The Ongoing Environmental Destruction and Degradation of Gaza: The Resulting Public Health Crisis

Abstract

This essay examines the resulting environmental health conditions in Gaza since October 2023. Evidence is drawn from international agency reports and peer-reviewed literature to document destruction and public health impacts over 18 months. Key themes include water, sanitation, contamination, noise and air pollution, food insecurity, susceptible populations, health system collapse, and trauma.

Palestinians are beset with a public health crisis resulting from targeted environmental destruction. Water shortages and sewage contamination increase dehydration, famine, and disease. Air pollution from explosives and waste burning exposes residents to toxins. Waste management has collapsed, heightening disease outbreaks, including polio. Agricultural land is devastated, and food security is threatened with the aid blockade. Power grid destruction has crippled essential services. The health care system’s collapse further exacerbates risks, especially for susceptible populations. In addition to mental and physical trauma, cultural and identity loss are immeasurable.

The crisis in Gaza has severe and lasting consequences for health, the environment, and regional stability. An end to the bombardment, along with urgent humanitarian aid, release of all hostages, infrastructure rebuilding, and environmental remediation, are essential to mitigate long-term impacts. (Am J Public Health. 2025;115(7):1053–1061. https://doi.org/10.2105/AJPH.2025.308140)

There is growing concern surrounding the environmental impacts of modern military warfare, including deforestation, soil erosion, wildlife loss, waste generation, and pollution,¹ with studies documenting and calling for an end to military-driven environmental destruction taking place worldwide, including in Ethiopia¹ and Ukraine.² Our essay focuses on an evidence-based summary of Gaza’s current environmental conditions resulting from Israeli bombardment and occupation, which present significant threats to the short- and long-term health of its population. We integrate existing sources on issues concerning

• 1.water, wastewater, and hygiene;
• 2.chemical and debris contamination from bombings;
• 3.noise pollution;
• 4.food insecurity;
• 5.environmental health impacts on susceptible populations;
• 6.destruction of health systems and lack of access to care, and
• 7.traumatic impacts of targeted environmental destruction.

We focused on reports from nonaligned international agencies (e.g., the United Nations [UN], Amnesty International, and Human Rights Watch) and peer-reviewed literature. We also refer to preliminary results from analyses conducted in Gaza by coauthors of this essay (M. G., M. A., H. A., A. B., R. A. D., M. E.). While we focus on the most recent conditions, the state of the environment was already dire before the latest war that began in October 2023. We highlight these past conditions to provide context where necessary.

WATER, WASTEWATER, AND HYGIENE

By the end of August 2024, the average amount of drinking water entering Gaza had been reduced to a quarter of what was available in August 2023.³ By December 2023, displaced children in southern Gaza had access to only 1.5 to 2.0 liters per day of total water use, less than the 3.0 liters of drinking water per day required for basic survival, and far below the minimum requirement of 15.0 liters of total water in emergency situations.⁴ Restrictions on drinking water access combined with the destruction of 88% of Gaza’s water wells and all of its desalination plants have resulted in a 94% decrease in the total water volume compared with the previous year.⁵ As a consequence, up to 70% of Gaza’s population reported consuming salinized or contaminated water,⁶ posing severe risks of dehydration and the spread of infectious diseases—evidence of which is widespread.⁷ Conditions have further deteriorated since then, exacerbated by the destruction of electricity and water infrastructure, as well as shortages of fuel, repair and spare parts, or chlorine.^8,9 The entry of aid, water, and electricity into Gaza was blocked once again in March 2025, intensifying fears of dehydration and disease among Palestinians in Gaza.^10,11

Even before 2023, Palestinians in Gaza were restricted to water consumption levels well below the recommended minimum. The World Health Organization (WHO) recommends 100 liters of water per day per person, yet, before the most recent war, Palestinians in Gaza had access to only 83 liters per day because of the occupation-driven lack of control over their own water resources.⁵

