Israeli gov't must reckon with decades of neglect - report
Decades of neglect by the government have left wide gaps in services in the realms of physical and mental healthcare, the economy, social welfare, unemployment, education, the Arab sector, and aliyah.
Whoever is prime minister and serves in government after the Gaza War ends will have their hands full faced with the herculean task of coping with years of neglect by the ministries – in the realms of physical and mental health, the economy, social welfare, unemployment, education, the Arab sector, and aliyah.So says the first chapter of the just-released annual State of the Nation Report of Jerusalem’s Taub Center for Social Policy Studies. This year, because of the war, the researchers decided to separately release each chapter of the 212-page Hebrew-language document. Two will be published weekly; the first presents a survey of the war’s social and economic effects. The next chapter – to be published on December 26 – will deal with social welfare and will be followed on December 31 by a chapter on education.The authors said they hope that the publishing method will make it possible for decision-makers and the public to “take a deep dive into each topic, even as we all deal with the complexities of our daily reality.”The Taub Center is an independent, nonpartisan socioeconomic research institute that studies and reports on critical issues to impact decision-making.“The October 7 War,” they wrote, “differs from any previous conflict that Israel has been involved in since 2000 – concerning its duration and the sheer number of reservists called to active duty. The Second Lebanon War in 2006 lasted for 34 days and involved the call-up of about 60,000 reserve soldiers; Operation Cast Lead in early 2009 lasted for 22 days and did not involve any major call-up of reserve soldiers; and Operation Protective Edge in 2014 went on for 50 days and involved the call-up of about 75,000 reserve soldiers.”
Healthcare systems must increase capacity
They noted that the country’s healthcare system began the war with insufficient budget, manpower, and difficulties in functioning. Since the beginning of the war, an unprecedented 7,500 people have been wounded, with more than 1,450 arriving at hospitals on the day of the terrorists’ incursion. Most of the wounded were taken to hospitals in the South in numbers well beyond their capacity.
For example, Soroka-University Medical Center in Beersheba admitted about 700 patients, of which some 120 were in serious condition, while the hospital’s previous worst-case scenario was for an intake of no more than 100 to 200 injured individuals.“The mental health system has suffered from long-term neglect in terms of manpower and infrastructure, particularly after the COVID-19 pandemic. The current crisis may prove to be a turning point and may bring about its rehabilitation and strengthening, with an emphasis on expanding the circle of patients in the public mental healthcare system and constructing a trauma-oriented system to ensure trauma awareness at every stage of treatment.”The poor sanitary and humanitarian conditions in Gaza have the potential to seriously affect the health of Israelis, they continued. The allocation of water to the residents of Gaza is currently about three liters per day, while the WHO recommends between 50 and 100 liters daily.
This situation, together with chronic sewage problems, which have been exacerbated in the course of the war, provides fertile ground for infectious diseases that can spread into Israel, they warned.The authors recommended a revision of plans for patient allocation in hospitals; accelerating the opening of the new Beersheba hospital with sufficient manpower; upgrading hospitals in Ashkelon, Nahariya, Tiberius, and Safed to admit and treat trauma victims; completing protective safety measures in all of the hospitals, particularly those along the border in the South and the North; rehabilitation, reinforcement, and expansion of the mental health and rehabilitation systems; and the creation of a trauma-oriented and trauma-aware healthcare system.
An unprepared social welfare system
The social welfare system in Israel began the war unprepared. On a single day, tens of thousands of residents were added to the rolls of the social welfare services, including 126,000 evacuees at 220 facilities. The vacuum created as a result of the slow response by the system during the first two weeks of the war was filled by the activities of more than a thousand civil society initiatives and tens of thousands of volunteers.Only in the second week of the war was the presence of the Welfare and Social Affairs Ministry felt, the researchers insisted. “Alongside the Ministry’s efforts to provide services to evacuees, the Defense Ministry dealt with the wounded and the families of fallen members of the security forces while the National Insurance Institute began to identify the injured, the families of hostages, and the murdered to provide them with immediate financial assistance as well as funding to meet other needs.”
Among their recommendations of steps to reinforce the system are the streamlining of processes to convey information about residents from the central government to the local authorities, the creation of a mechanism for the coordination of activities, and the support of civil society organizations that assist victims of the war; significantly improving the working conditions and salaries of social workers; and expanding the quantity of professional manpower in the social services departments.As war is a traumatic event with the potential to cause enormous emotional damage to parents and children, and the fact that early childhood is the most important period in a person’s life because of the rapid development of the brain and the nervous system and of cognitive, social, and emotional abilities, many young children in Israel are being exposed to stress due to the frequent sirens and bomb blasts that they hear.
“The emotional turmoil, which is accompanied by an extreme disruption of routine, is liable to affect the course of their development. Apart from the obvious decline in quality of life and welfare, the exposure to high levels of stress and the lack of positive stimulation can damage a child’s cognitive and emotional development,” they wrote.
“It can be assumed that the accumulated disruptions caused by the war will be seen in serious developmental delays and emotional and learning disorders in the future. Therefore, children must be exposed to positive and enriching experiences to the greatest extent possible.”
