February 29, 2024

In the months since Hamas attacked Israel, killing some 1,200 people and taking hundreds more hostage, Israeli forces have stormed Gaza in a campaign to dismantle the terrorist organization. The offensive has killed 22,000 Palestinians and dealt a severe blow to the territory’s fragile air, water and soil – and jeopardized the long-term health of its residents.

The ruin dwarfs anything Gazans have ever experienced. The ongoing air, naval and ground attack damaged or destroyed, according to one United Nations estimate, approx one fifth of the structures in Gaza. According to Thorsten Kallnischkies, a former disaster waste manager who has recommended cleanups in 20 countries, 15 million tons of debris now lie in the Gaza Strip.

The last major hostilities between Israel and Gaza, in 2021, left 1 million tons.

When these buildings, some 40,000 in all, were blown up, concrete, insulation and other materials – not to mention residents’ belongings – were pulverized into toxic dust. The Jabalia refugee camp, for example, a sprawling neighborhood of apartment towers known to contain asbestos, has seen repeated abuse.

Systematic research after the September 11, 2001 attacks in the United States was among the first to link exposure to such a mixture of detritus to lung and respiratory diseases and cancer. Public health experts say the death toll from debris-related illnesses resulting from the destruction in New York will soon surpass that of the day’s attacks, if it hasn’t already.

Yet such studies have not been replicated in places like Syria, Ukraine and Iraq, where the sheer level of urban and industrial infrastructure has left a legacy of pollution in addition to their costs in blood. Some environmental health advocates argue that it is time to give Gaza and other war zones the same attention that was given to Ground Zero.

“You can make a very solid case that civilians in these environments with a lot of dust, debris and litter are regularly breathing it in,” said Wim Zwijnenburg, a researcher with the Dutch peace organization PAX. “Right now, nobody is looking at those kinds of risks. But it has real effects.”

Gaza is one of the most urbanized places in the world, with a population density comparable to London’s. That makes the often toxic pollution associated with decades of conflict one of the “serious long-term public health and environmental problems” facing Gazans, according to a report PAX released on December 18. “It’s a known unknown,” Zwijnenburg said. “We know it’s a risk, we just don’t know how much it is in Gaza right now.”

Post-9/11 research has established links between the destruction of buildings and a variety of short- and long-term ailments. The attacks on the World Trade Center produced a toxic cloud of dust, smoke and fumes whose exact composition is still unknown even now. Most of the particles are thought to have been pulverized concrete, which gives the plume the alkalinity of lye, a common ingredient in household drain cleaners. The rest contained about 150 substances, from glass, wood, lead and asbestos to heavy metals and polychlorinated biphenyls or PCBs, carcinogens produced by burnt wiring and electronics.

Most building materials are harmless in their everyday state. Inflating them gives them appetizer to the body. “Just like tobacco smoke, it’s a toxic mix,” said Ana Rule, an assistant professor at the Johns Hopkins Bloomberg School of Public Health. The nose and throat can catch larger particles, but the smallest of them travel inside the body “a bit like a gas,” she said, transferring from the lungs into the bloodstream and to other critical systems.

According to the Centers for Disease Control and Prevention, or CDC, this chemical miasma affected about 400,000 people in metropolitan New York — first responders the worst, but also many who lived and worked near Ground Zero. The health consequences are still emerging. In 2011, the CDC, at the direction of Congress, launched the World Trade Center Health Program to identify, understand, and treat illnesses related to 9/11. It documented a long and growing list of ailments traced to the attack and, as of September, estimated that more than 6,500 of the program’s enrolled members had died. (It cautions that not all of those deaths were necessarily due to 9/11-related illness.) The most commonly observed illnesses are respiratory illnesses, mental health conditions, and cancers. A network of clinics across the US will treat them for free. In A 2021 paperprogram officials called their work “a model for how to address the complex health issues that arise in the near and long term from any large-scale environmental disaster.”