While sample collection and testing has been limited because of ongoing bombardment and destruction of laboratories, from February to August 2024, the Palestinian Environmental NGOs Network (PENGON) and researchers at Newcastle University measured contamination of solid waste landfills with total and fecal coliform bacteria, confirming the presence of untreated sewage water and toxic leachate in the groundwater reservoir.¹²

Similarly, solid and hazardous waste are piling up throughout Gaza. Bombardment destroyed approximately 70% of all sewage pumps and wastewater treatment plants in Gaza.^5,8 These pumps require electricity or diesel to function, leaving most of the remaining pumps nonoperational. Solid waste management was already a concern before the recent attacks, with landfill sites exceeding capacity and municipalities resorting to burning waste. According to the UN Environment Programme (UNEP), almost 40 million tons of debris have been generated between October 2023 and May 2024, equating to 107 kilograms of debris per square meter in Gaza, alongside an almost complete destruction of solid waste management systems.¹³ In addition to the solid waste generated from everyday usage, the tons of debris in Gaza are composed of building materials, asbestos, and human remains. The volumes of waste create a breeding ground for disease-carrying vectors (e.g., insects), increasing infectious disease risk.¹⁴

The destruction of homes, water, and waste infrastructure has led to a disintegration of sanitation and hygiene infrastructures. According to the UN Children’s Fund (UNICEF), as of March 2024, an average of 340 individuals were forced to share a single toilet, and 1290 persons shared 1 shower.¹⁵ Hygiene products, including soap, are unavailable or prohibitively expensive,¹⁶ and the more than 690 000 girls and women of childbearing age are forced to use scrap material as menstrual products.¹⁷ The impacts have led to an increase in communicable diseases; the WHO reports increases in acute respiratory infections, scabies, lice, and jaundice, with cases of diarrhea more than 25 times pre‒October 2023 levels.¹³ There was a 99% polio vaccination coverage in 2022; however, vaccine-derived poliovirus type-2 was detected in wastewater samples across the region in June 2024.¹⁸ In the first case in 25 years, a 10-month-old infant was infected with polio and became paralyzed.¹⁹ Despite the attempts to obstruct a UN convoy’s vaccination team and bomb vaccination-designated areas,²⁰ UN agencies managed to vaccinate approximately 560 000 Palestinian children by September 2024.²¹ A second dose was required to effectively contain the spread; however, because of the Israeli siege of northern Gaza, extreme bombardment and escalated mass displacement, the final phase of the campaign was postponed in October 2024.²² In November 2024, children were killed at a health center in northern Gaza while attempting to get vaccinated hours after the WHO campaign was reinitiated.²³

CHEMICAL AND DEBRIS CONTAMINATION FROM BOMBINGS

A major source of direct and indirect environmental exposures is the Israeli bombardment of Gaza. We describe the air and soil pollution in greater detail.

Air Pollution

A major source of contamination in Gaza is the destruction of buildings, roads, and infrastructure attributed to bombardment. To quote the 2024 UNEP report,

The debris situation in Gaza is unprecedented in several ways including: i) the extent of damage to the housing stock; ii) its geographic spread and spatial density across almost the entire territory of the Gaza Strip; iii) the quantity of debris generated; iv) the rate at which debris is being generated; and v) the expected extremely high levels of UXO [unexploded ordnance, i.e., military ammunition or explosive that failed to explode] contamination.^13(p23)

UNEP estimates that the approximately 40 million tons of debris will take 15 years to clear, based on the assumptions that the military blockade is lifted and 105 trucks with 12-cubic-meter or 19-ton capacity operating in 8-hour shifts for 30 days per month are available to carry the debris.¹³ To further demonstrate the extent of debris in Gaza, UN-HABITAT and UNEP estimated that the amount of debris is more than 14 times the combined total debris from all global conflicts over the past 16 years.²⁴ The potential health impacts of this debris are immense. For example, individuals involved in cleanup efforts after the events of 9/11 experienced elevated rates of respiratory diseases and cancer.²⁵ Particulate matter from the destruction can spread over long distances, contaminating air, water, and soil, with long-term health consequences for people in the wider region.²⁶ Damaged fibers of asbestos are estimated to contaminate approximately 800 000 tons of the debris, and should be treated as hazardous waste.¹³ However, because of the constant displacement of Palestinians and their struggle to find shelter, widespread asbestos exposure is likely, with hard-to-document long-term public health repercussions because of long latency periods (> 10 years).²⁷

