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The dermatology office at Nasser Hospital in central Gaza was thronged with distressed children and worried parents.
A little girl with blue hair cried as her mother showed how the red and white rash on her face had spread to her neck and chest. Another woman lifted her little boy’s clothes and showed the rash on his back, buttocks, thighs and stomach. There were open sores on his wrists from scratching. A father stood his daughter up on a desk so the doctor could examine the sores on her calves.
Causes of skin diseases in Gaza’s tent camps
Health officials say skin diseases are spreading rapidly in Gaza, due, they say, to dire conditions in overcrowded tent camps where hundreds of thousands of Palestinians have been driven from their homes, as well as deteriorating heating and sanitation systems that have left open sewage pools left by 10 months of Israeli bombardment and attacks on the territory.
According to the World Health Organization, doctors are battling more than 103,000 cases of lice and scabies and 65,000 cases of skin rashes. Among Gaza’s population of about 2.3 million, more than 1 million cases of acute respiratory infections have been recorded since the war began, as well as more than half a million cases of acute diarrhea and more than 100,000 cases of jaundice, according to the United Nations Development Program.
Palestinians say it is impossible to clean the ramshackle tents, which are made of wood and covered with blankets or plastic sheets and are crammed next to each other in long walkways.
“There is no shampoo, no soap,” said Munira al-Nahal, who lives in a tent in the dunes outside the southern town of Khan Younis. “The water is dirty. There is sand, bugs and rubbish everywhere.”
Her family’s tent was filled with her grandchildren, many of whom had rashes. A little boy stood scratching the red spots on his stomach. “One child gets it, and it spreads to all of them,” al-Nahhal said.
Palestinians in the camp report that clean water is nearly impossible to find. Some bathe their children in salt water from the nearby Mediterranean Sea. People have to wear the same clothes day after day until they are able to wash them, then they immediately wear them again. Flies are everywhere. Children play in sand filled with trash.
“First she had spots on her face. Then it spread to her stomach and her arms, to her forehead. And it hurts. It itches. And there’s no treatment. Or if there is, we can’t afford it,” said Shaima Marshoud, sitting with her young daughter in a cinder block structure they built among the tents.
More than 1.8 million of Gaza’s 2.3 million people have been driven from their homes, many fleeing Israeli ground attacks or bombing several times over the past few months. Most are now confined to 50 square kilometers (20 square miles) of dunes and fields on the coast, with almost no sewage system and little running water.
UN officials say the distribution of humanitarian supplies, including soap, shampoo and medicine, has slowed as Israeli military operations and general chaos in Gaza make it too dangerous for relief trucks to move.
Israel launched its campaign vowing to destroy Hamas after its October 7 attack on southern Israel killed about 1,200 people and kidnapped 250. Israel’s offensive has killed more than 39,000 people, according to Gaza health officials.
“The solid waste management system has collapsed,” said Chitose Noguchi, the United Nations Development Programme’s deputy special representative for assistance to the Palestinian people.
Also read: Children are suffering from skin diseases due to war in Gaza
The UNDP said in a report released Tuesday that Gaza’s two pre-war landfills were inaccessible during the fighting and that it has set up 10 temporary sites. But Noguchi said more than 140 informal dumping sites have emerged. Some of them vast ponds of human waste and garbage.
“People are living in tents near dumping sites, which is a really serious situation in terms of the health crisis,” Noguchi said.
Nasser Hospital dermatologist Nassim Basala said he receives 300 to 500 visits a day with skin diseases. Since Israel recently ordered the evacuation of the city, more people have gathered in the fields outside Khan Younis, where insects are plentiful in the summer.
Scabies and lice are at epidemic levels, but other fungal, bacterial and viral infections and parasites are also running rampant, he said.
Even simple cases can become dangerous due to the flood of patients.
For example, Basala said, impetigo is a simple bacterial infection that can be treated with creams. But sometimes by the time a patient gets to a doctor, “the bacteria has spread and affected the kidneys,” he said. “We have even had cases of kidney failure.” The rash caused by scratching and getting into the dirt becomes infected.
He said creams and ointments were in short supply at the hospital.
Children are most affected. But adults suffer, too. In the hospital’s dermatology office, a man opened his dusty shoes and showed painful lesions on the tops of his feet and ankles, where his rash had broken out. A woman showed her hands, which were cracked and red.
Mohammed al-Rayan, whose several children living in a tent outside Khan Younis have developed rashes or spots, said he has taken them to doctors.
“They give us creams, but it’s of no use when you have nothing to wash it with. You put the cream on and it gets better, but the next day it’s the same again,” he said.
Parents struggle to console their children, as their painful situation shows no sign of ending.
Manar al-Hessi’s baby cried as she applied cream to his forehead and chest, which were covered in scabs, sores and blemishes.
“It’s horrible,” said al-Hessi. “She always has flies on her face. She goes to the toilet or the trash and the flies get on her hands. The filth is too much.”
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