|
| |
 |
|
| ARTICLE |
|
| Year : 2020 | Volume
: 18
| Issue : 2 | Page : 108-118 |
|
The Impact of a Livelihood Intervention on Psychosocial Wellbeing and Economic Empowerment in an Ongoing Conflict Setting: The Gaza Strip
Jeyda Hammad, Rachel Tribe
University of East London, London, United Kingdom
| Date of Submission | 01-Jun-2020 |
| Date of Decision | 02-Jun-2020 |
| Date of Acceptance | 17-Jul-2020 |
| Date of Web Publication | 30-Nov-2020 |
Correspondence Address:
Jeyda Hammad
c/o School of Psychology, University of East London, Stratford Campus, Water Lane, London E15 4LZ
United Kingdom
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/INTV.INTV_35_19
The literature indicates that poverty and unemployment in conflict-affected areas are major stressors that negatively affect civilian wellbeing and mental health. Restoring livelihoods is expected to have a positive impact on wellbeing (Inter-Agency Standing Committee, 2007). There is a lack of research evaluating livelihood interventions in ongoing conflict settings. This study evaluated an economic empowerment programme (EEP) for seven young Palestinian university graduates experiencing poverty and unemployment (as per the selection criteria for the EEP), living in the Gaza Strip, occupied Palestinian territories. Semi-structured interviews were conducted. Thematic analysis was used. Three themes were identified: (1) economic empowerment, (2) psychological benefits (e.g. hope, confidence and improved morale) and (3) income generation fosters psychosocial empowerment. The evaluation findings indicated that despite the difficult economic conditions in Gaza, the EEP was found to help address psychosocial issues and reduced poverty and unemployment. It enabled participants to meet their own and their family’s basic and crucial needs, thus enabling financial survival and facilitating greater economic security. For some participants, income generation was found to increase agency, independence, social mobility, self-sufficiency and decision-making ability. The findings indicated that economic and psychological benefits were maintained 2 years 5 months after the EPP completion, including 8 months postwar. The analysis revealed that participants conceptualised empowerment as being able to work and having a livelihood and that income generation led to empowerment. The implications of this study and the relevance of the findings to mental health and disaster relief are considered, and further areas of exploration are discussed.
Key implications for practice
- A stand-alone livelihood intervention promotes psychosocial wellbeing and empowerment.
- A local livelihood intervention appears to be viable and sustainable in reducing poverty and unemployment in an ongoing conflict setting including post-war.
- Local Palestinian conceptualisations and experiences of empowerment are newly identified.
Keywords: conflict, economic, Gaza Strip, income-generating project, livelihoods, occupied Palestinian territories, personal and familial empowerment, poverty alleviation, psychosocial interventions, refugee, war-affected young people
How to cite this article:
Hammad J, Tribe R. The Impact of a Livelihood Intervention on Psychosocial Wellbeing and Economic Empowerment in an Ongoing Conflict Setting: The Gaza Strip. Intervention 2020;18:108-18 |
| Introduction | |  |
Populations that are affected by armed conflict face critical livelihood dilemmas when trying to survive in the short term and long term (Women’s Commission for Refugee Women and Children, 2000). Economic warfare and control over resources are common practices in political conflicts, with civilians often living in conditions of politically induced poverty and restricted livelihood opportunities (Hammad & Tribe, 2020a). Studies have found that poverty and difficulties in meeting basic and crucial needs are primary stressors in conflict-affected areas, which mediate and frame suffering (e.g. Barber, 2013; Eggerman & Panter‐Brick, 2010; Hammad & Tribe, 2020a; Save the Children, 2017).
Barber’s (2013) review of the literature on the experiences of young people in situations of political conflict highlighted how disruptions to access to key resources (e.g. economic/livelihood resources) can create more difficulty than exposure to violence. McNeely et al. (2014) found that human insecurity and chronic economic constraints in the occupied Palestinian territories (oPt)1 threaten wellbeing, arguing that perhaps this is more so than with direct exposure to violence. Similarly, Hammad & Tribe (2020a) found that systemic, ongoing and structural oppression can be viewed as potentially more psychologically detrimental than specific incidents of violence and conflict in the oPt. Hammad & Tribe’s (2020a) study examined the impact of economic oppression (e.g. politically induced poverty and restricted employability opportunities) and structural violence in the Gaza Strip. The study found that economic oppression and structural violence led to psychological, social and existential suffering, poor psychological wellbeing, human insecurity, multiple losses, humiliation, shame, injuries to dignity and experiences of life being on hold. In relation to the oppressive political and economic domains, a unique type of existential suffering in the oPt was reported in reference to one’s life, spirit, morale and/or future as destroyed or broken (Barber et al., 2014; 2016a,b; Hammad & Tribe, 2020a). See also Hammad & Tribe (2020a) for further detail about the impact of economic oppression on civilians in the Gaza Strip. Some studies have found that unemployment and the poverty associated with unemployment were found to be more distressing than war experiences and other traumas for conflict-affected people (Boothby et al., 2009; Kagee, 2004).
Community psychology draws attention to how social and economic arrangements of resources and power can generate adversity and distress for people (Kagan et al., 2011; Orford, 2008). Unemployment in conflict-affected areas has been found to create difficulties in surviving financially and it has undermined the healing process from war, especially amongst youth (Somasundaram & Sivayokan, 2013). For young people in particular, unemployment was considered to prevent their transition into adulthood, and it prevented people from being able to live their life with agency and plan for their future due to a lack of income (Hammad & Tribe, 2020a; Sharek Youth Forum, 2009).
Poverty has been found to mediate the relationship between armed conflict and psychological wellbeing and mental health (Miller & Rasmussen, 2010). In a systemic review of the psychological health of conflict-affected populations in low- and middle-income countries (LMICs), low income and assets and unemployment were associated with poorer mental health and poorer psychological wellbeing; insecure financial conditions of unemployment contributed to poorer psychological wellbeing (Roberts & Browne, 2011). Porter & Haslam (2005) carried out a meta-analysis of 56 research studies on mental health amongst refugee people (including internally displaced, asylum seeking and stateless people) using a worldwide study sample of 67, 294 participants. The meta-analysis findings indicated that better relative mental health amongst refugee people was associated with greater material welfare; restricted economic opportunities were associated with poorer mental health. Economic opportunity had a linear relationship with improved mental health. Studies in the oPt have found a relationship between poverty/low-income and greater psychological distress and poorer mental health (Khamis, 2013; Mataria et al., 2009; Thabet et al., 2016).
