Well, Yom Kippur is upon us and I had the misfortune of reading an editorial in Ha’aretz written by Margaret Atwood, the great Canadian writer, about one reason Israel and Israeli Jews should atone. Ms. Atwood reports that Palestinian children in Area C – this is the area in Judea and Samaria/West Bank that remains under full Israeli administrative control – are suffering from malnutrition at a rate even higher than Gaza’s and many are experiencing stunted growth and other negative outcomes of their dietary misfortune. She wrote:

On the Day of Atonement, when considering wrongs to other human beings for which you bear some responsibility, start with the children of Area C.

To say this was troubling to me would be an understatement, so I decided to investigate Ms. Atwood’s accusation.

Atwood quotes a report from a group called Save the Children. This is a first-rate name for an NGO – who doesn’t want to save the children?! This NGO, funded by the European Union, is the kind of group which wrote an entire report about the Gaza buffer zone and the hardship it causes Gazans without any mention of the reasons behind the zone. Nope, no rockets launched at Israel in this report or Israeli children from the Western Negev getting shelled regularly from the Gaza buffer zone. Israeli children apparently don’t need saving.

Already skeptical, I read the Save the Children report which Atwood quotes in the Ha’aretz op-ed entitled “Life on the Edge.” I couldn’t find the information she described. The statistics she lists appear nowhere in that report and there is no portion of the report dealing with nutrition of children in Area C. There is a section asking the surveyed Palestinians of Area C whether they have sufficient food security and 5% say they have none, but this information is not broken down further to propose how children are affected.

Be that as it may, I thought that perhaps Ms. Atwood erred in quoting this report and that Ha’aretz doesn’t employ fact-checkers when the issue relates to some purported Israeli evil being done to the Palestinians. So I looked around and I believe I figured out what happened.

Al Jazeera posted an article describing a pending report by Save the Children in which, according to the reporter, the NGO was going to describe how Palestinian children in Area C are suffering from malnutrition and stunted growth. Save the Children, however, never included this information in their report. Somehow, however, it appears the Al Jazeera report or its contents got to Atwood.

So is Atwood right? Isn’t that the material question here?

After searching a bit, I came across information that might help to unravel this question. It seems the basis for the information somebody fed to her is actually from a different report called Food Security and Nutrition Survey For Herding Communities In Area C and it was authored in 2009 by World Food Programme (WFP), UNRWA and UNICEF. We can express doubts about the reliability of reports from UNRWA, but let’s give this report the benefit of the doubt for the sake of Ms. Atwood’s good name. Here is how WFP describes their conclusions:

Food Security and Nutrition Survey in Area C, West Bank

In October 2009, WFP/UNICEF/UNRWA carried out a food security and nutrition survey in the Israeli controlled Area C, which covers approximately 60 percent of the West Bank. The survey is part of a broader inter-agency programme of food security and nutrition monitoring, providing protection and assistance to herding and Bedouin communities.

As territorial fragmentation continues in the West Bank, livestock dependent communities living in Area C have been affected by subsequent years of dry spells combined with deteriorated range lands. They are facing increasing movement restrictions and their access to range land and natural water resources is severely limited.

To prevent these herding communities from falling into deeper cycles of indebtedness and increased risk of livelihood erosion, WFP and UNRWA launched a joint emergency programme in August 2009. The aim of the programme is to protect and assist 5,200 Bedouin and Palestinian herder families to maintain their livelihood and way of life in the face of political and environmental challenges.

The joint survey has found unusually high levels of food insecurity and malnutrition among the communities. It found that 79% of the surveyed Bedouin and local Palestinian herders are food insecure as compared to the 25% of households at the national level (West Bank). The level of food insecurity for these communities is even higher than in the Gaza Strip (61%).

With regard to nutrition, a wasting, underweight and stunting prevalence was recorded of 5.9%, 15.3% and 28.5% respectively. These rates indicate a poor nutrition situation according to WHO categorizations. These results further indicate a deterioration of the nutrition situation when compared to the available West Bank data from the 2006 Palestinian Family Health Survey.

Inadequate child caring practices, high disease incidence and low coverage of some essential public health interventions predispose the population to increased risk of malnutrition.

The actual report is available here and the relevant sections about child hunger begin at around page 22.

The Report’s conclusions contradict many of the report’s details. For example:

The higher rates in the surveyed Area C communities can be attributed to the increased administrative and military restrictions imposed by the Israeli authorities in Area C, and several years of water scarcity and drought.

