Displaced Gazans Trapped Between Sewage, Disease, and Shrinking Space

 الأراضي المقدسة الخضراء / GHLands

In a tent erected near a sewage treatment facility in Gaza City's Sheikh Radwan neighborhood, Ikrami Jumaa says his family is no longer searching for safety as much as they are searching for any place where they can survive.

Jumaa and his family have been displaced approximately six times since the start of the war before eventually settling in an area surrounded by sewage water, foul odors, insects, and rodents. Yet, he says relocating is no longer a realistic option in a territory where the space available to civilians has dramatically shrunk, with most of Gaza’s population now crowded west of what is known as the "Yellow Line"—a narrow strip that has become home to nearly the entire population of the Gaza Strip.

"We could not find anywhere else in Gaza," said Jumaa, a father of six. "We are forced to endure these conditions despite all the suffering. It is not only the insects and reptiles; this environment exposes us to disease. I suffer from heart disease, diabetes, and high blood pressure. I simply cannot bear it, but we have no alternative."

Rising Skin Diseases

Jumaa’s testimony reflects a crisis that extends beyond deteriorating public health to a severe shortage of habitable space where displaced people can distance themselves from pollution and disease.

With thousands of tents crowded into areas west of the Yellow Line, residents find themselves trapped between destroyed, inaccessible, or unsafe zones on one side and overcrowded camps lacking adequate water, sanitation, and hygiene services on the other.

According to the United Nations, most of Gaza’s population remains displaced within increasingly congested areas while basic services are struggling to cope with overwhelming demand. The UN Office for the Coordination of Humanitarian Affairs (OCHA) reports that more than 70 percent of residents rely on water delivered by tanker trucks and warns that funding shortages threaten the continuity of these supplies as summer temperatures continue to rise.

At the Palestine Red Crescent Society's field hospital in central Gaza City, dozens of patients wait outside the dermatology clinic. Many are children suffering from rashes, skin irritation, and infections—visible signs of diseases associated with overcrowding, extreme heat, limited access to clean water, and shortages of hygiene supplies.

The mother of Maher Khalifa, a young patient receiving treatment, says life in displacement camps has worsened her son's condition.

"We are living in tents now, and my child cannot tolerate the heat or prolonged exposure to the sun," she said. "As a result, the skin eruptions on his body have become more severe. The overcrowding in the camps has led to the spread of diseases. There are many different skin conditions and infections affecting children, including my son."

Lack of Alternatives Deepens the Crisis

United Nations data indicate that pest-control campaigns have treated more than 2,000 locations since mid-May. Nevertheless, skin diseases and parasitic infections continue to rise.

UN agencies attribute the worsening situation to limited access to safe water, sanitation facilities, healthcare services, and restrictions on access to landfill sites, which have resulted in growing accumulations of waste within populated areas.

These conditions further compound the suffering of displaced families confined to increasingly limited spaces. With few or no alternative locations available, many families are forced to remain near temporary garbage dumps, sewage ponds, or densely packed tent settlements.

Abu Mohammad Habib, carrying his child who suffers from skin irritation, described the difficulties he faces while waiting outside a dermatology clinic.

"We woke up this morning and found our child's body covered with redness caused by an allergic reaction," he said. "We first went to primary healthcare services, where we were told to see a dermatologist. We have spent three hours here already—an hour and a half waiting for a registration ticket and another hour and a half waiting to see the doctor."

The United Nations warns that communicable diseases continue to place enormous pressure on Gaza's already strained healthcare system. Reported illnesses include acute respiratory infections, acute watery diarrhea, skin diseases, and infections linked to external parasites.

Overcrowded tent environments significantly increase the risk of disease transmission, particularly among children, the elderly, and people with chronic health conditions.

Familiar Diseases, Growing Severity

Dr. Raed Abu Sariya, a consultant dermatologist, says the conditions affecting patients are not necessarily new diseases but have become more severe and are increasingly accompanied by complications.

"I have worked as a dermatology consultant for nearly twenty years and have not encountered new diseases," he explained. "The illnesses are familiar, but I have observed a significant increase in their severity and in complications that we rarely saw before. This is likely linked to weakened immunity and poor nutrition resulting from prolonged food insecurity and hunger."

These health complications cannot be separated from the reality of repeated displacement. Families that have lost their homes or are unable to return to areas east of the Yellow Line are concentrated in overcrowded western zones, where tents stand only a few meters apart, making effective isolation measures nearly impossible and complicating waste and sewage management.

Ongoing Efforts to Remove Waste

In Gaza City, machinery operated by the United Nations Development Programme (UNDP) and local partners continues to transport waste from the Firas Market area—one of the city's largest waste accumulation sites—to locations farther away from residential areas.

According to the United Nations, partners in the Water, Sanitation, and Hygiene (WASH) sector have removed approximately 100,000 cubic meters of waste from the Firas Market area since early March and transferred it to the Abu Jarad disposal site.

However, waste management remains one of Gaza's most pressing challenges. The territory continues to rely on temporary dumpsites located near displacement camps due to difficulties accessing major landfills and shortages of equipment and materials needed for debris and waste removal.

Humanitarian organizations warn that accumulating garbage near living areas attracts rodents and insects and increases the risk of food, water, and sleeping-area contamination.

The United Nations reports that WASH partners have distributed more than 11,500 hygiene kits, 273,000 bars of soap, 1,500 gallons of water, and other essential supplies to tens of thousands of residents. Yet aid efforts continue to fall short of the rapidly growing needs within overcrowded camps and do little to address the broader problem: the confinement of large numbers of people within an increasingly limited area that no longer allows for further displacement or decongestion.

As temperatures continue to rise, humanitarian workers warn that the lack of alternative shelter options will force more families to remain in polluted environments, even as the tents themselves become breeding grounds for disease.

They caution that the combination of overcrowding, water shortages, waste accumulation, and the proliferation of insects and rodents could transform skin diseases, diarrheal illnesses, and respiratory infections into a broader public health emergency.

For Ikrami Jumaa, the tent pitched beside a sewage facility encapsulates Gaza’s current reality: illnesses visible on children's bodies, waste with nowhere to go, and families with nowhere else to turn.

His family remains there not because they can endure the conditions, but because they have no other choice. In Gaza today, the distance between danger and survival is no longer measured solely by bombardment or front lines, but by the few meters of space available between one tent and the next.