With 90% of Palestinians in Gaza internally displaced (some displaced 10 or more times within a year),¹³ burning materials for cooking or warmth and open-air waste burning are commonplace¹³—worsening air quality and heightening the risk of respiratory diseases, adverse birth outcomes, neurodevelopmental disorders, and other diseases. Fires ignited by explosives further contribute to this risk, releasing volatile organic compounds and building materials into the air, which will likely have long-term health impacts for those who survive the bombings. The Gaza Power Plant was bombed in January 2024, and the damages related to the fires of the diesel-powered plant are unknown.¹³ Between October 2023 and January 2024, 165 fires were captured by NASA’s open-source Fire Information for Resource Management System, likely a significant underestimate because of low temporal resolution.¹³ In October 2024, Médecins Sans Frontières‒ supported Al-Aqsa Hospital was struck by Israel, leading to fires that burned several people alive, including patients.²⁸

More than 29 000 bombs have been dropped on Gaza.²⁹ This estimate includes the regular use of 2000-pound bombs, where 84% of hospitals in Gaza were within the damage range of 800 meters.²⁹ Between 5% and 10% of weapons fired into Gaza have not detonated.³⁰ Following a pattern of previous use, including Operation Cast Lead (2008‒2009), there are also reports of the use of “unconventional weapons” in Gaza (and South Lebanon), such as white phosphorus.³¹ The constitutive chemical of white phosphorous is prevalent in high concentrations in the northern part of Gaza, and scientists warn it could “destroy the natural ecosystem of animals and plants and contaminate agricultural products through the food chain … caus[ing] health problems especially among children and the elderly.”³² White phosphorus exposure can lead to birth defects, as detected in Gaza before October 2023.³³ Surviving Palestinians in Gaza are likely to suffer from these long-term health and environmental consequences.

Although there are no air quality measures available for Gaza since October 2023, particulate matter was measured at higher concentrations at nearby Israeli air quality monitoring sites.¹³ A multiyear study is currently underway by coauthors of this essay to examine the air quality in Gaza more comprehensively. In addition, the first 3 months alone of emissions from bombardment since October 2023 are estimated to exceed the annual emissions of 26 countries and territories (> 400–600 kilotons carbon dioxide‒ equivalent emissions).³⁴ Though difficult to quantify, military conflicts significantly contribute to global greenhouse gas emissions through various processes,³⁵ and these global carbon budget perturbations have widespread climatic and environmental impacts.

Soil Contamination

Although the heavy metal, chemical, and radioactive contamination of Gaza’s soil is unknown because of laboratory functionality in Gaza, previous attacks involving munitions containing heavy metals, asbestos, and other hazardous materials have already contaminated the soil with high concentrations of cobalt and other metals.³⁶ The bombing and use of bulldozers disrupted soil layers and burned (with temperatures of explosions as high as 2000°C), deteriorated, scattered, or completely destroyed the soil (including soil microorganisms). This exacerbated the already severe food insecurity, with trees and other crops killed or rendered fruitless as a result.¹²

UNEP reported, “soil was significantly contaminated with Total Petroleum Hydrocarbons (TPHs) and aliphatic hydrocarbons, levels which surpassed the threshold requiring intervention.”^13(p30) Solar panels (initially installed to reduce dependency on Israel for electricity) were also destroyed by bombardment and may contaminate the soil through the leaching of cadmium and lead. From here, we can confidently speculate 2 important aftermaths of this war for Gaza: (1) crop yields are likely to be greatly reduced, exacerbating issues of food security for the (remaining) population of Gaza, and (2) crops that are yielded will be susceptible to levels of toxicity potentially damaging to human health, like the effects documented in Iraq after the US-led invasion of 2003.³⁷

