The Ministry of Health in Gaza said the number of people wounded has increased to 25,965.

On October 9, the Israeli military announced a total blockade of the already besieged enclave, including a ban on water and food. Two days later, it cut off the power and restricted the entry of aid and fuel.

An estimated 1.5 million people have been displaced, their condition ever more precarious because of the lack of essential supplies.

Severe water shortage

Rights groups have warned for years about the deteriorating water situation in the Gaza Strip. In 2021, the Global Institute for Water, Environment and Health and the Euro-Mediterranean Human Rights Monitor described Gaza’s water as “undrinkable”, with 97 percent of its water unfit for consumption.

Now, the lack of electricity means that desalination and wastewater treatment plants can’t run, further compromising access to safe drinking water.

On November 4, Israel destroyed a water reservoir in northern Gaza as well as a public water tank that supplied several neighbourhoods in the south.

Many people are drinking polluted, salty water and queue for hours in the hope of obtaining potable water.

The World Health Organization (WHO) says that between 50 and 100 litres of water per person per day are needed – but it has put the average daily allocation in Gaza at a mere three litres for all daily needs, including drinking and hygiene.

What is the impact of not drinking enough water?

A lack of water affects the body by first impacting the kidneys, and eventually the heart. Dehydration sets in fast for children and can often be deadly. A person can experience light-headedness and a racing pulse as the heart has to pump faster to maintain oxygen.

Water makes up about 60 percent of the human body. Dehydration can kill an infant in a stressful environment within hours, and a healthy adult in two to four days.

Is there enough to eat?

The Food and Agriculture Organization of the United Nations (FAO) says that 80 percent of the population in the Gaza Strip was already food insecure prior to the start of the attacks on October 7. Nearly half the population of 2.3 million people relied on food assistance from the UN Relief and Works Agency for Palestine Refugees (UNRWA).

Before October 7, about 500 trucks on average were allowed into Gaza each day.

According to the UN’s Office for the Coordination of Humanitarian Affairs (OCHA), since October 21, at least 451 trucks have entered Gaza, of which 158 carried food, including canned fish, pasta, wheat flour, canned tomato paste and canned beans; 102 carried health supplies; 44 had water or hygiene products; 32 ferried non-food items; and eight had nutrition supplies.

The remaining trucks carried mixed cargo. Fuel supplies are still not allowed to enter Gaza, which is seriously affecting the hospitals still functioning and risking the lives of thousands.

The World Food Programme (WFP) says food stocks in Gaza are running out, with barely five days of supplies left. For every person who has received WFP food assistance, at least six more are in need.

The bakeries that are still operational have to produce at six times their normal capacity, with residents waiting in line for 4-6 hours to get loaves of bread, and also leaving themselves vulnerable to Israeli attacks.

Only one of the bakeries contracted by WFP, and eight other bakeries in the southern and central areas, have been intermittently providing bread to shelters, depending on the availability of flour and fuel.

How does lack of nutrition harm a child?

Every human body needs a balanced diet enriched with vitamins to retain optimal function. In children, food deprivation can be felt quicker, as their growth and brain development hinge on the nutrition they are receiving.

According to the WHO, food deprivation or undernutrition in children results in the stunting of growth, wasting, and problems related to being underweight. Undernutrition prevents children from reaching their physical and cognitive potential and makes them much more vulnerable to disease and death.

Inadequate nutrition during pregnancy can also increase the risk of giving birth to a stunted infant.

Lack of access to healthcare

The WHO says that women and children are bearing the burden of the bombardment on Gaza’s health facilities and the lack of supplies. Women are delivering babies wherever they can, unable to access healthcare facilities to deliver in a sanitary environment, and doctors are having to perform Caesarean sections without anesthesia.

At least 180 women are giving birth each day. Maternal and neonatal deaths have escalated due to the lack of critical care.

Overcrowded UNRWA shelters are reporting cases of acute respiratory infections, diarrhoea and chickenpox. With facilities exceeding capacity, people are now living on the streets. The WHO has reported at least 22,500 cases of acute respiratory infections and 12,000 cases of diarrhoea, which can be deadly in children suffering from dehydration and lack of food.

Doctors have had to use vinegar as disinfectants – and screws and sewing needles for surgeries.

Vinegar from the corner shop to treat pseuodomonas bacterial wound infections. Its come to that. pic.twitter.com/mEE4haHMyj

— Ghassan Abu Sitta (@GhassanAbuSitt1) October 19, 2023

Dr Ahmed Mokhallalati from al-Shifa Hospital says the systems are collapsing and treatment in a sterile setting is limited: “Flies are filling the hospital, you will see worms coming out of people’s wounds.”

The only cancer hospital in Gaza was forced to shutter due to the lack of fuel, and patients with critical needs like dialysis and infants needing intensive care equipment are severely affected.

Since November 3, the main power generators at al-Shifa Hospital and the Indonesian Hospital have stopped working. Israeli warplanes have continued to attack hospitals and the areas around them, where patients, health workers and hundreds fleeing the conflict have found shelter.