy).


DECEMBER 2004

BUDGETLINE Indicative Budget in € for 1 year

Drugs and medical supplies, iron and vitamin complements, diagnostic materials and equipment (as a complement to the inputs from the MOH)

150.000

Logistics and salaries for mobile teams and establishment of evacuation system

250.000

Training and refresher courses 50.000

Reinforcement of communication system

50.000

Incentives for MOH personnel 30.000

Overhead for local NGO 50.000

Overhead for international NGO 170.000

TOTAL 750.000


DECEMBER 2004

Lebanon Apart from ECHO’s investment in the assistance to disabled and the small component for psycho-social activities, the bulk of the funds is allocated to projects aimed at the provision of primary and secondary health care for Palestinian refugees.

The information available on utilisation of the primary and secondary health care system is partial and does not allow calculating a proper cost per beneficiary. More investigation will be needed.

Some reference data are the following (to be completed and counterchecked)

Reference: Financing and payment of the Palestine Red Crescent Society/Lebanon branch hospitals, A report for the “Het Nederlandse Rode Kruis” October 2003

UNRWA cost per real beneficiary for health 43.49 U$

UNRWA cost per registered refugee in Lebanon for health 23.7 U$

Per capita allocation for health by the MOH in Lebanon 45 U$

Hospital services provided by the private sector are between 1,5 and 3 times as expensive as services provided by the Palestinian Red Crescent Society (PRCS)

= a major partner for ECHO

The financing of these hospitals is ventilated as follows:

Total per year (2002): 4,676,682 U$ (91%) for running costs and 473,562 U$ (9%) for investment costs.

42% from the Palestinian Authority (2.1 MU$) for salaries of the hospital staff

25% from contracts with UNRWA (1.3 M U$)

18% from fee for service for patients (0.9 MU$)

5% from ECHO for medical supplies and drugs (0.253 MU$)

plus from other NGO’s for purchase of equipment, maintenance and rehabilitation

Five main PRCS hospitals have a combined 182 beds and cover 18,915 admissions per year (2002).

The occupancy rate of the PRCS hospitals is relatively low ranging from 39% to 79%.

Average days of stay is only between 1.9 and 2.3 days/patient (which is very low). (The agreement with UNRWA is based on a per diem payment per patient but with a maximum ceiling. This leads to a bias in choice of patients in favour of the simple uncomplicated cases so to avoid complicated long term patient which cost would only partially be reimbursed by UNRWA. Agreement is to be


DECEMBER 2004

reviewed to avoid this kind of bias).

Running costs/number of admissions =

235 U$/admission

which is very high in particular when considering the fact that average length of stay is very low.

The same report mentions however other figures on page 15:

Number of admissions for 2003: 8743 (up to which month, as study report dates from October 2003?)

Total expenditure: 1,060,018 U$ ( I presume without salaries from the PA)

So cost per admission = 121 U$ (without salaries)

Cost per admission for drugs and medical supplies: 43 U$/admission

Alain, to be checked with the Red Cross please !!!!!

Information on attendance rates in the PHC system is also not clearly spelled out.

I presume that the UNRWA Annual report of the Department of health 2003 gives the following information (but to be counterchecked):

Out patient services in 2002

184,952 first visits and 680,047 return visits (not new cases!!!! And therefore not to be included when calculating the attendance rate):

184,952/395,000 registered refugees = 0.47 new cases/person/year covered by UNRWA PHC system which is quite low considering the fact that UNRWA is the main PHC provider to refugees in Lebanon.

The same attendance rate (UNRWA coverage approximately 0.5 new cases/person/year) is also found in the other UNRWA host countries in the region.

Johan, I tend to disagree, we can have the assumption that there are over 1 contact per year in Lebanon considering that health centers are available in all camps, they are free of charge and provide free medicine and refugee consumption of health service is generally high (no much else to do); if the assumption is right we then have a effective refugee population = catchments population of 184,952 persons. All surveys confirm that the number of refugees effectively present in Lebanon is much less than the official UNRWA figures.

The balance with 395.000 are those who are still registered with UNRWA but do not use its services, or are not present in Lebanon but abroad or gulf countries or have not been deregistered because they are dead…


DECEMBER 2004

3.4. Food aid

According to the WFP, as of mid 2004, approximately 1.3 million people in the OPT, or 38% of the population were food insecure. A further 26 percent of the population, or 586,000 people were at risk of becoming food insecure. Refugees were more at risk, 39% of refugees were estimated to be food insecure against 36% of non refugees.

Mainly two organisations are dealing with general food distribution:

UNRWA, concentrating on the registered refugees (covering 65% of all refugees) and

WFP, concentrating on the non refugees (covering approximately 24% of all non refugees) selection criteria are: (see WFP proposal)

o Not being a registered refugeeo to fall under poverty line of 2 U$/dayo unemployed, unskilled workers that have lost their jobs in WB, in

the settlements or in Israel o farmers who have lost their agricultural products due to loss and/or

inaccessibility of land and/or market o IDPs whose family house have been destroyed or confiscated (

UNRWA

For refugees only

For special Hardship cases

Food to be delivered

Number of beneficiaries

Monetary value (all costs included)

Cost per ton

Gaza 88.680 MT 589.000 40 MU$ 451 U$/MT

West Bank 67.752 MT 450.000 31.7 MU$ 468 U$/MT

Total UNRWA (WB and GS) 156.432 MT 1.039.000 71.7 M U$ 458 U$/MT


DECEMBER 2004

30 June 2004

UNRWA figures for refugee registration

Refugees registered in UNRWA’s area of operation was 4,186,711 refugees of which in GS and in WB…..

Total estimated population in GS and WB (not UNRWA figures)

Gaza Strip 938,531 1.200.000

West Bank 675,670 2.400.000

Total 1,614,201 3.600.000

WFP

For non refugee population

For special hardship cases

The WFP programme is slightly more cost efficient. The more so when considering that the programme includes also Food For Work (approximately 10% of beneficiaries) (more expensive per ton) and training, also rations for Supplementary food programme (dry and wet rations). The WFP programme is also more refined in its targeting and livelihoods analysis.

Gaza 25.458 MT 132.200

West Bank 52.968 MT 345.870

Total WFP (WB and GS) 78.426 MT 480.000 34.6 M U$ 441 U$/MT

TOTAL UNRWA and WFP 234.858 MT 1.519.000 106.3 M U$ 452 U$/MT

Presuming 3.6 Million people in WB/GS: UNRWA and WFP together are covering approximately 42% of the total population with food aid (not necessary a full ration though)

Rough estimation of the total coverage (UNRWA and WFP plus other organisations) would be rather around 50% of total population.

Ration for WFP (full ration) = 0.545 gr/day/person or 16.5 kg/month/person

Compared to the full ration of WFP, UNRWA’s ration is only a 83% ration.

Ration for two refugees for 45 days UNRWA

30 kg flower3 kg rice3 kg sugar2 l oil1 kg powder milk2 kg lentilsTotal 41 kg/2 persons/45 daysComes to 13.6 kg/pers/month


DECEMBER 2004

Compare with other regions:

Below information is drawn from a dataset of WFP budgets (total amount of 6 Billion U$), mixture of EMOPs and PRROs from (2000 -2002) (Alessandro De Matteis)

20

Total cost : USD / MT

0

200

400

600

800

1000

1200

Africa Asia ME Europe America

0

200

400

600

800

1000

1200

Africa Asia ME Europe America559655436America

519544509Europe

368329329ME

434547322Asia

591835432Africa

averagemaxminPRRO

482571218America

570650381Europe

391444231ME

432869215Asia

5801046322Africa

averagemaxminEMOP

21

The cost of food commodities

5200401540154015TM F100

4390534553455345TM F75

5400325035003000Therap milk

3600409538314WSB

4000314377276Fort Blend Food

3800463500450Famix

3800294450237CSB

450013922570678HEB/BP5

1800245024752425Canned fish

2650145014501450Dried fish

4000200020002000Canned meat

012630568Salt

3500273375200Sugar

4000400400400Groundnuts

8850663959475Veg oil

3800435463406Lentils

3800376694198Pulses

3800484600365Beans

3410320320320Millet

3450115115115Sorghum

3500195259140Wheat flour

3320143178124Wheat

3600218253200Maize flour

3570156229116Maize

3580235335170Rice

Kcal / MTAVGMAXMIN

0

1000

2000

3000

4000

5000

6000

USD / MT


DECEMBER 2004

26

Reference Unit Costs (€)

7%35 €ISC per MT

18%90 €International transport per MT

23%115 €ITSH/LTSH per MT

6%30 €Personnel (only in country offices, in DSC)

0.13 – 0.14 €Per 1000 Kcal total

45%230 €Per MT purchase FOB

100%500 €Per MT total cost


DECEMBER 2004

3.5. Food security

Food security activities in the strict sense are not a major priority in the Middle East. Some projects are financed in the OPT via ACH and CARE.