Palestinian conceptualisations of wellbeing include meeting needs (e.g. having money to meet the daily needs of their family; Schafer et al., 2014). Barber et al. (2016a) found that Palestinians view employment as an element of wellbeing or quality of life. Employment was found to be a protective factor for wellbeing in the oPt (Harsha et al., 2016). Restoring livelihoods can be expected to have a beneficial impact on wellbeing for conflict-affected people (Inter-Agency Standing Committee, 2007; Kumar & Willman, 2016).
The Gaza Strip
In times of poverty, people typically survive by living off the land, securing employment locally or migrating to different areas where jobs are available (Narayan et al., 2000). However, these options are limited or unavailable for people living in the Gaza Strip because of Israeli military measures. The Gaza Strip is a 25-mile long, narrow, coastal enclave with a population of 1.9 million people. The majority of Palestinians (73%) in the Gaza Strip are refugees (United Nations Relief and Works Agency [UNRWA], n.d.). The Gaza Strip, West Bank and East Jerusalem have been under Israeli military occupation since 1967 (Amnesty International, 2018). Contrary to international law, the Gaza Strip has been illegally under an Israeli military blockade (land, sea and air) since 2007 (Amnesty International, 2018). Freedom of movement is routinely denied for Palestinians, who are unable to leave the Gaza Strip to seek work elsewhere because the borders are closed (B’Tselem, 2017; Gisha, 2018; United Nations, 2015). The Gaza Strip has experienced numerous wars between Israeli military forces and Gazan forces in recent years. In relation to the 2014 war, the United Nations report that 1462 Palestinian civilians were killed, 11,231 Palestinians sustained injuries and 18,000 housing units were destroyed in whole or part (United Nations Human Rights Council, 2015). The 2014 war also severely damaged civilian basic and essential infrastructure (e.g. medical facilities, electricity, water supplies, etc.; United Nations Human Rights Council, 2015).
The blockade and the severe restrictions imposed on the movement of goods and people entering and exiting Gaza have resulted in widespread poverty, unemployment, aid dependency and livelihood dilemmas (Amnesty International, 2016; UNRWA, 2018a), whereby the population is struggling to survive (United Nations Office for the Coordination of Humanitarian Affairs occupied Palestinian territory [OCHA oPt], 2010). In 2002, only 10% of Palestinian refugees in Gaza were aid dependent; during this period the economy was functioning better (UNRWA, 2012) because the military blockade was not yet in operation; the military blockade was imposed in 2007. In 2018, 11 years after the military blockade was first enforced, 80% of the population were aid dependent (Amnesty International, 2017; Oxfam, n.d.).
Decades of conflict and occupation and the blockade have destroyed Gaza’s economy and industries (Oxfam, n.d.). The blockade in particular has increased unemployment for Palestinians in Gaza who cannot seek employment outside the Gaza Strip (OCHA oPt, 2018). The options to earn a livelihood are extremely limited inside the Gaza Strip due to: Israeli-imposed control over access to fishing waters and agricultural land (Amnesty International UK et al., 2010; OCHA oPt, 2011; Oxfam, n.d.; UNRWA, 2016);2 limited access to raw materials (Amnesty International UK et al., 2010; Oxfam, n.d.; UNRWA, 2018a); bans on exports (Oxfam, n.d.; UNRWA, 2018a); and inadequate public infrastructure (United Nations Country Team in oPt, 2011; United Nations Development Fund, 2017; UNRWA, n.d.). In 2000, prior to the blockade (which was imposed in 2007), 28% of youths were unemployed (UNRWA, 2015), whereas in 2018, 11 years after the blockade had been first enforced, youth unemployment increased to over 70% (OCHA oPt, 2018). Gaza has one of the highest levels of unemployment in the world (International Labour Office, 2018; UNRWA, 2015, UNRWA, 2018b), subsequently rendering people trapped in poverty and reliant on aid to survive.
The approach to poverty alleviation in Gaza has predominantly consisted of providing food aid or cash assistance and 3-month employment initiatives; however, this does not alleviate chronic unemployment or poverty in the long term (El-Namrouty et al., 2013). Furthermore, Palestinians are in need of income-generating opportunities in Gaza, in order to provide a stable income for themselves and their children and reduce dependence on external assistance (Hamad & Pavanello, 2012; Hammad & Tribe, 2020a). Abu-Rmeileh et al. (2012) found that, 6 months after the 2008/2009 war, the most requested need of 3102 randomly selected households was livelihood opportunities as opposed to humanitarian aid.
Livelihood/Income-Generating Interventions in Fragile and Conflict-Affected Settings
Research studies conducted in fragile and conflict-affected settings (FCS) and LMICs have found that livelihood/economic interventions improve income, reduce poverty (e.g. Blattman & Annan, 2011; Kock & Krysher, 2010; Koyabu, 2014; Leerlooijer et al., 2013; Olaimat & Al-Louzi, 2008; Sansour & Zahran, 2011; World Bank, 2015) and diversify livelihoods (e.g. Khanna et al., 2013). Livelihood/economic interventions in FCS and LMICs have also been found to promote female empowerment (Caeyers & Robert, 2015; Khanna et al., 2013; Koyabu, 2014), and improve mental health (Glass et al., 2014; Koyabu, 2014), psychological wellbeing (Ziveri et al., 2019) and family life (Kock & Krysher, 2010; Schafer et al., 2014). Glass et al.’s (2014) study with women affected by protracted conflict and multiple traumas in the Democratic Republic of Congo found that depression and traumatic stress reduced as the number of livestock/animal assets increased. Humphreys (2008) found cash transfers to aid income-generating projects reduced stress and worry.
