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Rafah water facility demolition raises health risks in Gaza, UN says


Two-year-old Ismail Abu Naji receives treatment for sores on his legs at Kamal Adwan Hospital in Beit Lahia, in the northern Gaza Strip, on July 29, 2024. U.N. agencies say scabies, chicken pox, skin rashes and lice are spreading quickly in Gaza.
Two-year-old Ismail Abu Naji receives treatment for sores on his legs at Kamal Adwan Hospital in Beit Lahia, in the northern Gaza Strip, on July 29, 2024. U.N. agencies say scabies, chicken pox, skin rashes and lice are spreading quickly in Gaza.

U.N. agencies warn that the demolition of a critical water facility in Rafah in the southern Gaza Strip increases the risk of infectious diseases as people are forced to drink unsafe water while sanitary conditions continue to deteriorate.

“Until recently, that reservoir served thousands and thousands of internally displaced people who had sought refuge in Rafah in the area,” James Elder, UNICEF spokesperson, told journalists at a briefing in Geneva on Tuesday.

“Now without it, vulnerable children and families are likely to be forced again increasingly to resort to unsafe water, so putting them again at all those risks that we see time after time, day after day in Gaza — dehydration, malnutrition, diseases,” he said.

The Israeli daily Haaretz reported Monday that the troops blew up the central reservoir “on the orders of the brigade commanders” but without receiving permission from the senior level of the Southern Command. It added that the incident was being investigated by Israel’s Military Police as “a suspected violation of international law.”

A satellite image obtained on July 30, 2024, shows the Canada Well water facility in Rafah before the site was damaged in an Israeli army explosion. (Planet Labs via Reuters)
A satellite image obtained on July 30, 2024, shows the Canada Well water facility in Rafah before the site was damaged in an Israeli army explosion. (Planet Labs via Reuters)

Infections spreading

Elder said the destruction of the Canada Well reservoir “is yet another grim reminder of the assaults on families who already are in desperate need of water.”

“We have seen spikes in diarrhea, in skin infections — all due to a lack of access to hygiene and a lack of access to water,” he said, noting that people in emergencies require a minimum of 15 liters (almost 4 gallons) of water per person per day.

Now, the range of water availability in Gaza has been reduced to between 2 and 9 liters per person, per day, and some people are getting just a fraction of that, Elder said.

“Somehow, people are holding on, but of course, we are now in that deathly cycle whereby children are very malnourished. There is immense heat. There is [a] lack of water. There is a horrendous lack of sanitation, and that is the cycle,” he said.

The World Health Organization reports a surge in infectious diseases in the Gaza Strip. As of July 7, it has recorded nearly 1 million cases of acute respiratory infections, 577,000 cases of acute watery diarrhea, 107,000 of acute jaundice syndrome and 12,000 of bloody diarrhea. It also has recorded nearly 200,000 cases of scabies, lice, skin rashes, chicken pox and other illnesses.

Polio threat

The recent identification of circulating vaccine-derived poliovirus type 2 in Gaza’s sewage system is of particular concern. Under prevailing conditions in Gaza, there is a high risk of spread of this paralytic, deadly disease within the Palestinian enclave and across borders.

“Having a vaccine-derived polio virus in the sewage very likely means that it is out there somewhere in people,” WHO spokesperson Christian Lindmeier said. “It most likely is in the population, but that does not necessarily mean that we see an outbreak of cases.

“But of course, we need to be prepared. We need to be utterly prepared. And we need vaccinations, and we need vaccination campaigns,” he said.

Displaced Palestinians queue for water in Khan Yunis, in the southern Gaza Strip, on July 30, 2024.
Displaced Palestinians queue for water in Khan Yunis, in the southern Gaza Strip, on July 30, 2024.

WHO Director-General Tedros Adhanom Ghebteyesus has announced that the organization will be sending more than 1 million doses of polio vaccine to Gaza to avert the spread of the disease.

“While no cases of polio have been recorded yet, without immediate action, it is just a matter of time before it reaches the thousands of children who have been left unprotected,” he said, adding that infants under 2 are especially vulnerable “because many have not been vaccinated over the nine months of conflict.”

Before Israel began its military offensive in Gaza following a brutal attack on Israel by Hamas militants on October 7, nearly the whole population of Gaza had been immunized against polio.

However, due to the impact of the conflict, “coverage of polio now is around 89%, down from around 99% before the conflict,” UNICEF’s Elder said. “Hence, there is an increased risk for children. Now, if the child gets the full course of the vaccine, then the risk of the child getting paralyzed by polio is negligible.

“This is why it is so critical that all children are immunized. But the mass displacement, the decimation of the health infrastructure, the tremendously insecure operating environment — they all make it much more difficult, hence putting more children at risk,” he said.

Cases of polio have declined by 99% since WHO launched its global polio eradication campaign in 1988.

WHO reports polio now is endemic only in Pakistan and Afghanistan. However, more than 30 countries, including Egypt and Israel, are subject to outbreaks. The reemergence of polio tends to occur in areas of conflict or instability and within countries with poor health systems.

“We were very, very close to eradicating polio fully,” WHO spokesperson Lindmeier said. “As you know, wartime, unfortunately, creates the situation where it is very difficult to get that last mile. And it has been less than a mile that we needed to go.

“There are a few pockets around the world. Hopefully, Gaza will not become another one,” he said.

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