In a
sprawling tent encampment in the Gaza Strip, 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.
اضافة اعلان
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 on Gaza.
For
two months after Salwa al-Masri, 75, and her family fled to the city of Rafah,
at the southernmost tip of Gaza, to escape Israel’s military offensive, she
said she would walk 200 yards 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,” al-Masri said via WhatsApp recently from her family’s ramshackle
tent, which they made out of wood and plastic sheeting. “I would not drink
water. I would stay thirsty so I wouldn’t have to go to the bathroom. I stopped
drinking coffee and tea.”
Many
other Palestinians in Gaza, 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 on eating and drinking even more to avoid an uncomfortable and
unsanitary visit to the toilet.
Recently,
al-Masri’s son and other relatives bought a cement toilet basin and dug a hole
behind their tent, where the sewage gathers. It is a closer bathroom and one
she shares with fewer people.
But
the challenges of getting water to wash with and of the accumulating sewage are
threatening their health, and the stench of sewage fills their makeshift
encampment.
Last
month, the World Health Organization reported that cases of hepatitis A had
been spreading in Gaza. It also said that there were several thousand people
with jaundice, which is caused by hepatitis A, among other conditions. Cases of
diarrhea among children have also skyrocketed. All of it is linked to poor
sanitation, according to UNICEF.
“The
inhumane living conditions — barely any clean water, clean toilets and the
possibility to keep the surroundings clean — will enable hepatitis A to spread
further,” Tedros Adhanom Ghebreyesus, the director-general of the WHO, wrote on
social media at the time, “and highlight how explosively dangerous the
environment is for the spread of disease.”
Prominent
public health researchers 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. Their
estimate represents “excess deaths” that would not have been expected without
the war.
Displaced
Palestinians fill jerrycans with seawater for washing and cooking, at the beach
in Deir al-Balah, in the central Gaza Strip, Oct. 28, 2023. Palestinians
struggling against hunger and cold now face a growing sanitation crisis with
barely any clean water or clean toilets in an “explosively dangerous”
environment for the spread of disease, a World Health Organization official
said.
Schools,
hospitals, mosques, and churches have become overcrowded shelters for
Palestinians seeking safety from Israeli airstrikes. The few available
bathrooms have to be shared among hundreds or thousands of people who sometimes
wait in lines for hours to use them.
Israel’s
bombardment of Gaza and the accompanying ground offensive have increasingly
pushed Palestinians south into the overcrowded corner of Gaza around Rafah and
forced them to erect makeshift tents. As a result, access to bathrooms and
sanitation has only worsened.
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 nearly 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 Israeli authorities prevented them.
“It
is a public health concern,” said Abrassac Kamara, a UNICEF manager for the
Palestine WASH program, which helps deliver safe water and sanitation services.
“But the second thing is simply just dignity. It is something we take for
granted, but it’s really how we are taking dignity away from people.”
Israel’s
civil administration, the bureaucratic arm of its military in the occupied West
Bank and Gaza, said the restrictions on certain goods entering Gaza prevented
the entry of items that could also be used for military purposes.
Hamas
“exploits civilian resources to strengthen itself militarily at the expense of
caring for the civilian population,” the civil administration said, 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 — materials already available in Gaza — often at
a high cost. The agency plans to make 500 such toilets in Rafah to help reduce
the congestion.
“At
the moment, anything that is considered construction material — mostly metal,
but also sandwich panels, nails, reinforcement rods — are all banned,” Kamara
said. “We are making do.”
UNICEF
had planned to build another 500 toilets in the southern Gaza city of Khan
Younis but had to abandon those efforts as Israel’s ground offensive moved into
the area recently.
“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,” Kamara
said. “We are back to the basic sanitation of digging a hole and covering it.”
In a
video posted on Instagram last month, Bisan Owda, a Palestinian journalist and
documentary filmmaker, chronicled the daily struggle of finding a latrine. As
she walked past tents in the street, carrying a large jug of water, she
narrated her challenges.
“This
is my daily routine,” she said, “walking for almost 20 to 25 minutes to reach a
bathroom — struggling to reach a bathroom.”
Some
women have lamented a desperate lack of sanitary pads in the territory, and at
least one of them told The New York Times that she had started taking birth
control pills to stop her period altogether.
Sana
Kabariti, 33, a pharmacist from Gaza City, in the north, said she fled home
with her family to the town of Nuseirat, in central Gaza, as Israeli bombs
rained down on their neighborhood in the first few days of the war. She and
some 40 members of her extended family, including 10 children, cloistered in a
small room and shared one bathroom, she said. But there was no water and no
toilet paper.
So
despite the dangers, they returned to their homes.
“With
regards to the toilet, there wasn’t any water,” she said. “And this is what led
the families with us to return to Gaza City, and to the danger, because they
couldn’t handle the lack of water and lack of toilet paper.”
Eventually,
the bombing in Gaza City became so intense that she and her family had to flee
again. They headed south, first to the city of Deir al-Balah and eventually to
Rafah.
They
are better off than many in Rafah because they are sheltering in a room in a
house shared among many. But the bathroom is small, and they must trek each day
to get water to wash themselves and try to keep the bathroom clean. Showering
is a luxury they can rarely afford.
They
do not use toilet paper. Even if they can find it at markets, the price is
exorbitant; Israel’s siege has driven up the cost of what few goods are still
available in Gaza.
Instead,
the family cuts up pieces of fabric to use, Kabariti said.
“There
are many people who aren’t willing to use the bathroom more than once a day,”
she said.
In
her neighborhood, she recounted meeting an older woman who refused to use the
bathroom in the center where she was sheltering because it was so dirty and
unhygienic. Instead, neighbors allowed her to use their bathroom.
But
not wanting to impose, she uses it only once a day — right after sunrise when
she has said her morning prayers. Afterward, she holds it in until the next
morning.
“I
don’t know how long a person’s body can continue like this after nearly four
months,” Kabariti said.
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