Ensuring a return to school routine
Efforts are needed to ensure normal learning routines for children in preschools and schools who have been forced to leave their homes. The voluntary and forced evacuees' population is about 250,000 (about 2.5% of Israel’s population), of which about 50,000 are children in preschool or school. The researchers noted that the Education Ministry is working to create temporary schools, but since they are not intended to be a long-term solution, it is worthwhile integrating these students into the local education systems in their new or temporary localities.In places with large concentrations of evacuees, efforts should be made to concentrate pupils from the same location in the same schools and classes whenever possible. It is also important to prepare for continued schooling throughout the country if the war expands and the entire country comes under rocket attacks for a prolonged period.The researchers suggested several policy alternatives for the education system, including the expansion of individual assistance in the schools and particularly for frontline civilians, to assist students who are finding it difficult to close the gaps created as a result of the war; strengthening the schools’ support systems, including guidance counselors, truancy officers, social workers, nurses, and psychologists; and examining alternative models for matriculation exams.
Effects on the environment and public health
The war is having far-reaching effects on the environment and public health. Due to the need to ensure an uninterrupted supply of electricity, the government has taken steps that are “potentially harmful to the environment, including issuing permits to use diesel fuel and coal to produce electricity despite the heavy air pollution they cause and their contribution to morbidity and mortality.Other factors liable to endanger public health include increased emissions of carcinogenic materials into the air as a result of looser supervision over the illegal burning of garbage and ground pollution by poisonous metals during the war that are liable to penetrate crops and, in turn, enter the human body.”To cut the environmental and health risks, the researchers recommend increasing supervision and enforcement activity, ensuring that the steps taken to guarantee the continuous supply of electricity will be canceled at the war’s end, and decontaminating and rehabilitating polluted land before rehabilitation projects for the settlements in the Gaza border area.
The war's impact on the workforce
The temporary absence from work of about 20% of the workforce (more than 900,000 workers) – especially young workers – alongside the direct costs of the war, are affecting the country’s economic systems and will continue to do so for a long time.In October, about 144,000 workers in the Gaza border area and the North were forced to leave their places of work after being evacuated; about 310,000 parents of young children were absent from work when the education system stopped operating normally; and about 135,000 workers were absent from work due to damage to their place of work. In November, the number of absent workers fell from about 900,000 to 500,000.According to estimates of the Bank of Israel, the total weekly cost of workers absent from work during the first three weeks of the war was about NIS 2.3 billion, which represents more than 0.1% of the GDP per week. This breaks down into absence from work due to the call-up of reservists, which costs about half a billion shekels per week; absence from work due to the evacuation of residents, which costs about NIS 0.6 billion per week; and absence from work due to the shutdown of educational institutions which costs about NIS 1.25 billion per week.There has been an increase in working from home during the war. The Bank of Israel estimates that about 12% of the evacuees from the Gaza border area, from Ashkelon, and the North are working from home, and, in total, 16% of the 4.1 million employees in the economy are working from home.The Israel Employment Service reported that since the start of the war, more than 190,000 applications for unemployment benefits were submitted by the end of November. The vast majority are a result of forced unpaid leave. Therefore, the proposed alternatives include the expansion of programs to return workers to the labor market, including giving incentives to employers, creation of mechanisms that allow for flexible unpaid leave, and the creation of programs to reintegrate reserve soldiers into the workforce if they are unable to return to their former places of work.
Integration of the Arab sector
The integration of the Arab population in most parts of the Israeli economy, which has improved over the years, suffered a setback during the war, the report notes. Similarly, the extent of mutual dependence between Jews and Arabs in Israel in the employment sector became clear, especially in the construction industry, which has been almost completely paralyzed since October 7.According to the researchers, the rifts need to be mended, and the partnership restored since the participation of Arab and Palestinian workers in the labor force is “one of Israel’s most important economic, security, and social interests.”
Economic impact of the war
According to Bank of Israel estimates, from July 2023, GDP was set to grow by 3.0% in both 2023 and 2024. In the revision caused by the war, the economists lowered their expectation for an annual rate of growth for 2023 to 2.0%. This implies a negative growth of 2% during the fourth quarter relative to the same quarter in 2022.In contrast, Standard & Poor’s and the Aaron Institute have presented a more pessimistic picture. They estimate that growth will be 1.5% in 2023 – negative growth of 4% in the fourth quarter relative to the same quarter in 2022. As for 2024, the Bank of Israel has lowered its forecasted growth rate by only one percentage point, and it estimates that growth will be 2.0%. Standard & Poor believes that the economy will grow by only 0.5%, and the Aaron Institute believes it will grow by only 1%. It should be remembered that Israel’s population grows by almost 2% annually. Thus, these forecasts are predicting a shrinkage of GDP per capita.“Aliyah is likely to be influenced by the developments in Israel and the increasing antisemitism abroad. The sharp increase in protests against Israel and the rise in antisemitism around the world, including in countries with a large Jewish minority, have made these countries much less attractive for Israelis who are considering emigrating and has made Israel more attractive for Jews who are considering immigrating. Therefore, it can be expected that net migration to Israel will increase during the next two years.However, if there is a renewal of the internal disagreements that poisoned the social climate and social discourse in Israel during most of 2023 and if the situation of conflict in Gaza and Judea and Samaria persists, Israel will almost certainly become less attractive to potential immigrants,” the Taub Center experts concluded.
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