Almost half of Gaza’s health facilities were damaged or destroyed during “Operation Cast Lead” and Gaza’s health-care system is currently unable to provide adequate responses to children’s health-care needs. As a result, some patients must seek treatment outside Gaza - in the West Bank, East Jerusalem, Egypt, Jordan and Israel - for a wide range of medical assistance. During the reporting period, while 1,407 of 1,648 applications for children who sought to obtain medical assistance outside Gaza were approved, nine children in Gaza died while waiting for the appropriate permits to travel outside Gaza. In 2009 there was also an increase in the number of interrogations at Erez crossing, including the interrogation of children leaving Gaza for medical treatment. Throughout 2009, the continuing high rate of settler violence against children was registered. Palestinian children continue to be shot, beaten and threatened while walking to school, grazing their livestock or playing outside their homes. According to reports, it has been revealed that a new pattern of violence has emerged since 2009, which suggests that Israeli settlers undertake attacks against Palestinians and their property in response to attempts by the Israeli authorities to dismantle "unauthorized” settlement outposts, raising additional concerns regarding the protection of Palestinian children. The Office for the Coordination of Humanitarian Affairs has documented at least two such incidents, in which 11 children were attacked by settlers. It is suspected that there are many more incidents that remain unreported. Perpetrators are never held accountable. This underscores the need for greater enforcement by the Israeli Government of the rule of law where violent settlers are concerned. --SPA 12:57 LOCAL TIME 09:57 GMT www.spa.gov.sa/783680