The besieged residents of the Gaza Strip who have so far survived Israel’s operations are threatened by an invisible and silent killer: disease.

The lack of food, clean water and shelter ehas impoverished hundreds of thousands of people and with the health system having collapsed it is inevitable that epidemics will break out in the enclave, doctors and aid workers who spoke to Reuters said.

“The perfect storm of epidemics has begun. Now the question is ‘how bad is it going to get,'” Unicef ​​spokesman James Elder said in an interview on Tuesday.

From November 29 to December 10 the number of diarrhea cases among children under 5 increased by 66%, at 59,895, and for the rest of the population by 55%, according to data from the World Health Organization. The UN agency pointed out that these numbers do not reflect reality as every system and service in Gaza has collapsed due to the war.

The head of the pediatric department at Nasser Hospital in Khan Younis, southern Gaza, Ahmed al-Fara told Reuters on Tuesday that his department is full of children suffering from extreme dehydrationwhich in some cases causes kidney failure, while cases of acute diarrhea are four times higher than usual.

Al Farah pointed out that he knows of 15 to 30 hepatitis A cases in Khan Younis in the past two weeks: “The incubation period of the virus is three weeks to a month, so after a month there will be an explosion in the number of hepatitis A cases.”

Hundreds of thousands of people in Gaza have been forced from their homes and are living in makeshift camps – abandoned buildings, schools, tents. Many others sleep in the open, with limited access to toilets or water to wash, aid workers report.

At the same time, 21 of Gaza’s 36 hospitals are out of orderwhile 11 are partially operational and four minimally operational, based on WHO data dated December 10.

Marie-Or Perot, Médecins Sans Frontières (MSF) operations coordinator in Gaza, said the NGO left a health center in Khan Younis ten days ago because Israel had called for the area to be evacuated. In this center doctors were dealing with cases of respiratory diseases, diarrhea and skin diseases.

According to Perot, two things are inevitable: “The first is that an epidemic like dysentery will spread in Gaza if we continue with this number of cases, and the other certainty is that neither the Ministry of Health nor humanitarian organizations will be able to support the response to these outbreaks.”

“The practice of medicine is under attack”

Researchers at the London School of Hygiene and Tropical Medicine warned in a report on November 6 that the war’s indirect effects will worsen over time.

They pointed out that two months after the start of the war there is expected to be an increase in infant malnutrition rates. “With time, the chances of introducing pathogens that cause epidemics increase. Risk factors: overcrowding and deficiency (in drinking water and sanitation)’.

Aid workers say experts in London predicted exactly what is happening now. Three experts commented that diseases such as dysentery and diarrhea may eventually kill as many children as Israeli bombing.

The UN’s Palestine Refugee Agency (UNRWA) announced that two months of fierce fighting combined with “a very harsh siege” have forced 1.3 million of Gaza’s 2.3 million residents to seek refuge in its facilities.

“Many of the shelters are filled with people seeking safety, four or five times their capacity,” said Juliet Touma, UNRWA’s director of communications. “Most shelters do not have toilets, showers or clean water.”

Since the start of the war, 135 service members have been killed and 70% of its personnel have fled their homes. These are two of the reasons why UNRWA operates nine of its 28 clinics, Touma explained.

Since the beginning of the war, at least 364 attacks against health infrastructure have been recorded in Gaza, according to the UN special rapporteur on the Right to Health Tlaleng Mofokeng. “The practice of medicine is under attack,” she said in a report dated December 7.

More than 300 members and doctors of Gaza’s health ministry have been killed, the ministry said yesterday, Wednesday.

Acute malnutrition

Gaza’s Ministry of Health announced yesterday that its stocks of childhood vaccines have run out. During last night strong winds and heavy rains hit Rafa where a makeshift camp for displaced people has been created, causing it to flood and people being forced to spend the night in the water.

The UN is monitoring the impact of 14 diseases that can develop into epidemics and is most concerned about outbreaks of dysentery, diarrhea and respiratory diseases.

Dr. Paul Spiegel, director of the Center for Humanitarian Health at the John Hopkins Bloomberg School of Public Health in Cairo, who is working on the UN response, pointed out that a diarrheal epidemic could break out even tomorrow if many more trucks are not allowed into Gaza. and clean water.

He noted that the UN plans to start recording levels of acute malnutrition among children in Gaza soon by starting to measure their upper arm diameter, known as the MUAC test.

“When there is acute malnutrition (…) people die from it, but they are also much more vulnerable to other diseases,” he stressed.

The UN World Food Program (WFP) announced on Monday that 83% of Palestinians displaced in southern Gaza do not consume adequate amounts of food.

Unfit for consumption

To prevent outbreaks, aid workers stress that hospitals and health centers must be able to provide care for large numbers of people affected by disease. At the same time, drinking water and water used for washing should meet minimum humanitarian standards, while greater quantities of food and medicine should enter Gaza.

Doctors at the Abu Yousef al-Nazar hospital in Rafah told Reuters on Tuesday that it is overflowing with people needing care for infections and communicable diseases because of the squalid conditions in the overcrowded shelters.

“There will be an outbreak of every kind of infectious disease in Rafah,” commented Dr. Jamal al-Hams.

Al Farah pointed out that continued hostilities make it difficult for families to get their sick children to the hospital in time to receive care, which will not be adequate anyway due to a lack of medicine.

“Children are drinking water that is not suitable for drinking,” he underlined. “There are no fruits, vegetables, so the children are deficient in vitamins in addition to anemia from malnutrition.”

No clean water to make baby milk, babies are also hungry. Even the most well-off Gazans, who work for international organizations or journalistic groups, say that their children are now sick and they do not have enough food or water.