There is, however, a lack of research evaluating income-generating initiatives in the oPt. In 2007, the United Nations Development Programme (UNDP) piloted the Deprived Families Disadvantaged Economic Empowerment Programme (DEEP) targeting 6600 poor Palestinian families in the West Bank and the Gaza Strip (oPt; El-Namrouty et al., 2013). Approximately 4400 families were provided with a grant (typically $5530) to set up an income-generating project (El-Namrouty et al., 2013). The remaining families accessed Islamic microfinance to help establish their income-generating project (UNDP, 2011 cited in El-Namrouty et al., 2013). Sansour & Zahran (2011) conducted a survey of 380 DEEP beneficiaries in the Gaza Strip and the West Bank. The study findings revealed that the majority of beneficiaries reported that their business helped them to reduce their reliance on aid to varying degrees; the majority of beneficiaries (80%) reported that their income increased as a result of the income-generating project. The majority of the income-generating projects were sustained post 6 to 12 months follow-up. Overall, the study found that income-generating projects increased self-employment, reduced poverty and vulnerability of families and improved living and housing conditions, food security, access to health care, transportation, leisure activities, social capital/enhanced participation in social activities and human development. The DEEP contributed to creating over 8800 job opportunities in the local market in the oPt.
El-Namrouty et al. (2013) conducted a survey amongst 170 randomly selected participants of the DEEP in the Gaza Strip. The study found that, for the majority of beneficiaries, it improved their income (74%), which enabled them to pay off accumulated debts (62%); income was predominantly spent on meeting basic needs. Families reported feeling more independent since having the income-generating project (70%), and that they could support themselves on their current income (68%). The DEEP was also found to reduce unemployment rates amongst family members, with the number of employees in the family increasing by 82% after the income-generating project. However, some projects had not developed sufficiently and therefore some people continued to rely on aid to a certain degree (49%). The majority of recipients reported that the project income led to improvements in their family’s psychological status (80%). This suggests that people’s psychological wellbeing and mental health can be enhanced when their livelihood needs are met.
There have been calls for more evaluations of livelihood interventions in FCS (Kumar & Willman, 2016) and the provision of livelihood interventions to promote psychosocial wellbeing and reduce social suffering in conflict-affected areas (Boothby et al., 2009; Eggerman & Panter-Brick, 2010; Hammad & Tribe, 2020a). A small number of studies evaluating livelihood interventions have been conducted in the oPt, therefore the aim of this study was to contribute to the literature. In this study, we evaluate a livelihood intervention referred to as an economic empowerment programme (EEP) in the Gaza Strip. In consultation with a nongovernmental organisation (NGO) in Gaza, we were informed that young people using their services were experiencing chronic disempowerment. They wanted to find ways to empower young people and understand the impact of the EEP intervention they had offered.
The Economic Empowerment Programme
The EEP is an intervention offered as part of the youth empowerment programme by a local NGO based in Gaza. To protect the anonymity of the participants the NGO will not be named. The aim of the EEP is to empower participants, including empowering them economically. The EEP was open to all young people across the Gaza Strip that fulfilled the criteria listed below. It was advertised via the NGO’s website and social media pages, specific websites for youth networks and via other NGOs that work with young people in the Gaza Strip.
The EEP consisted of a nine-day training course focused on how to establish and manage an income-generating project. The NGO arranged for the training to be delivered by external trainers/experts in the field. Approximately 80 young people received training, and 25 people received grants ranging from $3000 to $4500 to set up their income-generating project. The criteria for a grant award included assessment of the quality of the proposal, the type of project being proposed and whether it was needed in the community, feasibility of the project and the geographical location of where they proposed to set up their project and whether there were other existing businesses offering similar services/products in the locality.
The NGO’s recipient criteria for the EEP were as follows:
- University graduates
- Aged under 30
- Experiencing poverty (household monthly income of less than $350)
- Unemployed
The criteria for receiving the grant included the young person making a financial contribution towards their income-generating project (e.g. paying part of the rental costs or for some of the equipment).
| Methodology | | |
Sample and Recruitment
The sample consisted of seven young Palestinian professional university graduates aged 24 to 38 who had taken part in the EEP (see [Table 1]). The sample included six grant beneficiaries; five grant beneficiaries used their grant to set up their income-generating project and one grant beneficiary used their grant to improve their small income-generating project. One participant completed the training but was not awarded a grant and was included in the sample. All participants were experiencing poverty prior to the EEP and six were unemployed. One participant was included in the EEP despite being above the age criteria because of her particularly vulnerable situation, as a single widowed female-headed household with dependents experiencing poverty, with no family to support her. She needed support from the EEP to improve her existing small income-generating project. All participants completed the EEP in November 2012. Their income-generating projects had been running for at least 2 years and 5/6 months at the point of interview, with the exception of one participant, whose project was established earlier. The NGO was requested to recruit a balanced sample of male and female participants. The NGO recruited four male and three female participants. | Table 1 Participants’ Demographics and Income-Generating Project Details
Click here to view |
Accessing and recruiting participants who took part in the EEP would have been logistically difficult without the NGO’s assistance. The NGO director recruited participants by telephoning them and inviting them to take part in the study. The director informed the participants about the nature of the study and that the research was being conducted by someone independent and external to the NGO. If they were interested in taking part, they were provided with a research information sheet. Participants were recruited from different areas across the Gaza Strip. The NGO director informed us that their method of selection for participants was based on the beneficiaries’ interview availability. There were various challenges and barriers to deal with when conducting this research. Interviews had to be booked according to the varying electricity schedule of when limited electricity would be supplied in the Gaza Strip. The Gaza Strip receives between 2 and 4 hours of electricity per day (Amnesty International, 2018; Oxfam, n.d.). Additional factors that influenced when the interviews were arranged included the time difference in Gaza and the working hours in Gaza starting and ending earlier than the United Kingdom (UK).
After completing six interviews with participants who had received a grant, a request was made to interview a participant who did not have a positive experience to gain a more balanced perspective. The NGO recruited a participant who had completed the taught component of the EEP but was upset that he had not received a grant. We would have ideally liked to have interviewed all 25 beneficiaries who received a grant. However we were not able to do so due to limited time and resources. In addition, the NGO is no longer in operation, therefore, it was not possible to access information about the remaining beneficiaries for inclusion in the evaluation. Therefore, the focus of this study is on evaluating the experiences of the EEP for the seven participants who participated in this study.
