1. Monitoring CRC Article 39
1. INTRODUCTION
A. Strategic Objective
To ensure that Article 39 1 of the UN CRC, related to the responsibility of States Parties to
take all appropriate measures to promote the psychological recovery and social
reintegration of child victims of armed conflict, is respected by relevant state institutions,
and to improve the effectiveness of state actors in fulfilling their responsibilities.
This plan will draw on the example of child victims of armed conflict living in the Occupied
Palestinian Territories (oPT), but it is hoped that it could be adapted for use elsewhere.
B. General background
It is widely held that exposure to violence and armed conflict can have a devastating
impact on the psychosocial well-being and development of children. This is reflected in
Article 39 of the UN CRC. Psychological distress might manifest itself in symptoms which
could include flashbacks of stressful events, nightmares, headaches, withdrawal,
aggression, and an inability to concentrate. 2 However, there is a lack of universal
consensus around what psychosocial wellbeing or distress accurately means, and how it
manifests itself. What is clear is that not all individuals respond to disastrous events in a
similar way, nor are they likely to have the same needs. Save the Children Sweden argue
that creating structures such as education, normalisation, and empowering activities within
a safe environment will help the majority of children to recover over time, although in
addition to this, children often need special attention from adults in order to regain their
well-being. 3
Differences in understanding are reflected in the varying methodologies surrounding
psychosocial interventions. It is sometimes assumed that trauma counseling, commonly
used in western countries, is transferable universally. However, it is increasing held that
such interventions should not automatically be viewed as the first point of departure. 4
Different cultures attach different meanings to distress and cope with it in different ways.
For this reason, it is important that psychosocial interventions are culturally relative, finding
out how the local population view and respond to the events around them. 5 With this in
1 UN CRC Article 39: States Parties shall take all appropriate measures to promote physical and
psychological recovery and social reintegration of a child victim of: any form of neglect, exploitation, or
abuse; torture or any other form of cruel, inhuman or degrading treatment or punishment; or armed
conflicts. Such recovery and reintegration shall take place in an environment which fosters the health,
self-respect and dignity of the child.
2 Save the Children Sweden (2006): “Emergencies and psychosocial care and protection of affected
children”
3 Ibid.
4 Ibid.
5 For more information on this see Angus Murray, Tearfund report “Assessing psychological distress-
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2. mind, a participatory approach has been designed for the following monitoring plan,
ensuring that the beneficiaries, the children, are central, and that their voices are heard.
Concomitantly, the psychosocial wellbeing of individuals, and impact of targeted
interventions to assess and address psychosocial wellbeing, are hard to measure, and
lack clear transferable methodology, as with intervention methodologies. In addition to the
lack of agreement around psychosocial definitions, reasons for this include lack of basic
data, capacity restrictions, and constraints on security and access. 6 It is perhaps for some
of these reasons that state actors do not fulfill their obligations to the promote and protect
the rights which specifically highlight the mental health of children affected by armed
conflict, outlined in the international human rights instruments to which they are legally
bound to.
Situation in the oPT
The exposure to direct violence, and other related physical, economic, social and political
stresses that have resulted from the Israeli-Palestinian conflict have put a significant strain
on the psychosocial wellbeing of children living in the oPT. The Psychosocial Assessment
of Palestinian children, conducted in 2003 by the Secretariat for the National Plan of Action
for Palestinian Children, found that “The majority of sampled children (93%) reported not
feeling safe and exposed to attack. Almost half of the children (48%) have personally
experienced violence owing to the ongoing Israeli-Palestinian conflict or have witnessed an
incident of such violence befalling an immediate family member. One out of five children
(21%) have had to move out of their homes, temporarily or permanently, overwhelmingly
for conflict related reasons”. 7 Many Palestinian children frequently suffer from nightmares
and bed-wetting, aggressiveness and hyperactivity, as well as a decrease in attention
span and concentration capacity, and an inability to trust others.
The stress suffered by Palestinian children is accentuated by nearly half of parents feeling
unable to fully meet their children's needs for care and protection at the time of the study,
because of their lack of control over external events, financial and material limitations and
the fact that caregivers themselves are stressed and frustrated therefore having less
emotional energy to provide the necessary psychosocial support to their children.
