War on Gaza: Overflowing waste threatens health crisis as hepatitis spreads

Magdy al-Zaanen is often woken up at night by the cries of his two children.

Sleeping in a makeshift tent on the pavement of Gaza’s Deir al-Balah, they regularly get bitten by mosquitoes, leaving them in great pain. 

“My wife and I pretend to put medicine on the bites to trick them to go back to sleep,” says al-Zaanen. 

Mosquito bites are just one symptom of the growing environmental and health crisis that he and nearly two million internally displaced Palestinians in Gaza are facing since Israel began its war on the strip in October.  

Nearly eight months of relentless Israeli bombardment and siege has all but destroyed infrastructure, waste management facilities, and the Palestinian civil defence. 

This has left human remains buried under mountains of debris for months, heaps of uncollected solid waste piling up on streets and sewage overflows are a regular occurrence. 

Al-Zaanen fled his home in the northern Gaza Strip under heavy Israeli strikes shortly after the war started on 7 October. 

He spent two months at a school-turned-shelter in Deir al-Balah, before it became overcrowded and rife with disease.

'Our tent is made from plastic. It can’t protect us from Israeli bombs, mosquitos or bad smells'

- Magdy al-Zaanen, displaced Palestinian 

He then set up a tent for his family on the pavement of Deir al-Balah’s main road, but that wasn’t much better.  

"We moved to the tent looking for a cleaner environment, but we realised that was impossible when the sewage water overflowed right next to our tent,” the father of two told Middle East Eye.

“We walk through sewage puddles daily and the awful smells fill the place. We are exposed to all kinds of pollution all the time.”

Desperately trying to dispel the insects who are drawn by the pollution around him, once again he lights up a small fire in the tent, hoping the smoke will drive them away. His attempts are rarely effective.

“Our tent is made from plastic. It can’t protect us from Israeli bombs, mosquitos or bad smells."

Waste and sewage 

The Palestinian civil defence and local municipalities in Gaza struggled with clearing rubble and waste management even before the war. 

Under an Israel-led blockade since 2007, the coastal enclave has had shortages in essential equipment and resources for years. 

According to the United Nations Development Programme (UNDP), the strip produced a “staggering” 1,700 tonnes of waste daily and had only two main landfills, one of which was operating beyond capacity. 

Since the war started, Israeli bombing has caused major damage to infrastructure, including the targeting of waste collection vehicles, facilities and medical waste treatment centres, according to the UNDP. 

Satellite analysis by the Financial Times shows there are now more than 140 solid waste dump sites across the Gaza Strip. 

The crisis has been aggravated due to the permanent presence of Israeli forces in the Juhor ad-Dik area, where Gaza’s main landfill is located, making it inaccessible.

Wells and sewage networks have also been bombed during the ongoing assault, causing the loss of more than 60 percent of the water supply, according to Mohammad Mosleh, the mayor of Magazi refugee camp.

Mosleh was one of the first people to arrive in the Magazi camp in the central Gaza Strip in January, just after a brief ground invasion by Israeli troops. 

He said he was “shocked” by what he saw. Buildings were levelled, roads were razed and critical infrastructure was shattered. 

The municipality building was completely burnt, he said, while warehouses and vehicles were destroyed. Other local municipalities suffered similar damage after being targeted by Israeli forces. 

“It's a catastrophe,” Mosleh told MEE. 

He estimated more than five kilometres of the sewage network were destroyed, including the main lines that take sewage out of the camp. 

This has caused wastewater to overflow in the streets and gather in the large craters made by Israeli bombs, filling neighbourhoods with sewage swamps that generate bad smells, pollution and harmful insects. 

Additionally, 4,200 residential units were damaged and became uninhabitable in the camp. Piles of rubble blocked many streets, Mosleh added. 

According to the UN, there is an estimated 37 million tonnes of debris across Gaza, containing the remains of nearly 10,000 people, which will take years to clear. 

Mosleh said that despite a lack of resources, staff at the Magazi refugee camp municipality are doing everything they can to help, including dealing with the 25 tonnes of waste generated daily.

But with an influx of nearly one million people, who recently fled Rafah to Khan Younis and the central districts, their mission is getting harder each day.

Epidemics

Like al-Zaanen, Omar Nasser set up a tent on the pavement of Deir al-Balah main road after being forced to flee his home in eastern Khan Younis, an area that has been largely levelled during a three-month-long invasion by Israel. 

Gada Nasser, his nine-year-old daughter, recently contracted hepatitis A, which has spread rapidly across Gaza in recent months.  

“I immediately took her to al-Aqsa Martyrs where we waited for a long time before someone could check her,” Nasser, a father of three, told MEE. 

The doctor prescribed some medications and a nutritional diet, which Nasser could not provide. 

"The doctor said she must not eat canned food, but it's the only food we get from the aid organisations," he said.

“I used to work in construction and provide for my family, but I lost my job at the beginning of the war. I’ve had to ask people for food to provide for my daughter.”

The Palestinian Ministry of Health said in April that an outbreak of meningitis and hepatitis was underway in displacement camps, threatening a “health catastrophe”. 

They’re among many other diseases spreading due to the dire conditions in Gaza.

Mosquito bites are one of the most common issues people face, according to Dr Asmaa Saleh, who works at medical points in displacement camps in central Gaza. 

In addition to pain and discomfort, the bites can transmit disease and cause severe skin infections, especially among children with weak immune systems, according to Saleh. 

Skin diseases such as scabies, smallpox and lice are also spreading fast and are being made worse by the lack of clean drinking water, especially in overcrowded makeshift shelters. 

Food poisoning is another issue, with Gaza’s soil and water resources exposed to high volumes of waste. 

Dr Saleh told MEE several children have already died due to gastroenteritis and dehydration caused by consuming contaminated water. 

Projections by Johns Hopkins published in February estimate up to 11,000 Palestinians could die from epidemics. 

Back in his tent, al-Zaanen kept trying to dismiss the mosquitos as he lamented the loss of comfort from his life. 

But despite everything, he was “still clinging to life,” he said, hopeful of a return home soon.

"I'm looking forward to the day when we return to northern Gaza and I can build a tent on the rubble of our destroyed home.”