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A NAHḌA OF CHARITABLE ORGANIZATIONS? HEALTH SERVICE PROVISION AND THE POLITICS OF AID IN PALESTINE

Published online by Cambridge University Press:  01 May 2008

Benoît Challand
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Extract

Until recently, the topic of charitable organizations seemed to have fallen in disgrace. Social scientists have given little attention to this sector of associational life. Instead, a great deal has been written on the issues of democratization through pressure groups or on the transformation of social movements into professional organizations while assessing the overall impact of development promoted by donors. Yet three signs point to the need for a better understanding of charitable organizations. First, new research studying Islamic activism through the lens of social-movement literature has offered innovative results. Second, studies on the impact of aid during the second intifada have revealed that charitable organizations as well as Islamic organizations offered a significant amount of emergency support, sometimes competing with professional nongovernmental organizations (NGOs). Finally, the fact that Hamas, also known for running a vast network of charitable organizations, achieved such a significant political success in the 2005 municipal and 2006 legislative elections should invite social scientists to consider whether and how political momentum can also be obtained through activism in the charitable sector.

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International Journal of Middle East Studies , Volume 40 , Issue 2 , May 2008 , pp. 227 - 247
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Copyright © Cambridge University Press 2008

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References

NOTES

Author's note: I thank Armando Salvatore and Caroline Abu-Sada for their comments on earlier drafts of this paper, as well as the editors and anonymous reviewers of IJMES for their enriching and stimulating suggestions.

1 To name a few, see Wiktorowicz, Quintan, ed., Islamist Activism: A Social Movement Theory Approach (Bloomington, Ind.: Indiana University Press, 2003)Google Scholar; Schwedler, Jillian, “Who Opened the Window? Women's Activism within Islamist Parties,” Comparative Politics 35 (2003): 293–312.Google Scholar

2 See in particular the ten reports produced by Riccardo Bocco et al., Palestinian Public Perceptions on their Living Conditions (Geneva: University of Geneva, 2001–2006). The role of Islamic NGOs is discussed thematically from the fifth report onward. All reports are available at https://www.iuedpolls.org (accessed 14 December 2007).

3 See, for example, Roy, Sara, “The Transformation of Islamic NGOs in Palestine,” Middle East Report 214 (2000): 24–26.CrossRefGoogle Scholar

4 Hamzah, Dyala and Larzillière, Pénélope, “Entre lutte nationale et fondation étatique, les intellectuels palestiniens d'Oslo I à Intifada II,” in Les nouveaux intellectuels islamistes, ed. Khosrokhavar, Farhad and Zeghal, Malika (Paris: Balland, 2006).Google Scholar

5 al-Barghouthi, Mustafa and Giacaman, Rita, “The Emergence of an Infrastructure of Resistance. The Case of Health,” in Intifada: Palestine at the Crossroads, ed. Nassar, Jamal R. and Heacock, Roger (New York: Praeger, 1990), 73–87Google Scholar; Al-Krenawi, Alean, Graham, John R., and Sehwail, Mahmud R., “Mental Health and Violence/Trauma in Palestine: Implications for helping Professional Practice,” Journal of Comparative Family Studies 35 (2004): 185–209.Google Scholar

6 Giacaman, Rita, Abdul-Rahim, Hanan, and Wick, Laura, “Health Sector Reform in the Occupied Palestinian Territories (OPT): Targeting the Forest or the Trees?” Health Policy and Planning 18 (2003):59–67.CrossRefGoogle ScholarPubMed

7 Nabulsi, Karma, “The Peace Process and the Palestinians: A Road Map to Mars'” International Affairs 80 (2004): 221–31.CrossRefGoogle Scholar

8 Lindholm-Schulz, Helena, “The ‘Al-Aqsa Intifada’ as a Result of Politics of Transition,” Arab Studies Quarterly 24 (2002): 21–46Google Scholar; Salah Abdel-Shafi, Civil Society and Political Elites in Palestine and the Role of International Donors: A Palestinian View, EuroMeSCo Paper No. 33 (2004).