The volume of debris littering the strip is, by one estimate, about four times that of the Great Pyramid of Giza. Potentially toxic microparticles in it can be kicked up by footfalls or vehicles or lifted to other places on the wind. Rahim Khatib/Anadolu via Getty Images

Catastrophic wars in Syria, Ukraine and Iraq seem to qualify. The conflict in Syria has destroyed a third of the country’s housing stock and a quarter of its forest cover, largely through bombing and arson. In heavily industrialized Ukraine, Russian attacks on nuclear power plants, oil refineries and mines are among thousands possible sources of hazardous pollution suspected by the UN Environment Programme. In Iraq, where retreating ISIS fighters often set oil wells on fire, Zwijnenburg saw crude oil flowing into open pools and sheep blackened by soot.

In principle, making post-conflict zones livable again requires rigorous field sampling, remediation of pollution hotspots and health surveillance to watch for disease trends. In practice, these things are usually overlooked in the exhaustion that follows hostilities. Advocates for more health-focused cleanups say it’s hard to convince governments and funders that such efforts are more than a luxury. “When conflict ends, it can be a long and drawn-out issue. You need clean water, clean land to sustain livelihoods,” said Linsey Cottrell, a career chemist and the environmental policy officer at the Conflict & Environment Observatory, a British charity. “It’s not that it’s not happening, it’s just not as visible or highlighted as a priority as some of the other things.”

Without ground access to Gaza, observers rely on remote sensing and publicly available information to measure environmental impacts on the strip. Using satellite analysis, He Yin, an assistant professor of geography at Kent State University, estimates the fighting has damaged 15 to 29 percent of Gaza’s arable land. The PAX report identifies a plume of black smoke from a soda factory, suggesting burning plastic, and extensive damage at an industrial campus that produces pharmaceuticals, cosmetics, plastics and other chemical goods. In November, the New York Times observed a major fire at a water treatment plantan alarming development in one of the most water-stressed places in the world.

Debris is also likely to pose a risk. According to Kallnischkies, the volume of debris strewn on the strip is about four times that of the Great Pyramid of Giza. Given Gaza’s ultra-dense built environment and Israel’s extensive bombing of residential areas, experts told Grist, aerosolized concrete and asbestos are two likely threats to public health. Most of the area’s 2.3 million people live in apartment buildings. Many residents build informal additions to their homes using inexpensive but durable materials such as asbestos sheeting. Asbestos is safe in its inert state, but when destroyed, it releases microscopic fibers that can easily enter the body.

Inhaling silica, a key ingredient in cement and glass, also increases the risk of cancer. And while the greatest exposure occurs when a building is destroyed, even its wreckage carries a risk. “Based on the images I’ve seen, people may also be sleeping and living in houses that are partially damaged and filled with dust,” Rule said. These microparticles can be kicked up by footfalls or vehicles or pushed to other places on the wind, she said.

People also tend to overlook the risk posed by the things of daily life – bottles of bleach and detergent, cans of paint and thinner, cans of gas and oil. Businesses such as dry cleaners and printers and auto repair shops keep bulk chemicals on hand; so are high school chemistry labs. With proper handling by trained professionals, all can be disposed of safely. But too often in post-disaster scenarios, cleanups take place in bootstrap ways as people, governments and even humanitarian organizations continue to rebuild. Kallnischkies is skeptical that the residents of Gaza will get all the protective gear and equipment needed to do the job safely, and says it is very likely that a lot of debris will simply be dumped into the sea.

The PAX report said the war in Gaza offers a chance to do better. It recommends that the UN authorities and the World Bank lead a comprehensive environmental assessment when the shooting and bombing ends. By identifying any toxins in the environment and who may have been exposed to them, such an analysis can alert public health officials to the diseases they need to watch for.

In the longer view, some want to see greater reflection and consideration about where and how wars are fought. “We need the military to understand the human and environmental costs when they fight in urban areas,” Cottrell said. “We must see that wars are not fought where people live.”

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