Procedure
Semi-structured interviews were conducted in April and May 2015, 8 months after the 2014 war. The NGO used the following terms with beneficiaries to refer to the EEP: “training course and its activities”. Questions asked during the semi-structured interviews included “what was your experience of the training course and its activities?”, “have there been any changes for you since taking part in the training course and its activities?” and “are there any changes you would like to see incorporated into the training course and its activities?” If participants reported gaining benefits from taking part in the EEP, participants were asked “have you experienced or perceived any challenges in maintaining these benefits?”
Interviews were conducted over the internet in Arabic, with a bilingual native Palestinian interpreter and were audio-recorded. The participants were based in Gaza. The interpreter and the researcher were based in the UK because Gaza’s borders were closed, therefore it was not possible to enter Gaza to conduct face-to-face interviews. Interviews were transcribed verbatim in Arabic and then translated into English. A thematic analysis following Braun and Clarke’s (2006) guidelines was conducted on the English translations of the interviews. The analysis focused on evaluating the participants experience and reported impact of the EEP, including a focus on empowerment, poverty and psychosocial aspects.
Ethics
Ethical approval was granted by the University of East London and the NGO. Written and verbal consent was gained from all the participants before the interviews. Participants were aware that they could withdraw from the study, refrain from answering questions and that their data would be anonymised.
| Findings | | |
The findings regarding the impact of the EEP are described in relation to the experiences reported by the seven participants. Three themes were identified: (1) economic empowerment, (2) psychological benefits and (3) income generation fosters psychosocial empowerment.
Economic Empowerment
All participants who received a grant for their income-generating project reported being able to earn an income, which helped alleviate poverty. Participants reported using their income to meet their household’s basic needs.
…I started my project, benefited a lot from it and been able to support my family. (Dina, F/28)
Before I started this project...we weren’t able to afford all our needs and requirements; however, after I started running my project, I could provide all mine and my household’s needs and requirements... (Hala, F/27)
This shop is considered a lifeline for me because it offers us life necessities… (Farah, F/38)
All participants expressed learning relevant skills and knowledge to establish and manage a business, which they applied in practice to earn an income. Hassan, who was not awarded a grant to establish an income-generating project, reported that he gained transferable skills from the EEP that he applied to other work opportunities, which helped him secure a better income.
Interviewer: You mentioned some things that you learned on the training course…
Yes. One day, someone suggested to me to drive a group of people to and from their school in a taxi. Before making any decision, I wrote down the expenses, profit rate and all the other details. I planned these things very well and agreed on the idea. It has a good income. (Hassan, M/26)
Participants described how income-generating projects offer people a way to earn a living and to survive, in the absence of job opportunities.
I go everywhere, look for jobs, and work hard to get a job opportunity. I graduated from university in 2011; without this project, I wouldn’t have been able to get an opportunity to work. (Khalid, M/24)
It’s nice if we are offered projects like those because these projects help you live, even when there’s no job, you can open whatever you want. At least, you’ll be able to afford the basic needs for life. (Dina, F/28)
The income-generating projects also provided others with job opportunities, which made some participants feel happy.
...it’s not only my project but also I feel happy because it employs other people who gain from it and live. (Farah, F/38)
Some participants shared the skills they gained from the EEP to help their friends establish their own successful business.
…there was a friend who asked for help to make a feasibility study…about a specific project and I did help him with that. If I hadn’t taken part in the course, I wouldn’t be able to help him…however, I made a full feasibility study for his project and submitted it to him. Now thank God he’s leading a successful shop… (Khalid, M/24)
As expected, some losses are incurred when offering livelihood interventions in areas of ongoing conflict. Farah mentioned being apprehensive about investing in her income-generating project because of the political instability. She had previously mentioned that her project was financially prospering. However, after the war caused damage to her shop, she reported that her income went towards paying for the shop repairs.
There was destruction in my shop…not feeling safe is one of the obstacles that we face in our Palestinian community, even being under the occupation…I think of making more developments [to the income-generating project] but I feel afraid. (Farah, F/38)
…after the war I was forced to pay in instalments. …those are obstacles, when I wanted to start working on my project, Israel destroyed everything for me…I pay from what I gain from work. …the income covers the things I repair and renew. (Farah, F/38)
Although Yunus was able to earn an income, he experienced the poor economy as negatively impacting on trade because people lack salaries to spend on services and goods. This may also reflect the nature of the service he offered (computer repairs) which would require people to have a higher disposable income.
…I want jobs to be offered. My project will work because there’ll be a demand; it’ll happen like this. ….there are no salaries, many things are not there. (Yunus, M/30)
Psychological Benefits
The different components of psychological benefits discussed in this section include self-confidence, hope and improved morale. Some participants described how the income-generating project helped raise their morale.
I benefited materially and psychologically, it raised my morale. (Hala, F/27)
The EEP appeared to help foster hope for some participants, because it increased their options to be able to earn a living.
I used to have a pessimistic perspective; I had no job. However, after I did the course, I benefited that I should go on and never lose hope…my thinking was limited that I’ll work as a teacher. But the new things I learnt gives me the option of maybe more than one field rather than teaching to work in. (Hala, F/27)
Some participants referenced that successful income-generating projects would increase their self-confidence.
…many projects succeeded and this will absolutely increase our self-confidence… (Hala, F/27)
Another example of how the EEP fostered confidence refers to how the EEP helped participants recognise their achievements, goals and strengths.
…I was in a maze before the training course. I was a graduate who lives normally, without even planning my life. After the course, I found that I became a useful person who has goals, achievements, and obstacles to overcome… (Hassan, M/26)
Participants appeared confident in their business knowledge and skills.
…I believe that I’m able to manage any project with all its financial and technical aspects now or at any time in the future... (Khalid, M/24)
Despite the cultural stigma associated with women running a shop, the EEP supported and prepared participants to set up a business that was considered unconventional for women to run. Hala described how the EEP training helped increase her confidence to deal with the community’s negative response to her running a shop. The community eventually accepted it and her family also accepted and supported her through the difficulties she faced.
Maybe it was the public relations session. I was shy and withdrawn; nevertheless, this shyness started to go away and I started to deal with people…I had self-confidence to face people and these things…it wasn’t common for women here in Gaza to work in a shop or sell in any shop; that was something new to our society, and it used to be males’ job. The area where I opened my project was a traditional, uneducated, poor area, I mean not classy enough to accept this thing, but I insisted on working there and not to hire someone else to do that…the points we learnt on the course helped me ignore what people say and have my independent personality…indeed, after a while, people accepted it and I didn’t face their wonders any more…it became common; it became a regular thing. (Hala, F/27)
Income Generation Fosters Psychosocial Empowerment
The Palestinian conceptualisation of empowerment will be discussed first here to allow the reader to discern how the EEP empowered participants. Participants defined empowerment as being able to work, and in developing themselves to work.
