The poisoned wells of Gaza


One of many dumpsites along Wadi Gaza, Gaza’s only wetland and only open body of water. Once a stopover for migratory birds, once a contender for Ramsar designation, it is now compromised by leachate from the uncontrolled dumping of demolition waste.

The proportion of contamination from waste, however, appears to be insignificant compared to the load imposed on the wadi by raw sewage.

watermapThere is only one natural source of fresh water in Gaza, the coastal aquifer roughly delineated on the map to the right. The flow within the aquifer is from northeast to southwest, meaning the Gaza strip is at the extreme downstream end.

While the new report from UNEP, Environmental Assessment of the Gaza Strip following the escalation of hostilities in December 2008 – January 2009 (102-page pdf) examines a wide range of deteriorating environmental conditions in Gaza, it is the drinking water problem that rightly gets much of the attention. Most people seem to be focussed on the fact that the aquifer faces “imminent collapse” in the ICRC’s terms. This is largely a matter of simple over-extraction along the entire field of the aquifer:

It is estimated that the annual recharge from rainfall in the Gaza Strip to the coastal aquifer is about 45 million cubic metres. Abstraction has been well in excess of sustainable levels: indeed the most recent estimate of abstraction, dating from 2007, is about 163 million cubic metres per year (CMWU, 2008).

So the aquifer will continue to fall. It is already inadequate.

The average per capita daily consumption of water for personal and domestic use in Gaza is 91 litres. WHO recommends 100-150 litres daily. Israelis consume 280 litres per day.

As the aquifer level falls, intrusion of seawater from the Mediterranean into its downstream region increases. But that is only the beginning of the problem.

Overcrowding, porous soils, the breakdown of governance, uncontrolled agricultural runoff, uncontrolled waste disposal, and most of all the deterioration of sewage infrastructure that cannot be repaired due to the blockade have led to unbelievable levels of nitrate contamination in Gaza wells:


(The blue line at 50 mg/l is the WHO guideline. It is also our own EPA’s guideline. Please note this is not some suggested daily intake; it is in EPA’s terminology the Maximum Contaminant Level allowable consistent with human health. To avoid possible confusion, please note that you will see 50 and 10. They are the same standard expressed – unfortunately – in different ways. 50 mg/l of nitrate translates to 10mg/l – or 10 parts per million – of N from nitrate.

To give an idea of how seriously the nitrate standard is enforced in the US, when the well at Outlook School just up the road 20 miles from my house was found to have 10.36 ppm – .36 ppm over the limit – the Washington state health department ordered the immediate capping of the well.)

The Assessment‘s fact box on methemoglobinaemia – blue baby syndrome:

Blue babies in the Gaza Strip

Methemoglobinaemia is a blood disorder characterized by higher than normal levels of methemoglobin, a form of haemoglobin that does not bind oxygen. When haemoglobin is oxidized it becomes methemoglobin, its structure changes and it is no longer able to bind oxygen or deliver it to the tissues, and anaemia can result. This state is referred to as methemoglobinaemia.

Infants suffering from methemoglobinaemia may appear otherwise healthy but exhibit intermittent signs of blueness around the mouth, hands and feet. They may have episodes of breathing trouble, diarrhoea and vomiting. In some cases, infants with methemoglobinaemia have a peculiar lavender colour but show little distress. Blood samples appear chocolate brown and do not turn pink when exposed to air. When the methemoglobin level is high, infants express a marked lethargy, excessive salivation and loss of consciousness. Convulsions and death can occur when methemoglobin levels are extremely high.

Reduced oxygen transport capacity becomes clinically manifest when methemoglobin concentrations in the blood surpass 10 percent of the hemoglobin concentrations. The normal level of methemoglobin in the blood of adults is <2 percent; of infants under three months of age ❤ percent (WHO, 2007).

WHO established a guideline values for nitrates already in 1958. The 1993 guidelines concluded that extensive epidemiological studies supported the guideline value for nitrate at 10 mg/litre (as nitrogen) but that the value should be expressed as nitrates as this is the chemical entity that concerns public health. The current (WHO 2008) guideline value for nitrate is 50 mg/litre.

A disturbing feature of nitrate as a contaminant is that it is colourless, tasteless and odourless. This, and the fact that the population has not been warned about it, means that people will continue to consume drinking water with high nitrates unless they are informed about it.

Monitoring of groundwater in the Gaza Strip indicated the presence of nitrates as early as the 1990s. It emerged that the elevated levels of nitrate were primarily caused by the infiltration of sewage from domestic septic tanks as well as agricultural runoff into the groundwater. Nitrate values in the Gaza Strip have continued to rise and currently present a health risk throughout the territory. Since the aquifer is a continuum and pollution is occurring across the Gaza Strip, albeit in varying degrees, it is not surprising that high levels of nitrate are found throughout the Gaza Strip (see Figure 9).