9 Ibid., 9; Roy, “The Transformation of Islamic NGOs”: 24–26.

10 The focus on discourse throughout the text does not mean we should neglect health-care practice; it is the consequence of our focus on the importance of different framings of social movements.

11 LeVine, Mark and Salvatore, Armando, ed., Religion, Social Practice, and Contested Hegemonies. Reconstructing the Public Sphere in Muslim Majority Societies (New York: Palgrave Macmillan, 2005), 18.Google Scholar

12 Challand, Benoît, Palestinian Civil Society: Foreign Donors and the Power to Promote and to Exclude (London: Routledge, 2008).Google Scholar

13 Al-Krenawi, Alean and Graham, John R., “Principles of Social Work Practice in the Muslim Arab World,” Arab Studies Quarterly 25 (2003): 75–91.Google Scholar See also Barghouthi and Giacaman, “The Emergence of an Infrastructure of Resistance.”

14 The interviews were conducted in English for the most part, with four in Arabic. The eleven health NGOs interviewed (four in Hebron) were the Union of Health Care Committees, Gaza; the Union of Health Work Committees, Gaza; the Health Work Committees, West Bank; Bethlehem, Medical Relief and Development, Gaza; the Union of Palestinian Medical Relief Committees, Ramallah; the Gaza Community Mental Health Programme, Gaza; the Red Crescent Society for the Gaza Strip, Gaza; the Health Development Information and Policy Institute, Ramallah; the Ardh al-Itfal, Hebron; the Palestinian Red Crescent Society, Hebron; and JUZOUR, Jerusalem. We also conducted twelve interviews with charitable organizations (six in Hebron): the Family Association of Majdal, Beit Lahyia; the Family Association of Yafa, Jabaliya; the Union of Charitable Societies-Central Section, Jerusalem; the Palestinian General Union of Charitable Societies (National Board), Jerusalem; the Patient's Friends Society, Jerusalem; the Maqassed Charitable Hospital, Jerusalem; the Union of Charitable Societies (Hebron District), Hebron; the Patient's Friends Society, Hebron; the Tarqumyah Charitable Society, Tarqumya; the Ihsan Charitable Society, Hebron; the Islamic Charitable Society, Hebron; and the Hebron Zakat Committee.

15 We counted as charitable the organizations that describe themselves as charitable (khayriyya) or that are members of the Palestinian General Union of Charitable Societies.

16 As there are no exhaustive lists of NGOs, I have created my own database of Palestinian NGOs. I have merged into one database partial lists and have counted about 900 NGOs active by 2004, a figure that corresponds to the number proposed by a Palestinian research center: Palestine Economic Policy Research Institute, Ta˓dad al-Munazamat Ghayr al-Hukumiyya al-Filastiniyya fi-l-Dhifa al-Gharbiyya wa Qitta’ Ghazzah (Mapping of Palestinian NGOs in the West Bank and Gaza Strip) (Ramallah: Palestine Economic Policy Research Institute, 2001). This figure is likely to be lower than the actual figure. Nonetheless, the database is large enough to offer general insights into the whole NGO sector, including the relative weight of the charitable sector. Other lists compiled include the following: Office of the United Nations Special Coordinator, Directory of Non-Governmental Organisations in the Gaza Strip, 2nd ed. (Jerusalem: Office of the United Nations Special Coordinator, 1998, 2003); Office of the United Nations Special Coordinator, Directory of Non-Governmental Organisations in the West Bank (Jerusalem: Office of the United Nations Special Coordinator, 1999); Palestine Economic Policy Research Institute, Ta˓dad al-Munazamat Ghayr al-Hukumiyya; Union of Charitable Societies–Jerusalem, Activities and Services of the Societies (Jerusalem: mimeo, 2003); Union of Charitable Societies, Hebron District, Provoke and Aspiration. 1990 (n.p. [Khalil]: [1990]); Nader Said and Ayman Abdul-Majeed, Institutional Structures in Palestinian Refugee Camps in the West Bank and the Gaza Strip: An Evaluative Study for the PLO Department of Refugee Affairs (Birzeit, Palestine: Birzeit University, 2000).