NOISE POLLUTION

Since 1997, studies have shown that more than 90% of Palestinians in Gaza were affected by noise pollution.³⁸ Today, as noise pollution is at an all-time high with an average of 1 bomb dropped every 10 minutes in Gaza, “continuous drone and jet flights, rockets, bombardment from tanks and ships, and other military activities was noted to result in more than double the allowable limit [of 75 A-weighted decibels; dBA³⁹] (the allowable limit is for short periods [of 8 hours] not for months as in this case).”^40(p8) To put that into perspective, 75 dBA is equivalent to a vacuum cleaner, and double that would be equivalent to a jackhammer.³⁹ Chronic exposure to noise pollution is linked to adverse mental and physical health outcomes, including, but not limited to, sleep disruption, hearing loss, cardiovascular disease, negative social behavior, and absenteeism.⁴¹ A review identified psychological and mental impacts in children and youths living in Gaza from hearing shelling and drones.⁴² Among preschool-aged children, noise exposures were linked with anxiety disorders, phobias, and posttraumatic stress disorder,⁴³ highlighting the psychological toll of drone warfare and shelling in Gaza.

FOOD INSECURITY

Following Israel’s 2005 internal withdrawal from Gaza and its subsequent military blockade, food supplies entering the region were heavily restricted. The quantity of food permitted was determined by a report from the Israeli Ministry of Health entitled “The Red Lines Document.” This report relied on several assumptions, including estimates of the population size, food production within Gaza at the time, and Israeli dietary habits. However, the report failed to consider key factors, such as the ways in which food would be transported into Gaza and the closing of borders, such as the Rafah crossing between Egypt and Gaza, preventing goods from entering.^44,45 Before the current war, 63% of households were already experiencing moderate to severe food insecurity, equating to more than 990 000 Palestinians in Gaza (about 50% of the total population of approximately 2 million people) experiencing food insecurity.

According to an Integrated Food Security Phase Classification (IPC) report published in November 2024, the entire population of Gaza contends with emergency levels of food insecurity (IPC phase 4 classification), of which 345 000 people are expected to experience catastrophic levels of food insecurity (IPC phase 5 classification) through April 2025.⁴⁶ The IPC phase 4 classification⁴⁷ indicates that the entire population is suffering from severe food shortages, acute malnutrition, and a high risk of starvation-related deaths. An independent commission to the Human Rights Council found that starvation most severely impacts infants, children, and pregnant and lactating women,⁴⁸ leading to child and infant deaths from malnutrition and dehydration.⁴⁹ Oxfam International reports that people in northern Gaza were forced to survive on 245 calories per day,⁵⁰ less than 12% of the IPC’s minimum required daily requirement of 2100 calories for an average adult.⁵¹ Unsurprisingly, in 2024, Gaza was seeing the worst level of child malnutrition anywhere in the world.⁴⁹

As a direct result of the destruction and ruination of 68% of all agricultural lands and 33% of greenhouses,⁵² which Palestinians have historically relied on for food before the current crisis, and the reinitiation of the aid and food blockade during the month of Ramadan, Palestinians are dealing with a human-made high risk of famine.^11,53 Most of Gaza’s remaining trees, including olive, pomegranate, and citrus orchards—essential not only for food and income but also for air purification and shade—were completely uprooted.⁵⁴ As of May 2024, the UN’s Food and Agricultural Organization estimated that every governorate had 36% or more of its agricultural wells damaged, with the Khan Younis region experiencing 56% of its 410 wells damaged or destroyed.⁵² As a result, groundwater overpumping has led to a sharp increase in water salinity from 1800 to 4000 milligrams per liter, resulting in newly planted olive trees drying out in the nursery stage.¹²