Over the last decade there have been several psychosocial interventions in the oPT by
various actors including the Palestinian National Authority, NGOs, and INGOs. The
Secretariat for the National Plan of Action for Palestinian Children conducted a
Psychosocial Assessment of Palestinian Children in 2003, the same year that the World
Health Organisation began psychosocial programmes in the oPT. In December 2005 the
Palestinian Ministry of Planning, the Union of Social Workers and Psychologists, UNICEF
and the Canadian International Development Agency launched the First Psychological
Standards in occupied Palestinian Territories. The aim of the Standards was to work
towards reinforcing children's and parent's capacity to prevent and deal with violence – all
forms of violence: in homes, schools, communities and from the conflict. [I can't find what
has happened in relation to this now]. In 2005, UNICEF equipped more than 50,000
which lens?” on Humanitarian Practice Network website at http://www.odihpn.org/report.asp?id=2861
6 HPG Research Briefing Number 15 June 2004, ODI, London www.odi.org.uk
7 The Secretariat for the National Plan of Action for Palestinian Children (2003): Psychosocial
Assessment of Palestinian Children
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3. children and 25,000 caregivers with needed skills on how to prevent and deal with all
forms of violence.
The Palestinian Red Crescent Society (PRCS) currently run 5 psychosocial centres in the
oPT to meet the needs of disadvantaged children, adolescents, parents and medical staff
and volunteers. In addition, the PRCS gives awareness raising of psychosocial issues,
psychosocial diagnostic and counseling services are offered to the community, and
psychosocial support is offered to children and affected families.
Despite the monitoring survey conducted in 2003 by the Secretariat for the National Plan
of Action for Palestinian Children, there is currently no regular monitoring of the
psychosocial wellbeing and development of children in the oPT either by the Palestinian
National Authority, or by Israel, under whose jurisdiction occupants of the oPT reside. [As
far as I'm aware]
C. Relevant state laws and standards include:
Israel
Children's Ombudsman for Israel
Although Israel, the Occupying Power, has ratified many international standards (including
the CRC in 1991), it denies their applicability to the Palestinian territory. Israel contends
that human rights treaties to which it is party were intended for the protection of nationals
from their own government in time of peace, and do not apply to the current situation in the
occupied Palestinian territory. However, the international community widely accepts the
applicability of international human rights law to situations of armed conflict and
occupation, and Israel therefore has a moral and legal obligation to uphold international
human rights standards in its administration of the territory.
Palestine
Palestinian National Child Law (1994)
International
UN CRC:
Article 39
Article 32
Article 27
Article 24
Universal Declaration of Human Rights (UDHR)
Article 25 (1)
International Covenant on Economic, Social and Cultural Rights (ICESCR)
Article 12
Convention on the Elimination of All Forms of Discrimination against Women (CEDAW),
Article 12
International Convention on the Elimination of All Forms of Racial Discrimination (ICERD)
Article 5 (e) (iv)
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4. UN Special Representatives and Rapporteurs
Special Representative of the UN Secretary-General for Children and Armed
Conflict
Special Rapporteur of the Commission on Human Rights on the situation of human
rights in the Palestinian territories occupied since 1967
Special Rapporteur of the Commission on Human Rights on the right of everyone to
the enjoyment of the highest attainable standard of physical and mental health
Special Rapporteur on the situation of human rights and fundamental freedoms of
indigenous people
Representative of the Secretary-General on the human rights of internally displaced
persons
Special Rapporteur on the human rights of migrants
2. MONITORING PLAN
A. Purpose of Monitoring
For State Institutions 8 , with assistance from other actors, to monitor the psychosocial
welfare of [Palestinian] children in order to:
gain a precise understanding of how children view their life and how they are coping
with the life-events around them
gain an understanding of [Palestinian] children's psychosocial well-being and
development from the perspective of their care-givers and teachers
gain a quantifiable understanding of some of the environmental factors which
contribute to negatively to children's psychosocial development
monitor the capacity of families and communities to protect children's psychosocial
wellbeing and development
learn more about the resulting psychosocial symptoms of the situation on children
monitor whether relevant States Parties are taking 'appropriate measures to
promote physical and psychological recovery and social reintegration of child
victims of armed conflict' in accordance with UN CRC Article 39.
measure impact and outcomes of targeted psychosocial interventions (applicable to
all actors conducting psychosocial programmes)
assess current needs
reveal areas for further intervention
monitor levels of improvement (or decline) over time
Specific indicators would be developed.