17 Figures for 1990 taken from Union of Charitable Societies, Hebron, Provoke and Aspiration, 3. The 2003 figures were communicated to the author by the vice-president of the union; interview with Sameh Hashem abu Aysheh, Union of Charitable Societies, Hebron, 12 February 2004. The 2006 figures are taken from the Office of the United Nations Special Coordinator, Directory of Non-Governmental Organisations in the West Bank, 2nd ed. (Jerusalem: Office of the United Nations Special Coordinator, 2006).

18 This does not mean that the PNA and United Nations Relief and Works Agency for Palestine Refugees in the Near East are not important health actors. On the PNA, see Brigitte Curmi, “Relations intra-palestiniennes, persistance du conflit et surenchère des bailleurs de fonds internationaux: le cas de la santé dans les Territoires palestiniens,” in États et ONG: vers une internationalisation des politiques de santé dans les pays en développement? ed. Sylvia Chiffoleau (Paris: IFEAD, 2003). On the role played by the United Nations Relief and Works Agency in the field of health (especially during the second intifada), see Bocco, Palestinian Public Perceptions, Report X (2006), 84–89.

19 Roy, Sara, The Gaza Strip. The Political Economy of De-Development, 2nd ed. (Washington: Institute of Palestine Studies, 2001), 108.Google Scholar

20 Al-Haq, An Ailing System: Israeli Military Government Health Insurance in the Occupied Palestinian Territories (Ramallah: al-Haq, 1993), 12.

21 Jihad Mash˓al, “Palestine,” in The Concept of Health Under National Democratic Struggle, ed. International People's Health Council (Jerusalem: Union of Palestinian Medical Relief Committees, 1995), 90.

22 Robinson, Glenn, Building a Palestinian State. The Incomplete Revolution (Bloomington, Ind.: Indiana University Press, 1997).Google Scholar

23 Olle Jeppson and Claes Lindhal, Health Services in Transition. An Evaluation of the Union of Palestinian Medical Relief Committees. Unpublished assessment report for SIDA. mimeo (s.l.: SIDA 1995), 2; Union of Palestinian Medical Relief Committees, Annual Report [2000] (s.l.: Union of Palestinian Medical Relief Committees Publications, 2001), 6.

24 Hans-Joachim Rabe, “Palestinian Elites after the Oslo Agreements (1993–1998)” (PhD diss., University of London, School of Oriental and African Studies, 2000), 277.

25 Ibid., 85, 265.

26 Hammami, Rema, “NGOs: The Professionalisation of Politics,” Race & Class 37 (1995): 51–63.CrossRefGoogle Scholar By no means should the number of clinics serve to measure the quality of health provision. They merely indicate structural changes that affected the health sector in various historical moments. See also Craissati, Dina, “Social Movements and Democracy in Palestine: Politicization of Society or Civilization Of Politics?” Orient, Zeitschrift des Deutschen Orient-Instituts 37 (1996): 111–36.Google Scholar

27 For a further elaboration of distinctions between charitable and Islamic organizations and between Islamic and Islamist NGOs, see International Crisis Group, Islamic Social Welfare Activism in the Occupied Palestinian Territories: A Legitimate Target? (Bruxelles and Amman: International Crisis Group, 2003): 3 fn. 14, 7–9.

28 Benthall, Jonathan and Bellion-Jourdan, Jérôme, The Charitable Crescent. Politics of Aid in the Muslim World (London: I. B. Tauris, 2003), 105.Google Scholar

29 Amaney A. Jamal, “From Active Resistance to Democratic Missionaries?” Palestine Report (Jerusalem: Jerusalem Media and Communication Centre, 2000). Yet the charitable organizations had benefited from Arafat's support for Saddam Hussein in 1990 because part of what the PLO lost in financial support from Arab countries was redirected to the charitable sectors.

