On Nov. 14, 2023, Palestinian journalist Bisan Owda declared the start of winter in Gaza as sheets of rain flooded the streets. A month later, Owda told her followers that “we’re drowning” in an Instagram reel that showed displaced civilians bailing out an inundated tent. In January, she turned the camera on her own tent, describing how the rain seeped through the plastic sheeting as she slept.
The conditions that Owda depicted will be far worse when Gaza’s winter rains return this year, after 14 months of unprecedented destruction that has left 90 percent of Gaza’s 2.1 million people displaced. Approximately 86 percent of Gaza’s landmass is under permanent evacuation order. A Sept. 29 United Nations satellite analysis showed that Israeli military operations had damaged or destroyed 66 percent of all structures in the territory, including 227,591 housing units. By June, 67 percent of Gaza’s water and sanitation infrastructure was out of commission.
Each year, from December to February, some parts of Gaza receive one-third of their annual rainfall, and large swaths of the territory flood. A 2020 review in the Journal of Environmental Health Science and Engineering identified 34 factors that increase people’s risk of death in floods, such as cold temperatures and poor quality housing; Gaza currently qualifies for 33 of them.
In addition to casualties in Gaza caused directly by Israeli military action, tens of thousands of people have likely died from indirect causes due to Israel’s blockade of the territory and widespread destruction of infrastructure. Winter floods will exacerbate these issues, leaving the population more vulnerable to life-threatening health and environmental hazards. Without immediate, large-scale humanitarian intervention backed by the United States, Gaza’s water and sanitation crisis could cascade into an unprecedented catastrophe.
Al-Mawasi is a sandy, 9-mile-long strip of seaside land in southwestern Gaza that Israel has designated as the only “humanitarian safe zone” in the territory. Currently, 1.8 million people are thought to be living in al-Mawasi, almost all in makeshift tents. The Norwegian Refugee Council estimated in September that the area had a population density of some 78,000 people per square mile, approximately twice that of Cairo.
The coming winter rains will transform al-Mawasi and the rest of Gaza into a death trap. The combination of poor shelter, lack of drinking water, and abysmal sanitation will cause unknown numbers of preventable deaths. Waterborne diseases, acute diarrhea, and infection often arise in such conditions. Floodwaters are a transmission vector for bacteria such as cholera-causing Vibrio cholerae, viruses such as Hepatitis A, parasites, and fungal infections. The inability to keep dry will also leave Palestinians in Gaza vulnerable to hypothermia and pneumonia.
Israel’s assaults on Gaza have destroyed every sewage processing plant and 70 percent of sewage pumps in the territory. In June, Oxfam reported that al-Mawasi contained only 121 latrines, then serving half a million people; on Nov. 16, Al Jazeera reported that Khan Younis had no fuel for sewage pumps, wells, or water purification.
Infection control and hygiene have long been severely compromised in Gaza. Before Oct. 7, 2023, waterborne illness was already the top killer of children in Gaza. Oxfam reported in 2017 that “Israel’s illegal blockade of Gaza severely limits, or prevents altogether, the entry of materials that would allow the water and sanitation sector in Gaza to recover from years of conflict and de-development.”
The widespread destruction of housing, sewage, water, and sanitation infrastructure—as well as prolonged malnutrition and repeated displacement—has severely exacerbated this long-standing problem. During the summer dry season, rates of diarrheal disease in Gaza were 25 times higher than prewar levels. People used makeshift latrines and were forced to dump waste wherever they could. The practice further polluted Gaza’s already contaminated shoreline and groundwater supplies.
Furthermore, Israel’s blockade of commercial goods has caused such scarcity that a 2.6-ounce bar of soap costs $10, while shampoo and laundry detergent are unavailable. Israel has blocked organizations such as Doctors Without Borders from importing hygiene kits. U.S. health care workers who volunteered in Gaza recently reported that since October 2023, basic sanitation items have been unavailable even in hospitals.
Hydration is an acute challenge for Palestinians in Gaza, too. Proper rehydration for those suffering from intestinal diseases is impossible. International humanitarian law requires that civilian infrastructure related to water and civilian access to water be protected. However, since October 2023, people in Gaza have had access to only 6 percent of the water they had prior to the war. Israel has cut or undersupplied water lines that run into Gaza. It has also banned fuel from entering the strip, blocked the transfer of bottled water, compromised local desalination capacity, and destroyed water warehouses. That means that 95 percent of people in Gaza currently have no access to clean water.
Oxfam estimated in July that Palestinians in al-Mawasi could access only 2.5 liters of water per person per day when only 1 million people were sheltering there, far below the international standard of 15 liters per person per day in a humanitarian crisis. Repairing water delivery systems is dangerous in Gaza; the Israeli military recently bombed a car carrying Palestinian water engineers attempting to repair infrastructure, killing four people, despite the fact that they had coordinated their movements with Israel.
