Overcrowding, pollution and water shortages fuel the spread of disease in Gaza

Ikrami Jumaa and his family were displaced about six times before they settled in an area besieged by sewage water, odors, insects, and rodents. But he says that moving is no longer a realistic option in a sector where the spaces available to civilians have shrunk, with most of the population congregating west of what is known as the “yellow line,” an area that has come to accommodate the entire population mass in Gaza within a narrow and crowded strip.

Ikrami Jumaa, the father of a family of six, said: “We couldn’t find it anywhere else in the Gaza Strip. We are forced to endure this place despite all the suffering. It is not limited to insects and reptiles, as this environment transmits diseases to us. I suffer from heart disease, diabetes, and high blood pressure, and I cannot endure it, but we have no alternative“.

Multiple skin diseases

Jumaa’s testimony reflects a crisis that goes beyond deteriorating public health to the lack of geographical space that allows displaced people to move away from sources of pollution and infection. With the accumulation of tents west of the Yellow Line, residents find themselves trapped between destroyed, prohibited, or unsafe areas, and between overcrowded camps in which water, sanitation, and hygiene are not available.

The United Nations says that most of Gaza’s residents are still displaced in increasingly narrow and overcrowded spaces, while basic services are under pressure beyond their capacity. The United Nations Office for the Coordination of Humanitarian Affairs reported that more than 70 percent of the population depends on water transported by tankers, warning that a lack of funding threatens the continuity of these supplies as the summer peak approaches.

At the Red Crescent Field Hospital in central Gaza City, dozens of patients wait in front of the dermatology clinic. Many of them are children whose bodies show blisters, redness, and skin irritations, an indication of the spread of diseases linked to overcrowding, heat, and lack of water and hygiene materials.

The child’s mother, Maher Khalifa, says that living in tents has made her son’s condition worse. She added: “We now live in tents, and this child cannot tolerate the high heat or exposure to the sun. Because of this, the spread of pimples on his body increased. Because of the large number of displaced people in the camps, diseases spread, and there is more than one type of skin disease and pimples, such as the condition that affected my son and other cases.“.

The absence of alternatives exacerbates the ordeal

UN data indicates that the pest control campaign has treated more than 2,000 sites since mid-May, but skin diseases and external parasitic infections remain on the rise. UN organizations link this to limited access to safe water, sanitation, and treatment, and continued restrictions on access to waste dumps, which leads to the accumulation of waste within populated areas.

These conditions exacerbate the crisis of displaced people confined within a narrow space. The absence of alternative places for displacement forces families to remain near temporary dumps, sewage swamps, or closely packed tents.

Abu Muhammad Habib said, while holding his child suffering from skin irritations, while waiting in front of the dermatology clinic: “We woke up this morning to find the child’s body red due to allergies. I came to primary care, and they said I should see a dermatologist. We spent three hours here; An hour and a half to get the ticket, and another hour and a half waiting to get into the doctor“.

The United Nations says communicable diseases continue to put pressure on an exhausted health system. Reported cases include acute respiratory infections, acute watery diarrhea, skin diseases, and infections associated with ectoparasites. The crowded tent environment increases transmission of infection, especially among children, the elderly, and patients with chronic diseases.

Diseases known but increasing

Dr. Raed Abu Sariya, a dermatology consultant, said that the conditions that patients suffer from are not necessarily new diseases, but they have become more severe and appear with greater complications.

He added: “As a consultant dermatologist who has been working for nearly twenty years, I have not encountered new diseases. The diseases are known to me, but I noticed an increase in their severity and the emergence of complications that I had not seen before. This is often due to weak immunity and malnutrition as a result of the famine that people experienced“.

These complications are inseparable from the reality of repeated displacement. Families who have lost their homes or are no longer able to return to their areas east of the Yellow Line are crowded into crowded western areas, where the distance between tents is reduced to such an extent that sanitary isolation is almost impossible, and waste and wastewater management becomes more difficult.

A tireless international effort to transport waste

In Gaza City, mechanisms affiliated with the United Nations Development Program and local partners are working to transport waste from the Firas Market area – one of the largest waste collections in the city – to another location away from population centers.

The United Nations says that since early March, water, sanitation and hygiene sector partners have removed about 100,000 cubic meters of waste from Firas market and transported it to the Abu Jarad site.

However, waste management remains one of the most prominent challenges, as the sector relies on temporary dumps close to displacement areas, in light of the difficulty of accessing the main dumps and introducing the necessary equipment and materials to remove rubble and waste. UN organizations say that the accumulation of garbage near residential areas attracts rodents and insects, and increases the risk of contamination of food, water, and sleeping areas.

According to the United Nations, during the recent response, partners in the water, sanitation and hygiene sector distributed more than 11,500 hygiene kits, 273,000 bars of soap, and 1,500 gallons of water, in addition to other materials, reaching tens of thousands of residents. However, the amount of aid does not keep pace with the expanding need in crowded camps, and does not address the broader cause of the crisis: the presence of large numbers of people in a limited space that does not allow for new displacement or relief of overcrowding.

As temperatures rise, humanitarian workers warn that the lack of alternative places will push more families to remain in contaminated environments, even as the tents themselves become hotbeds of disease. They say the combination of overcrowding, water shortages, waste accumulation, and the spread of insects and rodents could turn skin diseases, diarrhea and respiratory infections into a broader crisis within population centers.

For Ikrami Jumaa, the tent set up near the sewer encapsulates Gaza’s current predicament: a disease that can be seen on the bodies of children, waste that does not find its way to landfills, and a population that has nowhere else to go.

Jumaa says that his family does not stay there because they can bear it, but because they no longer have a choice. In Gaza, the distance between danger and survival is no longer measured only by bombing or lines of control, but by the few meters available between one tent and another.