30 This is not true for all international donors. Islamic Relief (based in the United Kingdom and funded in part by the European Union) is very keen to check on the recipient's record to ensure money will not go to Islamist groups. The International Committee of the Red Cross's program of “smart aid” (through vouchers) seemed also “to be deliberately aimed at providing an alternative source of effective support” to that of Islamist circles. See Benthall and Bellion-Jourdan, The Charitable Crescent, 106. See also the dossier on Muslim NGOs, ISIM Review 20 (2007): 6–19.

31 As suggested in Abdel-Rahman Ghandour, Jihad humanitaire: enquête sur les ONG islamiques (Paris: Flammarion, 2002).

32 Jean-François Legrain, “HAMAS: Legitimate Heir of Palestinian Nationalism,” in Political Islam. Revolution, Radicalism or Reform? ed. John L. Esposito (Boulder, Co.: Lynne Rienner, 1997), 163.

33 Roy, “The Transformation of Islamic NGOs.”

34 Palestine Economic Policy Research Institute, Ta˓dad al-Munazamat Ghayr al-Hukumiyya, 1.

35 Ibid., 2. Let us note such a study does not distinguish between charitable and Islamic or even Islamist NGOs; instead it relies on the self-description provided by the NGOs. Therefore, most of the religious organizations are included in the charitable sector.

36 Ibid., 112 (Statistics 4-2). The two tables are based on the responses of 881 NGOs for a total expense of $112 million for the year 2000.

37 Ibid., 120 (Statistic 8-3).

38 Hilal, Jamil, “Problematizing Democracy in Palestine,” Comparative Studies of South Asia, Africa and the Middle East 23 (2003): 169.CrossRefGoogle Scholar

39 On reform pressure, see Keating, Michael, More, Anne Le, and Lower, Robert, ed., Aid, Diplomacy and Facts on the Ground: The Case of Palestine (London: Chatham House, 2005).Google Scholar On health reforms, see World Bank, West Bank and Gaza: Medium-Term Development Strategy for the Health Sector (Washington, D.C.: World Bank, 1998).

40 Ibid., 1.

41 Giacaman et al., “Health Sector Reform”: 60, 66.

42 Benoît Challand, “The Evolution of Western Aid for Palestinian Civil Society: The Bypassing of Local Knowledge and Resources,” Middle Eastern Studies 44 (forthcoming). For figures on the Oslo years, see Brynen, Rex, A Very Political Economy. Peacebuilding and Foreign Aid in the West Bank and Gaza (Washington, D.C.: United States Institute of Peace Press, 2000).Google Scholar

43 There are only partial figures on disbursement to the health sector after the boycott of the PNA and the introduction of the so-called temporary international mechanism in June 2006. The European Union alone increased its envelope for health activities from €270 million in 2005 to €340 million in 2006. See their operation and financial report for June-December 2006, 4. Available at http://www.delwbg.ec.europa.eu/en/tim/tim_in.htm (accessed 14 December 2007).

44 I have argued elsewhere that there are important differences according to the size of the donors, the origins of their own funding (governmental vs. solidarity based), or their geographic origins (north vs. south Europe, Europe vs. the United States), and so forth. See Challand, “The Evolution of Western Aid.” For a bleak picture on the role of donors during the stand-off between Hamas and Fatah in 2006 and 2007, see Sayigh, Yezid, “Inducing a Failed State in Palestine,” Survival 49 (2007): 7–39.CrossRefGoogle Scholar

45 Kuttab, Eilen, “Women and the Current Intifada,” Between the Lines 2 (2001): 4–6.Google Scholar

46 Hammami, Rema and Tamari, Salim, “The Second Uprising: End or Beginning?” Journal of Palestine Studies 30 (2001): 6, 18.CrossRefGoogle Scholar

47 Roger Heacock, “Seizing the Initiative, Regaining a Voice: The Palestinian Al-Aqsa Intifada as a Struggle of the Marginalized” (unpublished paper, 5th Mediterranean Social and Political Research Meeting, IUE, Montecatini, Italy, 2004): 15.

