Extreme Heat Poses New Challenge for Aid Agencies in Gaza

Flames rise following an Israeli strike on a residential building, amid the ongoing conflict between Israel and Hamas, in Gaza City, in this screen grab taken from a video, August 11, 2024. Reuters TV via REUTERS
Flames rise following an Israeli strike on a residential building, amid the ongoing conflict between Israel and Hamas, in Gaza City, in this screen grab taken from a video, August 11, 2024. Reuters TV via REUTERS
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Extreme Heat Poses New Challenge for Aid Agencies in Gaza

Flames rise following an Israeli strike on a residential building, amid the ongoing conflict between Israel and Hamas, in Gaza City, in this screen grab taken from a video, August 11, 2024. Reuters TV via REUTERS
Flames rise following an Israeli strike on a residential building, amid the ongoing conflict between Israel and Hamas, in Gaza City, in this screen grab taken from a video, August 11, 2024. Reuters TV via REUTERS

In Gaza, the sky is full of menace. As well as the missiles that rain down on schools and shelters, the brutal rays of the sun have made the summer unbearable for those struggling to survive in a ravaged landscape of ruins and rubble.
Samaher al-Daour sometimes wishes she had been killed in the early days of the Israel-Hamas war rather than have to watch her son, who lost a leg during the conflict, endure the unbearable heat.
"The situation is horrible," said Daour, 42, as she sat beside her 20-year-old son Haitham in their sweltering tent in the southern city of Khan Younis in June.
"During the day, it is incredibly hot inside and outside the tent," she said in a telephone interview with Reuters. "We go to the sea but it is still very difficult."
Haitham lost his leg in February during an Israeli airstrike on a school run by the United Nations Relief and Works Agency for Palestinian Refugees (UNWRA) in the Maghazi refugee camp in the central Gaza Strip.
Now the stifling heat is denying him the rest he needs to recover his strength. He sweats all the time and this is irritating his leg and making it swell.
"He is suffering because of this," said Daour.
After 10 months of war, almost all of Gaza's 2.3 million people are displaced. They live in tents or overcrowded shelters, and there is almost no electricity and little clean water.
Hungry and weak, they cannot shower and struggle to sleep in their boiling shelters. In the heat, food is rotting, drawing insects and flies to crowded camps where people, who have been forced to flee again and again, now risk heatstroke and other heat-related diseases.
Since April, Gaza has experienced several periods of extreme heat, with temperatures reaching around 40 degrees Celsius (104 degrees Fahrenheit) during that month. Temperatures throughout August reached an average high of 34 C (93 F), according to U.S. private forecaster AccuWeather.
In late June, the World Health Organization said scorching heat could exacerbate health problems for the millions of displaced, warning that a public health crisis was looming due to the lack of clean water, food and medical supplies.
The heat is also making things more difficult for aid agencies, already hamstrung in their work by the airstrikes, fighting and ravaged infrastructure.
"It would be fair to say that the majority of humanitarian responders, including donors ... have not really considered the threats of heat and extreme heat," said Paul Knox Clarke, principal at ADAPT, a climate and humanitarian initiative.

"The horrors" humanitarian organizations address in crises, he said, often take up too much bandwidth and prevent them from tackling additional challenges, like adapting to the effects of climate change during relief operations.
"It is not unprecedented, but it's not part of the normal playbook," he said.
"It has been complicating everything," said Prabu Selvam, medical officer for the Americares relief agency, adding that the transport of medicines that need to be kept cool was proving particularly challenging.
Because of Israeli restrictions, aid trucks often spend hours under the sun, waiting for clearance.
"Of course, it is going to impact the communities, because often the cold chain medicines are the ones that are most critically in need," Selvam said.
NEW CHALLENGE FOR AID AGENCIES
Nearly 40,000 people have been killed and around 92,000 wounded since the Israeli army began its assault on Gaza, according to the Palestinian health ministry.
Israel launched its offensive after Hamas-led militants stormed into Israel on Oct. 7, killing around 1,200 people and taking around 250 hostages, according to Israeli figures.
The offensive has laid waste to homes, schools and vital infrastructure such as hospitals and clinics.
Israel has severely restricted the flow of food and aid into the Strip and humanitarian agencies have been warning of the risk of famine.
Now, the summer's extreme heat has added another layer to the suffering. Recent years have seen a series of lethal heatwaves strike the Mediterranean region and scientists say climate change is driving these dangerous heatwaves.
Save the Children is already adapting its operations in Gaza, said Fadi Dweik, a climate resilience expert at the charity.
Usually, the agency would focus on delivering mental health services and educational support as a first response, Dweik told the Thomson Reuters Foundation.
But now, it has prioritized delivering water and sanitation services and nutrition and health support.
"The conflict made us think of details and apply alternatives we had not thought of before," Dweik said. "For the first time the environmental factors are a priority because we cannot ignore them despite the war and destruction that exists."
The heat is not something Sabah Khames can ignore either.
The 62-year-old fled her home in Rafah close to the Egyptian border in May and now lives in a tent with 18 other relatives.
"The tent is a cramped caravan constructed entirely of sheet metal. It is like a sauna inside," she said in a phone interview.
"Sometimes, I can barely catch my breath."