IMPACTS ON SUSCEPTIBLE POPULATIONS

Pregnant people, children, infants, the elderly, and disabled Palestinians in Gaza are highly susceptible to bombardment and are directly targeted.^48,55,56 From October 2023 to April 2024, the largest percentage of Palestinians killed were aged 5 to 9 years, followed by children aged 10 to 14 years and 0 to 4 years.⁵⁷ In May 2024, an estimated 183 women were giving birth in Gaza each day without pain medication or anesthetics; miscarriages increased by 300%; and 95% of pregnant and nursing people were severely food insecure.⁵⁸ With a lack of or limited access to health care facilities and decreasing sanitation, many women are giving birth in high-risk environments such as tents, on streets amid the rubble, or in overcrowded, partially functioning health care facilities.⁵⁹

This has important adverse health implications for children and infants, who are not only more susceptible to the devastating conditions but are also exposed during critical developmental periods with potential lifelong impacts. In utero and early life exposures to contaminants in Gaza from previous Israeli bombardments are linked to various adverse birth and health outcomes.^60,61 In addition, malnutrition and dehydration increase the risk of fetal and infant morbidity and mortality. Nine of every 10 families in Gaza were displaced, and at least 19 000 children were forced to fend for themselves because of being separated from or being the only survivors in their families. The acronym, WCNSF (wounded children, no surviving family), was coined in Gaza because of the frequency of these cases.⁶² This does not account for the cumulative effects of being born and surviving in Gaza: a 16-year-old child has lived through 6 separate wars. Gaza is now home to the largest number of child amputees worldwide,⁶³ all of whom have an exacerbated risk of infection because of open and untreated wounds.

Many Palestinian elderly have been forcefully displaced multiple times over the past 77 years.⁶⁴ With 70% of elderly Palestinians suffering from chronic illnesses, their frailty and comorbidities make them particularly susceptible to environmental exposures.⁶⁵ For both the elderly and amputees requiring wheelchairs or crutches, navigating through the rubble is nearly impossible, leaving them highly susceptible to malnutrition, dehydration, injuries, and illnesses. Without access to adequate health care, the deaths of susceptible populations will continue to rise.

Palestinians have been experiencing a combination of high environmental exposures, war-related trauma, chronic stress, mass displacement, and famine, with predictable systemic health effects likely lasting decades according to the developmental origins of disease.⁶⁶ In addition, a serious epidemic of poverty is unfolding, with more than 60% of Palestinians now estimated to experience poverty.⁶⁷

DESTRUCTION OF HEALTH SYSTEMS AND LACK OF ACCESS TO CARE

In addition to the severe impacts on public health systems described thus far, the resources available to provide care have been decimated, with the entire health system on the “brink of collapse,”⁶⁸ exacerbating the health effects of Palestinians. As of February 2025, 18 of Gaza’s 36 hospitals remain operational, all of which are only partially accessible and functioning.⁶⁹ The lack of fuel and critical shortage of medicine, essential medical supplies, and blood units severely threaten the functionality of the health care system. Between October 2023 and July 2024, 498 strikes on health care facilities were documented by the UN Independent International Commission of Inquiry on the Occupied Palestinian Territories, including in East Jerusalem and Israel.⁷⁰ More than 700 Palestinians were killed in those attacks, with hundreds more injured since. The WHO representative for the West Bank and Gaza stated, “it would take five to ten years to evacuate all these critically ill patients [in Gaza].”⁶⁸ The UN Commission also reported violence against medical personnel.⁷⁰ The future of Palestinians is also under attack, with the destruction of the largest fertility clinic in Gaza, which housed 4000 embryos.⁴⁸