Empowerment is the thing that offers you the beginning to work and train…as we say in our everyday language, it puts you on the first step of the ladder... (Yunus, M/30)
Empowerment is continuity. [Interviewer: The continuity of what?] Youths want to empower themselves in their work, so they have to continue working. (Omar, M/28)
There were references to the EEP facilitating empowerment in all the interviews with grant beneficiaries. In the context of talking about empowerment, Yunus described how he found it empowering that his socio-economic status changed and that he was able to employ others.
…I used to be an employee but nowadays I’m an employer. (Yunus, M/30)
Some participants mentioned how they held a position in society since earning an income to financially support their families. Participants spoke about how their income-generating project facilitated independence and reduced their reliance on external assistance and other people to provide their needs.
I felt that I’m responsible and I have a position in society. I have work that offers me an income to spend on my family… (Dina, F/28)
…after I started running my project, I could provide all mine and my household’s needs and requirements. …I became an independent person. (Hala, F/27)
I broke the barriers … to surrender to the inevitable situation I live, to be the widow who spends the day waiting for the charitable institutions to bring her a coupon [aid]. No, I broke all those and challenged them; I want to work and to maintain my family from my work, labour, and effort. (Farah, F/38)
Omar gave his income-generating project as an example of how he has felt empowered, because it has enabled him to work and provided him with a base to plan for his future; he also refers to feeling hopeful. His income-generating project relates to his academic degree specialism.
Interviewer: How do you describe empowerment?
Honestly, regarding my work…it helped me get the project and find a job in this field…at the beginning, I was unemployed, but after I got the project, I found a spot from which I can start to build my future…this project paved the way for our future. (Omar, M/28)
Taking part in the EEP helped provide Farah with a means to seek greater security, pursue further education and to maintain her independence and self-sufficiency.
…I attended the course. Of course, I felt a difference; I had possibilities…I achieved many things I wished for. For example…nowadays I study MA [Master’s degree]…I achieved a great part of my dreams and depended on myself. (Farah, F/38)
| Discussion | | |
This research study has gained important insights into the impact of EEPs in the Gazan context, revealing that participants appeared to benefit from the EEP in respect to reduced unemployment, income generation/poverty alleviation, fostering of economic empowerment, psychological benefits (hope, morale and confidence) and psychosocial empowerment. The evaluation findings indicated that the benefits of the EEP extended beyond the participant to their family, friends and community (e.g. El-Namrouty et al., 2013; Kock & Krysher, 2010; Koyabu, 2014). Consistent with the literature, livelihood interventions have been found to have a positive impact on psychological wellbeing (El-Namrouty et al., 2013; Glass et al., 2014; Ziveri et al., 2019), reducing poverty and increasing income in FCS (El-Namrouty et al., 2013; Kock & Krysher, 2010; Koyabu, 2014; Leerlooijer et al., 2013; Sansour & Zahran, 2011; World Bank, 2015).
The evaluation found that the benefits of the EEP appeared to be maintained and the majority of income-generating projects appeared to be sustainable over a period of 2 years and 5 months after participants completed the EEP training and received their grants, including 8 months postwar. The EEP appeared to create sustainable employment opportunities and a means to earn an ongoing income that helped alleviate poverty, promoted empowerment and enabled participants to support themselves and meet their basic and crucial needs and household living costs. It provided them with an opportunity to work their way out of poverty when faced with a lack of job opportunities in Gaza. This is an important finding considering Gaza has high levels of poverty, unemployment and people depending on aid to survive. With the borders closed and the blockade stifling the economy, graduate youths and people in general have extremely limited options available to them to earn a living. It also challenges the notion that self-reliance and sustainable livelihoods are unlikely to be achieved in the context of protracted conflict (Jaspars & O’Callaghan, 2010), including an area under economic embargo. This study’s findings add to the growing body of evidence (El-Namrouty et al., 2013; Sansour & Zahran, 2011) that indicates that livelihood interventions are an effective poverty alleviation intervention in conflict-affected areas, and in Gaza, where there is a military blockade.
Political and economic oppression, inadequate civilian infrastructure, difficulties in accessing raw materials and restrictions on trade and goods entering and exiting the Gaza Strip all impact on the choice of livelihoods available and their sustainability. Despite the high levels of unemployment and poverty in Gaza, which would mean people lacked salaries/income to spend on goods and services, participants described that their income-generating projects enabled them to earn an income. This is likely to reflect demand/need for the type of services and products they offered. The criteria for grant awards included assessing the feasibility and need for the proposed income-generating project in the locality, therefore increasing the chances of projects being successful. Some participants in particular emphasised that their projects were doing well financially. These projects included a printing/photocopying and office/stationery supplies shop, a children’s education centre, a beauty salon and the design and printing of shop advertisements. Education is highly valued in the oPt (Barber et al., 2014); UNRWA (2012) highlights how Palestinians in the oPt are highly skilled and well-educated. Palestinians generally equate education with attaining a PhD degree or Master’s level qualification (Barber et al., 2014). This may partly explain why the first two projects prospered.
The results indicated that the income earned from the income-generating project gave some participants greater stability, decision-making ability (e.g. Khanna et al., 2013) and agency over their lives. Some participants, following their participation in the EEP, referenced improved status (Glass et al., 2014; Humphreys, 2008; Olaimat & Al-Louzi, 2008), having gained greater social mobility, self-sufficiency, independence and economic independence, and that they were able to plan for their future and afford to fund their own postgraduate education. This is in line with Hobfoll’s (2002) theory that accessing resources at one level (e.g. economic) is associated with access to resources at other levels. Similarly, Kock & Krysher’s (2010) evaluation of a livelihood intervention in Afghanistan found that an increase in family income led to beneficiaries being able to afford to send their children to school and it enabled them to support community development projects.
