Environmental Health in Gaza Strip

1.  Environmental Health in GazaStrip

2. Historical perspective • "If you want to learn about the health of a population, look at the air they breathe, the water they drink, and the places where they live.“ • Hippocrates, the Father of Medicine

3. The Hippocratic Oath: ''well being of man is influenced by all environmental factors: the quality of the air, water, food, the winds and the topography of the land''.

4. Introduction Environmental health is the branch of public health that: • focuses on the relationships between people and their environment; • promotes human health and well-being; • and fosters healthy and safe communities.

5. Environmental health is a key part of any comprehensive public health system. • The Environment is an important contributor to health and well being of the population. • The environmentalists work to advance policies and programs to reduce chemical and other environmental exposures in air, water, soil and food to protect people and provide communities with healthier environments.

6. * Understanding the effect of environmental factors on health and disease requires studying many factors like social, cultural, political, economical and physical factors that interact with psychological and physiological rhythms that form the foundations of human existence.

7. Definition of Environmental Health byWHO • Environmental health comprises those aspects of human health that are determined by physical, chemical, biological, social and psychosocial factors in the environment. • It also refers to the theory and practice of assessing, preventing and controlling those factors in the environment that can potentially affect adversely the health of present and future generations.

8. Definition of Environmental Health by National Institute of Environmental Health SciencesEnvironmental healthis the branch of public health that is concerned with all aspects of the natural and built environment that may affect human health.

9. Background of Environmental Health in Gaza StripGaza Strip is a semi-arid region of roughly 365 km2 which lies on the Mediterranean Sea. On this narrow strip, almost 2 millions of the Palestinian people live. A " Catastrophic" water shortage, and water pollution, lack of sewage and solid waste treatment, maritime pollution, overcrowding, poverty and uncontrolled use of pesticides are the most pressing environmental problems in Gaza Strip.

10. In general, these environmental problems have multiplied the Palestinian suffering and increasing health hazards.Therefore, the environment in Gaza Strip requires a more thoughtful and comprehensive plans and interventions.

11. Water See also the two attachments: أزمة المياه في قطاع غزة * * Health hazards of contaminated water

12. Water Characters:1- Physical: the water should be colorless, tasteless and odorless. Change of odor, color or taste indicates water pollution or contamination. 2- Biological: Drinking water should be free from all microorganisms. The best indicator for water contamination is the presence of E. Coli indicates fecal contamination. 3- Chemical: The accepted level of chemical concentration is referred to the maximum concentration of specific material in water that if exceeded it will endanger human heath .

13. Health Hazards of WaterWater Sources in Gaza Strip are subjected to excessive over-exploitation and over-pumping, this has led to degradation of water quality in Gaza Strip, where severe water shortage are experienced and where the situation has become catastrophic. Water Pollution with different pollutants (Salinity such as Chloride and Nitrate and Micro - pollutants such as Pesticides, Fertilizers & Detergents).

14. Waste Water Unfortunately about 50% the raw sewage is discharged untreated in the Mediterranean Sea where the biological oxygen demand increases. The rest of sewage is treated with semi treatment such as the first step of primary treatment and sometimes the secondary treatment. This pollutes the ground water because our aquifer is shallow.

15. Sewage networks cover no more than 70 % of total residential areas in the Gaza Strip. Open sewage channels spread in some parts of the Gaza Strip, particularly in refugee camps, creating health hazards.

16. Health Hazards of Waste Water * Disease transmission: such as Cholera, Dysentery, Parasites and Hepatitis A. * Bad smell resulted in psychological disturbance. * Sewage collection is a breading place for insects as mosquitoes and flies. * Contamination of underground water by biological and chemical pollutants.Management of Sewage: Treatment: Biological treatment is performed by these mechanisms:a. Filtration b. Aeration (تَرْوِيح , تَهْوِيَة ) c. Disinfection

17. Solid WastesThere are no enough dumping sites, sanitary landfillsمكب النفايات, containers and vehicles. Therefore, the solid waste is sometimes thrown everywhere. Gaza Strip utilizes the old method of landfills for disposal thus negatively affecting the environment. This leads, in turn, to the spread of diseases and increases the difficulties encountered for disposal.