Playfulness: When do the children play? What kind of games do they prefer to
play? Whom do they prefer to play with?
Trust: What does “trust in others” mean? Who do the children trust and why, and
who do they mistrust and why?
Tolerance: What does “tolerance” mean? What does it mean to be different from
others? What is the attitude of the children to other groups (e.g. Israelis, other ethnic
groups, refugees, marginalized groups)?
8 Preferably Israeli State Institutions, more realistically the Palestinian Authority
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5. Joyfulness: What does it mean to feel “joyful or happy”? When do the children
feel happy and why? 9
Anger: What does it mean to feel angry? When do children feel angry? What makes
them angry? What do they do when they feel angry?
Sadness: What does it mean to feel sad? When do children feel sad? What do they
do when they feel sad?
Fear: When do children feel afraid? What does it mean to be afraid? When do they
feel anxious? What do they do when they feel this way?
Safe/unsafe: When do children feel unsafe? What makes them feel this way? When
do they feel safe? Why?
B. Scope of monitoring
Focus group research would be conducted on a random and representative sample of
children, parents and teachers to elicit information on the psychosocial wellbeing of
children. This participatory methodology enables and allows for the inclusion of varying
perspectives and insights into how children, parents, and teachers understand life events
and share these understandings with one another.
Teams comprised of psychosocial professionals (e.g. social workers, family or school
counselors, psychologists), would help make the initial random selection of children,
parents and teachers. The representative child sample would consist of children aged 5-17
living in the West Bank and Gaza who would participate in the monitoring survey [exact
number to be confirmed but would aim for 3-5% of the child population]. The sample
selection, should correspond closely to the characteristics of the general population of
children living in the West Bank and Gaza. The sample should be random and stratified
taking into account age group (5-12 and 13-17), gender, districts and place of residence
(village, camp or city). It should include a representative sample of children taken from
areas that suffer high levels of conflict (e.g. Balata refugee camp in the West Bank) and
from areas which experience less (Ramallah). An equally representative but smaller
sample of parents and teachers would also participate in the survey [exact number to be
confirmed].
C. Methodology
i. Kinds of data to be collected:
A combination of qualitative data and quantitative data would be collected from focus
group meetings with either children, parents, or teachers. Each focus group would
comprise of 6 to 10 individuals, and the focus group meetings would not exceed 2 hours in
time. Focus groups may be repeated to elicit further information. This participatory
methodology would be followed because questions in focus groups meetings tend to be
open-ended and can provide in-depth information on what people think and believe.
Questions included in the focus groups with children might include:
How do you perceive the current situation? How do your family and friends cope
9 Danish Red Cross (2004): Framework for School Based Psychosocial Support Programmes for Children
– PSPC
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6. with the situation?
What does the situation mean to you?
How are you coping with life events?
How do you spend your day? What do you do? What did you do yesterday?
How do you spend their free time?
When do you have a happy time?
To whom do you turn for help and support?
What are your expectations for the future?
When do you feel safe?
When do you not feel safe?
ii. How data will be collected and timing:
Assessment teams, including trained professionals from the government health sector,
other local partners, and trained representatives from NGOs, INGOs, would conduct a
baseline survey taking information from interviews and focus group meetings. This would
comprise of focus group meetings with the selected sample of participants. Parents and
teachers would be interviewed separately. All meetings would be recorded.
The survey would be repeated on an annual basis using the same methodology in order to
draw comparisons with the baseline survey. Through capacity building it would be hoped
that the ownership of the survey would ultimately fall under the responsibility of the state,
with assistance from partner organisations where necessary. This would help States
Parties fulfill its obligations of protecting and promoting Article 39 in the CRC.
iii. How data will be analyzed:
The data collected from each focus group would be consolidated into quantitative and
qualitative information. The quantitative data would be analysed and recorded as individual
data. The quantitative, open-ended, data would be tallied collectively, recording the three
most prevalent responses for each question provided by each group, in order to facilitate
data analysis and allow sufficient weighting of group responses.