The majority of livelihood interventions focus on female empowerment, with little attention to the experience of disempowerment amongst males. The findings in this study indicated that there was little difference between identified men and women in this age group regarding their experiences of empowerment following their participation in the EEP; both reported improved agency, status, self-reliance and independence. The increase in independence and self-sufficiency reported by the participants are often used as an indicator of empowerment in livelihood evaluation studies. The findings from this study indicated that the Palestinian conceptualisation of empowerment referred to being able to work and having a livelihood. Based on this definition, it would suggest that the EEP fostered empowerment, as the participants were able to work and have a livelihood because the EEP provided them with business training and an income-generating project, which enabled participants to use their skills to earn a living in an ongoing manner. Some participants gave their income-generating project as an example of how they experienced empowerment. It has been argued that for someone to be empowered, they need to also be economically empowered (e.g. Kuttab, 2010).
The definition of empowerment found in this study is in line with theories on empowerment that specify that it needs to be redefined to suit the context and that the definition of empowerment encompasses different meanings in different political and sociocultural contexts and amongst different populations of people (Kuttab, 2010; Orford, 2008). According to Kuttab (2010), empowerment is tied to everyday resistance in an anticolonial struggle in the Palestinian context; economic independence is part of resisting the injustice of the occupation. There is a lack of studies investigating everyday resistance in the context of livelihoods in the oPt (Hammad & Tribe, 2020b), although perseverance has been identified as an important strategy to endure the occupation (Hammad & Tribe, 2020c); arguably livelihoods support perseverance. Simaan’s (2017) study revealed that olive growing as a means of a livelihood, as well as navigating restrictions which obstructed olive growing, was conceptualised as resistance to the occupation. Empowerment is not considered possible when under occupation because the occupation is pervasively disempowering in all facets of Palestinian life (Kuttab, 2010; UNDP, 2015). As reported by the participants, it is promising that some degree of empowerment can be experienced in the adverse and oppressive conditions in Gaza through offering livelihood interventions. It would suggest that EEPs might have the added benefit of helping empower people, as per the local definition identified in this study, as well as addressing practical poverty alleviation concerns in Gaza.
The findings regarding the fostering of psychological benefits indicated that hope was fostered for some participants because their income-generating project gave them the opportunity to plan their life and their future. This would suggest that the income earned from their income-generating project provided them with stability and economic security to be able to think beyond survival. The EEP was also found to foster hope because it had taught the participants transferable skills regarding how to establish and run a business, which provided them with greater options to earn a living when faced with a lack of job opportunities in Gaza. It appears that participating in the EEP helped foster confidence for some participants for various reasons, such as their income-generating projects being successful, feeling confident in the skills and knowledge they gained from the EEP and the EEP helping them to recognise their achievements and aims in life. Other studies have similarly found increased confidence amongst beneficiaries of livelihood interventions in FCS (Blattman & Aman, 2011; Koyabu, 2014; Olaimat & Al-Louzi, 2008). Working in their business and being able to offer others job opportunities appeared to boost morale for some participants.
Limitations
The small sample size limits generalisability. However, this study has accessed a hard-to-reach community and contributed to an under-researched area. Although the NGO director informed us that recruitment was based on the participants’ interview availability, it is possible that there may have been unintentional or intentional bias to recruit participants with positive experiences of the EEP, so that the EEP evaluation would be favourable. However, it is important to note that some participants appeared to speak frankly about the challenges they encountered in running their projects. The NGO was also cooperative in recruiting a participant with a negative experience and recruited a participant that it knew was upset with the organisation because they had not received a grant. The premise of the grant is to set up an income-generating project in order to alleviate poverty and economically empower participants. It is therefore to be expected that participants who received a grant are likely to have had a positive experience because they now have a livelihood and greater economic independence to be able to meet their basic and crucial needs, whereas beforehand they were unemployed, in poverty and likely to have been relying on aid to survive. This, of course, is likely to have implications for the results because six of the participants received a grant and one participant did not. It is possible that poverty may have prevented other participants of the EEP from completing the EEP and inadvertently these experiences would not have been captured in the evaluation. However, participants came from the poorest sections of Gaza’s society as they met the inclusion criteria for the EEP, which was a monthly household income of less than $350, which by consensus is the lowest category of poverty in Gaza.
In terms of improving the EEP evaluation, it would have been ideal to have collected supplementary data on levels of income, what their income was spent on, their income prior to the project, whether participants continued to rely on aid and the number of people in their household and dependents who benefited from the income-generating project. Although this information is sensitive, it would have helped to enhance the evaluation of the economic benefits of the EEP. It would have also been useful to have interviewed more people who had taken part in the EEP but were not awarded grants to gain their insights, as well as to collect data on what other recipients of the EEP were doing; whether they had established a business independently and how other recipients who received a grant to set up an income-generating project were doing. The original plan was to also interview NGO staff and the participants’ family members to gain their perspective on the EEP, but this was not possible.
| Implications and Recommendations | | |
This study highlights the benefits of livelihood interventions in FCS, helps us understand some of the psychological benefits of livelihood interventions and highlights the ways it can help empower young people. It has evaluated a local poverty alleviation intervention that appears to be viable and sustainable even postwar and may help to reduce suffering, hardship and the ill effects that poverty creates, even in an area under economic embargo and experiencing ongoing conflict.
In this section, we discuss programming and how evaluations of livelihood/psychosocial interventions could be improved. It is important to recognise that the community are the experts and to be prepared to change ideas and do something different if that is what is requested. Providers are advised to consult the local community to understand what their needs and difficulties are and to ensure that interventions are co-produced with the local community and are suitable within the context where they will take place. The information from the needs assessment can be used as part of the intervention evaluation to assess whether identified local needs have been met. The application of Western conceptualisations of wellbeing, healing, resilience and empowerment in non-Western settings is problematic because it neglects indigenous understandings (see e.g. Fernando, 2014). Identifying and incorporating local understandings of resilience, recovery, empowerment and wellbeing into evaluation outcomes of livelihood/psychosocial interventions are recommended. This may help to capture what is important to participants and whether these aspects have been impacted by the intervention.
Recommendations regarding programming include building in ongoing support in livelihood/psychosocial programmes such as peer support to assist with problem solving and sharing knowledge and ideas, which may help promote sustainability. Other suggestions include beneficiaries who have completed the programme training others. Ziveri et al. (2019) highlight how programming neglects the relationship between livelihood, hope and agency. Integrating livelihood opportunities into psychosocial wellbeing interventions has been recommended (e.g. Ziveri et al., 2019).
