December
20, 2023
Untreated sewage and overcrowding are leading to the rapid
spread of disease, while three-quarters of the Strip’s hospitals have stopped
functioning.
In
late November, Margaret Harris, a spokesperson for the World Health
Organization, warned that without urgent action to repair the Gaza Strip’s
rapidly collapsing health system, more people would soon die from disease than
from Israel’s bombings. “[There are] no medicines, no vaccination activities,
no access to safe water and hygiene and no food,” she said, summarizing the
dire humanitarian conditions amid Israel’s ongoing bombardment and intensified
siege.
Nearly
a month later, the full extent of the crisis is still not being fully
comprehended outside of the Strip, according to Palestinian health care
professionals in Gaza. “The information, statistics, and news circulating
worldwide only scratches the surface of the actual reality,” Dr. Adnan
al-Wahidi, a child health expert from Gaza City, told +972. “It captures just a
small fraction of the alarming health situation in the Gaza Strip.”
With
Israel’s airstrikes and ground invasion forcibly displacing nearly all of the
Strip’s 2.2 million residents, there is unprecedented overcrowding in parts of
southern Gaza — in particular the city of Rafah, near the border with Egypt,
which is still being bombed despite the Israeli army having declared it a “safe
zone,” and the coastal area of Al-Mawasi where there is very little
infrastructure at all. Tens of thousands of families are sheltering in flooded
tent encampments, while starving children queue for hours every day at food
distribution centers.
The
crowded conditions, as well as the lack of clean water and sanitary bathrooms,
are leading to the rapid spread of disease throughout the besieged enclave,
according to experts.
Al-Wahidi
explained that the issue of water contamination is particularly grave,
affecting “all ages and demographic groups, with the repercussions being most
pronounced in children.” He also noted that a lack of water and electricity,
along with an inability to dispose of or treat sewage water, could have
disastrous consequences, adding that the risk of the spread of disease has been
further exacerbated by the halt in Gaza’s child vaccination programs due to the
war.
Dr.
Tamer M. Alnajjar, a project coordinator at the National Institute for
Environment & Development in Gaza City, told +972 that the widespread
contamination of water sources and the proliferation of sewage in public areas
have resulted in a heightened risk of contracting diseases such as cholera.
“The absence of adequate purification infrastructure further compounds this
issue, exacerbating the risk of waterborne illnesses and gastrointestinal
infections,” he added.
Moreover,
al-Wahidi estimates that approximately 40 percent of children in Gaza are
currently suffering from malnutrition, which can severely impact their growth
and development. “The younger a child is, the more vulnerable they are to the
effects,” he explained.
There
are also specific risks to pregnant and nursing women, especially those
currently in shelters. On top of the psychological impacts of being displaced
and sheltering in facilities that are not fit for purpose, malnutrition is of
particular concern for these women because what little food is currently
available lacks important nutrients. This, al-Wahidi explained, can affect the
health of the mother, the fetus, or the breastfeeding infant.
Critical
shortage of health services
The
spiraling threat of disease is being compounded by the fact that three-quarters
of Gaza’s hospitals are no longer functional — a result of the Israeli army’s
expulsion orders and direct attacks on health facilities in recent weeks. The
result is that “there is nowhere to treat sick children, leading to potential
long-term impacts on children’s health,” al-Wahidi said.
Even
in hospitals that are still functioning, medical staff are overwhelmed by the
continuous influx of people with severe burns and other wounds as a result of
Israeli airstrikes. Hospitals are facing shortages of essential products,
including orthopedic devices to stabilize bones, surgical supplies, and
treatment for burns.
Dr.
Tareq Abu A’anza, a pediatrician at Al-Nasser Hospital in Khan Younis in the
southern Gaza Strip, told +972 that within the remaining hospitals,
gastrointestinal diseases have surged fourfold, while skin diseases have
tripled.
In
a 24-hour period, he explained, Al-Nasser’s emergency department receives
between 700 and 1,000 children suffering from various health issues, including
skin rashes, meningitis, epidemic hepatitis, respiratory distress, and
gastrointestinal infections with severe dehydration. Abu A’anza expressed
particular alarm that some children are sick with more than one of these
ailments.
According
to Abu A’anza, medical teams have reached the point of exhaustion and are
unable to sustain their work efforts. Hospitals find themselves incapable of
handling additional cases, especially with the arrival of hundreds of thousands
of people displaced from northern Gaza. This critical shortage of health
services, he warned, will endanger people’s lives.
In
a press conference on Dec. 18, Dr. Ashraf al-Qidra, the spokesperson for Gaza’s
Health Ministry, addressed Israel’s attacks on Gaza’s hospitals. “The
international silence over the crimes of the Israeli occupation forces against
hospitals in northern Gaza — their destruction and the arrest of their staff —
constitute a green light to implement the criminal scenario in southern Gaza,”
he said, adding that Israel had targeted Al-Nasser Hospital twice the day
before.
“The
health situation in hospitals in southern Gaza is catastrophic and complex as a
result of the lack of clinical, medical, and human capabilities required for
the number and type of wounded people,” al-Qidra continued. He also described
the conditions in the shelters for displaced people as “catastrophic and
inhumane.”
According
to al-Qidra, Israel has killed 310 health care professionals, destroyed 102
ambulances, and rendered 138 health care facilities inoperable since the start
of the war, including 22 hospitals and 52 primary care centers. The army is
also detaining 93 health care workers, including the directors of the three
main hospitals in northern Gaza: Dr. Muhammad Abu Salmiya of Al-Shifa Hospital
in Gaza City (who +972 interviewed in the first days of the war), Dr. Ahmad
al-Kahlout of Kamal Adwan Hospital in Beit Lahiya, and Dr. Ahmed Muhanna of
Al-Awda Hospital in Jabalia.
The
result of all this is what al-Wahidi described as a “health disaster” — and he
foresees even more challenges ahead. “The health system in the Gaza Strip has
been completely destroyed, leaving little hope for any sort of recovery in the
near future,” he said. Even when the war ends, he warned, the effects of
ailments such as child malnutrition will linger for a long time to come.
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