Gaza Is Cleaning Up Its Piles of Garbage From the War, Including Human Waste

A new Unicef cash-assistance program is helping Gazans remove piles of garbage accrued during the war, including human feces. The goal is to stop the spread of infectious diseases in the enclave as millions of civilians are forced into flimsy shelters or to live in the streets.

By Dawn Clancy via PassBlue

Bombs, bullets and the suffocating weight of bodies trapped under slabs of fallen concrete where houses once stood are just a few reasons the death toll in Gaza is still soaring. But recently, contaminated water paired with an overwhelmed sanitation system are helping to spread infectious diseases that could kill more Palestinians in the strip.

To improve the situation, Unicef has launched a specific cash-for-work program in southern Gaza, where approximately 100 volunteers, from Al-Quds University in Rafah city, will get paid 40 Israeli shekels, the currency of Gaza, or the equivalent of $10 to $12 a day, to collect and contain solid waste, including human excrement.

As a Norwegian Refugee Council (NRC) staff member, who asked not to be identified, said of conditions there: “The first thing that comes to mind is shit. Literally and metaphorically. Then, of course, words like disgusting, appalling, unlivable and inhuman can also describe the smell and the conditions. When you approach a collective site, the smell can hit you from 30 meters away. It burns your nose and makes you tear up.”

The Unicef program, launched on Jan. 11, is slated to last three months. Workers will be paid through a monitored electronic payment system used by the World Health Organization (WHO) every 10 days, or roughly three times a month. The $2 million project is funded by the Australian committee for Unicef for humanitarian assistance in West Bank and Gaza.

Jonathan Crickx, Unicef’s chief of communications in Palestine, said the plan was an offshoot of the agency’s humanitarian cash-assistance program, where families are given money to buy food, water and hygiene products in crises.

The waste cash-for-work program works off the same principle, Crickx said, but instead of civilians being given money to buy essential goods, “it is cash to help improve the situation,” he noted, adding that the program’s main focus is “indeed human waste.” PassBlue interviewed Crickx from his office in Jerusalem. The Gaza workers are provided with the protective equipment they need to do the job safely.

“We are seeing the number of respiratory infections, chronic diarrhea, all cases of waterborne diseases increasing,” he said. “And one of the reasons for that is the fact that you don’t have any form of sewage system,” or any solid waste collection.

PassBlue was unable to interview people working in the program in southern Gaza because of Internet disruptions linked to Israel’s siege.

“Since schools are being used as collective sites for internally displaced people, the septic tanks reach capacity very quickly and need regular emptying, which is not possible under current conditions,” said Shaina Low, the communication adviser for the NRC in Palestine, an international nongovernmental organization, in an email to PassBlue. “As a result, sewage water is overflowing and running between tents.”

“The network in Rafah was designed to cover the needs of approximately 200,000-300,000 people. There are currently more than one million people there, which pushes the system to its limits,” Low, also based in Jerusalem, added. “Garbage disposal has also become a huge issue. Garbage is everywhere, and the whole area has basically turned into one large garbage dump.”

According to Low, under normal circumstances, once garbage is collected it is brought to Gaza’s Middle Area, also known as Deir al-Balah, where it is buried and decomposes without contaminating the ground or the aquifer. But now the needs are so great that the garbage is being tossed wherever there is empty land. “There is also a problem with medical waste,” she added, “which should be treated before dumping.”

In a CNN interview, Catherine Russell, the head of Unicef, who visited Khan Younis in November, said of the “bleak landscape” there, “I saw piles and piles of garbage in the street.” On Palestinian children killed in the conflict then, she said, “As adults we have to do everything we can to protect [children] in places where they should be safe, like schools and hospitals, but also more generally, to take every step humanly possible to make sure that, you know, 4,700 children, whatever the number is now” — and need to be protected. (She also said she would revisit the area in a “couple of weeks,” but Unicef now says she needs to follow up on medical care related to a car accident she was in during her trip to the Mideast at the time.)

