Over the many years I spent working in conflict zones, certain encounters will always stand out in a very special way. Meeting young Rana, a 12-year-old UNRWA student from the Qabr Essit refugee camp in southern rural Damascus, had a deep impact on me.
At 3:50pm on February 21, 2016, her life changed for ever.
Rana had gone to buy vegetables in the market at the entrance of the camp, and at that precise moment a double car bomb attack occurred, killing more than 120 people and injuring dozens more.
"After six hours of searching in the streets, I found Rana at Al-Mujtahid Hospital," her mother, Mahdiyeh, recalls with teary eyes. "She was in a terrible condition; her face and hands were burnt and her legs were filled with shrapnel." She pauses briefly before adding: "My nephew … he was found dead …"
|Rana meets the author in Syria, May 2016 [UNRWA/Taghrid Mohammed]
To save Rana's life, doctors made the difficult decision to amputate one of her legs. She stayed in the hospital for a month, with her mother at her bedside. She recovered with the support of UNRWA disabilities interventions - providing her with an artificial limb and aiding the recovery process through physiotherapy and home adaptations - and through the provision of the Agency's psychosocial support services.
When I met Rana in Qabr Essit in May last year and was struggling to find the right words to give her strength, she described her determination to put the nightmares behind her and live the rest of her life to the fullest.
Rana's story is frighteningly common in the Palestine refugee community in Syria. While the physical devastation of the conflict is visible for all to see, the human consequences, the accumulated fear and suffering, are at times more difficult to map out. In Syria, we are dealing with yet another generation of Palestinians enduring the trauma of displacement and loss in its multiple forms.
Adequately responding to their needs has required major adaptations to UNRWA operations over the past five years. Today, 430,000 Palestine refugees - 95 per cent of those remaining in Syria - are in need of emergency humanitarian assistance. Overall, 280,000 are internally displaced and around 43,000 are trapped in hard-to-reach or besieged areas. In addition to this, there are more than 30,000 Palestine refugees from Syria who have fled to Lebanon and nearly 17,000 who have fled to Jordan, where they face a marginalised and precarious existence.
Our operations are carried out by some 4,000 staff, mostly Palestinians, who have shown immense courage under the most trying circumstances. UNRWA is by some margin the largest provider of assistance to Palestine refugees. Our interventions include cash assistance, water and sanitation, food and non-food items, shelter, health, education, livelihoods, microfinance and protection.
Unemployment and food insecurity
We also run emergency operations in the occupied Palestinian territory. As in Syria, I have met many UNRWA students in Gaza, who are enduring the multiple consequences of repeated armed conflicts, in addition to lack of freedom of movement and a closed personal horizon.
Unemployment reached record levels in 2016, with 43.2 percent of the population without a job in the third quarter of the year; 67.3 percent of women and 66.5 percent of youth. Loss of livelihoods has eroded the coping strategies of already vulnerable refugee communities and has led to rising food insecurity among Gazans.
It is projected that in 2017, 911,500 refugees will be dependent on UNRWA food assistance. This is more than a tenfold increase on the 80,000 refugees receiving assistance from UNRWA at the start of 2000, before the imposition of the blockade. We will also provide repair grants to more than 57,000 refugee families whose homes were damaged or destroyed by the fighting in Gaza in 2014.
I find it very difficult to reconcile any of these indicators with the security concerns and dignity of anyone in the region.
In the West Bank, including East Jerusalem, violence, military operations, access restrictions, forced displacement and demolitions have increased significantly since October 2015. As a result of this intensified protection crisis, Palestinian living standards and the psychosocial health of refugee children are being undermined and the demand for UNRWA emergency assistance remains strong.
High food insecurity and unemployment levels within the West Bank refugee community are the main drivers of need. This is particularly true in the camps where food insecurity levels have reached 29 percent and unemployment stands at 19.5 percent within the refugee community.
UNRWA has stood by the Palestine refugees for nearly seven decades, providing increased emergency assistance in times of critical need, supplementing our long-term human development programmes, all in one continuous intervention.
This is our distinctive contribution - working with one of the most disadvantaged and marginalised communities in one of the world's most unstable and radicalised regions, instilling human capital while fostering dignity, self-reliance and innovation.
UN member states in adopting the New York Declaration on Refugees and Migrants in September 2016, stated that UNRWA requires sufficient funding to enable it to carry out its activities effectively and in a predictable manner. This applies both to UNRWA provision of emergency humanitarian assistance and support to build the human capital of Palestine refugees and to ensure that they live their lives in dignity pending a lasting solution to their plight.
In 2017 UNRWA requires $411m for its humanitarian response to the Syria crisis. In the occupied Palestinian territory we require $402m. We call on our partners and donors to preserve and, where possible, to increase the support to our crucial operations.
At the same time, we call for resolute political action to bring conflicts to an end and join UN Secretary-General Antonio Guterres, in his appeal to make efforts for peace the priority focus of 2017. Nothing would be more important for Rana and the 5.2 million Palestine refugees in the Near East.
In the meantime, they can count on UNRWA's unflinching support.
Pierre Krahenbuhl is the Commissioner-General of UNRWA.
The views expressed in this article are the author's own and do not necessarily reflect Al Jazeera's editorial policy.