48 On overcentralization, see Kassis, Mudar, “Civil Society Organisations and Transition to Democracy in Palestine,” Voluntas 12 (2001): 35–48.CrossRefGoogle Scholar

49 Majdi al-Malki, “Entraide sociale et clientélisme en Palestine,” Études rurales 173–74 (2005): 201–18. al-Malki, Majdi, “Le système de soutien social informel et les relations de néo-patrimonialisme en Palestine,” Les Annales de l'Autre Islam 8 (2001): 171–87.Google Scholar See also Heacock, “Seizing the Initiative.” These two works highlight how the ḥamūla structure has been used for political purposes mostly by Fatah and the Islamist sectors. Caroline Abu-Sada suggests that some professional NGOs (in the field of agriculture) have also used the repertoire and networks of the ḥamūla (and of notable families) in the last years. See Caroline Abu-Sada, “ONG et construction étatique, l'expérience de PARC [Palestinian Agricultural Relief Committees] dans les Territoires Palestiniens, 1983–2005” (PhD diss., Institut d'Etudes Politiques, 2005), Part III. On the many transformations of the Palestinian ḥamūla, see the classic work of Cohen, Abner, Arab Border-Villages in Israel: A Study of Continuity and Change in Social Organisation (Manchester: Manchester University Press, 1972).Google Scholar

50 A similar argument is made about the Arab Muslim world in general by Krenawi and Graham, “Principles of Social Work.”

51 Despite the level of professionalization of secular NGOs, they may not compete successfully against the Islamist social network, precisely because these secular NGOs rely “primarily on foreign funding rather than grassroots participation.” See International Crisis Group, Islamic Social Welfare Activism, 26, fn. 183, 3, and 12.

52 Quoted in Heacock, “Seizing the Initiative,” 26. The survey is the Participatory Poverty Assessment, Relationship between the Poor and the Different Institutions: Learning from the Poor (Ramallah: Ministry of Planning and UNDP, 2004). See also Jean-François, Legrain, “La Dynamique De La ‘Guerre Civile’ En Palestine,” Critique Internationale 36 (2007): 148.Google Scholar

53 Interview with Majeed Nasser ed-Din, board member, Hebron Zakat Committee, Hebron, 12 February 2004.

54 Abu-Sada, Caroline, Madi, Amer, and Uweidat, Ahmad, Food and Agriculture Organization, Strengthening Resilience: Food Insecurity and Local Responses to Fragmentation of the West Bank (Jerusalem: U. N. Food and Agriculture Organization, 2007): 44–47.Google Scholar

55 Formally, they are detached from the parties, and the board of directors is multipartisan. Yet the network of organizations with which they work and the public positions these NGO leaders take clearly demonstrate a continuation of links (even if not formally institutionalized) with the party.

56 Source from author's database.

57 Despite these renewed efforts, many interviews conveyed the sense that these urban-based NGOs are actually perceived by people in the periphery as urban organizations active mostly in central zones of the OPTs.

58 The issue of “meta-NGOs” that redirect funding to smaller NGOs can best be exemplified by the NGO project run by the Welfare Association since the mid-1990s. It is now in its third phase. For an overview, see http://www.pngo-project.org (accessed 10 December 2007). See also Challand, Palestinian Civil Society, chaps. 6, 7.

59 Interview with Iyaad Surour, public relations officer, Ihsan Charitable Society, Hebron, 11 February 2004.

60 Source from author's database.

61 We are speaking here of the locations where the organizations were registered. Some large or medium-sized NGOs are active in villages or refugee camps but are registered elsewhere. Source from author's database.