Food security for vulnerable families in rural areas by distribution of ewes and other inputs and provision of training

When 10 months (2004)Where West BankBy ACH (Action Contra el Hambre)What Procurement of livestock inputs (ewes, fodder, feeding trays)

Veterinary inspection of ewesAnimal distribution (and other livestock inputs) (2 pregnant sheep)

Amount 480,000 €Beneficiary type

Vulnerable Palestinian families in rural areasVulnerable Bedouin families

Total direct beneficiaries

330 families

Technical expertise

1 food security coordinator 1 socio economist (part time)


1450 € per household

Other

Improvement of food security in villages affected by the wallWhen 12 months (2004)Where West BankBy CARE AustriaWhat Participatory household livelihoods security assessments

Delivery of livestock, material for building sheds, feed and bee hivesDelivery of seedlings and gardening tools, chickens and green house materialRehabilitate 2 km long agricultural access roadTraining in bee keeping, livestock management, home gardening and food processingPromotion of social networks and women’s association

Amount 900,000 €Beneficiary type

Families who have lost their sources of income and are in danger of becoming poor


700 households or 4200 individuals

Technical expertise

4 outreach officers


1285 € per household

Other


DECEMBER 2004

3.6.Water and sanitation

West Bank/Gaza Strip - Cistern construction in the for rainwater harvesting

ECHO partners in the WBGS engaged in water projects often include the construction of household rain water harvesting systems, where the collected water is stored in cisterns. These cisterns typically are of 2 types:

Concrete (square) cisterns: On average 60-70 m3 in volume, this storage unit is constructed out of steel reinforced concrete, with dimensions according to space available. They can be built above ground level, but are usually built partially under the ground-level, requiring excavation (either with machines or by hand) – in some cases they are constructed under the houses, as basement-cisterns (also requiring some level of excavation). Safe and quality construction requires a basic level of expertise, including the use of steel-reinforcement in concrete and the techniques requisite to build basic concrete structures.

Pear shaped cisterns: Also on average 60-70 m3, the preferred (and traditional) choice of cistern, which is cheaper to construct and is fully below ground-level. It requires appropriate soil conditions, where sufficient rock solidity allows for the excavation of a pear-shaped cavern underground, without the need for reinforcement or support. Excavation in the hard-rock sub-surface requires machinery, but other than the ability to operate this equipment, no construction expertise is required. Once the cavity has been excavated, the surface is plastered with a thin layer of cement, to promote hygiene and add surface stability.

Access to both cisterns is usually made through a trap-door, sufficiently large to allow access by a person (for cleaning/repairing), as well as to access the water by bucket. Ventilation/purge pipes are similar in both constructions, as are the filling pipes connected to the roof-top rain water harvesting surfaces (sometimes rain water harvesting is done on ground surface). In many cases a pump unit is added to the cistern to allow for the transport of water to a roof-top water tank, supplying the household pipe network through gravity.

Note: The 60-70 m3 capacity is the volume advised by the Palestinian Water Authority for household cisterns. It is regarded as the maximum volume for a safe pear shaped cistern, though concrete cisterns can be built as large as possible/required, and thus also appropriate for community cisterns.

A capacity of 70 M3 (70,000 liter) gives an autonomy of approximately 70,000/600 liter per day for a family of 6 people = 110 days (Bart please check if this is correct?). This may cover approximately ½ to ¾ of the dry season.

Concrete Cistern (70M3)

No: Description: GVC OXFAM CARE ACH ACPP1 Materials 1,900 1,500 1,750 1,1242 Equipment rent 430 270 400 1123 Skilled labour 320 200 550 2144 Unskilled labour 190 300 80 2375 Pump - 80 100 -6 Other* 500 70 50 - Total: 3,340 2,420 2,930 1,687


DECEMBER 2004

Concrete Cistern (70M3): leaving out the pump and the other

No: Description: GVC OXFAM CARE ACH ACPP1 Materials 1,900 1,500 1,750 1,1242 Equipment rent 430 270 400 1123 Skilled labour 320 200 550 2144 Unskilled labour 190 300 80 2375 6 Total: 2,840 2,270 2,780 1,687

Pear-shaped cistern (60 m3):

No: Description: GVC OXFAM CARE ACH ACPP1 Materials 370 260 520 342 2 Equipment rent 820 660 560 417 3 Skilled labour 270 100 400 100 4 Unskilled labour 140 280 160 326

5 Pump - 80 100 /

6 Other* 500 20

50 /

Total 2,100 1,400 1,790 1,185

Pear-shaped cistern (60 m3): leaving out the pump and other

No: Description: GVC OXFAM CARE ACH ACPP1 Materials 370 260 520 3422 Equipment rent 820 660 560 4173 Skilled labour 270 100 400 1004 Unskilled labour 140 280 160 3265 6 Total: 1,600 1,300 1,640 1,185

Use of grey water treatment units in OPT (liquid waste disposal)

Technical specifications: Small cement tank filtering the waste water to make it useable again with piping.Social and cultural acceptability Bart can you look into this?

Unit cost: Variable upon the size of the tank and the filtration capacity.Approximately 500 to 600 € per unit (1 unit per Household)


DECEMBER 2004

Lebanon and Yemen programmes

01.02.01 Waste disposal and latrines

Definition Intervention involves improving the environmental conditions through community training on safe waste disposal and construction of latrines.Sewage system in semi urban or urban setting or refugee camps with connection to individual shelters or houses, with cleaning or suppression of inadequate septic tanks.

Technical expertise required specialized watsan engineer. Technical validation by external engineering office recommended prior implementation and regular evaluation of work. Close coordination with water intervention and water analysis is recommended.

Indicators 1. Reduction in infections related to poor environmental hygiene such as scabies, diarrhoea and dysentery, etc. (from epidemiological reports)

2. Improvement of under ground water quality 3. Number of families involved in putting up environmental health

facilities such as pit latrines, rubbish pits, dish racks, better ventilated shelters, draining of stagnant ponds etc.

4. Proportion of areas examined where there is no unwanted human waste to be found around settlements

5. Number of household connected to sewage systema. For grey water b. For solid waste

6. Number of latrines put up as compared to original situation7. Number of families per latrine before and after8. Number of latrines actually being used9. Changed behaviour/attitude to environmental health (to be

evaluated via focus group discussion)

For sewage intervention

For the cost per beneficiary there is a need to consider - The cost per Household connected - The type of connection for grey water only or also for solid waste- The cost per meter between drainage at household level and exit point at

municipality line. Entry strategy

- High pollution of underground water due contamination from the surface or from non hermetic septic tanks

- High concentration of population or refugees with inadequate sanitationPreconditions

o Authorisation for sewage connection to main sewage line and or treatment plant


DECEMBER 2004


Sewage system rehabilitation for Palestinian refugees living in refugee camps

When 2004 duration 12 months Where Lebanon – South area By COOPI ItalyWhat Sewage pipes, home connections for grey and black water

Excavation concrete casing around the pipes; back filling; concrete manholes with heavy duty cat iron circular cover 62-65 cm external frame 80x80, PVC European standard sewer pipe 8’’

Amount € 800,000 for 12 monthsBeneficiary type Refugee population living in small gatherings non official

campsTotal direct beneficiaries

4,229 families – Houses connected

Technical expertise

One full time expatriate engineer + project coordinator


€189 per family (including goods & services, support cost, indirect cost)

Other comments

Technical validation document from engineering company was funded and conducted before implementation of the work. Document available.