This is a partial fabrication. Water scarcity and drought have indeed affected the entire region for several years and Israel itself has been very hard hit. It is not surprising that Arab herders are affected in Area C, as are Jewish farmers inside Israel. However, Israel’s administrative and military restrictions have been eased over the past couple of years, which is one of the key reasons the Palestinian economy is booming. Last year, the PA and World Bank announced economic growth for the second year in a row at over 7%. This spectacular growth while the rest of the world dithers in a recession is favorably influenced by fewer military activities by the Israelis and the easing of roadblocks and Palestinian movement in Judea and Samaria/West Bank.

So fine, it’s partially a UNRWA report and we have come to expect deep bias from them. Ignoring the biased conclusions, there is something to learn in the report’s body. We learn that the population that’s affected is about 5200 families. Average number of children in these families is 5.2 so we’re talking about 26,000 children. Of these, 5.9% are wasting, 15.3% are underweight and 28.5% are experiencing stunted growth.

According to the report, the bodies in charge of providing food, aid and medical assistance to these Bedouins and Palestinian herders are a number of UN bodies including UNRWA and WFP. Not the Israelis. Still, as Atwood points out, they live under Israeli rule and that’s a meaningful point.

The report mentions that grazing lands are becoming more scarce and the drought is affecting water costs and the herding lands upon which these families make their living. While it’s easy to pin this on the Israelis, the fact is that in 1967 the entirety of Mandate Palestine – minus Jordan, of course – had a population of about 4 million. Today that population stands at 10 to 12 million. It should surprise nobody that grazing lands are disappearing – there are many more people, homes, cars, businesses and roads. There is less space for everybody.

Furthermore, these are rural, often nomadic families. Their levels of education do not enable them to work or compete in the modern world and they often do not have permanent homes – no, not because Israel destroys them but because they are nomadic and poor – which hampers availability of modern water sources and makes it more challenging to offer them income support in a modern society. Access to water appears to be what these families consider to be their greatest challenge. This makes sense when considering the following information:

Survey results indicate that the majority of households interviewed in herding communities in Area C are living in houses made of block, wood or metal sheeting (36%) followed by tents (25.5%), and other forms of accommodation such as apartments (6%) or single room properties (3.5%). This compares against the West Bank average where the majority of the respondents lived in houses or apartments (56% and 40%, respectively).

And they are nomads:

Survey results show that 80% of the interviewed families did not own agricultural land…Conversely, 57% of surveyed households in Area C possessed some livestock while only 5% of total households in the West Bank owned livestock.

As far as availability of medical and nutritional knowledge, the report points out that women in these families stop breastfeeding too early either because they are pregnant again, have received bad information from other family members or were not encouraged to breastfeed by medical professionals (provided by the UN support groups).

Among the children currently not breastfeeding (including those that have never been breastfed, representing 3.1% of the total), about 26.6% of them are breastfed for less than one year, against the recommended 2 years.

Table 16: Length of breastfeeding period
Length of breastfeeding period
Less than 6 months 10.2%
6‐11 months 16.4%
12‐15 months 37.2%
15 months and over 32.0%
Never breastfed 4.2%

Some of the reasons given by the mothers for not breastfeeding include detection of pregnancy (46.2%), availability of commercial baby formula (3.6%), advice from someone (2.1%) and information from the media (0.9%). About 47.3% of the mothers gave other reasons. Health care providers (doctors, nurses, midwife) and immediate family members (mother in laws and husbands mainly) were reported to provide advice that lead to cessation of breastfeeding.

This indicates a level of ignorance that may have import for the children’s growth as they grow up. It is notable that the rate of stunted growth of 28% is similar to the percentage of women who stop breastfeeding in less than a year. And there’s more:

Early introduction of complementary feeding greatly compromises the exclusive breastfeeding rate in the first 6 months of life among the inhabitants of Area C. About 12.9% of infants receive fluids and foods in their first 3 months of life, while a total of 48.8% of infants are not exclusively breastfed in their first 6 months of life.

Okay, so Ms. Atwood wants to blame Israel for the plight of the Bedouin in areas under its control although many of the factors pertain to the culture of these families or advice given by medical professionals. Is that fair?

To answer this question, it’s important to compare the nutrition of these herders and Bedouin children to other Bedouin children. WFP, the same organization which co-authored this Area C survey, also authored a survey of Sinai Bedouins in 2005. Of course, Sinai Bedouins have lived under Egyptian rule for the past century except for 10 years (1967-1977), so the Israelis can’t be blamed for their nutritional circumstances. What does this report tell us?

