When the evacuation order came on Oct. 13, Salwa Tibi left her home in Gaza City as quickly as she could, leaving almost everything behind.
I put all of the women and the children in the car and left the men in the house. We have with us grandchildren; the first one is two years and a half, and the other one will be four in a month.”
Salwa is just one of the more than 1.7 million people in Gaza forced from their homes since Oct. 7.
In some ways, she is fortunate. She and her family are together in a house, rather than a shelter. In the shelters, on average, 160 people share a single toilet, and there is only one shower unit for every 700 people.
But even this bit of good fortune has come with its own complications.
“I was lucky to find a house for us when we arrived,” Salwa says from Rafah, where she now lives. “But the problem is that it’s only people in shelters who receive humanitarian aid, so I have to go to the market and walk around 4 miles to find some biscuits and some other food for the children.”
Finding food is a critical issue, but one of the most critical for everyone in Gaza – whether in a house or in one of the United Nations shelters – is also one of the most basic: access to clean water.
The absolute minimum
“The people that are living in these very highly crowded locations are sent by the UN or people who have lived at the homes of their relatives at the south of Gaza strip, they have no water to drink and to maintain the basic hygiene,” Saaed Rafiq Al-Madhoun, CARE’s Emergency Response Coordinator in Gaza, says.
According to the World Health Organization, communities need between 50 and 100 litres of water per person per day – for drinking, showering, hand washing and cooking. That is the amount “to ensure that most basic needs are met, and few health concerns arise.”
In many humanitarian crises, according to Julian Tung, a CARE Water and Sanitation expert with more than 14 years’ experience working in emergency contexts, that number can go down to 15 litres per person per day in a crisis, but “that’s seen as the bare minimum for hygiene.”
But today in Gaza, tens of thousands in cramped shelters are given much less than that, if any at all, for drinking and personal hygiene.
This has led people not only to ration what little water they have but also to seek out any source of water they can find, safe or unsafe.
“We don’t have water at all,” Salwa says. “Just every 10 or 15 days we see some water from the municipality pipeline, and it comes just only for one or two hours, and we try to use it for washing our clothes, for taking a shower.
Just a shower every 15 days instead of a daily shower before that.”
A drop in the ocean
The United Nations and UNICEF reported distributing 19,500 liters of fuel to water and sanitation facilities in south Gaza on Nov. 19, but they only expect it to last for about 24 hours. Saaed Rafiq Al-Madhoun, CARE Emergency Response Coordinator in Gaza, says:
It’s like a drop in the ocean. There is such a huge need on the ground.”
The UN estimates there are now almost 900,000 internally displaced people in Gaza who are staying in only 154 designated shelters.
The overcrowding in these shelters is contributing to the spread of diseases, including acute respiratory illness and diarrhea, prompting environmental and health concerns from experts.
In Rafah, when Salwa goes out for bread and basic supplies, she says she can see the disaster unfolding all around her:
“Around 40 people live now in one classroom. Sometimes, it’s even 70. It’s a terrible situation, especially for the children, and there’s a lot of diseases. Skin rash and many more.
“They have to spend three hours and four hours to reach the bathroom because it’s very crowded and all the people are using the bathroom – women, men, children.”
Najwan Halabi, who shares a house with 120 people in southern Gaza, says they have been trying to organize turns for the families to shower, if there is water.
When Najwan’s turn finally came up, she gave her time to her daughter.
“I’m so happy, even if I did not have a shower,” she says. “But I know that my daughter did, so I feel refreshed. I feel happy.”
It’s the type of small scrap of normality that the people of Gaza have to cling to so they can maintain some hope that the situation won’t last forever.
Running out of ‘miracle water’
At the start of the conflict, CARE’s team in the West Bank was able to find “miracle water” –- 72,000 bottles — and distribute it to those in need, but the escalating crisis has stretched the miracle as far as it can go.
Hiba Tibi, CARE’s Country Director in the West Bank, has kept in touch with one of the families who received water early in the crisis but has had to carefully ration it over the past month.
“They kept all the bottled water that they had received for the baby formula, so they don’t give the baby contaminated water,” Hiba told the BBC.
“But the rest of the family is using and consuming contaminated water.”
Even if the families in Gaza make it through their water-less days, there are still the nights of darkness and fear. “All the children are crying at night, because there is no light at the house,” Salwa says. “There is no electricity.”
“The children are scared, and we can't do anything for them.”
At CARE’s office in the West Bank, the team says it is struggling to keep in touch with colleagues in Gaza as communications are continually disrupted or shut off.
Over the weekend, the CARE team lost contact with their Gaza colleagues for multiple hours, but, early on Sunday, the communications were restored.
CARE continues to work in cooperation with their colleagues in Egypt to deliver aid, but, for every hour the conflict goes on, the humanitarian disaster increases exponentially, especially for the most vulnerable communities.
“Women and children are subjected to increased levels of traumatic experiences,” says Nour Beydoun, CARE’s regional advisor on protection and gender in emergencies. “This puts children, especially those without surviving family members, at higher risk of trafficking and forced recruitment.”
CARE has integrated a gender and age-specific approach into its emergency response, but the strain is immense for both those affected and for those trying to help.
Salwa, fortunate as she is to have a house, finds herself searching for comfort for her family. She says:
“I was walking for two hours just to search for some candles. But I didn’t find anything.”
CARE International is calling for an immediate ceasefire, as this crisis is rapidly deteriorating into a humanitarian catastrophe.
Civilians must be able to access healthcare, and the needs of women and children must be met. It is vital that humanitarian workers have safe, sustained, and unimpeded access to help people in need of assistance. All parties must abide by the rules of international humanitarian law: this includes the release of all hostages and the protection of civilians at all times.