DECEMBER 2004

01.02.02 Rural water sources

Definition

Development of water supply sources (construction, rehabilitation, regeneration) or protection of existing ones in order to improve the provision of adequate, clean water (increase the quantity and improve quality) and reduce the distance to water points from settlements. Household or village water harvesting and stocking. Water network per gravity to individual village or large village community boreholes or hand dug wells + pump + generator + water tank + fountains or individual connections. NB Rehabilitation of existing water sources is often the most cost-effective and has the most immediate impact in comparison with the development of new resources and should therefore be given priority if and when possible.

Indicators 1. Amount of potable water available per beneficiary per day before and after intervention

2. Improvement in the quality of the water to be evaluated via regular sampling and bacteriological testing (bacteriological test for E.Coli) and chemical testing (heavy metals, fluor, nitrates etc.) see details in annex (should be compulsory for all water programmes) before and after intervention but also during project period with regular intervals

3. Number and type of water facilities developed (e.g. springs protected, water tanks constructed, wells, pans, dams, cattle troughs) and the production capacity of these facilities

4. Reduction in the distance from a community to its nearest water source (before compared to after)

5. Formation of water user associations and evaluation of their functioning (reports, participation, focus group discussion, aspect of cost recovery for maintenance costs, sustainability)

6. Number of water facilities being run by the community themselves on a sustainable basis

7. The degree of reduction of time spent by women fetching domestic water, before and after (via focal group discussions), reduction of queuing time, reduction of number of people before and after

8. Degree of reduction of watering intervals of livestock, mainly small stock

9. Utilization of improved facilities during rainy season.(focal group discussion)


DECEMBER 2004


Rural watsan CARE Triangle DIA UNICEF

Springs €41.07 € 916

Village schemes €39.5

Large schemes per gravity

€82.37

Rural rain water catchments

When 2005 duration 12 months Where Yemen – highlands areas By CAREWhat Spring and rain catchments and storage in water tank and

reticulation system to villagesAmount € 312,908 for 12 monthsBeneficiary type 25 Poor rural communities with water deficitTotal direct beneficiaries

7,500 persons

Technical expertise

One full time expatriate


€41.7 per individuals (including goods & services, support cost, indirect cost)

Other comments Small communities scattered make cost expensive per communities – Specification not available

Rural water supply by gravity

When 2003-4 duration 12 months Where Yemen – Tiramah desertic areas By DIAWhat 2 Water network supplied from deep wells to reservoir

and supply network by gravity to individual housesHygiene and sanitation

Amount € 312,908 for 12 monthsBeneficiary type Poor rural populationTotal direct beneficiaries

4,701 persons

Technical expertise

One full time watsan expatriate, local engineer, female sanitation educator


€82.37 per individuals (including goods & services, support cost, indirect cost)


DECEMBER 2004

Other comments Cost is expected to decrease as increased number of household will connect to the new scheme when convinced that it works – Component of free access to very vulnerableWater meter were used and successful

Specifications Pumping station with Pumps Landini D8/80/14 capacity 8l/s - Generator Iveco

57HP diesel engine Réservoir 160m3 Water network of 27,263 km with PVC and galvanised pipes

Rural water supply by gravity

When 2003-20044 duration 12 months Where Yemen – Hadranamout wadi river area By Triangle What 26 village water schemes supplied from shallow wells

(15m maxi) to reservoir and supply network by gravity to fountains, min 30l/d/pHygiene and sanitation

Amount € 388,000 for 12 monthsBeneficiary type Poor rural populationTotal direct beneficiaries

9,780 persons

Technical expertise

One full time watsan expatriate, local engineer, no female sanitation educator


€39,5 per individuals (including goods & services, support cost, indirect cost)

Other comments H&H component under estimated and poor results. Different technical solutions per village according to the situation- Community contribution for digging wells.

Cost of intervention without support cost, expatriate cost

Small communities: 50-250 inhabitants€5,803 water schemes with well, pump, generator, and water tank;€916 for spring rehabilitation up to €9,583 with one site with solar equipment, Medium communities: 250 - 500 inhabitants €10,416water schemes with well, generator, and water tank; Large communities: 500 – 1,500 inhabitants €18,333 water schemes with well, generator, and water tank;


DECEMBER 2004

01.02.03 Urban and municipal supply system

Definition

The water supply chain in a semi-urban or urban setting, starting from the source to the end user and its management including extraction, treatment (if any), marketing and overall management.

Rehabilitation or construction of a water scheme per gravity in semi urban or urban settings or for refugee camps with water connection to individual shelter or houses. Wells + pump + generator + water tank + water treatment + individual connections

Technical expertise required: specialized watsan engineer. Technical validation by external engineering office recommended prior implementation and regular evaluation of work.

Indicators 1. The number of water users and water production in absolute terms and per beneficiary per day (before, during and after the intervention)

2. The number and type of operational supply facilities (e.g. water sources & points, the supply network, sewerage and treatment plants/equipment) compare before and after

3. Ability and willingness to pay for the water (focus group discussion or survey)

4. Existence of a management association for the facility (including the number of people and different skills they have)

5. Management system evaluation (degree of cost recovery)6. Quality indicators: see above under 01.02.02, compulsory7. Reduction in queuing time before and after 8. Reduction in numbers of people per water source before and

after

For the cost per beneficiary there is a need to consider - The cost per Household connected - The cost per meter of pipe installed.

Advice: o Design of water scheme should be based and designed on real population

figures. Previous surveys to quantify the real number of consumers are needed in order to avoid developing non appropriate schemes.

o The design of water schemes should be based and designed on beneficiary capacity to bear the cost of the water supply. Careful in over designing a water scheme with high level of water supply 150-400l/p/day when communities can not pay the running cost involved and when a lighter scheme would have been more adapted to community capacity.


DECEMBER 2004


Semi urban water supply for Palestinian refugees living in refugee camps

When 2004 duration 12 months Where Lebanon – South area By CISP - ItalyWhat Water network to individual houses from deep wells and large

water tanks, galvanised iron steel pipe from 5” to ½” and submersible pumps for deep wells 10/20 HP, motor starter panel, diesel generator 32 to 50 KVA and chlorination system, house connection, water supply 109 – 275 l/d/p

Amount € 700,000 for 12 monthsBeneficiary type Refugee population in 8 non official campsTotal direct beneficiaries

10,605 persons

Technical expertise

One full time engineer


€66 per person (including goods & services, support cost, indirect cost)

Other comments Due underground water pollution additional activities to clean septic tanks 100 m around wells was added to the project Technical validation document from engineering company was funded and conducted before implementation of the work. Document available.

Urban water supply for Palestinian refugees living in refugee camps

When 2004 duration 12 months Where Lebanon – North Nahr el Bared camp By CESVI – ItalyWhat Water network to individual houses from deep wells and large

water tanks, specifications belowAmount € 800,000 for 12 monthsBeneficiary type Refugee populationTotal direct beneficiaries

10,450 persons – System capacity for above 15,000 persons.

Technical expertise

One full time engineer


€77.55 per person (including goods & services, support cost, indirect cost)

Other comments Technical validation document from engineering company was funded and conducted before implementation of the work. Document available.

Specifications


DECEMBER 2004

Item BRANDGenerator PerkinsSubmersibles Pumps Subteck SGate valve 4”No return-valves 4” Peglers

Galvanized pipe DIN 2440

Water meter ZennerMaddalena

Distributors AzzanChlorination System Pulsafeeder Ind. Corp.