Malnutrition and starvation weaken a person’s immune system and ability to heal from injuries. They also permanently impair children’s development. Most people who die of starvation succumb to otherwise trivial infections due to weakened immunity. Widespread malnutrition and starvation have left Gaza’s entire population vulnerable to waterborne disease, especially children under 5. Recent reports place 86 percent of Gaza’s population in phases three to five of acute food insecurity, where mortality increases significantly.
Amid flooding, displaced people are also at grave risk for exposure to environmental hazards such as toxic sludge, as rainwater combines with the rubble of bombed-out buildings. Exposure-related hypothermia and pneumonia will become additional problems, particularly for children. Nighttime temperatures of 50 degrees Fahrenheit, which are typical of winters in Gaza, are not harmful to adequately sheltered people—but young, sick, older, and malnourished people whose clothes are continuously wet will slowly die in such conditions.
The Biden administration has recognized that winter rains and flooding portend a humanitarian catastrophe in Gaza—unless Israel significantly eases its stranglehold on the territory. On Oct. 13, U.S. Secretary of State Antony Blinken and Defense Secretary Lloyd Austin sent the Israeli government a letter with clear and specific criteria related to the humanitarian situation in Gaza, to be met within 30 days. “Failure to demonstrate a sustained commitment to implementing and maintaining these measures may have implications for U.S. policy,” they wrote.
The letter listed measures on which Israel was obligated to act to avoid potentially triggering legal provisions that would halt U.S. weapons transfers. Blinken and Austin further specified that proposed legislation in the Knesset, Israel’s parliament, to ban activities by the United Nations Relief and Works Agency for Palestine Refugees (UNRWA) “would devastate the Gaza humanitarian response.”
Those 30 days elapsed on Nov. 12, but Israel has facilitated less than 15 percent of the specified aid delivery goal. Humanitarian aid deliveries are at their lowest levels in 11 months. “Israel’s actions failed to meet any of the specific criteria set out in the U.S. letter,” a coalition of eight international aid organizations wrote in a detailed “Gaza Scorecard.”
Israel not only failed to meet the U.S. criteria but also took action that dramatically worsened the situation on the ground, particularly in northern Gaza. On Oct. 28, the Knesset banned UNRWA from any activity in Israel, East Jerusalem, the West Bank, or Gaza. Still, a U.S. State Department spokesperson said on Nov. 12 that “we at this time have not made an assessment that the Israelis are in violation of U.S. law.”
The Gaza Health Ministry has reported 43,985 Palestinian deaths since Oct. 7, 2023, of which 70 percent are women and children. Though ongoing hostilities and the decimation of Gaza’s medical facilities complicate precise recording, available data indicates that Israeli military action has directly and indirectly killed at least 118,908 people. Drawing on comparisons to other conflicts, one public health scholar estimated that by the end of 2024, a total of 335,500 Palestinians may have died since the beginning of the war.
A growing list of U.N. institutions and experts, governments, rights groups, and scholars have labeled Israel’s actions in Gaza as war crimes, crimes against humanity, and genocide.
Mitigating the imminent winter catastrophe in Gaza would require at the very least a cease-fire, a surge of aid deliveries, safe access for humanitarian and engineering teams, and the entry of fuel. Israel has staunchly refused to allow such moves in the past, arguing that they would aid Hamas.
Only extreme U.S. pressure on the Israeli government can achieve these ends. Since Israel has not responded to the Biden administration’s calls to protect civilians in Gaza, the United States should take decisive action by halting arms transfers and jet fuel deliveries. In line with recommendations from Human Rights Watch and other international organizations, Washington could also apply targeted sanctions on Israeli officials “credibly implicated in ongoing serious violations.”
For now, the United States is increasingly out of step with international institutions and its own allies in its support for Israel. This week, the U.S. Senate rejected legislation designed to restrict weapons sales to Israel, and Washington vetoed an otherwise unanimous U.N. Security Council cease-fire resolution. On Thursday, the International Criminal Court issued arrest warrants for Israeli Prime Minister Benjamin Netanyahu and former Defense Minister Yoav Gallant on charges of war crimes and crimes against humanity, including the crime of starvation.
The impending winter rains will place hundreds of thousands of Palestinians in Gaza in immediate and entirely avoidable lethal jeopardy. There is a very narrow window for action. A massive humanitarian effort now could save hundreds of thousands of lives. This may be the last opportunity for the Biden administration to make a difference in Gaza.
The post The U.S. Must Support Gaza Before Winter appeared first on Foreign Policy.