IMPACTS OF TARGETED ENVIRONMENTAL DESTRUCTION

We have detailed the impacts of this war on the environment and human physiology in a traditional Western sense. However, institutions often fail to highlight the mental and psychological damage, cultural cost, and loss of identity from the destruction of the Palestinian environment and the uprooting of wildlife, orchards, and farms. Historic Palestinian lands are home to olive, fig, pomegranate, and citrus trees, as well as wild herbs and plants used for cooking and medicinal purposes, such as zaatar (wild oregano), sage, chamomile, orchids, and chard. The olive tree is symbolic to Palestinians, not only as an important source of economic livelihood but also because of its representation of connection to the land.^71,72 An olive tree in historic Palestine can take 10 to 12 years to bear fruit, and orchards are often passed down through generations, making them a symbol of heritage and continued connection to land.⁷²

A thematic analysis revealed 3 main key elements regarding how Palestinians view olive trees in their communities: sutra (securing sustenance for a family), a’wna (collaboration and family solidarity), and sumud (perseverance, steadfastness, and connection to community).⁷³ The occupation has uprooted or burned olive trees for decades, some of which were thousands of years old.^71,73,74 Nonetheless, while harvesting amid the bombs, Palestinians feel that “Olive trees are like us: resilient and with deep roots in this land.”⁷⁵ Olive harvesting was historically viewed as a time of community and joy; however, it has been transformed into a time of tension, as olives need to be harvested quickly to avoid destruction and death.^54,74,75 This is comparable to the buffalo slaughter in North America, severely impacting populations’ reliance on and connection to their land.⁷⁶ This loss of connection to land and previous and future generations through olive trees is a traumatic experience, expressed heavily in various Palestinian literature and art forms.⁷⁷ For example, Khaled Baraka, a 65-year-old Palestinian who was forced to flee his home, shared his anguish: “These trees lived through my moments of joy and sadness. They know my secrets. When I was sad and worried, I would talk to the trees, take care of them … but the war killed those trees.”⁷⁸

CONCLUSION

Our essay does not describe the full magnitude of the devastating environmental and health impacts of the bombardment and occupation of Palestinians. More research and practical knowledge are urgently needed by the global scientific community to protect Indigenous communities and the environments they reside in from further harm. In all that we have highlighted thus far, we have not touched on the destruction of 80% of schools or the destruction of every university in Gaza.⁷⁹ As of February 2024, at least 95 professors have been killed.⁸⁰ Palestinians, who have one of the highest literacy rates in the world and deeply value education, are facing an attack on their future.⁸¹ We write this as Palestinians in Gaza no longer have space to bury their dead (an estimated at least 186 000 deaths⁸² and an estimated 41% of mortality being underreported⁸³—with only approximately 40 000 deaths having been reported since June 2024). On March 2, 2025, the Israeli authorities announced a halt to humanitarian aid entering the Gaza Strip, including fuel.^84,85

The 1-year mark has been surpassed of what the International Court of Justice labeled a “plausible” genocide⁸⁶; what Amnesty International,¹⁴ Human Rights Watch,⁸ and the UN Special Committee⁸⁷ labeled consistent with genocide; and what journalistic investigations have labeled an ecocide.^54,88,89 UNEP called the environmental impacts of Israeli bombardment in Gaza “unprecedented,”¹³ as “Water and sanitation have collapsed. Critical infrastructure continues to be decimated. Coastal areas, soil and ecosystems have been severely impacted.” Palestinian human rights organizations (including Al Haq and Al Mezan Center for Human Rights) and groups in Israel (including B’Tselem and Yesh Din), have called for preventing the crimes of starvation and forcible transfer, which are leading to the liquidation of northern Gaza.⁹⁰

Despite overwhelming evidence objectively gathered by many well-respected organizations of violations of international law, the situation has not improved for Palestinians. The crisis in Gaza has severe and lasting consequences for human health, the environment, and regional stability that can only be mitigated by an end to the bombardment and occupation, urgent humanitarian aid, release of all hostages, infrastructure rebuilding, and environmental remediation. The critical air, water, and food quality contamination in Gaza must be acknowledged and addressed immediately for the health of Palestinians now and future generations to come.