Series 100/150

Water Tank Treatment

Happy Wall Texture FinishHappy Wall Bond WaterproofPlaster Deter WaterproofPlaster Primer DeterPermaquik 130 Lamposilex

Additional recommendations for water systems

The internal pipe diameter should be calculated to meet the design flow taking into account the topography, head losses, and residual head. The optimal diameter can be found by formulae or charts.

Care must be taken so that the closed system pressure, at the lowest point in the system, does not exceed the pressure rating of the pipe. In some cases a break pressure tank can allow the water pressure to return to zero and reduce the pressure downstream.

Care must be taken with the design to avoid negative pressures, which can cause air locks and polluted water to enter the network.

At water collection points, a residual pressure of 5-10m is usually calculated to allow a reasonable discharge rate from the taps.

Water pipes come in standard diameters and thicknesses and are rated in terms of their pressure. Poly Ethylene and U-PVC pipe are specified in terms of outside diameter and Galvanized Iron pipe in terms of inside diameter.

Poly Ethylene pipe should be used in cold regions. PE pipe has good thermal properties and retains ductility even down to -60˚C without bursting.

Poly Ethylene pipe is joined by either electro-fusion welding, butt welding, push fit couplings, or compression couplings. U-PVC pipe is joined using rubber push-fit connectors, or U-PVC solvent. GI pipe is joined by threading both ends and connecting together using a female-threaded fitting. Hemp and oil paint or PTFE tape may be used to make the connection water-tight.

Galvanized Iron pipe should be used in special circumstances such as sections of high pressure, above ground in rocky areas, streams and gulley crossings, areas of cultivation, or exposed pipe at water points.

Pipes can be laid directly into dug trenches provided there are no sharp stones. If needed, the pipe may be protected with sieved soil.

All pipes should be anchored with thrust blocks to resist unbalanced forces at bends, junctions, changes in diameter, and valves.

Air release valves should to be positioned at high points along the pipeline to release air locks caused by trapped air.


DECEMBER 2004

Washout valves should be positioned at low points along the pipeline to allow accumulated sediments to be flushed from the line.

01.02.04 Water treatment

Definition

An intervention which involves chemical, physical or microbiological manipulation of the water supply to make it cleaner, softer or safer to use. In most emergencies the microbiological quality is by far the most important consideration. This may range from very simple to more complex processes depending on the available resources.

NB In nearly all cases chlorination will provide basic treatment of water and is the first line of defense in emergency situations where the water quality is unknown. Groundwater from uncontaminated sources will in virtually all cases provide acceptable water quality in emergency situations.

Chemical products used are aluminum sulfate (for flocculation/coagulation i.e. to reduce unacceptable turbidity.

NB: Turbidity is not only unattractive in water, its less known effect is that it reduces the effectiveness of chlorine (for disinfection).

Residual levels of chlorine should be between 0.2 – 0.5 mg/l in disinfected water in order to be effective. Treatment of water through a continuous flow of a 1 % solution of chlorine is usually sufficient.

Indicators 1. Reduction of incidence of water-related diseases in the user community. The water related diseases that affect people are mainly infectious and parasitic diseases such as; Faeco-oral infections that cause diarrhea and include

cholera, typhoid and dysentery. They can be spread by contaminated water or poor hygiene.

Various worm infections, including Guinea worm and Schistosomiais (bilharzia), many of which are caught by wading in contaminated water

2. Laboratory tests that provide evidence of safe water (see above)3. Quantities of chemicals actually used in water treatment.

01.02.80 Training, local capacity building – Health and Hygiene promotion

Definition

Capacity building and awareness creation on environmental and household hygiene to lower the incidence of health problems associated with poor hygiene/environment (hygiene promotion)

Also training in skills to manage water sources and animate community participation systems and associations.

Indicators 1. Number of trainers/promoters available with proven


DECEMBER 2004

Community health education skills2. Number of trained “managers”, (technical and managerial

skills) to supervise community management systems of water sources

3. Number of hygiene promotion activities conducted e.g. talks, demonstrations, pamphlets, focal group discussions, etc.

4. Change in behaviour and attitude towards personal and household hygiene among target beneficiaries (KAP surveys or focal group discussions)

Additional recommendations on Health and Hygiene training

Adequate budget and duration allocated to allow proper implementation and follow up.

Repetitive training and monitoring; one session per village is not enough or adequate

Gender balanced project team, female staff are needed to access women groups.

Effective and realistic messages Adapted training materials and messages

Monitoring compare to base line;

Gender, female team is a must to access to women

Malaria prevention which in all H&H sessions should be tackle seriously

Prevention measures such as distribution of impregnated mosquito nets, insecticide spray if necessary in village with high level of malaria, cleaning of stagnant water…

Model of LFM for watsan operation (see in annex)


DECEMBER 2004

3.7. Permanent shelter

01.07.01 Permanent shelter

Definition Support to long term refugees/IDPs with rehabilitation, repair or reconstruction of permanent shelters variable according to family size and including one or several rooms + kitchen+ wc + electricity and water tank + plumbing,+ painting and tiling

Technical inputs may be in terms of construction expertise and standardization or for rehabilitation adaptation to individual needs and context.

Indicators 1. Number of shelters erected and quantity of materials provided

2. Cost of one shelter (one household size) 3. Space of covered shelter provided per individual (overall

surface taken by the shelters/number of people or size of the tent); M2 per family and per person

4. Space of general area per individual (overall surface/number of people)

5. Degree of respect for appropriate privacy and separation between individual household shelters

6. Degree of security measures taken in settlement7. Degree of safe access to water, sanitary facilities, health

care, solid waste disposal, graveyards and social facilities including schools, places of worship, meeting points and recreational areas (see other sub sectors)

8. The design of the shelter is acceptable to the affected population and provides sufficient thermal comfort, fresh air and protection from the climate to ensure their dignity, health safety and well-being

9. The degree to which the adverse impact on the environment is minimised by the design of the settlement, the base materials used and the construction techniques

Type of interventions in the Middle East

Rehousing European standards

This entails the construction of a new shelter i.e. the provision of one to four Rooms + Kitchen + WC/Shower and complete infrastructure with European standards applied.

Applicable in case of political agreement for refugee’s resettlement; example the UNRWA Neirab rehabilitation project or specific rehabilitation after home destructions in Gaza funding ECHO 2001/29001. (Cost per family €43.409 including infrastructure activities) Not in ECHO strategy and should not be funded


DECEMBER 2004

Construction /Reconstruction (according to specifications below)

This entails the construction of a new shelter or the demolition of an existing shelter and the construction of a new shelter i.e. the provision of one to four Rooms + Kitchen + WC/Shower equipped

Rehabilitation/Partial reconstruction / Extension

This entails the construction of an extension to an existing shelter or the demolition and reconstruction of part of a shelter, the reconstruction of one or more rooms and/or a Kitchen and/or a WC/Shower. Works may include the replacement of part or the entirely of a roof. (NB. Works include structural works).

