Since Israel tightened its closure of the Gaza Strip in 2007, severely restricting the import of fuel and construction materials, repairing and maintaining the waste management facilities to meet the needs of the people of the Gaza Strip has become near impossible.Sanitation conditions are rapidly deteriorating and, if the problem is not rapidly addressed, this could have a major impact on the health of the people of the Gaza Strip.

Salam Mohammed Abu Ghararah is a 46-year-old former construction worker who lives with his wife and seven children in the Bedouin village in Beit Lahia, in the north of the Gaza Strip.

A stone’s throw away from the border with Israel, the area surrounding the village is dotted with numerous large pools of sewage waste.

The smell is pungent, attacking the senses, and, in the summer heat, the air is thickened by the stench. Salam lives a mere 600 metres from one of the pools of sewage.

“I want to sell my house and move. My wife, too, has had enough. Before the closure, I worked in construction, commuting every day to Israel. I was physically fit. Now, living by the sewage has given me breathing difficulties. I can’t do anything without losing my breath. At night, I can barely sleep because I cough so much. I can no longer live a normal life.”

On 7 March 2007, Salam and his family suffered a great tragedy, when a pool of sewage on top of a nearby hill overflowed.

The ensuing flood, referred to by those living in the village as a ‘tsunami’, caused widespread destruction in the village and resulted in the deaths of five people. Salam’s 12-year-old daughter was drowned in the flood.

“I was at work,” says Salam. “I did not know it, but my daughter had decided not to go to school that day. It was early in the morning, and many people were still in bed. I came home as soon as I heard what had happened and found that my daughter had been carried down the street by the flood. She had drowned. Another of my daughters had only saved herself by hanging onto the branch of a tree. My house was completely destroyed along with everything inside. Imagine coming home and finding your daughter has died and there is nothing left in your home.”

It is difficult for Salam, knowing that his children’s health is suffering because they live so near the pools of sewage.

“We educate our children. We send them to summer camps about having good hygiene, but they live next to this sewage so there is only so much we can do. If only you could smell it on a bad day. Even the people who live here, and are used to it, suffer headaches. Mosquitoes gather around the pools and spread diseases. I am trying to sell my house, but who would want to live in a place like this?”

Dr Mohammed Yaghi, a doctor for the Palestinian Medical Relief Society, outlined some of the medical concerns that he and other doctors share about the effects of living so close to open sewage.

“There are many concerns. Both short- and long-term effects must be taken into consideration. For a start, humidity from the pools of sewage causes air pollution. It also creates a perfect environment for insects which, in turn, carry diseases and spread them among people living in the area. Waste from people, factories, and hospitals is stored altogether in the pools. In the hot sun, it releases poisonous gases which cause skin diseases and asthma. Children are especially susceptible to these effects.”

The long-term effects are equally worrying, as Dr Yaghi explains:

“There are many side effects that could be carcinogenic if there is daily exposure. Aside from the poisonous gases and the insects, the sewage seeps into the ground and contaminates the natural underground water supply. Because there is human waste in these pools, nitrogen from human excrement contaminates the water supply. When ingested, this has serious consequences for a person’s health. It may also affect the new generation, as pregnant mothers may give birth to children with brain defects. We have also seen a rise in infertility, both in those who have come of age since the beginning of the sewage crisis, and those who were already adults. The contaminated water affects men and women of all ages.”

Medical facilities in the Gaza Strip can cope with the short-term needs brought about by the waste management crisis. However, the medical services cannot address the root of the problem, the presence of open sewage and the contamination of the water supply.

The water table in the Gaza Strip is further contaminated due to the pumping of 90,000 cubic metres of sewage into the sea every day.[i] In an effort to address the issue, the Palestinian Authority set up a new central committee for sewage treatment based east of Jabalia. An EU-funded water treatment project, to be built in the northern area near the ‘buffer zone’, was scheduled to begin in 2008.

However, construction has been delayed due to frequent incursions in the area by Israeli forces. Construction workers have been prevented from accessing the area, despite an agreement between the EU and Israel which guaranteed access.

The implementing partner responsible for the project is aiming to recommence construction in six months’ time, but this will depend on the actions of the Israeli forces.

Israel, as the occupying power of the Gaza Strip, is obliged under international humanitarian law to ensure and maintain public health and hygiene, with the cooperation of national and local authorities (Article 56 of the 1949 Geneva Convention (IV) Relative to the Protection of Civilian Persons in Time of War). Also, the Committee on Economic, Social and Cultural Rights (CESCR) has affirmed that Israel has the duty to fulfil its obligations under international human rights in the Gaza Strip.

In this context, Israel has the duty, under Article 12 of the 1966 International Covenant on Economic, Social and Cultural Rights, to recognise the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, and is obliged to respect and protect this right by improving all aspects of environmental and industrial hygiene, and by preventing, treating and controlling epidemic, endemic, occupational, and other diseases.

According to the CESCR, “environmental hygiene, as an aspect of the right to health […] encompasses taking steps on a non-discriminatory basis to prevent threats to health from unsafe and toxic water conditions” (CESCR, General Comment no. 15, 2002).

In order to comply with this requirement, Israel should ensure that natural water resources are protected from contamination by harmful substances and pathogenic microbes. Likewise, Israel should monitor and combat situations where aquatic Eco-systems serve as a habitat for vectors of diseases wherever they pose a risk to human living environments.

Also, Israel must “ensure an adequate supply of safe and potable water and basic sanitation; [and] the prevention and reduction of the population’s exposure to harmful substances such as radiation and harmful chemicals or other detrimental environmental conditions that directly or indirectly impact upon human health” (CESCR, General Comment No. 14, 2000).

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