By Nidal al-Mughrabi and Dawoud Abu Alkas
CAIRO/GAZA, July 21 (Reuters) - In pre-dawn darkness, Ibtisam Al-Helou leaves her tent on Gaza's seafront on a daily search for fresh water. The Mediterranean lies only a few steps away, but the water she needs to cook, drink and wash will mean a trek across Gaza City.
Setting out before the heat rises to the scorching 33 degrees Celsius (91 F) of midday, the 40-year-old mother of three makes her way through shattered neighbourhoods where word has spread that
water might be available.
"I live by the sea, and water is very scarce. I suffer from it every day," she said, washing kitchen utensils outside the tent where her family now lives.
"I reach Al-Mina, I reach Al-Amadi, we reach Abu Mazen (areas in Gaza City) where there is water, because water does not reach here at all. We only get water once every three days."
Her struggle reflects a wider reality across Gaza.
Aid agencies, U.N. officials and Palestinian health authorities warn that Gaza is facing an unprecedented collapse of its water and sanitation systems, leaving much of the population trapped between immediate thirst and a longer-term environmental crisis whose consequences could last decades.
Families queue for hours beside battered water trucks to receive a few litres, before returning to disease-stricken, overcrowded tent camps.
The shortages have transformed even the routines of childhood.
CHILDREN RISK INFECTION, DISEASE BY SWIMMING IN THE SEA
Before the war, Al-Helou's children — she cares for a total of nine children in her household — would wash themselves in fresh water three times a day in Gaza's summer heat. Now they are lucky to wash once a week.
Many children in the enclave cool off in the sea, but Helou says the price can come later.
"When my children swim in the sea, I need 50 ($17) shekels (worth of treatment) for each one of them," she said. "They get itching, scabies and allergies."
As families struggle to find enough water for basic hygiene, health officials warn that untreated sewage from hundreds of thousands of cesspits is seeping into Gaza's coastal aquifer, the enclave's only natural source of fresh water.
Children suffering from diarrhoea and skin infections return from clinics to tents where clean water, soap and sanitation are scarce. Residents increasingly depend on trucked water, damaged wells and untreated groundwater.
More than half of Gaza's population, around 1.3 million people, have access to less than six litres of drinking water a day, according to U.N. assessments. People use unhealthy salted water to bathe and wash their clothes.
Medical charity Médecins Sans Frontières (MSF) says its own data suggest things may be even worse, with most residents receiving an average of 4.3 litres per person per day. Before the war, average daily water consumption was about 85 litres per person.
WATER TRUCKS STRUGGLE THROUGH RUBBLE-STREWN ROUTES
"People are still queuing and waiting for water trucks to arrive and distribute water," said Alessandro Mrakic, head of the U.N. Development Programme (UNDP) in Gaza.
"It is a very difficult, complex operation because you need to go through rubble. You need to reach the population where it is," he told Reuters.
As temperatures rise, so do health concerns.
"The lack of sufficient water is directly affecting people's health and ability to maintain basic hygiene," said Ozan Agbas, Emergency Operations Manager with MSF Netherlands.
MSF says acute respiratory infections account for 46% of reported illnesses in its surveillance data, while skin diseases account for 31% and acute watery diarrhoea for 21%.
Palestinian officials say the crisis extends far beyond shortages of drinking water and warn that every day the crisis goes unresolved deepens damage to Gaza's water infrastructure and could leave consequences lasting for decades.
Said El-Aklouk, a sanitation and wastewater monitoring official at Gaza's Health Ministry, said Gaza had around 320 water wells pre-war but fewer than 100 remain operational. About 80% of the water distribution network and most desalination capacity were damaged or destroyed by Israeli attacks, he said.
The Israeli military says that it does not deliberately attack such essential infrastructure. COGAT, the military body in charge of humanitarian matters, said on July 9 that it was working with international agencies to tackle sanitation and hygiene problems and to improve water supply in the enclave.
WATER NETWORK NEEDS TO BE REVIVED
A U.S.-brokered ceasefire in October halted major fighting but failed to end attacks by Israel, which says it targeted Hamas and other Gaza militants who posed an imminent threat.
Months after the ceasefire, water trucks remain a lifeline for many, but aid agencies say they cannot replace a public water system.
As trucks arrive, children, women and men queue to fill plastic jerrycans some carry on their backs or shoulders. Others ferry the water in small home-made trolley carts.
Many people living in tent camps along the coastline bathe in the sea, despite widespread concerns about pollution.
For those who contract infections, aid agencies say medical care isn't enough.
Agbas said patients returned from treatment to overcrowded shelters with little access to clean water, soap and sanitation, creating conditions for repeated illness and reinfection.
At least 5,000 cases of chickenpox have been detected per week in the past month, according to health officials.
The collapse of sanitation systems has compounded the crisis. Aklouk said more than 300,000 cesspits and soak pits were discharging untreated wastewater into Gaza's coastal aquifer, the territory's only natural freshwater source.
"Today, for the first time, we have effectively lost control of our water sources," Aklouk said.
"This is the worst situation Gaza has ever experienced."
(Reporting and writing by Nidal al-Mughrabi in Cairo. Additional reporting by Dawoud Abu Alkas in Gaza, Editing by William Maclean)
