A MARTÍNEZ, HOST:
In Gaza, access to food, sanitation and clean water is scarce as the war between Hamas and Israel rages on.
ASMA KHALID, HOST:
The World Health Organization warns disease may eventually kill more people than actual combat if the health system is not fixed.
MARTÍNEZ: We've got NPR's Ari Daniel here to walk us through what's being done to try to stay ahead of an outbreak. Ari, first off, can you give us a snapshot of infectious disease in Gaza right now? What's it looking like?
ARI DANIEL, BYLINE: Sure. It's bad, and it may well get worse. The WHO says rates are, quote, "soaring." Here's one example, A - more than 100,000 cases of diarrhea, with rates among children that are 25 times higher than before the war. Our producer Anas Baba spoke to pediatrician Tahrir Al-Sheikh, who's seen some brutal cases of diarrhea...
TAHRIR AL-SHEIKH: (Through interpreter) I treated a 4-month-old baby who had 20 bowel movements in a day.
DANIEL: ...Along with a torrent of respiratory diseases.
AL-SHEIKH: (Through interpreter) I've had cases that didn't respond to any treatment.
DANIEL: The WHO says there are also numerous cases of meningitis, rashes, scabies, lice and chicken pox.
MARTÍNEZ: All right, wow, so really bad. How have things gotten so bad?
DANIEL: Well, Gaza's health infrastructure has really crumbled amidst Israel's bombardment and ground offensive. The WHO says more than half of Gaza's hospitals are no longer functioning. And that's because Israel has accused Hamas of harboring fighters and weapons in and around those hospitals and under them in tunnels, putting them in the line of fire. Plus, the conditions inside Gaza are a perfect storm for the spread of infectious disease. There is intense overcrowding, colder winter weather and a lack of clean water, sanitation and proper nutrition, which are services that are difficult to secure under Israel's near-total siege of Gaza. Here's Amber Alayyan, deputy program manager for Doctors Without Borders in the Palestinian territories.
AMBER ALAYYAN: It's just sort of a cauldron of possibility of infectious disease. This really just is an infectious disaster in waiting.
MARTÍNEZ: And that brings us back, I suppose, to the World Health Organization's prediction that disease could endanger more lives than military action.
DANIEL: Exactly. And it's why global health groups are racing to ramp up disease surveillance efforts.
MARTÍNEZ: What did that look like in Gaza before the war?
DANIEL: Pretty good, actually, despite the Israeli blockade. But the war has compromised all that. Here's Dr. Al-Sheikh again.
AL-SHEIKH: (Through interpreter) We used to culture bacteria in Gaza, prescribe medication based on the results. Now we can't do cultures or anything, and the infections are spreading.
MARTÍNEZ: So then what are public health professionals doing to try and catch an outbreak before it even takes off?
DANIEL: Well, a WHO official recently traveled to Gaza with rapid tests for hepatitis and cholera. They want to resuscitate one or two of the local laboratories that used to do pathogen screening. Negotiations are also underway to bring a mobile lab into Gaza or ferry specimens out to Egypt for testing. For now, Rick Brennan, a regional emergency director with the WHO, told me it's fortunate that terrible diseases like measles or cholera haven't yet surfaced.
RICK BRENNAN: To be honest, I'm grateful that we've got to this point - we've got increased rates, but we haven't had a deadly outbreak yet.
DANIEL: Whether that good fortune lasts isn't certain, but early detection will be critical to keeping potential disease outbreaks contained before they lead to further suffering.
MARTÍNEZ: That is NPR's Ari Daniel. Ari, thank you.
DANIEL: Thanks so much for having me, A. Transcript provided by NPR, Copyright NPR.
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