Haneen Harara wakes up each morning in the southern Gazan city of Rafah thinking about the long queues and crowds that stand between her and the survival basics of food, water and medical care.
The film-maker and employee at a Dutch charity considers herself lucky that she and 15 members of her family reached the city on Gaza’s border with Egypt in time to find a house at which to stay. Many others have found shelter from the winter cold in tents that fill with water every time it rains.
“You don’t feel that your home is a comfort zone,” she said. “It’s not easy at all to find shelter. People are suffering in tents where there’s no protection, these tents are full of rainwater.”
While tens of thousands of people cluster around every school or clinic in Rafah run by the UN agency for Palestinians in a desperate effort to find shelter, the UN Relief and Works Agency (UNRWA) faces punishing funding cuts from many of its largest international donors, including the US and UK, after Israeli officials accused 12 of its employees of taking part in the attack on 7 October when Hamas militants killed about 1,200 people and took hundreds hostage in a raid on southern Israel.
The UN has launched an investigation and the agency’s head, Philippe Lazzarini, described funding cuts over accusations levelled at a small group of staff as “shocking”. The agency also provides food, flour, sanitation and desalination services to Palestinians in Gaza.
Even before the current conflict, Gaza was considered one of the most densely populated places on Earth. Since 7 October, Israeli bombing and ground campaigns have forced Palestinians to move south, leading to severe overcrowding in places such as Khan Younis and Rafah.
Observers describe masses of people fleeing using any means they can find, with people so packed into cars that they are forced to travel with every door open to fit extra people inside.
Before the war Rafah, a small city of just of 150 square kilometres and impoverished even by Gaza standards, housed an estimated 250,000 people. Last week, the UN human rights office (OHCHR) in Gaza reported that more than half of the territory’s population of 2.3 million people was staying there.
Rafah has not escaped airstrikes by Israel. One this month killed 16 members of the same family who had been displaced three times before they reached Rafah, survivors said.
Harara, who fled to Rafah in recent weeks, said when she first arrived 15 of her family members were staying in one bedroom. “Mothers, fathers, parents and kids, with one bathroom. This was considered things going well under the circumstances,” she said. “After five days we were forced to evacuate again as there were huge bombardments and we felt at risk. My father began looking for a new shelter, a new home – anything to escape the shelling and rockets and bombs. No place is safe here in Gaza.”
Eventually they reached the home of family friends, who offered them a place to stay. Harara was relieved, although the situation outside continues to worsen. Crowding in the streets, plus hours-long lines for food and water, have led to the rapid spread of disease, with local health officials recently reporting a rapid outbreak of hepatitis A – a condition that spreads from close contact.
Tamara Alrifai, the head of external relations for UNRWA, said: “The first step to stopping it is isolating the patient but this is physically not possible. In overcrowded shelters or makeshift camps around them, isolating is not an option.”.
Constant crowding, including thousands sharing few showers and toilets, has aggravated outbreaks of skin diseases including scabies and lice, worsened by people being unable to shower. “Our latest figures show that for every 2,000 people there is one shower unit, and 500 people for every toilet,” she said.
Dr John Kahler of the organisation MedGlobal, who left Gaza this week after setting up a clinic in Rafah, said he had witnessed crowds of up to 700 people clamouring outside its doors every day. He estimated that he treated about 140 children daily, a fraction of the vast need.
“Our office was along the beach road in the west of Gaza. When we arrived there were tents up but things were pretty open. By the time we left two weeks later, no square metre was available to put a tent up. People were coming in, row after row of desperate people, pulling donkey carts and in cars loaded up sky high,” he said. “It was heartbreaking. I saw people looking at a garbage dump trying to figure out if they could clear space to set up a tent for a family of six people.”
Building materials for making even the most basic shelter are at a premium. Tens of thousands more people are expected to arrive in the coming days as Israeli forces push deeper into Khan Younis, less than six miles north. Several thousand people sheltering in the UNRWA compound in Khan Younis began moving south last week, said Alrifai.
She warned that there was already massive overcrowding and a lack of shelter space and tents in Rafah. “People will start arriving to Rafah literally to be on the streets,” she said. “I’m seeing it in WhatsApp groups where colleagues arrive there and ask about where to find plastic sheeting or even a tent. Everywhere you look now there are people living on the streets and in makeshift shelters.”