Bedouins live in small clusters of 3-4 households near to each other, and separated from other clusters by about 1-2 km. The mean family size is 5.4. It was found that 71.2% of the surveyed households lived in new houses built from cement blocks, but only 10% had piped water. Although 60% had toilet facilities, most toilets inside the houses were not used. This may be due to shortage of water supply or social habits. The percentage of households with electricity is high (71.7%), but it was provided for only 6-8 hours/day.

…The percentage of children enrolled in schools is 23.8% of the total number of school-age children…

Nutritional and health status of Bedouin children: The anthropometric data of the children aged 2-5 years old revealed that…20.6% were underweight (6.4% of those severely so). Wasting was prevalent in 6.0% of the children, with 2.0% severely wasted. Forty-three percent of the wasted children were also stunted, reflecting the presence of current, as well as previous long standing malnutrition. The prevalence of anemia (Hb <11gm) was 42.1%. These results indicate that the Bedouin children are severely under-nourished. Vitamin A deficiency indicators were present in only 3.3% of the examined children, while 5.4% of them had thyroid enlargement (goiter).

Nutritional and health status of Bedouin mothers: The anthropometric data of mothers revealed that only 38.8% of the mothers had normal BMI, while 32.3% of them were overweight and 20.1% obese. Only around 6.4% were underweight. Nearly 37.0% of those classified as overweight, and 42.0% of those classified as obese, were stunted. This indicates a relative or misleading obesity. In addition, 55.5% of stunted mothers had a BMI >25 (pre-obese or obese). About 39.2% of the examined mothers showed signs of vitamin A deficiency.

So in the Egyptian Sinai, child and parent malnutrition for this group of people seems even worse than in Area C. How do the nomadic Bedouin fare inside Israel when it comes to nutrition? Ynet reported on a Beersheba District Health Office report from 2009 on this subject:

About 9% of Bedouin children under the age of five suffer from growth delays and 4.4% are underweight. Bedouin girls are at higher risk, and suffer seven times more than boys from growth problems and 10 times more from weight problems.

The trend only widens as the children get older, and in the first and second grades some 13% of Bedouin children suffer from growth delays, while 17% are underweight.

Over half (56%) of Bedouin infants at the age of six-months-old suffer from anemia, and about a tenth of them have zinc deficiencies. At the average age of 18-months-old 27% of Bedouin children suffer from anemia, while 11.5% lack zinc, 5% lack Vitamin A and 3% have Vitamin E deficiencies.

The infant mortality rate among Bedouins stands at 11.5 deaths for every 1,000 births, and is almost three times higher than the national average of 4.1 deaths for every 1,000 births.

According to the report there has been a 5.5% decline in the infant mortality rate among Bedouins since 2004. The leading causes of infant mortality are related to birth defects and hereditary diseases.

Despite the harsh numbers, the report said a relatively high rate (90%) of Bedouin children are given all the routine vaccinations recommended by the Health Ministry and very few cases of infectious diseases are reported among this population. The average vaccination rate in Israel ranges from 92% – 97%.

The report goes on to suggest the reasons for the problem.

Despite the high vaccination rates, there has been no drop in the rate infectious diseases that are not preventable by vaccinations, such as digestive tract diseases, that could be related to poor infrastructure and living conditions in the Bedouin sector.

The report says, “It’s difficult for the residents to keep their houses cool or warm and to maintain personal and environmental hygiene in the absence of access to flowing water and waste disposal systems.

Bedouins living in unrecognized communities are in much poorer condition that those living in permanent communities, and according to the report, children born in unrecognized communities have a lower average weight at birth, are 2.4 times more underweight at the ages of six and seven-years-old and have a lower vaccination rate than Bedouin children living in permanent communities.

In other words, the Bedouin who have agreed to move to planned Israeli communities and essentially give up their nomadic lifestyles do not suffer from the same levels of malnutrition, disease and infant mortality as those who have ignored Israel’s plans and who continue to live as their culture has dictated for hundreds and possibly thousands of years.

And this is the real conclusion to draw here. The problem is that it is extremely challenging to change someone’s culture, particularly when the individual resists the change. Perhaps Israel can do more, maybe Egypt can, maybe the UN can, but it appears that even with great efforts exerted, actual change is difficult to achieve. Much of the malnutrition happening to children in these families is not due to the authorities’ ignorance or ill-will, but rather a desire or inability to change patterns that have a very strong foothold in this nomadic society.