Light rehabilitation / Repairs / Home adaptation

This entails comprehensive upgrading of a shelter or ‘routine maintenance’ but does not include any structural works. Works may include new doors & windows, tiling, plastering, new plumbing and electrical wiring etc or adaptation of the house to specific requirements of refugees in case of disability or elderly: wheel chair access or European toilet…

Shelter specifications, size and dimensions

- Rooms/roof made of concrete + plastering + emulsion paint Tyrolean finish - Kitchen zinc + Water tank 1m3 + plumbing - Wc /shower washing basin with Turkish slab- Electric wiring + Ceramic tiling + Doors, windows

Number of rooms

1-2 persons: 1 room, kitchen and sanitary3-4 persons: 2 rooms, kitchen and sanitary5-7 persons: 3 rooms kitchen and sanitary 8 persons and above: 4 rooms kitchen and sanitary

Size and dimensions

14 m2 maximum per room 10 m2 for kitchen 5/6m2 for sanitary WC Turkish slab + shower 25% or 2m2 for circulation (or 25%) One room 36m2 - Two rooms 54 m2 - Three rooms 71 m2 – Six rooms 90m2


Shelter Lebanon 2005

UNRWA MPDL PU Caritas

Reconstruction € 14,454 € 6,481

Rehabilitation € 5,583

Home adaptation €1,580 €366


DECEMBER 2004

Permanent shelter rehabilitation or construction

Context: Palestinian refugees When: 2004 - 2005 Where: Lebanon - Syria - Jordan By: UNRWA What: Shelter specifications (see above)

Cost per shelter (construction and supplies only – No support or admin cost)

UNRWA Lebanon/Syria/Jordan

Complete shelter one room 36m2 €4.640 - €7.520Complete shelter two rooms 54m2 €6.720 - €9.800Complete shelter three rooms 71m2 €8.800 - €13.280Complete shelter six rooms 90m2 €10.800 - €15.600Kitchen only €2.000 – €2.880WC only €1.160 – €1.600

Permanent shelter – Reconstruction/rehabilitation

Context Palestinian refugeesWhen 2004 - 2005 Where LebanonBy UNRWAWhat Shelter specifications (see above) or additional infoAmount € 1,080,000 for 12 monthsBeneficiary Refugees populationTotal direct beneficiaries

141 families one per shelter 33 reconstructions / 108 repairs

Technical expertise 1/3 expatriate consultant and local staffCost per beneficiary €14,454 per shelter reconstructed and per family

€5,583 per shelter rehabilitated and per family (including goods & services, support cost, indirect cost)

Other comments Cost should be further elaborated according the number of rooms reconstructed per family or m2 per family members

Permanent shelter - Reconstruction

Context Palestinian refugeesWhen 2004 - 2005 Where LebanonBy MPDL What Shelter specifications (see above) or additional info

Demolition and reconstruction of 54 shelter, with foundations columns

Rooms + roof made of concrete + plastering + emulsion paint Tyrolean finish

Kitchen zinc + plastic water tank 1m3 + plumbing, WC /shower washing basin with Turkish slab; Electric wiring + Ceramic tiling;


DECEMBER 2004

External steel door and internal wooden doors, windows aluminium frame

Amount € 350,000 for 12 monthsBeneficiary Refugees populationTotal direct beneficiaries

54 families, one family per shelter

Technical expertise One full time expatriate coordinator and six months engineer expatriate

Cost per beneficiary €6,481 per shelter and per family (including goods & services, support cost, indirect cost)

Other comments Cost should be further elaborated according the number of rooms reconstructed or m2 per family members

Permanent shelter rehabilitation

Context Palestinian refugees When 2005 duration 12 months Where Lebanon – Un official refugee camp By Première Urgence What Reconstruction of 11 shelter, rehabilitation 217 shelters

Rooms made of concrete + plastering + emulsion paint Tyrolean finish

Roof zinc sheets (no authorization was given by authorities for durable solution)

Kitchen zinc + Water tank 1m3 + plumbing WC /shower washing basin with Turkish slab Electric wiring + Ceramic tiling Steel doors windows aluminum frame

Amount € 500.000 for 12 monthsBeneficiary Refugees populationTotal direct beneficiaries

……..shelters and families (to be completed)

Technical expertise One full time expatriate coordinator and six month expat engineerCost per beneficiary €……. per families (including goods & services, support cost,

indirect cost)Other comments Cost to be readjusted according to different type of intervention

Persons With Disability - home adaptations

When 2004 duration 12 months Where Lebanon – South area By MPDL SpainWhat home modifications, social support, ergo therapy training;

(criteria in annexe)Amount € 158,760 for 12 monthsBeneficiary Palestinian refugees living in refugee camps - People with

disability including elderly population – Special need group – 37

UNIT COSTS OF HUMANITARIAN ACTIVITIES in the MIDDLE EAST CLUSTERDECEMBER 2004

Hardship casesTotal direct beneficiaries

110 families

Technical expertise full time expatriate physiotherapist specialised in occupational therapy

Cost per beneficiary €1,580 per family (including goods & services, support cost, indirect cost)

PWD home adaptations

When 2004 duration 12 months Where Lebanon – Beirut By CaritasWhat home modifications, social support, ergo therapy training;

(criteria in annexe)Amount € 319,309 for 12 months –

€22,340 (estimate) for home adaptationBeneficiary Palestinian refugees living in refugee camps – Elderly population

– Special need group –Total direct beneficiaries

110 families

Technical expertise full time expatriate physiotherapist specialised in occupational therapy

Cost per beneficiary €366 per family (including goods & services, support cost, indirect cost)


DECEMBER 2004

3.8. Post emergency – semi permanent shelter

01.05.02 Post emergency /Semi permanent shelter

Definition Assistance provided to households to build or repair their dwellings with the perspective of middle to long term settlement in the area. This can be permanent settlement or resettlement after repatriation or after return from displacement to the place of origin or this can be a settlement away from “home” but on a semi permanent basis and not following an acute departure.

The design of the dwelling will reflect the semi permanent nature of the settlement and more durable and expensive materials are likely to be used. However, building of solid houses will not be included and should be categorized under permanent shelter (see 01.07.01)

Support to long term refugees/IDPs with rehabilitation, repair or reconstruction of semi permanent shelters variable according to family size and including one or several rooms + external latrines

Temporary solutions such as refugees camps in Yemen

Technical inputs may be in terms of construction expertise and standardization or for rehabilitation adaptation to individual needs and context.

Indicators 1. Number of shelters erected and quantity of materials provided

2. Cost of one shelter (one household size) 3. Space of covered shelter provided per individual (overall

surface taken by the shelters/number of people or size of the tent); M2 per family and per person

4. Space of general area per individual (overall surface/number of people)

5. Degree of respect for appropriate privacy and separation between individual household shelters

6. Degree of security measures taken in settlement7. Degree of safe access to water, sanitary facilities, health

care, solid waste disposal, graveyards and social facilities including schools, places of worship, meeting points and recreational areas (see other sub sectors)

8. The design of the shelter is acceptable to the affected population and provides sufficient thermal comfort, fresh air and protection from the climate to ensure their dignity, health safety and well-being

9. The degree to which the adverse impact on the environment is minimised by the design of the settlement, the base


DECEMBER 2004

materials used and the construction techniques


Context Influx of Somalia refugees – UNHCR campWhen 2000 duration 12 months Where Yemen – Aden By TriangleWhat Shelter

- Double shelters of 20m2 each - Walls of precast hollow concrete blocks on stone footing for

the basement- Roof of mud layers overriding corrugated metal roofing

sheets + Window frame Lime paint Latrine

- External pit latrines - Concrete walls hollow blocs ; still roof, plastic pipe 6’’- Wooden door and looker pre cast slab

Amount € 172.000 for 6 monthsBeneficiary type Refugees populationTotal beneficiaries 100 familiesTechnical expertise One full time expatriate coordinator and local NGO specialists Cost per beneficiary €1.720 per families for shelter and latrine (including goods &

services, support cost, indirect cost)Other comments Cost per shelter without admin and support cost

- Cost per shelter €1.106 - Cost per latrine € 334

Context Influx of Somalia refugees – UNHCR campWhen 2004 duration 12 months Where Yemen – Aden By UNHCRWhat Shelter

- Habitable surface of 46,74 m²- Walls of precast hollow concrete blocks on stone footing for

the basement- Roof of 100mn of mud layers overriding corrugated metal

roofing sheets + Window frame Lime paint - Latrine idem as above

Amount € 450.000 for 12 monthsBeneficiary type Refugees populationTotal beneficiaries 200 familiesTechnical expertise One full time expatriate


DECEMBER 2004

Cost per beneficiary €2.250 per families (including G&S, support cost, indirect cost)Other comments Cost per shelter without admin and support cost

- Cost per shelter € 1.123 - Cost per latrine € 410

3.9. Psycho-social activities

Mental or psycho-social programmes remain somewhat enigmatic and in the literature, definitions of the concept, values and appropriateness vary widely. ECHO is financing a wide variety of psycho-social activities starting from 95 in Bosnia-Herzegovina to sporadic programmes in Sub Saharan Africa (often for rape victims) to a solid programme in the Occupied Territories (approximately 1 M€/year). The recent Tsunami emergency has also contributed to further reflection on the issue of mental and social health during and after emergencies.

