“We have noticed that, due to the lack of clean water for drinking or other uses, patients suffer from intestinal disorders and the flu virus, which is circulating widely,” says MSF health promotion manager Mohammad Abu Zayed. “Lately, we’ve also witnessed children suffering from skin rashes due to the lack of clean water for bathing or washing.”
Other health risks include dehydration and hepatitis A. "The lack of clean water can lead to many diseases related to the quality of the water, such as diarrhoea and skin diseases, but simply not having enough water can also lead to dehydration," says MSF medical advisor Marina Pomares, in Gaza. Cooking and personal hygiene are also affected, increasing the risk of infection. "The effects are worse in children, who have weaker immune systems than adults, and are more exposed to diseases and allergies," she says.
MSF teams are providing basic healthcare in two locations in Rafah. As of 2 February, almost 30 percent of morbidities of patient under five-year-olds coming to the MSF Shaboura clinic and Al-Mawasi health post were for diarrhoea or skin diseases. In recent weeks MSF teams in Rafah have also received 43 patients with suspected hepatitis A. These medical conditions are all related to the shortage of clean water and are compounded by the lack of functioning medical facilities in the area.
To respond to some of the most urgent needs of the displaced people in Rafah, Médecins Sans Frontières teams started a water distribution programme in December 2023. Today, MSF water and sanitation teams are providing an average of 110,000 litres of safe drinking water per day to around 20,000 people. However, this is nowhere near enough to go around. “In a normal situation, one person needs two to three liters of drinking water per day,” says MSF water and sanitation agent Youssef Al-Khishawi. “Now, with the current shortage, the average for one family of six is one gallon of water (3.8 litres).”
Hanin fled her home in Gaza City in the early days of the war due to shelling and is now sheltering in Rafah. Like most people in the town, she struggles to get hold of enough food, water and other essentials. "We stand in lines to get water,” she says. “If we get the chance to get some water, we will use it for washing and dish-washing, and if we can’t get any water, we will wait for the next day.”