In an email to PassBlue, Tarik Jasarevick, a spokesperson for the World Health Organization (WHO), said that since mid-October 2023, over 200,000 upper-respiratory infections have been tracked from temporary shelters in Gaza, and over 150,000 cases of diarrhea have been reported. That number includes 84,000 cases among children under age five.

“The number of diarrhea cases among children under five years of age recorded during the last three months of 2023 are 26 times higher than reports from the same period in 2022,” Jasarevick said.

Other reports of increasing diseases include chickenpox, jaundice, scabies, lice, impetigo and hepatitis.

“Cases of #HepatitisA, an inflammation of the liver, have been confirmed in #Gaza,” wrote Tedros Adhanom Ghebreyesus, the director-general of the WHO, on X on Jan. 18.

“The inhumane living conditions — barely any clean water, clean toilets and possibility to keep the surroundings clean — will enable hepatitis A to spread further and highlight how explosively dangerous the environment is for the spread of disease. We continue to call for unimpeded and safe access of medical aid and for health to be protected.” He added, “CeasefireNOW.”

Gaza’s sanitation emergency stems primarily from the mass evacuation of nearly two million Gazans, or internally displaced people (IDPs), fleeing relentless Israeli bombardment in the northern and central parts of the enclave to tighter spaces in the south, including Khan Younis and Rafah, two cities where the sanitation systems, if not destroyed by the bombing, are overwhelmed by demand.

“In some camps or in some shelters, you have one toilet for between 500 to 700 people, Crickx said. “And then, basically, since the end of December, it started raining a lot, but you don’t have any kind of drainage system. You don’t have any kind of sewage system. So that you have the streets which are simply flooded, covered in mud, covered in waste, any kind of waste, including human waste.”

Some IDPs have resorted to defecating in the open.

According to the UN Relief and Works agency (Unrwa), since Oct. 7 — when Hamas’s attacks killed some 1,200 people, mostly Israelis, while around 136 others were taken hostage — 1.7 million Palestinians are sheltering in Unrwa facilities in Gaza.

Gaza’s health ministry estimates that approximately 25,000 Palestinians have been killed in the war between Israel and Hamas so far. Before the current Israel-Hamas war, Gaza’s total population was 2.3 million.

Chiara Saccardi, the Mideast regional director for Action Against Hunger, a global humanitarian group, told PassBlue that “the biggest priority and worry” for her team of 18 currently working in Rafah is the sewage that’s flooding the streets, which is further complicated by a limited amount of fuel. The fuel, Saccardi said, “isn’t being distributed to the needed areas,” making it difficult for the water and sanitation systems that haven’t been physically damaged to operate fully. (Saccardi is based in Madrid.)

“Our colleagues are telling us that [Palestinians] are sheltering in places that get filled with this polluted sewage water and that to get from place to place, they have to walk through it,” Saccardi said. “It really is a grim picture.” Repairing equipment, as the fighting rages in Gaza, is not possible.

“The problem is that the list of items that can be imported [to Gaza] or that can come through [aid] convoys are very much limited . . . in terms of construction materials, equipment, machinery and so on, which is now even stricter than it was before seventh of October,” Saccardi said. “It’s really difficult to operate or to even think to be able to do some small repairs or to intervene because everything is lacking.”

Stéphane Dujarric, the UN spokesperson, said on Jan. 19, that “limited amounts of fuel have entered the Gaza Strip from Rafah. However, since these are insufficient, hospitals, water facilities and other critical facilities are still only operating at limited capacity.”

Omar Hamarsheh, a professor of molecular biology at Al-Quds University, in Jerusalem, said in an interview with PassBlue: “This situation [in Gaza], created by war, makes the spread of infectious diseases very high.”

“Then you have people living not at home but in schools and camps, and they don’t have access to bathrooms and can’t take showers, making personal hygiene an issue too, making it possible for people to contract diseases,” Hamarsheh said.

“The health system in Gaza is very fragile,” he added. “So when you do become ill or suffer from certain diseases and don’t have access to care, it makes it worse. My concern is that the situation in Gaza is becoming a bubble for epidemics.”

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