Supervisors should be given responsibility for reviewing completed group data forms;
ensuring that they were completed in accordance with the agreed methodology; and
confirming that they are technically sound. In the case of missing or invalid data, the
supervisor should return the forms to the data collectors, asking them to verify the correct
response. Should the data not be verifiable, the group data should be discarded.
The data would be entered into a statistical programme to examine consistency.
3. REPORTING AND ADVOCACY
Local level awareness-raising initiatives:
By emphasising a community approach involving the health system, school system,
community groups and other stakeholders, and calling for awareness raising
through advocacy initiatives, encourage self-help and build on local culture, realities
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7. and perceptions of child development 10
Promote normal family structures and everyday life to reinforce children's natural
resilience
Raise awareness of the values of children's participation and non-discrimination
National level reporting and advocacy:
Advocate directly with the Israeli government for it to fulfill its obligation to protect
and promote the psychosocial development of Palestinian children living under its
jurisdiction in the oPT, as stated in Article 39 of the CRC, to which it is a member
Advocate with the Palestinian Authority to further develop [? I'm not sure what the
current progress is on this] the psychosocial monitoring of children living in the oPT
and to address their needs accordingly
Capacity building to take place to ensure that the State and relevant partner
agencies are able to take future responsibility for monitoring this Article.
Operational actions:
Ensure that staff who care for children are adequately trained
Organisations conducting psychosocial interventions to assess the outcomes of
their programmes based on information revealed in the monitoring, and develop
their work as appropriate
International level:
Write regular reports, at least on an annual basis, to the CRC, outlining the
psychosocial wellbeing of Palestinian children living in the oPT in relation to Article
39, and drawing attention to the failure of Israel to fulfill its obligation to promote and
protect this right
Write timely reports to Special Rapporteurs and Representatives (as listed above)
drawing their attention to the impact of the conflict on the psychosocial development
of Palestinian children living in the oPT, and the failure of Israel to fulfill its obligation
to the children under its jurisdiction
Call for a General Comment on Article 39 of the CRC.
4. Operational risks and areas of concern include:
General:
Logistical difficulties in carrying out such work in a conflict/post-conflict environment.
Access could be a significant risk. The risk would be reduced if individuals were
selected for the assessment teams from geographical areas around the West Bank
and Gaza.
How can you measure long-time outcomes and impact if the conflict is ongoing, or
intensifies after intervention, leading to symptoms reoccurring or exacerbating?
The increasing emphasis on results has led to concern that the focus on
measurement could reduce operational effectiveness, and lead to the neglect of
issue such as protection because they are difficult to measure 11 .
10 Save the Children Sweden (2006): “Emergencies and psychosocial care and protection of affected
children”
11 HPG Research Briefing Number 15 June 2004, ODI, London www.odi.org.uk
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8. OPT:
Although the Palestinian health system has many strengths, including a relatively
healthy population, a high societal value place on health, many highly qualified
health professionals, and a strong base of government and nongovernmental
institutions, there are areas of concern which could hinder such a monitoring plan.
The RAND Corporation notes that the operational effectiveness of the health
system upon which Palestinians rely is currently suffering from an acute financial
crisis, inefficiency and a lack of coordination, with multiple providers, public, UN,
NGO and private, operating in parallel or even at cross purposes. They conclude
that “Overall, the health system is poorly positioned to address the health needs of
the population, particularly with respect to...psychosocial trauma” 12 . This monitoring
plan has taken these factors into consideration and recommends that NGOs and
INGOs play a central role, but stresses the need for improved coordination and
efficiency.
Although mental health is a significant part of the Palestinian health system,
psychological and developmental problems remain stigmatised, as elsewhere.
There is concern that patients and family members may not recognise such
problems, or view them as treatable, and they may be reluctant to seek care in any
case. By emphasising a community approach involving the health system, school
system, community groups and other stakeholders, and calling for awareness
raising through advocacy initiatives, it is hoped that this monitoring plan would have
a successful strategy.
12 RAND Corporation (2005): Strengthening the Palestinian Health System
(http://www.rand.org/pubs/monographs/2005/RAND_MG311-1.sum.pdf)
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