The sewage crisis: A silent epidemic among Gaza’s children

Sila Hamdan amidst the rumble in the Shams displacement camp, built around the al-Shati refugee camp in North Gaza

Sila Hamdan, 5, awakes every morning in a tent constructed between crumbling concrete and sewage pools in the Shams displacement camp, built around the al-Shati refugee camp in North Gaza.

Sila scratches at a recurring rash that has spread across her arms and legs. Her tiny hands, once used to playing in parks, are now dusty and sore from constant itching.

With tears in her eyes, her mother Amina Hamdan said Sila's illness began in April 2025, shortly after sewage began to flow into the open areas surrounding their tent. After being uprooted by air strikes, they found refuge in the Shams camp. Amina explained to me her child never had skin problems, but now she wakes up most nights crying from itching. "She's not the same child anymore," her mother told me. "She refuses to leave the tent for fear of the filth outside. She doesn't laugh. "She doesn't play."

A pool of sewage water near the displacement camp where the Hamdan family is staying near the al-Shati Refugee Camp Photo Credit: Maher Daher, May 13, 2025

Sila is one of hundreds of thousands of children whose minds and bodies are bearing the brunt of Israel’s genocidal onslaught. Over the past nineteenth months, hundreds of thousands have contracted skin diseases like scabies, chicken pox, lice, impetigo and other debilitating rashes (1, 2, 3). Many more hundreds of thousands if not millions have experienced acute diarrhea or jaundice. Israel is waging a kind of biological warfare.

Further, Israel’s expulsion orders in recent weeks have forced Palestinians to evacuate from 60-80% of water and sanitation sites, including desalination plants, water reservoirs, water wells and wastewater pumping stations. 

Meanwhile, Israeli airstrikes have destroyed Gaza’s sewage infrastructure and replaced street blocks with streams of raw sewage. Pumping stations have collapsed, and fuel shortages make it difficult to operate the remaining equipment. 

The result is that Palestinians in Gaza do not have access to enough water, let alone clean water.

Sila's mother tried to find help. A volunteer doctor, Dr. Khaled Ahmed, examined Sila and determined that rashes were caused by highly polluted water and poor hygiene. "We have no clean water to bathe her with, only the polluted trickle that leaks into our buckets," she said.

Sila’s mother told me the family must travel a long distance twice a day to access water, often waiting for hours in line. On average, they collect 40 liters of polluted water per day. 

Hygiene products such as soap and disinfectants are extremely scarce—often unavailable or prohibitively expensive.

Dr. Mohammed Ashraf, a physician working at a makeshift clinic close to the Shams Camp where Sila's family resides, stated Sila's case is not unique. "We are seeing mostly dermatological illnesses," he said, including "dozens of children every week with similar or worse infections—bacterial, fungal, and even parasitic."

He went on to say that some children get secondary infections from scratching that go untreated because there aren't enough antibiotics and wound care supplies available. "The collapse of the infrastructure is no accident," he said. "This is systematic. The destruction of public health services is intended to undermine our ability to survive.”

Dr. Mohammed described a recent case involving a two-year-old boy who developed open sores that became infested with flies. The family did not have any antiseptics. "We used saltwater to clean his wounds. "That was all we had."

The stink lingers in the small spaces between tents. Flies swarm, and children walk barefoot through filthy puddles. There is no running water, no sanitation, and no sense of safety.

 Sila's mother made a final plea: "My daughter is only five. She should be painting, fantasizing, and learning to write her name rather than suffering like this. The entire world must witness what is happening. "The world must act."

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