The cost of these programmes is difficult to estimate and even more difficult to compare as the scope of activities under this denominator is vast and loosely defined.

During discussions with the teams in Amman and Jerusalem, many TA’s requested an external expertise in order to assist in defining the sector and the appropriate strategy priorities for ECHO.

Below is some crucial information from literature or reports which can be useful for further reference.

1. A proposal to define/describe the concept : mental health services provided by relief organisations are psychosocial interventions based on a primary concern for the psychological and social wellbeing of the individual but extending to the repair of collective social structures. The term psychosocial emphasises the dynamic relations between psychological effects (e.g. emotions, behaviours and memory) and social effects (e.g. altered relations as a result of death, separation and family and community breakdown). Psychosocial interventions try to help survivors of mass violence to cope with the demands of a social world shattered by violence. (3)

2. Definition

Intervention addressing emotional disorders of individuals or groups of population affected by a traumatic event linked to the effects of natural disasters or man made conflicts including violence, torture… or destruction and in need for psychological rehabilitation.

Signs of mental trauma for children due to the stress of living with the daily threat of violence and conflict: "Among these symptoms that children experience are withdrawal, inability to pay attention, sleep problems, nightmares, irrational fears, irritability, refusal to attend school, outbursts of anger and fighting, depression, anxiety, guilt feeling and emotional numbing…”, stuttering and bed-wetting

3 Mental health in complex emergencies (The Lancet, 2004; 364: 2058-67), R.F. Mollica, B. Lopez Cardozo, H.J. Osofsky, B. Raphael, A. Ager, P. Salama.


DECEMBER 2004

PTSD (Post traumatic Stress Disorder) and traumatic event: For some groups of specialists, the diagnosis of the disorder requires the pre-existence of a traumatic event capable of generating an intense anguishing response to the subject which is experienced by the subject as a vital threat.

Qualification of disorder and measurement: Some experts suggest that the syndromes of traumatized people have certain basic features in common, and that recovery processes also follow a common pathway; which allows systematization and the use of PTSD measurement. Other specialists defend that systematization and generalization of the disorders is not possible and response is case by case according to individual resilience and history.

Range of activities

Psycho-clinic: Specialised in medical and mental health related activities, o Detection of early signs of psychological trouble e.g. distress and mental disorderso Early detection of mother and child psychosocial trouble in Primary health Care o Referral to specific institutions of acute psychological and social distresso Treatment and rehabilitation including medication and therapeutic follow up made by

specialised staff (psychologist or psychiatrist)o Crisis counselling for victims or survivors of a traumatic event by trained counsellorso Clinical stress management programme (for targeted population facing regular stress,

ambulance drivers of RC or humanitarian workers…)o Psychological follow up for boy and girls, adolescents and young women who have

been or are involved in abusive relationships

Psychological first aid o Early intervention which support the reduction in mortality and morbidityo Individual, familial or group counselling for emotional expression, expression and

advises, mobilising support from family members, and protecting the survivors from further arms by trained counsellors supervised by psychologist (avoid single session psychological debriefings)

o Identifying and referring serious ill patients for specialised care

Psychosocial : Specialised in social activities for adultso Promotion of psychosocial well beingo Health, hygiene, family, adolescent and parental guidance by trained staff, social

workers o Adolescent centres, library support, outdoor activities

Psychosocial : Specialised in educational and recreational activities for children o Promotion of psychosocial well being and early detection of psychological trouble in

schools;o Kindergarten support with guidance and early detection of psychological trouble by

psychologist; o Children and adolescent open centre and activity support;o Outdoor and summer camps activities;

Training


DECEMBER 2004

o Training of counsellors (social workers, school and KG teachers)o Training of health care practitioners, traditional healers for psychological counselling

and early detection

Targeted population

Population affected by armed conflicts or natural disasters; People living in or close to an active conflict or areas frequently shelled; People injured, disabled, hospitalised, by conflict or disaster; People tortured, hostages, detained or abducted children in armed conflict; People living in families whose members have been killed, injured, tortured and/or

detained. People living in families who suffered property losses, including house demolition or

damage, destruction/damage of agricultural land etc.; People displaced or unable to access basic services; Children in conflict with the law; People living in acute poverty; Persons sexually or economically abused and/or neglected; particularly those who live

in homes or institutions where abuse occurs; People living with other individuals who are physically and/or mentally disturbed,

abusing drugs, or suffering from a life threatening illness. Workers in conflict areas or natural disaster environment: humanitarian workers,

volunteers, first aid or ambulance drivers…

3. The main WHO reference publication is “Mental Health in Emergencies” (Mental and social aspects of health and populations exposed to extreme Stressors) (2003): the paper describes clearly the social and psychological priority interventions in an acute emergency phase and in the reconsolidation phase. The paper explains also the eight basic principles for mental health in emergencies (see table below).

“Encourage the organisation of normal recreational activities for children.”

“Encourage starting schooling for children even partially.”

“Widely disseminate uncomplicated, reassuring empathic information on normal stress reactions to the community at large.”

“Most acute mental health problems during the acute emergency phase are best managed without medication following the principles of psychological first aid (i.e. listen, convey compassion, assess needs, ensure basic physical needs are met, do not force talking. Provide or mobilise company from preferably family or significant others, encourage but do not force social support, protect from further harm).”

Principle Explanation

1

Contingency planning

Before the emergency, national-level contingency planning should include (a) developing interagency coordination systems, (b) designing detailed plans for a mental health response and (c) training of relevant personnel in indicated interventions.

2 Assessment Assessment should cover the sociocultural context (setting,


DECEMBER 2004

culture, history and nature of problems, local perceptions of illness, local ways of coping), available services, resources, and needs. With respect to assessing individuals, a focus on assessing disability or daily functioning is recommended.

3

Long-term perspective

Even though impetus for mental health programmes is highest during or immediately after acute emergencies, the population is best helped by a focus on the medium and long-term development of services.

4

Collaboration Strong collaboration with other agencies will avoid wastage of resources. Continuous involvement of the government, local universities or established local organizations is essential for sustainability.

5

Integration into primary health care

Led by the health sector, mental health treatment should be made available within primary health care to ensure access to services for the largest number of persons.

6

Access to service for all

Setting up separate, vertical mental health services for special populations is discouraged. Nevertheless, outreach and awareness programmes are important to ensure the treatment of vulnerable groups within PHC or community services.

7

Through training and supervision

Training and supervision should be by mental health specialists - or under their guidance - for a substantial amount of time to ensure lasting effects of training and responsible care.

8

Monitoring indicators

Activities should be monitored and evaluated through key indicators that need to be determined, if possible, before starting the activity. Indicators should focus on programme implementation, services, and functioning of beneficiaries.