There is a large evidence base demonstrating how poverty and unemployment are associated with poorer psychological wellbeing and mental health and how re-employment is associated with improved psychological wellbeing and reduced distress (e.g. Karsten & Moser, 2009; Lund et al., 2010; McKee‐Ryan, Song, Wanberg, & Kinicki, 2005). Studies have also shown the pervasive negative impact poverty has on multiple aspects of life (e.g. Eggerman & Panter‐Brick, 2010; Hammad & Tribe, 2020a; Narayan et al., 2000). Evaluations of livelihood interventions would benefit from assessing the impact the intervention has on psychosocial wellbeing, dignity, agency, self-sufficiency, food security, human security and mental health, as well as other domains, such as recreation, family life, development, social capital, health, living conditions, education, etc. Assessing wellbeing and other factors mentioned before and after the livelihood/psychosocial intervention would help enhance the evaluation by measuring the impact the intervention has had. The evaluation of livelihood/psychosocial interventions would be further enhanced by including and assessing the impact the intervention has had on household/family members. Ensuring evaluations are completed at intervals could be another recommendation for future programming. The absence of a livelihood increases human insecurity in respect of being able to survive daily, but also people will be more likely to take risks that endanger their lives to earn a livelihood (Jaspars & O’Callaghan, 2010). Livelihood/psychosocial intervention evaluations can also be improved by assessing the reduction of livelihood dilemmas and associated risks, long-term impact, positive societal changes from investment of grant monies (Kock & Krysher, 2010), long-term sustainability of projects and protection against shocks. In addition, adopting a mixed methods approach and, if viable, having a control group for comparison purposes can help enhance the evaluation. Involving NGOs and service users in the evaluation of interventions can help build capacity, however, this is resource intensive and research skills training and support are required.
Further research evaluating livelihood interventions in FCS is needed, including in the oPt, and in particular research exploring the impact livelihood interventions can have on mental health and wellbeing is encouraged. This is the most protracted conflict in the world (Jaspars & O’Callaghan, 2011), with no sign of being resolved. Ultimately, a political solution is needed. However, until this is achieved, economic interventions to reduce unemployment and poverty are needed, like livelihood interventions. Additionally, such interventions may foster wellbeing and psychological benefits and were requested by Palestinians in Gaza (e.g. Abu-Rmeileh et al., 2012).
Acknowledgments
We would like to thank Professor Nimisha Patel for her support with this research. We would also like to thank Manal Awwad from Gaza for her help with many aspects of this study. She has asked us to make clear that the manuscript reflects our research and does not necessarily reflect her view.
Financial support and sponsorship
None.
Conflicts of interest
There are no conflicts of interest.
1The oPt refers to the Gaza Strip, West Bank and East Jerusalem.
235% of Gaza’s farmland and 85% of its fishing waters are totally or partially inaccessible due to Israeli military measures (UNRWA, 2016; Oxfam, n.d.).
| References | | |
| 1. | Abu-Rmeileh N. M. E., Hammoudeh W., Mataria A., Husseini A., Marwan K., Shannon H. S., Hogan D., Watt G. C. M., Zurayk H., Giacaman R. (2012). Health-related quality of life of Gaza Palestinians in the aftermath of the winter 2008–09 Israeli attack on the Strip. European Journal of Public Health, 22(5), 732-737.  |
| 2. | |
| 3. | |
| 4. | |
| 5. | Amnesty International UK Broederlijk Delen, Cafod, CCFD-Terre Solidaire, Christian Aid, Church of Sweden Cordaid, Diakonia Euro-Mediterranean Human Rights Network Handicap International ICCO Ikv Pax Christi International Federation for Human Rights Medical Aid For Palestinians Medico International Merlin MS Action Aid Denmark Norwegian Refugee Council Quaker Council for European Affairs Oxfam International Rehabilitation and Research Centre for Torture Victims Redd Barna Save the Children UK Trocaire & Cfd. (2010). Dashed hopes: Continuation of the Gaza blockade. https://www.amnesty.org.uk/sites/default/files/dashed_hopes_report_0.pdf |
| 6. | Barber B. K. (2013). Annual research review: The experience of youth with political conflict − challenging notions of resilience and encouraging research refinement. Journal of Child Psychology and Psychiatry, 54(4), 461-473. |
| 7. | Barber B. K., Spellings C., McNeely C., Page P. D., Giacaman R., Arafat C., Daher M., El Sarraj E., Abu Mallouh A. (2014). Politics drives human functioning dignity and quality of life. Social Science and Medicine, 122, 90-102. |
| 8. | Barber B. K., McNeely C. A., El Sarraj E., Daher M., Giacaman R., Arafat C., Barnes W., Abu Mallouh M. (2016a). Mental suffering in protracted political conflict: Feeling broken or destroyed. PLoS One, 11(5), https://doi:10.1371/journal.pone.0156216 |
| 9. | Barber B. K., McNeely C., Allen C., Giacaman R., Arafat C., Daher M., El Sarraj E., Abu Mallouh M., Belli R. F. (2016b). Whither the “children of the stone”? An entire life under occupation. Journal of Palestine Studies, 45(2), 77-108. |
| 10. | Blattman C., Annan J. (2011). Reintegrating and employing high risk youth in Liberia: Lessons from a randomized evaluation of a landmine action agricultural training program for ex-combatants. Evidence from randomized evaluations of peacebuilding in Liberia: Policy report. Innovations for Poverty Action. |
| 11. | Boothby N., Crawford J., Mamade A.(2009). Mozambican child soldier life outcome study. In Barber B. K. (Ed.), Adolescents and war: How youth deal with political violence (pp. 238-254). Oxford University Press. |
| 12. | Braun V., Clarke V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. |
| 13. | |