62 al-Barghouthi, Mustafa, “Popular/Mass Movement in the Community,” Journal of Refugee Studies 2 (1989): 128.Google Scholar

63 See http://www.who.int/hpr/NPH/docs/declaration_almaata.pdf (accessed 14 December 2007); Litsios, Socrates, “The Long and Difficult Road to Alma-Ata: A Personal Reflection,” International Journal of Health Services 32 (2002): 709–32.CrossRefGoogle Scholar

64 Barghouthi and Giacaman, “The Emergence of an Infrastructure,” 80, fn. 27, 84.

65 Interview with Salah Abdel Shafi, director, Gaza Community Mental Health Programme, Gaza City, 2 February 2003.

66 Dr. Haydar Abdel Shafi headed the Palestinian delegation to the Madrid conference in 1991 and was later elected to the PLC in 1996.

67 Interview with Dr. Haydar Abdel Shafi, president, Red Crescent Society for the Gaza Strip, Gaza City, 2 February 2003.

68 Interview with Zakaria al-Ba˓lousha, secretary general, Family Association of Majdal, Beit Lahiya, 1 February 2003.

69 Interview with Khamees al-Battran, chairman of the north Gaza branch, Family Association of Yafa, Jabaliya Refugee Camp, 1 February 2003.

70 Sayigh, Yezid, Armed Struggle and the Search for State. The Palestinian National Movement, 1949–1993 (Oxford: Oxford University Press, 1997), chap. 4.Google Scholar

71 Interview with Nora Qort, board member, Palestinian General Union of Charitable Societies, Beit Hanina, 23 January 2004. Following quotes from the same interview.

72 Interview with Iyaad Surour, public relations officer, Ihsan Charitable Society, Hebron, 11 February 2004.

73 Ibid. See also the interview with Baasem Natsheh, public relations officer, Patient's Friends Society (running al-Ahli Hospital), Hebron, 11 February 2004.

74 Interview with Izzo Ghrayb, board member, Tarqumya Charitable Society, Tarqumya, 10 February 2004.

75 Interview with Maajed ˓Aloush, board member, Union of Charitable Societies of Jerusalem, 28 January 2003.

76 Western donors, however, should not be treated homogenously, because they have variegated ways of working with local organizations. See Challand, “The Evolution of Western Aid.”

77 See Alexander, Jeffrey C., “The Paradoxes of Civil Society,” International Sociology 12 (1997): 115–33.CrossRefGoogle Scholar For a counterview, see Harik, Iliya, Democracy and the Paradoxes of Cultural Diversity. Beyond the Veil of Difference (Byblos: UNESCO, 2003).Google Scholar

78 See Abdel-Shafi, Civil Society and Political Elites.

79 Hammami, Rema, “Palestinian NGOs since Oslo. From NGO Politics to Social Movements?” Middle East Report 214 (2000): 18.Google Scholar The multiplication of dakakīn was also engineered by USAID, which preferred creation of new NGOs to funding NGOs with credentials that could be difficult to verify.

80 On this tension, see Carapico, Sheila, Civil Society in Yemen. The Political Economy of Activism in Modern Arabia (Cambridge: Cambridge University Press, 1998): 4–8.CrossRefGoogle Scholar

81 Mohammad I. al-Madhoun, “Hal al-Qawi al-Islamiyya ˓Ajiza ˓an al-Musharaka al-Mujtama˓iyya al-Fa˓ila?” (Are Islamic Forces Incapable of Having an Effective Social Participation?) Al-Quds al-Arabi, 27 July 2004.

82 Interview with Majeed Nasser ed-Din, board member, Zakat Committee Hebron, Hebron, 12 February 2004. See also Abu-Sada et al., Strengthening Resilience, 46.

83 On the 10th cabinet, see http://www.jmcc.org/politics/pna/pagovmar06.htm (accesssed 14 December 2007). For a sociological analysis of the Palestinian cabinets and of the proportion of civil society actors, see Challand, Benoît, “Palestinesi contro. Una storia lunga quarant'anni,” LIMES—Rivista Italiana di Geopolitica 5 (2007): 57–77.Google Scholar

84 LeVine and Salvatore, Religion, Social Practice, and Contested Hegemonies, 18.

85 See Roy, “The Transformation of Islamic NGOs”; International Crisis Group, Islamic Social Welfare, 12.