Médecins Sans Frontières (MSF) has released a report documenting how Israel is deliberately depriving Palestinians in Gaza of water and sanitation.
Despite the ceasefire, Israel is also still restricting access to essential services in the Gaza Strip and, at the time of writing, controls about 65% of the Gaza strip.
The report, Water as a Weapon, released on April 28, draws on MSF’s data and medical evidence gathered throughout 2025, as well as first-hand testimonies.
According to MSF, Palestinians in Gaza face engineered water scarcity, where “needs far exceed supply” at distribution points. “Between May and November 2025, one in every five of MSF’s water distributions ran dry while people were still waiting,” the report notes. From the start of the war in October 2023, until January this year “prices for water produced by private providers have increased by up to 500 per cent, placing it beyond the reach of most households that have lost their livelihoods”.
People endure entirely preventable and dire sanitation and hygiene conditions, due to the collapse of sanitation systems.
“In displacement camps, families dig makeshift latrines in their tents or have to share one with many others; they fill up quickly and are often too close to boreholes, contaminating groundwater. Heavy rains flood these rudimentary facilities, spreading waste and faecal bacteria. Solid waste accumulates in living areas due to halted collection systems and fuel shortages. Hygiene items such as soap, disinfectant, diapers and menstrual products have been unavailable or scarce, and remain prohibitively expensive.”
As a result, diarrhoea, skin diseases and infections are rife.
The report also documented the profound impact on people’s mental health from the lack of access to water and sanitation, with “high levels of distress linked to the constant struggle to find enough water and hygiene items” and the lack of dignity and privacy, “particularly for women, the elderly and people with disabilities”.
MSF reports that Israeli military operations have destroyed nearly 90% of water, sanitation and hygiene infrastructure, with desalination plants, boreholes, pipelines and sewage systems “rendered inoperable or inaccessible”.
According to estimates by UNICEF, more than 90% of Gaza’s water is undrinkable due to high salinity and contamination from sewage leakage, alongside the long-term depletion of the coastal aquifer.
Meanwhile, Israeli authorities continue to block the delivery of essential means of existence into Gaza.
“Since October 2023, electricity and fuel — critical to water treatment and distribution — have been cut or tightly restricted. Requests for authorisation to bring in critical supplies have been rejected or left unanswered, including water desalination units, pumps, chlorine and other chemicals to treat water, water tanks, insect repellent, and latrines. Even when approved, shipments have been turned away at crossings, leaving lifesaving equipment stranded for months,” the MSF report said.
The report concludes that the effect of Israel’s policies and actions “is the collective punishment of Gaza’s population through the deprivation of services and supplies indispensable to civilian survival”.
Meanwhile, Middle East Monitor reported on April 28 that, according to the International Commission to Support Palestinian Rights, Israel is carrying out a “slow genocide” in the Gaza Strip, with the commission warning that famine continues to spread as humanitarian access remains severely limited.
Salah Abdel-Aati, the commission’s head, said the situation has deteriorated sharply; aid entering Gaza over the past six months has met less than 40% of residents’ needs.
Abdel-Aati said Israeli is violating the ceasefire and targeting civilians; 823 people have been killed over the past six months, mostly women and children, and a further 2280 reported injured. He said about 90% of Gaza has been destroyed due to the use of more than 250,000 tonnes of explosives, equivalent to “12 atomic bombs like those dropped on Hiroshima and Nagasaki”, across an area of roughly 360 square kilometres.