None of this explains Ms. Atwood’s op-ed and truthfully, I am extremely troubled by the shallowness of her article, her research and her commentary. Along with the unjust and incorrect criticism of Israel in her article, she also throws a bunch of “yes but” comments intended to illustrate those issues people raise when they reject “compromise” in the Arab-Israeli conflict. Incredibly, she only raised one “yes but” for the entirety of the Arab world and several for Israel – including a “yes but…you’re an antisemite” remark.

A few months ago, Ms. Atwood visited Israel to receive a prize for her career’s efforts. She came under withering public criticism from anti-Israel advocates. She decided to come anyway, positioning herself as an advocate for open speech and the importance of cultural exchange. At the time I wrote that somebody should be sure to have her tour with a knowledgeable person who could explain the complexities of the conflict fairly.

However, after receiving the lucrative award, she wrote an op-ed criticizing Israel. It became clear to me that the people who showed her around were those who had encouraged her not to go in the first place. Or perhaps she felt she needed to atone for taking money while her friends on the Left were opponents of Israel.

She blamed the conflict and its outcomes such as “Child-killing in Gaza” and “Killing aid-bringers on ships in international waters,” not to mention the tendentious (as if the other two aren’t?) “Civilians malnourished thanks to the blockade?” on Israel. Not enough one sided propaganda? She then added for good measure: “Forbidding writing paper? Forbidding pizza? How petty and vindictive!” She added, “Am I a tool of terrorists for saying this? I think not.”

It is a wonder to behold. Petty and vindictive to place pressure on people bombing Israeli children for years? Petty and vindictive to attempt to force the hands of those who hold an Israeli captive for years without a single visit permitted by a Red Cross worker or anybody else for that matter?

She wrote:

“but until the structural problem is fixed and Palestine has its own “legitimized” state within its internationally recognized borders, the Shadow will remain [she was claiming a shadow hangs over Israeli society but I suspect this is really the shadow that hangs over the wacko who gave her the tour of the country].

Israel, of course, offered a legitimized Palestinian state per the terms of UN Security Council Resolution 242 – which is the only meaningful international document (338 is essentially a rehash) pertaining to internationally recognized borders in the conflict – in 2000, 2001 and again in 2008. The Olmert offer in 2008 even included an internationalized Holy Basin! The Palestinians, throughout these offers, have relented on nothing and rejected all that was offered. Their explanation? In 2008, Abbas explained why we don’t have peace and two states by stating that after Olmert’s fair and generous offer, “The gaps were too wide.”

In other words, Abbas gave the biggest “yes but” imaginable.

And now this op-ed in Ha’aretz. What a terribly sad read for me. I did not think that a person with her intelligence and worldliness could fall for the usual bullshit that accompanies very complex issues surrounding this conflict. Is it possible that the work of such a great author could descend into the realm of cheap, shallow propaganda?

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  • I do not know why you are so surprised about Atwood. Having read some of her works, not all mind you because quite frankly they are self-righteous, insipid diatribes about those who do not agree with her political views. Quite frankly she is boring as a writer and quite frankly apparently as unintelligent and inadequate a researcher as I thought. She is of the feminist movement that decided decades ago to become part of the anti-Israel left. One of these days the left in Israel is going to learn that when they say they want to destroy Israel that includes them too…they remind me of the Jews who kept saying that Hitler wasn’t talking about them, just those other Jews…I wonder if those idiots in Tel Aviv have learned their lesson yet? Doubt it.

  • a handmaids tale is a very well crafted and somewhat prescient novel

    its sad that its author is just another moron

  • I am stunned by allegations of malnutrition and death due to related illnesses in Area C in West Bank coupled with accusations of the Israeli government. With billions of dollars that flood West Bank treasury one would expect the Palestinian Authority to take care of their children. Palestinians have to be accountable for the moneys that they get. It is not Israel’s business to take care of Palestinians. Rather Haaretz should have published an article about an Israeli organization “Save a child’s Heart” http://www.saveachildsheart.org which surgically correct congenital heart defects in children. By now they repaired such defects in more than 1000 Palestinian kids. If you, Haaretz, want to build bridges with the Palestinian than you must emphasis the possitive, Save a Child’s Heart. Like my very old neighbor in Meah Shearim said:”You can fight every thing in this world except for fighting stupidity.” Oh, yes, how stupid you are. Isaac Barr MD FACC, Michigan, USA