Weakened by hunger, many Gazans trek across a ruined landscape each day to haul all their drinking and washing water – a painful load that is still far below the levels needed to keep people healthy.
Even as global attention has turned to starvation in Gaza, where after 22 months of a devastating Israeli military campaign a global hunger monitor says a famine scenario is unfolding, the water crisis is just as severe according to aid groups.
Though some water comes from small desalination units run by aid agencies, most is drawn from wells in a brackish aquifer that has been further polluted by sewage and chemicals seeping through the rubble, spreading diarrhoea and hepatitis.
COGAT, the Israeli military agency responsible for co-ordinating aid in the Israeli-occupied Palestinian territories, says it operates two water pipelines into the Gaza Strip providing millions of litres of water a day.
Palestinian water officials say these have not been working recently.
Israel stopped all water and electricity supply to Gaza early in the war but resumed some supply later though the pipeline network in the territory has been badly damaged.
Most water and sanitation infrastructure has been destroyed and pumps from the aquifer often rely on electricity from small generators – for which fuel is rarely available.
COGAT said the Israeli military has allowed co-ordination with aid organisations to bring in equipment to maintain water infrastructure throughout the conflict.
Moaz Mukhaimar, aged 23 and a university student before the war, said he has to walk about a kilometre, queuing for two hours, to fetch water. He often goes three times a day, dragging it back to the family tent over bumpy ground on a small metal handcart.
“How long will we have to stay like this?” he asked, pulling two larger canisters of very brackish water to use for cleaning and two smaller ones of cleaner water to drink.
His mother, Umm Moaz, 53, said the water he collects is needed for the extended family of 20 people living in their small group of tents in Deir Al Balah in the central Gaza Strip.
“The children keep coming and going and it is hot. They keep wanting to drink. Who knows if tomorrow we will be able to fill up again,” she said.
Their struggle for water is replicated across the tiny, crowded territory where nearly everybody is living in temporary shelters or tents without sewage or hygiene facilities and not enough water to drink, cook and wash as disease spreads.
The United Nations says the minimum emergency level of water consumption per person is 15 litres a day for drinking, cooking, cleaning and washing. Average daily domestic consumption in Israel is 165 litres a day according to the government’s Central Bureau of Statistics.
Bushra Khalidi, humanitarian policy lead for aid agency Oxfam in the Israeli-occupied Palestinian territories said the average consumption in Gaza now was three to five litres a day.
Oxfam said last week that preventable and treatable water-borne diseases were ‘ripping through Gaza’, with reported rates increasing by almost 150 per cent over the past three months.
“Water scarcity is definitely increasing very much each day and people are basically rationing between either they want to use water for drinking or they want to use a lot for hygiene,” said Danish Malik, a global water and sanitation official for the Norwegian Refugee Council.
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