A Growing Sanitation Crisis in Gaza
In a sprawling tent encampment in Gaza, the Israeli bombs fall close enough to hear and feel. But daily life is also a struggle against hunger, cold and a growing sanitation crisis.
A lack of sufficient toilets and clean water, as well as open sewage, are problems that displaced Palestinians have struggled with since the early days of Israel’s assault.
For two months after Salwa al-Masri, 75, and her family fled to Rafah, at the southernmost tip of Gaza, to escape Israel’s military offensive, she said she would walk 200 meters to reach the nearest bathroom. If she was lucky, younger women in line would let her jump ahead. Other times, she might wait up to an hour to use a dirty toilet shared with thousands of other people.
“It’s horrible,” Ms. al-Masri said via WhatsApp recently from her family’s ramshackle tent, made out of wood and plastic sheeting. “I wouldn’t drink water. I would stay thirsty so I wouldn’t have to go to the bathroom.”
Many other Gazans, already facing hunger and thirst as a result of Israel’s more than four-month siege of the territory, say they, too, have tried to cut back even more on eating and drinking to avoid a visit to the toilet.
Recently, Ms. al-Masri’s relatives bought a cement basin and dug a hole behind their tent, where the sewage gathers. It is a closer toilet shared with fewer people. But the challenges of getting water to wash with and of the accumulating sewage are threatening their health, and the stench fills their encampment.
In January, the World Health Organization reported that cases of hepatitis A had been spreading in Gaza. Cases of diarrhea among children have also skyrocketed. All of it is linked to poor sanitation, UNICEF said.
“The inhumane living conditions — barely any clean water, clean toilets and possibility to keep the surroundings clean — will enable hepatitis A to spread further,” Tedros Adhanom Ghebreyesus, the W.H.O. director general, posted on social media.
Epidemiologists have estimated that an escalation of the war in Gaza could cause up to 85,000 Palestinian deaths over the next six months from injuries, disease and lack of medical care, in addition to the nearly 30,000 that local authorities have already reported since early October.
Schools, hospitals, mosques and churches have become crowded shelters for Palestinians seeking safety from Israeli airstrikes. The few available bathrooms have to be shared among hundreds or thousands of people. Israel’s bombardment of Gaza and the accompanying ground offensive have pushed residents south. Some 1.5 million displaced Palestinians are now in Rafah — more than half of Gaza’s total population of about 2.2 million — even as Israel threatens to invade the area.
After the Hamas-led attacks on Israel on October 7, Israel’s near-complete siege on Gaza has prevented most things from coming into the territory, creating a dire shortage of food, water and medicines. Additionally, representatives of both UNICEF and the Palestine Red Crescent Society said their organizations have tried to bring in portable toilets and materials to build sanitation facilities, but the Israeli authorities prevented them.
“It is a public health concern,” said Abrassac Kamara, a UNICEF manager for the Palestine WASH program, which helps deliver sanitation services. “But the second thing is simply just dignity.”
Israel’s civil administration, the bureaucratic arm of its military in the occupied West Bank and Gaza, said the restrictions on certain goods prevented the entry of items that could be used for military purposes, without explaining how portable bathrooms could serve military needs. UNICEF officials said they have had to resort to constructing toilets out of wood, concrete and plastic sheeting. The agency plans to make 500 such toilets in Rafah.
“They will literally put any sort of privacy screening — plastic at the back of the tent — and just dig and bury when they need to relieve themselves,” Mr. Kamara said. “We are back to the basic sanitation of digging a hole and covering it.”
Aid workers say war is taking away people’s dignity.