Sickness Can Be ‘Death Sentence’ in Gaza as War Fuels Disease 

A Palestinian woman reacts at the site following Israeli strikes on a tent camp sheltering displaced people, amid the Israel-Hamas conflict, at the Al-Mawasi area in Khan Younis, in the southern Gaza Strip, September 10, 2024. (Reuters)
A Palestinian woman reacts at the site following Israeli strikes on a tent camp sheltering displaced people, amid the Israel-Hamas conflict, at the Al-Mawasi area in Khan Younis, in the southern Gaza Strip, September 10, 2024. (Reuters)
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Sickness Can Be ‘Death Sentence’ in Gaza as War Fuels Disease 

A Palestinian woman reacts at the site following Israeli strikes on a tent camp sheltering displaced people, amid the Israel-Hamas conflict, at the Al-Mawasi area in Khan Younis, in the southern Gaza Strip, September 10, 2024. (Reuters)
A Palestinian woman reacts at the site following Israeli strikes on a tent camp sheltering displaced people, amid the Israel-Hamas conflict, at the Al-Mawasi area in Khan Younis, in the southern Gaza Strip, September 10, 2024. (Reuters)

In Gaza, falling ill can be a death sentence. Cancer patients are waiting to die, polio has returned, and many of the doctors and nurses who might have offered help are dead while the hospitals they worked at have been reduced to rubble.

Doctors and health professionals say that even if the Israel-Hamas war were to stop tomorrow, it will take years to rebuild the healthcare sector and people will continue to die because preventable diseases are not being treated on time.

"People are dying on a daily basis because they cannot get the basic treatment they need," said Riham Jafari, advocacy and communications coordinator at rights group ActionAid Palestine.

Cancer patients "are waiting for their turn to die," she told the Thomson Reuters Foundation.

Last week, Israel and Hamas agreed on limited pauses in the fighting to allow children to be vaccinated against polio after a one-year-old baby boy was found to be partially paralyzed from the disease, the first case in the crowded strip in 25 years.

But even as crowds gathered in the southern cities of Rafah and Khan Younis for vaccinations on Sept. 5, bombs continued to fall in other areas with Gaza health officials saying an Israeli strike killed five people at the Al-Aqsa Hospital in Deir Al-Balah.

"It will take long and so much effort in order to restore the level of care that we used to have in Gaza," said Mohammed Aghaalkurdi, medical program lead at Medical Aid for Palestinians.

Every day he sees around 180 children with skin diseases that he "just cannot treat," he said.

"Due to vaccination campaign interruptions, lack of supplies, lack of hygiene items and infection prevention control material, it (healthcare) is just deteriorating."

The conflict was triggered when Hamas-led fighters attacked southern Israel on Oct. 7, killing 1,200 people and taking more than 250 hostages, according to Israeli tallies.

Since then, more than 40,800 Palestinians have been killed by Israel's offensive in the enclave, according to the Gaza health ministry, with around 92,000 wounded.

But beyond the death toll from the fighting and airstrikes, people are also succumbing to illnesses that could be cured in normal circumstances.

As with the re-emergence of polio, children will bear the brunt of these long-term consequences, health experts say.

"We are talking about disabilities, we are talking about intellectual disabilities, mental health issues," said Aghaalkurdi.

"Things that will stick to the child until they die."

SPECIALISTS KILLED

At least 490 healthcare workers have been killed since the conflict erupted, according to Gaza's health ministry. A Reuters investigation found that 55 highly qualified specialist doctors were among those killed.

With each specialist killed, Gaza has lost a source of knowledge and human connections, a devastating blow on top of the destruction of most of the Strip's hospitals.

Many people have become weak from a lack of food, as prices of basic commodities have more than quadrupled since the conflict began. When they become ill, they are also too frightened to journey to the few remaining hospitals, Jafari said.

Eighty-two percent of children aged between 6 and 23 months have limited access to quality food, according to a report by the Global Network Against Food Crises, and more than 90% of children under 5-years-old suffer from infectious diseases.

Meanwhile, skin diseases are rampant because of a lack of cleaning supplies and hygiene products, Jafari said. In markets, a bottle of shampoo can cost around $50.

Israel has severely restricted the flow of food and aid into Gaza, and humanitarian agencies have warned of the risk of famine.

Jafari expects a reckoning after the war ends.

"There is delayed suffering, delayed sadness, there are diseases that are being delayed," she said. "There is an entire journey of suffering that is being delayed until the end of the war," she said.

CANCER 'DEATH SENTENCE'

Manal Ragheb Fakhri al-Masri, 42, is one of those facing that health reckoning.

Displaced seven times with her nine children, she has a heart condition and a benign tumor in her stomach and was supposed to leave Gaza for treatment earlier this year.

But then her husband was killed and she could not bear to leave her children.

Now, having also suffered several strokes, she is bedridden, unable to leave her tent by the sea in Al-Mawasi, which Israel had declared a safe zone. She has not had any medicine in five months and has not even been able to shower for two weeks.

"My husband used to take care of me and get medicine and feed his children," she said in a phone interview with the Thomson Reuters Foundation. "Now I do not know what do. We do not have the most basic things."

Her children try to help as much as they can and sometimes bring her seawater for her to wash with but the salty liquid offers no respite. Her children are also all suffering from red rashes but they have no creams to soothe their burning limbs.

Waseem Alzaanin, a general practitioner with the Palestine Red Crescent Society, said the lack of drugs, equipment and medical facilities is killing his cancer patients.

Gaza's only cancer center was destroyed earlier this year, he said, and many of his stage-one cancer patients are now classified as stage-four.

"The most basic requirements are not present. We cannot do anything except give them painkillers and make them comfortable with what life they have left," he said.

"It is like a death sentence," he added. "Let us not kid ourselves. We have no medical system."