In the 1990s, data began to emerge about the incidence of blue babies in the Gaza Strip. A 1998 survey (Al Absi 2008) studied 640 blood samples from children in paediatric hospitals across the Gaza Strip. The presence of 10 percent methemoglobin was taken as the minimum level indicating methemoglobinaemia. The study showed that the prevalence of methemoglobinaemia – or “blue babies” – in the Gaza Strip, according to this criterion, is 48 percent.

In a more recent study (Abu Naser et al. 2007), 338 babies under one year old who attended 12 primary health centres for vaccination were tested for methemoglobins between June 2002 and November 2002. The study group was 53.3 percent male and 46.7 percent female; the mean age of the group was 4.5 months. The main source of water that they consumed was tap water from groundwater (59.5 percent) followed by treated water (20.4 percent), home filtered water (11.2 percent). The rest used private wells. The proportion of children with methemoglobin higher than 5 percent was 48.5 percent.

The current status of methemoglobinaemia in the Gaza Strip is unknown as there are no systematic studies available in the public domain. However, as mentioned previously, nitrate levels in the groundwater have increased and nitrates are more widespread in the area. Consequently, it can be expected that the problem is still prevalent in the Gaza Strip, and in the absence of widespread awareness, a large number of children are at risk.

The following actions are proposed to address this challenge.

• Provide safe water for infants: There is enough evidence to suggest that some children in the Gaza Strip are at risk of consuming water with elevated levels of nitrates, leading to methemoglobinaemia. Immediate action should be taken to provide all children under one year old with adequate clean, safe water.

• A study on the prevalence of methemoglobinaemia: Due to the reported prevalence of methemoglobinaemia in the Gaza Strip, a comprehensive study should be undertaken. WHO, UNEP, the United Nations Children’s Fund (UNICEF) and UNRWA can provide technical support for such a study.

Methemoglobinaemia may be the most serious and obvious problem, but it is far from the only one. While studies of the correlation between high nitrates in drinking water and neural tube defects like anencephaly and spina bifida remain maddeningly inconclusive, none have looked at these levels, and none have looked at Gaza. Certainly if it were my child, I would err on the side of caution.

All these problems are compounded by the ever worsening diet in Gaza, especially its low levels of the micronutrients that could in marginal cases ameliorate the problems associated with high nitrate levels.

Then there is the simple matter of increasing salinity in the drinking water as the Mediterranean infiltrates the falling aquifer. Current salinity levels in many wells far exceed universally accepted standards and are very clearly linked to the increased prevalence of kidney damage and gastric cancer among other problems.

The Assessment includes a number of recommendations, each more fanciful than the last in the face of the blockade. One seems particularly questionable. The sewage that isn’t leaching into the aquifer simply flows untreated into the sea. Criticizing an attempt at some sort of temporary fix – one that could be done without the forbidden construction equipment, cement, and pvc pipe – the UNEP says

Two aid organizations, Acción Contra El Hambre and Gruppo Volontario Civile, are planning to construct artificial reed beds as an interim measure until the problem can be solved by installing a more sophisticated wastewater treatment plant. While the development of interim measures is understandable, reed beds in this context will not eliminate groundwater contamination completely, and may give a false sense that the problem has been addressed. Issues of sewage treatment and
disposal in the Gaza Strip need to be tackled in a systematic way to avoid a catastrophic groundwater situation in the area.

So what is the UNEP’s suggestion?

Dispose of all sewage deep offshore:

All sewage that is currently pooled in the various lagoons should be drained into the sea. Until new and efficient sewage treatment plants are established, all sewage should be disposed at a safe distance and depth offshore, as an interim arrangement.

The damage to marine fisheries from raw sewage and other pollution flowing directly into the Mediterranean is discussed at length elsewhere in this very report. Piping it a little further out to sea hardly seems a serious answer.

The recommendation that Wadi Gaza be restored to its previous condition as a healthy wetland is almost laughable. Again, how in the face of the blockade? With a team of unicorns?


3 Responses to “The poisoned wells of Gaza”

  1. sisdevore Says:

    I read the WaPo so little now (for giving voice to more idiots than ever), but I stumbled upon this horrid column about the success of Operation Cast Lead:

  2. cometman Says:

    Interesting take on salting the fields of the enemy. Everything old is new again. *sigh*

    • artemis54 Says:

      The most disgusting, racist comments imaginable at JPost, Israel Matzav, etc on this story. Let them drown in it, it’s all Hamas’ fault, the ICRC hates Israel, etc. It washes up on the beach at Tel Aviv too, I guess they can’t figure that out. It all sounds so much like comments I have heard all my life about dirty Mexican field workers. Yeah guess what, people get a little dirty when you deprive them of water and any means of basic sanitation.

      If consigning children not even born yet to brain damage and worse isn’t collective punishment, what is?

      Chemical warfare by other more insidious means.

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