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Source: United Nations Children's Fund (UNICEF)
30 April 2010

Water, Sanitation and Hygiene Household Survey Gaza


Executive Summary
Gaza’s 1.5 million residents rely on the Coastal Aquifer to supply them with water but overuse and contaminants seeping into the ground are threatening this vital resource. UN agencies and the Coastal Municipal Water Utility (CMWU) estimate the aquifer’s supply of water, suitable for human consumption, will disappear over the next five to 10 years.

Exacerbating the problem is the decrepit state of Gaza’s sanitation services. Israel’s blockade of Gaza since 2007 and its 23 day military operation in this tiny Palestinian territory during the 2008-09 winter has pushed Gaza’s water and wastewater system to the edge of collapse.

Israel’s operation “Cast Lead” destroyed large tracts of public infrastructure including the water and sewerage system. More than 30 kilometres of water networks, 11 groundwater wells, 6,000 roof tanks and 840 household connections were damaged, leaving around 500,000 people without clean water.

Deficient supplies of industrial fuel and the severe, almost non-existent, supplies of essential materials such as cement and pipes for repair and maintenance work have rendered the water and wastewater services unreliable and hazardous. Ninety eight per cent of Gazans are connected to the water network but access to a continuous supply of running water is much less widespread.

Supply is intermittent, with just 48 per cent of surveyed households reporting running water four to seven days a week and 39 per cent just two to three days a week. Despite the limited supply, 54 per cent say they are satisfied with the quantity of water, perhaps because most households store water in ground and roof top water tanks for use when there is no running water.

Most households do not use municipal water supplies for drinking, as 90 to 95 per cent of the aquifer, Gaza’s only water source, is considered unfit for human consumption due to levels of chlorides and nitrates as high as six times the WHO guidelines. While there is no in-depth research or evidence yet on impact to public health, elevated levels of nitrates can lead to methemoglobinaemia, or “blue baby” syndrome among infants.1 Risks of other water-borne disease including typhoid or hepatitis are also present because the water table is not deep and sewage infiltration is probable.

While households in Beit Lahiya and Tal el Hawa use water filters to purify water, 86.9 per cent of the households surveyed buy their drinking water from unregulated private vendors selling desalinated water for an average cost of NIS 35/m3 – rates unaffordable for poor households. Eighty-six per cent of respondents rely on the network for water for domestic purposes such as cooking and washing. Although more than 47 per cent of the respondents say they are reluctant to use water from the network for cooking, many are forced to do so due to the high cost of privately-supplied water. Cooking heightens the concentration of nitrates and other salts even further.

More than 79 per cent of the surveyed households are connected to a wastewater network and the remainder have cesspits. Although sewage stagnation was expected due to the hydro-geologic condition of Gaza, no serious stagnation was reported primarily because the survey was conducted outside of the rainy season.

Only 25 per cent of respondents in Juhor ad Dik and Rafah area reported incidents of waste piling up on their streets. Community-generated solid wastes are collected at least once a week and 90 per cent of respondents said they are satisfied with the frequency of collection. Open burning and uncollected wastes piles were reported in some areas.

Forty-four per cent of respondents said they take daily showers and 65 per cent wash their hands before eating. Although appropriate hygienic supplies for menstruation are available, they are costly and public awareness of proper hygiene practices is low.

Due to poor water quality and hygiene practices, one in five households (20 per cent) had at least one child under the age of five who had been infected with diarrhea in the four weeks prior to being surveyed. The incidence of diarrhea was much higher in Beit Hanoun, with 38 per cent of households reporting at least one child affected by severe diarrhea symptoms during the survey period.

Two immediate priorities include a comprehensive survey on water quality and health indicators to correlate the incidence and prevalence of water borne diseases with water quality; and additional desalination units to expand access to safe water for drinking and home use.

1Infants suffering from methemoglobinaemia may appear otherwise healthy but exhibit intermittent signs of blueness around the mouth, hands and feet. They may have episodes of breathing trouble, diarrhoea and vomiting. In some cases, infants with methemoglobinaemia have a peculiar lavender colour but show little distress. Blood samples appear chocolate brown and do not turn pink when exposed to air. When the methemoglobin level is high, infants express a marked lethargy, excessive salivation and loss of consciousness. Convulsions and death can occur when methemoglobin levels are extremely high.


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