4. The report “ Psycho-social assistance to victims of war in Bosnia-Herzegovina and Croatia, an evaluation for ECHO, Inger Agger and Jadranka Mimica (1996)”, gives an overview of the psycho-social assistance financed by ECHO in Bosnia from May ‘95 to April ’96. Although the report is not very clear on the content of the programme, some excerpts:

“Psycho-social emergency assistance was defined as actions which promote mental health and human rights that enhance the already existing protective social and psychological factors and diminish the stressor factors at different levels of intervention.” (4)

The pyramidal model as used in Bosnia Herzegovina in 95-96 identified five levels for psycho-social interventions:

emotional/social survival interventions task-oriented interventions psychologically oriented group interventions counselling intensive psycho-therapy

Some recommendations on psycho-social field action (Former Yugoslavia)

An overall policy should be outlined before psycho-social field action is instigated in a country, including aims, priorities and methods

4 Psycho-social assistance to victims of war in Bosnia-Herzegovina and Croatia, an evaluation for ECHO, Inger Agger and Jadranka Mimica (1996)


DECEMBER 2004

Systematic needs and resource assessments should be carried out at regional levels in order to ensure maximum coverage with the means available

Decisions on funding should be based on policy and needs and made in close cooperation between experts and donors

Projects should include a quality assurance mechanism from the very beginning. Project proposals should therefore include a description of how the NGO will measure the impact and quality of their actions

Project proposals should also include plans for how the NGO will ensure continuity between emergency and rehabilitation phases, i.e. sustainability

Psycho-social programmes working from a model which includes establishment of a “centre” or types of care –giving environments which encourage the development of social networks should be given priority.

An orientation towards peace-building and human rights advocacy should be encouraged in areas of ethnic conflicts and war

In conflict areas, both national and international staff (including aid workers) should be given training, supervision and support, in recognition of the traumatizing effects of working under stressful conditions

Monitoring of projects should be carried out by mental health professionals who participate in formulating policy, needs assessments and quality control

5. From the Mental Health Policy and Service Guidance Package (WHO): Description of the Organization of services for mental health, 2003:

The importance of the integration in the Primary health care structures is emphasised.

“With the development of a range of community based and specialised services there is no need for mental hospitals.”


DECEMBER 2004


Bosnia-Herzegovina ECHO funded programmes via 25 NGO’s (wide range of psycho-social activities) (see

8.24 M€ for 50,000 beneficiaries

or


DECEMBER 2004

report)

From May ’95 to April ‘96

165 € per beneficiary

Burundi (2004) UNICEF and Care

For 12 months

Project for psycho-social care for rape victims

Approximate figures

500,000 € for 550 beneficiaries (UNICEF) = 909 €/beneficiary

185,000 € for 300 beneficiaries (CARE Austria) = 617 €/beneficiary

includes: legal and psycho-social counselling, livelihood rehabilitation, PEP and specific antibiotics, workshop/training for community leaders, radio messages, temporary residence in special centres, preventive measures

Some other unit costs

Psycho-clinic interventionContext Palestinian refugees living in refugee campsWhen 2004 duration 12 months Where Lebanon – South area By Handicap International France, Pilot project What Diagnosis, therapeutic counselling, networking; training of

counsellors ans social workers; therapeutic mediation workshop, groupe de parole for adolescent

Amount € 166.243 for 12 months;Beneficiary type

Children from refugee population.


200 individuals

Technical expertise

One full time expatriate psychotherapist and local specialist from local counterparts


€831 per persons (including goods & services, support cost, indirect cost)

Other comments

Pilot phase - Cost should be reduced in a second phase

Research to be done:

Psycho-clinic interventionContext Victims of an earthquake When 2003 - 2004 Where Iran – Bam By MDM-F or UNICEF


DECEMBER 2004

Reference documents (to be completed)

- WHO glossaire - http://www.wpro.who.int/multimedia/whd2001/Glossary.pdf- WHO and woman violence - http://www.who.int/gender/violence/en/v7.pdf- UNHCR - Sexual and Gender-Based Violence Against Refugees, Returnees

and Displaced Persons: Guidelines for Prevention and Response - Http://www.unhcr.ch

- Mental health in complex emergencies - The Lancet 2004 vol 364, - Palestinian code of conduct for psychosocial interventions - “A psychosocial assessment of Palestinian children” - By Cairo Arafat, Dir. Of

the secretariat for the national plan of action. 2003- Palestinian adolescent survey in Gaza, Childhood exposure to violence:

psychosocial and behavioral aftermath in adolescence – PRCS – UNESCO – 1998

- http://www.hhri.org/lr/ (with plenty of links related to the subject)

.


DECEMBER 2004

http://www.hhri.org/lr/

http://www.who.int/gender/violence/en/v7.pdf

http://www.wpro.who.int/multimedia/whd2001/Glossary.pdf

3.10. Activities for disabled population

Definition:

Special programmes for PWD (People With Disability) when not addressed in a special centre (see above) and which require home based assistance such as home care, rehabilitation therapy, CBR (community based rehabilitation) or home adaptations. Technical expertise required with medical and para-medical staff with expertise in physiotherapy, occupational therapy, and speech therapy. People with disability in a broader sense will include elderly population in need of specific care and assistance including training to family members. Technical expertise required with health staff or para-medical staff with expertise in geriatrics.

Scope of the problem:People with disability according to WHO:

“The estimated number of people who require rehabilitation services at any point in time is 1.5% of the population, i.e. about 90 million people. The number of disabled people continues to be estimated at 7% to 10% of the population, although individual countries have given numbers that vary from approximately 4% to 20%”.

Range of activities:

People with disability o Provision of medication and medical or non medical consumables;o Home nursing and rehabilitation therapy (physiotherapy, occupational therapy,

speech therapy…); o Training of family members on adequate nursing and care for PWD disabled

persons;o Home adaptations (see criteria), improved access of public places, schools, health

centres… may require the presence of an occupational therapist;o Referral to specialised centres or health centerso Surgical orthopaedic interventions, diagnose, referral, rehabilitation o Supply of appliances or equipment for individual mobility or home nursing;o Inclusive programs such as CBR (Community based rehabilitation)o Support to immunisation campaigns (such as polio) o Psychosocial support to parents and PWD themselves (refer to psychosocial

intervention)o Community programmes for reintegration and re-adaptation for mine victims

Elderly population o Provision of medication and medical or non-medical consumables and specific

drugs (pain reliever, insulin…) o Supply of appliances or equipment for individual mobility or home nursing o Home nursing and physiotherapy sessions o Prevention of pathologies linked to old age (such as diabetes); information on the

need for nutrition changeso Training of family members on adequate nursing o Home adaptation, access improvement of public places health centres…by

occupational therapist


DECEMBER 2004

o Psychosocial assistance for family membersTargeting population and contexts

PWD identified as Special Need Group, (including congenital or disability due to a trauma) in conflict, post conflict or post disaster period;

PWD identified as Special Need Group within refugees or IDPs population;

Persons directly affected by conflicts and living in conflict areas and subject to injuries with increase trauma pathologies (such as paraplegics, amputees, injured) in need of technical devices and physical rehabilitation, home nursing, home adaptation…

Persons affected by natural disasters especially earthquakes, which may lead to an sudden increase of trauma pathologies and orthopaedic injuries (such as paraplegics, amputees, injured) in need of technical devices and physical rehabilitation, home nursing, home adaptation…

Recommendations

PWD needs should be addressed in a holistic approach. The medical part of their situation should be considered simultaneously with PWD mental well being, economic reintegration, legal status within the national laws, prevention and early detection programs, the advocacy for the ban of landmines…. There is also the need to consider the support to specialised centres or institutions (orthopaedic, physical rehabilitations centre, mental health…).

