Deir Al-Balah, Gaza – Eman Mahmoud Shamia has been uprooted several times since Israel’s genocidal war on Gaza began in October 2023, before finally settling into a new home – a tent in a camp.
It provides rudimentary shelter for 33-year-old Eman, her husband, Yahya Shamia, 50, and their five children, all under 11, but it lacks many of the basic amenities her old home provided.
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With the help of a worker who specialised in digging soakaway underground drainage pits, the community in the camp built a “municipal toilet”. It provides relief but Shamia said it reminds her of the Stone Age.
There is little in the way of privacy, particularly for women and children, and for some it is difficult to use or access, particularly for her husband, who suffers from an advanced stage of lung cancer.
“I am deprived of my basic right to have a proper toilet seat in my tent. This is exhausting for me as a woman and a mother of five children and my husband is sick and unable to use the makeshift toilet. What is happening to us is madness,” Shamia told Al Jazeera.
“I cannot believe this is our situation. Sometimes I feel like I am going crazy. How did the toilet become like this and how did the door become just a piece of cloth?”
While hundreds of thousands have lost their homes in Gaza, often overlooked are the daily struggles the displaced face in maintaining some level of dignity in their tent towns. The primitive communal toilets they often rely on are an example.
The ongoing Israeli siege has seen the price of sanitation supplies shoot up with a used toilet seat now costing between 1,500 ($503) and 2,000 shekels ($671).
Due to unaffordable prices, Palestinians are making their own primitive toilets by cutting holes into plastic chairs with a layer of sand underneath.
Mohammad Al-Hanouti, 30, from Al-Bureij refugee camp, has an unstable income from his small streetside stall and lives in an unfinished apartment without proper plumbing. What little he earns, he puts towards a toilet.
“I will live without tiles, without a kitchen and without a proper toilet… I have been saving to buy a toilet seat because it is the most important thing in the apartment. Honestly, I am in trouble – getting the basic necessities will cost me around $2,000,” he told Al Jazeera.
“The crisis over toilet seats needs to be addressed urgently. I am not the only one suffering from this; I have friends in the tents who are also struggling.”
He said proper toilet access is a “most basic right” and called on international organisations to import toilets and distribute them in Gaza to those in need for free.
Economist Omar Salouha said the toilet crisis is the result of a “severe supply shock” caused by restrictions on importing toilets, sanitation supplies and plumbing materials.
With more than nine in ten Palestinians in Gaza displaced and over 90 percent of homes damaged or destroyed during the war, there has been a massive increase in demand for toilet products.
“The huge imbalance between supply and demand has caused the prices of used toilets to increase several times over and created a market suffering from scarcity and distortion,” Salouha says.
Some Palestinians are using the rubble of their destroyed homes to make toilets, but Omar says that is not a low-cost option, with seats becoming “a monopoly commodity”.
This means that communal toilets are the only option for most in Gaza, with a single toilet being used by 20 or 25 people.
“There are usually no separate facilities for men and women… [making toilet access in Gaza] a daily necessity linked to health, privacy and dignity”, said Omar.
These facilities often lack proper sinks and taps, so residents use water hoses or barrels of water. Hand sanitiser and toilet paper have become “luxuries”, he added.
In some areas of Gaza, water is only available once a week and many of the camps lack integrated sewage networks, forcing residents to dig pits next to communal toilets to dispose of wastewater.
Hossam Al-Huwaity, spokesperson for the Chamber of Commerce, said it is encouraging traders to submit formal import requests to bring in essential sanitation supplies to help cope with the crisis.
The chamber has also called on UNICEF, the World Food Programme, OCHA, the European Union and Water, Sanitation and Hygiene (WASH) organisations to help. But, the main obstacle remains the Israeli blockade on Gaza, he said.
“Most commercial requests and appeals remain stuck due to unjustified restrictions and delays at the crossings,” Al-Huwaity added.
A WASH assessment by the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) found that only half of people surveyed in Gaza had access to basic sanitation. Around 60% were exposed to wastewater or human waste within 10 metres of where they lived, contributing to the spread of diseases.
Dr Ahmed Al-Jedi, an emergency department physician at Al-Aqsa Martyrs Hospital in Deir al-Balah, said large numbers of children, women and older people are arriving at the emergency department with recurring cases of diarrhoea, skin diseases or gastrointestinal problems.
“Many of these cases are linked to the difficult living conditions inside the tents, where there are not enough facilities for bathing and personal hygiene, and some families may only be able to bathe once a week,” he said.
“Children spend long hours outside the tents because of the heat, playing in the sand, while the same limited space is used for eating, drinking and sleeping, and in some cases toilets are located very close to living areas.”