| 14. | |
| 15. | Eggerman M., Panter-Brick C. (2010). Suffering hope and entrapment: Resilience and cultural values in Afghanistan. Social Science Medicine, 71(1-2), 71-83. |
| 16. | El-Namrouty K. A., Alhabil W., Al-thalathini D. A. (2013). Effect of micro-grants on poverty alleviation of Palestinian families (Gaza Strip − Palestinian territories). Journal of World Economic Research, 2(5), 82-88. |
| 17. | |
| 18. | Glass N., Perrin N., Kohli A., Remy M. (2014). Livestock/animal assets buffer the impact of conflict-related traumatic events on mental health symptoms for rural women. PLoS One, 9 (11). https://doi.org/10.1371/journal.pone.0111708 |
| 19. | |
| 20. | Hammad J., Tribe R. (2020a). Social suffering and the psychological impact of structural violence and economic oppression in an ongoing conflict setting: The Gaza Strip. Journal of Community Psychology. https://doi.org/10.1002/jcop.22367 |
| 21. | Hammad J., Tribe R. (2020b). Culturally informed resilience in conflict settings: A literature review of sumud in the occupied Palestinian territories. International Review of Psychiatry. https://doi.org/10.1080/09540261.2020 |
| 22. | |
| 23. | Harsha N., Ziq L., Ghandour R., Giacaman R. (2016). Well-being and associated factors among adults in the occupied Palestinian territory (oPt). Health and Quality of Life Outcomes, 14(122), 90-102. |
| 24. | Hobfoll S. E. (2002). Social and psychological resources and adaption. Review of General Psychology, 6(4), 307-324. |
| 25. | |
| 26. | Inter‐Agency Standing Committee. (2007). IASC guidelines on mental health and psychosocial support in emergency settings. Inter‐Agency Standing Committee. |
| 27. | |
| 28. | |
| 29. | Kagan C., Burton M., Duckett P., Lawthom R., Siddiquee A. (2011). Critical community psychology. Wiley-Blackwell. |
| 30. | Kagee A. (2004). Present concerns of survivors of human rights violations in South Africa. Social Science & Medicine, 59(3), 625-635. |
| 31. | Karsten I. P., Moser K. (2009). Unemployment impairs mental health: Meta-analyses. Journal of Vocational Behaviour, 74(3), 264-282. |
| 32. | Khamis V. (2013). Gender responses to psychological distress among Palestinians: Risk and protective factors. British Journal of Psychology, 105(3), 338-351. |
| 33. | |
| 34. | Kock T., Krysher S. (2010). The use of micro-grants to mitigate gender inequity in Afghanistan by empowering rural farmers and agribusiness entrepreneurs. Journal of International Agricultural and Extension Education, 17(1), 13-20. |
| 35. | |
| 36. | Kumar S., Willman A. (2016). Healing invisible wounds and rebuilding livelihoods: Emerging lessons for combining livelihood and psychosocial support in fragile and conflict-affected settings. Journal of Public Health Policy, 37(1), 32-50. |
| 37. | Kuttab E. (2010). Empowerment as resistance: Conceptualizing Palestinian women’s empowerment. Development, 53(2), 247-253. |
| 38. | Leerlooijer J., Bos A., Ruiter R., van Reeuwijk M., Rijsdijk L., Nshakira N. (2013). Qualitative evaluation of the teenage mothers project in Uganda: A community-based empowerment intervention for unmarried teenage mothers. BMC Public Health, 13(816), 1-15. |
| 39. | Lund C., Breen A., Flisher A. J., Kakuma R., Corrigall J., Joska J. A., Swartz L., Patel V. (2010). Poverty and common mental disorders in low and middle-income countries: A systematic review. Social Science and Medicine, 71(3), 517-528. |
| 40. | Mataria A., Giacaman R., Stefanini A., Naidoo N., Kowal P., Chatterji S. (2009). The quality of life of Palestinians living in chronic conflict: Assessment and determinants. European Journal Health Economics, 10(1), 93-101. |
| 41. | McNeely C., Barber B. K., Spellings C., Giacaman R., Arafat C., Daher M., El Sarraj E., Abu-Mallouh M. (2014). Human insecurity chronic economic constraints and health in the occupied Palestinian territory. Global Public Health, 9(5), 495-515. |
| 42. | Miller K. E., Rasmussen A. (2010). War exposure, daily stressors and mental health in conflict and post-conflict settings: Bridging the divide between trauma-focused and psychosocial frameworks. Social Science & Medicine, 70(1), 7-16. |
| 43. | Narayan D. R., Patel K., Schafft A., Koch-Schulte S. (2000). Voices of the poor: Can anyone hear us? Oxford University Press. |
| 44. | Olaimat H., Al-Louzi S. (2008). Empowering rural women through income-generating projects: A case study in Jordan. Jordan Journal of Social Sciences, 1(1), 153-168. |
| 45. | Orford J. (2008). Community psychology: Challenges, controversies and emerging consensus. John Wiley & Sons. |
| 46. | |
| 47. | Porter M., Haslam N. (2005). Predisplacement and post displacement factors associated with mental health of refugees and internally displaced persons: A meta-analysis. The Journal of the American Medical Association, 294(5), 602-612. |
| 48. | Roberts B., Browne J. (2011). A systematic review of factors influencing the psychological health of conflict-affected populations in low- and middle-income countries. Global Public Health, 6(8), 814-829. |
| 49. | |
| 50. | |
| 51. | Schafer A, Masoud H., Sammour R. (2014). Mediation of daily stressors on mental health within a conflict context: A qualitative study in Gaza. Intervention, 12(2), 171-186. |
| 52. | |
| 53. | Somasundaram D., Sivayokan S. (2013). Rebuilding community resilience in a post-war context: Developing insight and recommendations − A qualitative study in northern Sri Lanka. International Journal of Mental Health Systems, 7(3), 1-25. |
| 54. | Simaan J. (2017). Olive growing in Palestine: A decolonial ethnographic study of collective daily-forms-of-resistance. Journal of Occupational Science, 24(4), 510-523. |
| 55. | Thabet A. M., Thabet S. S., Vostanis P. (2016). The relationships between mental health problems and family coping strategies among Palestinian in the Gaza Strip. British Journal of Medicine & Medical Research, 17(8), 1-11. |
| 56. | |
| 57. | |
| 58. | |
| 59. | |
| 60. | |
| 61. | |
| 62. | |
| 63. | |
| 64. | |
| 65. | |
| 66. | |
| 67. | |
| 68. | |
| 69. | |
| 70. | |
[Table 1]
|
Search Pubmed for