The residents of the Gaza Strip are suffering under continuous Israeli bombardment and a stifling siege after cutting off electricity, water and fuel, which threatens the spread of many diseases and epidemics.
Doctors in Gaza say that patients arriving at hospitals are showing signs of illness due to overcrowding and poor sanitation after more than 1.4 million people were displaced from their homes to temporary shelters under the heaviest Israeli bombing ever, according to a Reuters report.
“The crowding of civilians and the fact that most schools are used as shelters housing large numbers of people is fertile ground for the spread of diseases,” said Nahed Abu Ta’imah, a public health doctor at Nasser Hospital in Khan Yunis.
With all hospitals running out of fuel to run their generators, doctors warned that vital equipment, such as newborn incubators, was at risk of shutting down.
The Palestinian Ministry of Health in Gaza said that 40 medical centers have suspended their operations at a time when bombing and displacement are putting enormous pressure on the regime.
In temporary shelters where displaced Palestinians gather with their families, people have begun to suffer from stomach pain, lung infections and skin rashes, Abu Taima said.
As for Sojood Najm, a woman residing in a United Nations facility, she said, “It is hot in the tent under the midday sun and there are insects and flies… It is cold at night and there are not enough blankets for everyone. The children are all sick.”
For his part, the owner of a pharmacy said that there were only a few medications left. People stocked up on over-the-counter medicines, but there were fears that treatments for chronic diseases might run out.
Dr. Adam Levine, chief of global emergency medicine at Alpert Medical School and Brown University School of Public Health, said, “We know that in other conflicts around the world, whether it’s in Africa or the Middle East or South Asia, that infectious diseases actually kill a number of people.” Civilians are bigger than bombs or bullets,” according to a report published in the American “NBC News.”
Levine added that infectious diseases are of particular concern to people in Gaza, “populations that do not have access to clean water and sanitation, as well as populations that have been displaced and are living together in very crowded conditions.”
Without clean water, Gazans are forced to drink or cook with polluted water.
This water is likely to be full of bacteria that can lead to violent intestinal diseases, such as dysentery and cholera.
Dr. Paul Spiegel, director of the Johns Hopkins Center for Human Health, said that a person infected with cholera “dehydrates and dies in a very short period of time.”
Doctors say that children are most at risk, because their blood volume is much lower compared to adults.
“In general, they will become dehydrated faster than adults,” Levine added. “The younger the child, the more at risk.”
An outbreak of cholera or other diarrheal diseases could have a particularly widespread impact on Gaza’s population, nearly half of whom are 18 or younger, according to UN estimates.
Influenza and other viruses
There are also signs that other diseases – specifically, respiratory viruses – are beginning to spread, with thousands of people evacuated from northern Gaza forced into cramped, crowded areas in the southern half of the Strip.
Dr. Ahmed Al-Mughrabi, head of the plastic surgery department at Nasser Hospital in the city of Khan Yunis, south of Gaza, said that he has witnessed what he believes is an increase in influenza infection rates “even among medical workers,” despite the lack of availability of tests.
Covid rears its head
Returning to the director of the Johns Hopkins Center for Humanitarian Health, Paul Spiegel, he said that it is also expected that “Covid will rear its head” in Gaza, “as people move from the north to the south, there will be increasing crowding and more exposure to infectious diseases.”
Widespread vaccination against influenza or other viruses, such as respiratory syncytial virus or Covid, remains out of the question as the conflict continues.
There is no evidence that measles is widespread, but it is a virus that worries doctors. Measles is one of the most contagious viruses in the world, and a single case in a crowded shelter can infect every unvaccinated person.
While measles vaccination rates among children in Gaza were as high as 97% before 2020, they have declined during the Covid pandemic, Levin said.
As a result, measles returned to Gaza in 2020 for the first time in decades.
For his part, Dabney Evans, assistant professor of global health at Emory University’s Rollins School of Public Health and director of Emory’s Center for Humanitarian Emergencies, said, “I would not be surprised if measles appears again.” This has happened “in other situations where displacements or mass movements of people have occurred.”
Evans said the lack of clean drinking water, food and sanitation among Gazans would exacerbate the health impact of any spread of viruses or bacterial diseases.
Dr. Barbara Zende, a pediatrician from Colorado who traveled to Gaza with the Palestinian Children’s Relief Fund on the Friday before the war began and is still there, estimates that between 300 and 400 people have to share one toilet.