By Gaya Gupta, Hiba Yazbek and Ameera Harouda

JERUSALEM – Infectious diseases are ravaging the population of the Gaza Strip, health officials and aid organizations said Monday (11), citing cold, wet weather; overcrowding in shelters; scarce food; dirty water; and little medicine.

Adding to the crisis in the enclave after more than two months of war, those who become ill have extremely limited treatment options, as hospitals have been overwhelmed with patients injured in airstrikes.

“We are all sick,” said Samah al-Farra, a 46-year-old mother of 10 struggling to care for her family in a camp housing displaced Palestinians in Rafah, in southern Gaza. “All of my kids have a high fever and a stomach virus.”

While the collapse of Gaza’s health system has made it challenging to track exact numbers, the World Health Organization has reported at least 369,000 cases of infectious diseases since the war began, using data collected from the Gaza Health Ministry and UNRWA, the UN agency that cares for Palestinians — a staggering increase from before the war.

And even the WHO’s extraordinarily high number fails to capture the scale of the crisis: Shannon Barkley, the health systems team lead at the World Health Organization’s offices in Gaza and the West Bank, said it does not include cases in northern Gaza, where the war has destroyed many buildings and what remains of the health system is overwhelmed.

The most common diseases raging through Gaza are respiratory infections, Barkley said, including colds and pneumonia. Even normally mild illnesses can pose grave risks to Palestinians, especially children, older adults and the immunocompromised, given the dire living conditions, she said.

Al-Farra, speaking by phone, said her family had been sleeping on the ground since they fled Khan Younis, a city just to the north of Rafah, a week ago. For the last three days, al-Farra said, she and her children have had high fevers and suffered from persistent diarrhoea and vomiting.

Like many others in the battered enclave, al-Farra said that she and her family had been drinking the same foul-smelling water that they used to wash themselves.

“When I wash my hands, I feel like they get dirtier, not cleaner,” she said.

Her youngest child, 6-year-old Hala, spent the majority of the last three days sleeping and was too weak to ask for food after weeks of going hungry, al-Farra said. “She used to beg for more food, but now she can’t even keep anything down,” she said. Her 9-year-old son, Mohammad, has been having seizures, likely from his fever, she added.

The Israeli military announced on Monday that it was opening a second security checkpoint at the Kerem Shalom Crossing — on the border between Israel, Gaza and Egypt — to screen humanitarian aid arriving via Egypt, a move meant to allow more food, water, medical supplies and shelter equipment into Gaza. Aid organizations have said that the rate of aid coming into Gaza since the collapse of a temporary cease-fire earlier a week and a half ago has been far from enough.

Hospitals that are still considered to be functioning are focused on providing critical care for patients with trauma injuries from airstrikes, according to Marie-Aure Perreaut Revial, an emergency coordinator at Doctors Without Borders, who was speaking from Al-Aqsa Hospital in central Gaza. But many of those patients receive postoperative care in unsanitary conditions, resulting in severe infections, she said.

And the primary health care system in central Gaza has completely collapsed, she said, leaving those in need of basic medical care without treatment.

“There’s a very big focus on the wounded and the injured patients, but it’s the entirety of the health care system that is just being brought to the ground,” she said.

One Gaza resident, Ameera Malkash, 40, said that when she first took her pale and jaundiced son, Suliman, to a hospital in Khan Younis last month, it was overrun with casualties from airstrikes that day. They were not able to see a doctor.

They tried again the next day, she said by phone, and the doctor told them it was hepatitis A — a liver infection caused by a highly contagious virus that spreads easily through contaminated water. Suliman was supposed to quarantine, but there were no rooms left in the hospital, Malkash said, so they had little choice but to go back to a shelter crammed with thousands of other people.

Last week, the Palestinian Authority’s health minister, Mai Alkaila, said about 1,000 cases of hepatitis A had been recorded in the Gaza Strip. The Palestinian Authority’s health ministry is based in the West Bank and operates separately from the health ministry in Gaza.

Dr. Marwan al-Hamase, the director of Abu Yousef al-Najjar Hospital in Rafah, said on Sunday that his small facility was accommodating hundreds of displaced people and that they were sleeping on floors where wounded people were also being treated. Those floors have not been cleaned in weeks, he said, because “we are unable to find cleaning products.”

Malnutrition has become “beyond control,” and anaemia and dehydration cases among children have nearly tripled, al-Hamase said.

Milena Murr, a spokesperson for the relief agency Mercy Corps, said that when her colleagues in Gaza fled their homes two months ago, they did not prepare for weather that has turned cold and rainy. Many did not bring blankets, jackets or warm clothes.

Displaced people taking refuge in U.N.-run shelters have been sharing bathrooms without running water. And fecal matter accumulating on the streets can contribute to the spread of disease and further contaminate water sources, Barkley, of the WHO, said.

Firas al-Darby, 17, who is at a U.N. school-turned-shelter in the south, said that he’d had a fungal infection all over his body for weeks. “Bacteria, filth, disease and epidemics are all over the school,” he said.

Hala al-Farra also had a skin rash, her mother said, as well as lice. Al-Farra added that she was considering cutting off Hala’s hair because she could not afford shampoo.

“I have no idea how I will help my kids,” al-Farra said. “I’m now going around knocking on people’s homes and begging for clean water.”

-New York Times