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Supervisor Elham AbolFateh
Editor in Chief Mohamed Wadie

Water in Times of War

Tue 24 Oct 2023 | 12:32 PM
Dr.Magdy Badran
Dr.Magdy Badran
Dr Magdy Badran

United Nations officials are warning that millions of Palestinians face dehydration and are at risk of waterborne disease in an escalating water crisis as Israel continues to withhold essential supplies from Gaza in the wake of Hamas’ Oct. 7 attack. 

Israel cut off the main supplies to Gaza, including a pipeline from Israel, desalination plants on the Mediterranean Sea and wells. Besides water, Israel has also cut off fuel and electricity that power water and sewage plants. With around 47% of the population of Palestine below the age of 17, millions of people are struggling without water.

The World Health Organization stresses the importance of preventing the development and spread of waterborne diseases in conditions where these diseases can easily attain epidemic proportions, especially in war affected or spontaneous settlements. 

Water is an Important Nutrient

Water is essential for the survival and development of life. Water plays important roles in various physiological processes, including maintaining the normal osmotic pressure and electrolyte balance of the body fluid, and participating in the metabolism of the body. 

Every cell, tissue and organ in your body needs water to work properly. Water gets rid of wastes through urination, perspiration and bowel movements, water keeps your temperature normal, and water lubricates and cushions your joints.

Maintaining adequate water intake is vital in ensuring normal physiological functions. Insufficient water intake has negative impacts on cognitive performance and physical activity, and it also increases the risk of urinary and cardiovascular diseases.

Damage to Water Supply

In times of war, both human health and the environment are affected. Damage to water supply and sanitation can deprive people of their human right of access to water. Water supply and wastewater treatment plants and networks, monitoring systems and other important infrastructure can stop functioning, fully or partially, because of physical destruction by shelling, electricity cuts, lack of supplies, or maintenance personnel losing control, access or being forced to flee the premises. 


On average, children under the age of 15 who are living in conflict are nearly three times more likely to die from diseases linked to unsafe water and sanitation than from direct violence. For younger children, the situation is worse. Children under five years old are more than 20 times more likely to die from diseases linked to unsafe water and sanitation than from direct violence. 

More Water pollution

Wars lead to various cross-border transport of air and water pollution. Wars increase pollution in rivers, lakes, wetlands, and aquifers. For example, air strikes and shelling can destroy industrial installations, landfill sites and waste storage facilities, including mining tailings. This can result in spills of hazardous substances. 

Water can also become a weapon and its use to achieve military objectives is no new phenomenon. A destroyed dam can flood lands and cities far downstream. Seizing strategic water infrastructure can become a military purpose in itself. 

Toxic Dust

Airborne dust can be flammable and can constitute a danger of explosion in industries such as mining, iron casting, wood and even food production. Dust is a risk to be taken seriously. Airborne dust can be incredibly fine-grained; soot and several types of smoke are smaller in particle size than most viruses. In landscapes which have been subjected to excessive use by heavy military vehicles, toxic dust is a very real environmental issue. 

The residue of toxic metals often ends up in water sources which can lead to serious health issues for both humans and surrounding plant and animal life. Containing heavy metals such as cobalt, barium, arsenic, lead and aluminum, toxic dust can cause serious respiratory disorders for military personnel and local residents alike. Across the globe, traces of perchlorate are commonly found in groundwater sources located near weaponries. As a man-made chemical used to create rocket fuel, fireworks, flares and explosives, perchlorate is not a nice element to find near any water source.

Lack of Hand Hygiene 

Lack of water and of handwashing put millions at increased risk to infectious diseases. Dirty hands can be a vector for several gastrointestinal infections, such as diarrhea, and respiratory infections, such as influenza. These infectious diseases can cause serious complications, especially for people with poor compromised immunity.

Poor Sanitation

Sanitation generally refers to the provision of facilities and services for the safe disposal of human urine and feces. Sanitation refers to the maintenance of hygienic conditions, through services such as garbage collection and wastewater disposal.

Prolonged conflict or war affect access to sanitation. Lack of clean water and proper sanitation puts children's futures at imminent risk. These threats are exacerbated during conflict when indiscriminate attacks destroy infrastructure, injure personnel, and cut off the power that keeps water, sanitation and hygiene systems running.


Dehydration is a deficiency of water in the body. People feel thirsty, and as dehydration worsens, they may sweat less and excrete less urine. If dehydration is severe, people may be confused or feel light-headed.

Dehydration is particularly common among older people because their thirst center may not function as well as that in younger people. Certain disorders such as diabetes mellitus, diabetes insipidus, and Addison disease can increase the excretion of urine and thereby lead to dehydration.

Symptoms of mild to moderate dehydration include thirst, reduced sweating, reduced skin elasticity, reduced urine production, and dry mouth. In severe dehydration, the sensation of thirst may actually decrease, and blood pressure can fall, causing light-headedness or fainting, particularly upon standing. If dehydration continues, shock and severe damage to internal organs, such as the kidneys, liver, and brain, occur. Very severe dehydration can lead to coma and death.

Brain cells are particularly susceptible to more severe levels of dehydration. A 2% decrease in brain hydration can result in short term memory loss and have trouble with math computations. Prolonged dehydration causes brain cells to shrink in size and mass. Mental symptoms of dehydration can include depression, afternoon fatigue, sleep issues, inability to focus and lack of mental clarity, sometimes referred to as brain fog. The brain itself is made up of approximately 85% water. Water gives the brain energy to function including thought and memory processes. Water is also needed for the production of hormones and neurotransmitters in the brain. Confusion is one of the best indicators that dehydration has become severe. 

Waterborne Infectious Diseases

Contaminated water can transmit diseases such diarrhea, cholera, dysentery, typhoid, polio, amebiasis, hepatitis, gastroenteritis, giardiasis, campylobacteriosis, scabies, and worm infections. Waterborne illnesses can cause a variety of symptoms. While diarrhea and vomiting are the most commonly reported symptoms of waterborne illness, other symptoms can include skin, ear, respiratory, or eye problems.

Diarrhea is the most common of all water-borne diseases. Diarrhea mainly affects children below five years of age. It usually lasts for a couple of weeks and can turn out to be fatal if it goes untreated.

Cholera is mainly caused by bacteria named Vibrio cholerae via consumption of contaminated food or drinking water. The symptoms include diarrhea, vomiting, fever, and abdominal cramps. Cholera occurs predominantly in children but can also affect adults. It possesses a mortality rate that is alarmingly high among the water-borne diseases.

Public Healthcare 

Delivery of quality healthcare should take place in a hygienically clean and safe environment which must have an adequate supply of clean running water and good sanitation for both patients and staff.

The loss of clean, plentiful water can have a huge impact on hospitals and other health care facilities. Beyond the hazards of losing water for clinical needs and operational functions such as instrument sterilization, food preparation and environmental services, a loss of water also could damage or render inoperable crucial medical and infrastructure equipment.

Water cuts can lead to infections in public hospital patients. The problem threatens hospital patients suffering from diabetes, renal failure, and malignancies. Long stays in hospital, surgical or invasive procedures, insertion of medical devices, and intravenous tubing and artificial joint replacement also pose a risk. Hospital water outage threatens lives of dialysis patients.