Gaza Strip: Every meal in Umm Nahed Abu Shar's tent in a Gaza camp is shared with a cloud of flies and accompanied by the overpowering stench of sewage - a growing threat alongside the ongoing war.
A report released by a European activist group on Thursday said the Gaza Strip is "drowning" in hundreds of thousands of tonnes of uncollected human waste and rubble from the Israel-Hamas war, which could soon spread to the surrounding region.
While the danger for Gaza is imminent, the overall region could soon confront grave ecosystem and public health problems.
Amid rising summer temperatures, Abu Shar and her family are living a nightmare in their tent in the central Gaza city of Deir Al Balah, where authorities said this week that wastewater treatment stations had been turned off due to a lack of fuel.
"We are just suffering; we are not living," said the 45-year-old Abu Shar.
"The heat, the diseases, the flies, the mosquitoes and their hissing, it all hurts us," she told AFP.
"We don't sleep at night because of the smell of sewage. My children do not sleep because they are always ill with something spread by the waste."
On top of the hunger that UN agencies say has gripped Gaza since the war erupted on October 7, doctors report that scabies, chickenpox, skin rashes, and lice are spreading fast.
UN agencies have repeatedly warned of the risk of cholera and other more serious diseases becoming epidemics.
Suffocating
Umm Yussef Abu Al Qumsan, 60, has also had to leave her home and move to Deir El Balah where she said it was "a miserable life among rubbish and insects".
Nearly every day she accompanies her children or grandchildren to queue for a nurse to help for diseases or mosquito bites.
"We buy many treatments. But we don't know if it is safe to eat or drink. Whether we can sit or sleep," she said.
The Deir El Balah city authority this week predicted that "roads will be flooded by wastewater" and "diseases will spread" after it turned off sewage water pumping and treatment stations.
It said 700,000 people who have descended on the city in search of safety from fighting and air strikes are at risk.
A fire has burned on one dump at Al Mawasi, a giant tent city near Khan Yunis in the south, for the past week, according to 35-year-old Muhammad Al Kahlot of the Palestinian Red Crescent in Gaza.
The under-equipped emergency services have been unable to stop it.
Al Mawasi has been bombed several times - once last Saturday in an Israeli bid to kill Hamas military commander Mohammed Deif and his deputy - and Kahlot said the war waste is an added threat.
"We are suffocating from the foul smell of waste, the smoke and the heat," he said.
Pax, a Dutch activist group, said in a new study that "months of continuous bombing and Israel's fuel blockade have decimated" Gaza's outdated waste collection system.
"Local authorities report that the Israeli Defense Forces are preventing access to Gaza's three official landfills."
Pax said it has studied satellite imagery showing 225 growing waste dumps across Gaza.
The group said a "chemical soup" of matter and heavy metals could contaminate water supplies and farmland and "eventually toxic substances penetrate the food chain and find their way back to humans".
Pax warned that as water can "migrate over long distances" the danger could spread beyond the war zone.
"While the danger for Gaza is imminent, the overall region could soon confront grave ecosystem and public health problems."