18. Sources of Solid Wastea-Houses are the main source of the solid waste and are the main place, which necessitate proper waste disposal.b-Streets this is mainly dust and the amount of solid wastes depends on the population orientation to their health. Healthy communities have clean streets.c-Industries result in huge amount of solid waste mainly metals, containers and carton, this waste could be dangerous if it contains chemicals or poisonous material.

19. d-Hospital wastes should be managed carefully where it contains contaminated syringes, gloves, cotton and utensils of patients. This material could be a source of serious infection for the community.

20. Hazards of Solid Wastes1-Socio – psychic: The population does not accept the sight of wastes. Thrown wastes are source of fire. 2-Economic: Disposal of the waste without proper utilization is an economic loss. Recycling is one of the ways were the material could be used again.

21. 3-Health Hazards:1- Fly & Rodent: Garbage is a good media for breading of flies and rodents. Both of them are harmful for human health.2- Mechanical injuries: Where children are exposed to wounds and injuries if they handle the refuse مخلفات un-properly.3- Chemical pollution: Chemical hazards are common in factory waste.4- Bacterial contamination: The presence of a great number of pathogens that could influence human. 

22. Management of Solid wastes: Management of solid wastes includes these items: 1- Collection 2-Transport 3- Disposal a- Dumping b- Incineration c- Recycling

23. PesticidesMore than 350 metric tons of formulated pesticides (more than 100 pesticides) are used annually in Gaza Strip. Such heavy use of pesticides causes water pollution and soil degradation and contamination of the agricultural products which finally affect seriously the human and animals.It was found that 19 of these pesticides, that have been used, are internationally suspended, cancelled and banned pesticides, according to their mutogencity, carcinogencity and delayed neurtoxicity.

24. Food HygieneThe primary objective of food safety is to prevent illness and possibly death from spoiled or contaminated foods. The local health department is responsible for protecting the public’s health against food contamination.

25. FOOD – BORNE DISEASES: Bacterial infections: - Botulism: toxins produced by growth of (Clostridium botulism) in food under anaerobic conditions المعلبات الفاسدة, الطعام الغير محفوظ. Symptoms develop in 2 hs to 8 days. - Staphylococcus food poisoning: The onset is 1-6 hours after ingestion - Amine poisoning:Cheese and certain tranquilizers can result in such poisoning - Salmonellosis: caused by eating raw or undercooked meat, poultry, eggs

26. Viral Infections:-Infectious hepatitis A • Parasitic infections:- Amebiasis - Tape worm diseases (see photo 1) - Giardiasisجارديا معوية : infection in small intestine by eating contaminated food or drinking contaminated water with (Giardia lamblia) . - Ascariasis: (see photo 2) is the most common roundworm infection

27. Tape worm Ascariasis

29. The solutions1. Low-cost solutions for environment and health problems. For instance, simple filtration and disinfection of drinking water reduces the risk of diarrhea disease at low cost. 2. Education is also a key – (Mothers: better storage and safe use of chemicals at home prevent poisoning among toddlers, who explore, touch and taste the products found at home.3. Hygiene and sanitationWash hands with soap before food preparation, before meals and after defecating significantly reduces the risk of diarrhea disease.

30. 4. Follow the WHO Keys to Safer Food to reduce the risk of food borne disease: keep clean; cook thoroughly; store at safe temperatures; and use safe water for washing and cooking. 5. Good ventilation in the home decreases indoor air pollution and prevent acute respiratory infections.6. Good home sanitation provide a very effective means of protecting them against vector-borne diseases.

31. “The environment we personally create for ourselves, through our habits, diet and lifestyle are very crucial for our health”Thanks