Possible examples of disabilities and their causes that may be associated to potential interventions

Health conditions

Causes Impairment Problems in body function or structure

Activity limitation

Intervention

Amputee Mines/UXO, accident, disease

Amputation Mild to heavy mobility incapacity

Surgical intervention, support to orthopaedic centres, supply of mobility devices, physiotherapy

Spinal injury

Bullet, explosive accident

Paralysis Heavy mobility incapacity

Support to specialised institutions, appliances

CP (cerebral palsy)

Congenital Physical rehabilitation, supply of mobility devices, physiotherapy

Poliomyelitis

Lack of prevention/

Paralysis of lower limbs

Mild to heavy

Physical rehabilitation,


DECEMBER 2004

vaccination and malformations

mobility incapacity

supply of mobility devices, physiotherapy

Deafness Congenital, Mine, explosion

Hearing impairment

Hearing

Blindness Mine, expl. Visual impairment

Heavy mobility incapacity

Re-education; mobility devices

Dumb Trauma disorder, congenital

Speech impairment

Re-education; therapeutic counselling

Reference documents (to be completed)International Classification of Functioning, Disability and Health - http://www3.who.int/icf/WHO glossary


Impairment Cost per beneficiary

MPDL Caritas UNRWA HI

Orthopaedic Surgical interventions

€6,450

Old age Health and social assistance

€638

Hearing Provision of devices €1,028

Visual Provision of devices €26

Mobility Home modification €1,580

PWD Physical disability - Hearing and vision impairment - for Palestinian refugees living in refugee camps

When 2005 duration 12 months Where Lebanon By UNRWAWhat Hearing and vision impairment supply of devices

Amount € 205,769 for hearing impairment for 200 children€ 51,442 for vision impairment for 2,000 children

Beneficiary type

People with disability – Children school age


2,200 children


DECEMBER 2004

http://www3.who.int/icf/

Technical expertise

Internal expertise and referral for to specialist for audiograms €25,000


€1,028 per child € 26 per child(including goods & services, indirect cost, No support cost charged by UNRWA)

Other comments

PWD home adaptations for Palestinian refugees living in refugee camps

When 2004 duration 12 months Where Lebanon – South area By MPDL SpainWhat home modifications, social support, ergo therapy training;

(criteria in annexe)Amount € 158,760 for 12 monthsBeneficiary type

People with disability including elderly population – Special need group – Hardship cases


110 families

Technical expertise

One full time expatriate physiotherapist specialised in occupational therapy


€1,580 per family (including goods & services, support cost, indirect cost)

Other comments

PWD surgical intervention for Palestinian refugees living in refugee camps

When 2004 duration 12 months Where Lebanon – North area By MPDL SpainWhat Orthopaedic surgical intervention, diagnose, surgical

intervention rehabilitation, training of PRCS surgeonsAmount € 64,650 for 12 monthsBeneficiary type

Special need group - People with orthopaedic disability


10 cases

Technical expertise

One orthopaedic surgeon consultant, PRCS hospitals


€6,450 per case (including goods & services, support cost, indirect cost)

Other comments

Cost need to be adjusted, partner will provide details


DECEMBER 2004

Elderly projec t for Palestinian refugees living in refugee campsWhen 2004 duration 12 months Where Lebanon – Beirut areaBy Caritas AustriaWhat all range of activities: nursing, home modification, social

support, awarenessAmount € 319,309 for 12 monthsBeneficiary type

Elderly population – Special need group – Hardship cases


500 elderly persons from health related activities

Technical expertise

One full time expatriate physiotherapist specialised in geriatrics


€638 (including goods & services, support cost, indirect cost)

Other comments


DECEMBER 2004

3.11. Rehabilitation

01.07.04 Self sufficiency


DECEMBER 2004

Definition Projects aiming at supporting community initiatives or support to individuals or (groups of) households to increase their capacities in order to become independent from external assistance provision.

This can include:

Support to vocational training

Micro credit programmes

Micro projects aiming at self sufficiency or stimulation of markets

Cash for work programmes – Emergency job creation

Professional Tool kits

Indicators % of revenu earned or distributed and coverage of one person or family needs per day / month or year

Increase of income and coverage of individual or family needs

Rate of reimbursement

Emergency job creation

Estimates of unemployment have increase significantly during the last 4 years from 15.5% to 36.8% in Gaza and from 7.5% to 22.3% in the West Bank. Clearly the 2nd Intifada is at the origin of this. This has inevitably lead to a sharp increase of poverty with current figures from the PCBS (Palestinian Central Bureau of Statistics) reaching as high as 62.5% or 2.2 Million people living below the poverty line of 2 U$/day.

UNRWA and different NGO’s are trying to compensate this high rate of unemployment and poverty via two ways:

via direct hire: where UNRWA funds and directs the programme of work,

via indirect hire: where UNRWA funds and supervises activities implemented through community organisations

There is a wide range of different activities financed under these schemes, with varying degree of required technical expertise. There is also a wide range of (incomplete information) which can only give some indication of what it costs. More research and discussion with the partners can clarify this issue further. Below are some estimations (some information is contradictory) and an attempt to evaluate to which extent this contributes to keep the unemployment and poverty under control. Information is drawn from the UNRWA appeal document and from different NGO project (Alberto, which ones were these again, I did not write them down!)


UNRWA

Overall estimate all included

14.5 U$/job day

(including a 11% programme support cost)

In theory, the project aims at providing a wage of 10 to 12 U$/day for a worker covering 5 other dependants (2 U$/day/person)

UNRWA

Direct hire all included

12.4 U$ to 15.9 U$/job day

(including a 11% PSC)

UNRWA

Indirect hire all included

26 to 50 or even 80 U$/job day

(11% PSC included)

somewhere a mistake in here!!!

NGO’s (cross section) Alberto plse specify which NGO’s and if

12.5 €/day plus 30% for materials and 11%


DECEMBER 2004

we talk about indirect or direct hire

for Programme Support Costs

= approximately 18€/day

14 to 21 €/day all included

To compare:

Liberia’s Civil Reconstruction teams (for ex-combatants and community members working on community projects in 1997)

Managed by UNOPS

3.4 U$/day on average with 36% (1.25 U$/day) as incentive for the worker and 64% for cost of materials, equipment, transport, supervision and overhead

(not included are salaries of expatriate management staff)

The difference in unit cost is mainly caused by the difference in daily incentive for the worker

See Alain!!!!! Could not get information back to old

Estimation of the impact on unemployment levels (only the UNRWA 2005 planning figures are taken into account.

Total population 3.600.000 people

Labour force (presuming that all people between 19 and 60 want to work)

See annual report of the department of health UNRWA 2003

Based on population pyramid (population older than 19 and younger than 60 years) both sexes

46.45%

or

1.672.200 people

Average of 27% unemployment rate for WB/GS (see above)

451.494 unemployed

Jobs planned for 2005 (UNRWA only)

2.800.000 jobdays/260 working days = 10,770 people at work continuously (even though the total job-days is spread over different people

Coverage of 10,770 people covered/451.494 unemployed =

2.4%

Tool kits approach Lebanon 56

UNIT COSTS OF HUMANITARIAN ACTIVITIES in the MIDDLE EAST CLUSTERDECEMBER 2004

Professional tool kits distribution to provide source of income to vulnerable individuals who show good motivation and willing to start a private activity in order to increase their income. Training on small business management and accountancy is provided with a tailored took kit to start new activity. Part of the tool kit cost needs to be refunded. Refunding of the tool kit cost is allocated to community projects identified by local communities.

Lack of work opportunities and lack access to credit justify professional tool kit program in rehabilitation phase or long lasting crisis in order to increase family income and decrease dependency to aid.

In targeting in particular youth in the case of Palestinian refugees, it will have an important psychological aspect in restoring self esteem and in decreasing frustration and the need for psychological assistance or attraction to extremism.

Professional tool kits distributionWhen 2003 duration 12 months Where Lebanon – Beirut area and BeqaaBy Premiere Urgence – Grant 2003/08017What Professional tool kit distribution – technical training –

community work Amount € 810,000 for 12 monthsBeneficiary type

Palestinian refugees – vulnerable groups, young people


300 beneficiaries – 1,650 persons including family benefiting

Technical expertise

Three expatriates – Mostly logistic cost


€1,700 (including goods & services, support cost, indirect cost)1,350 average value of a kit no support cost

Other comments

15% refunding for community work – Part of the cost is for the follow up of previous project.

Special consideration should be made on availability of micro credit in order not to have unfair competition.

Priority should be made to those are not solvent or do not access to micro credit.

Evaluation of the project is available (in French)


DECEMBER 2004

ec.europa.euec.europa.eu/echo/files/evaluation/watsan2005/annex_file… · Web viewPumping...

Documents

Transcript of ec.europa.euec.europa.eu/echo/files/evaluation/watsan2005/annex_file… · Web viewPumping...