Lice, scabies, rashes plague Palestinian children as skin disease runs rampant in Gaza's tent camps

KHAN YOUNIS, Gaza Strip (AP) — A steady stream of miserable children and worried parents flowed into the dermatology office at Nasser Hospital in central Gaza.

A toddler with a blue hair bow sobbed as her mother showed how the red and white spots covering her face have spread to her neck and chest. Another woman lifted her little boy’s clothes to reveal the rashes on his back, butt, thighs and stomach. On his wrists, he had open sores from scratching. A father stood his daughter on the desk so the doctor could examine the lesions on her calves.

Skin diseases are running rampant in Gaza, health officials say. The cause, they say, is the appalling conditions in overcrowded tent camps housing hundreds of thousands of Palestinians driven from their homes, along with the summer heat and the collapse of sanitation that has left pools of open sewage amid 10 months of Israel’s bombardment and offensives in the territory.

Doctors are wrestling with more than 103,000 cases of lice and scabies and 65,000 cases of skin rashes, according to the World Health Organization. In Gaza’s population of some 2.3 million, more than 1 million cases of acute respiratory infections have been recorded since the war began, along with more than half a million of acute diarrhea and more than 100,000 cases of jaundice, according to the United Nations Development Program.

Cleanliness is impossible in the ramshackle tents, basically wood frames hung with blankets or plastic sheets, crammed side by side over wide stretches, Palestinians say.

“There’s no shampoo, no soap,” said Munira al-Nahhal, living in a tent in the dunes outside the southern city of Khan Younis. “The water is dirty. Everything is sand and insects and garbage.”

Her family’s tent was crammed with her grandchildren, many of whom had rashes. One little boy stood scratching the red patches on his belly. “One child gets it, and it spreads to all of them,” al-Nahhal said.

Palestinians in the camp said clean water was almost impossible to get. Some wash their children in salt water from the nearby Mediterranean. People have to wear the same clothes day after day until they’re able to wash them, then they wear them again immediately. Flies are everywhere. Children play in garbage-strewn sand.

“First it was spots on her face. Then it spread to her stomach and arms, all over her forehead. And it hurts. It itches. And there’s no treatment. Or if there is we can’t afford it,” said Shaima Marshoud, sitting next to her little daughter in a cinder block structure they’d settled in among the tents.

More than 1.8 million of Gaza’s 2.3 million people have been driven from their homes, often moving multiple times over the past months to get away from Israeli ground assaults or bombardment. The vast majority are now crowded into a 50-square-kilometer (20-square-mile) area of dunes and fields on the coast with almost no sewage system and little water.

The distribution of humanitarian supplies, including soap, shampoo and medicines, has slowed to a trickle, U.N. officials say, because Israeli military operations and general lawlessness in Gaza make it too dangerous for relief trucks to move.

Israel launched its campaign vowing to destroy Hamas after its Oct. 7 attack on southern Israel, in which some 1,200 people were killed and 350 abducted. Israel’s assault has killed more than 39,000 people, according to Gaza health authorities.

“The solid waste management system has collapsed,” said Chitose Noguchi, the deputy special representative of the U.N. Development Program’s Programme of Assistance to the Palestinian People.

In a report released Tuesday, the UNDP said Gaza’s two pre-war landfills were unreachable amid the fighting and it had set up 10 temporary sites. But Noguchi said there were more than 140 informal dumping sites that have cropped up. Some of them are giant pools of human waste and garbage.

“People are having tents and living next to dumping sites, which is really, really critical situation in terms of the health crisis,” Noguchi said.

Nassim Basala, a dermatologist at Nasser Hospital, said they get 300 to 500 people a day coming in with skin diseases. After the most recent Israeli evacuation orders, more people have crowded into agricultural fields outside the city of Khan Younis, where insects are rife in the summer.

Scabies and lice are at epidemic proportions, he said, but other fungal, bacterial and viral infections and parasites are also running wild.

With the flood of patients, even simple cases can because dangerous.

For example, Basala said, impetigo is a simple bacterial infection treatable with creams. But sometimes by the time the patient gets to a doctor, “the bacteria have spread and affected the kidneys,” he said. “We’ve had cases of kidney failure” as a result. Scratched rashes get infected in the pervasive dirt.

He said creams and ointments were in short supply at the hospital.

Children are the most affected. But adults suffer as well. At the hospital’s dermatology office, one man untied his dirt-covered shoes to show the painful looking sores on the tops of his feet and ankles where his rash had rubbed open. A woman held up her hands, chapped raw and red.

Mohammed al-Rayan, several of whose children in a tent outside Khan Younis, have rashes or spot, said he has taken them to doctors.

“They give us creams, but it’s no use when you don’t have anything to wash with,” he said. “You put a cream and it gets better but then the next day it’s back the same.”

Parents are left struggling to comfort children with painful conditions that won’t go away.

Manar al-Hessi’s toddler cried as she spread cream on her forehead and chest, covered in scabs, sores and spots.

“It’s horrible,” al-Hessi said. “There are always flies on her face. She goes in the toilet or the garbage, and it gets in her hands. The filth is huge.”

Shurafa reported from Deir al-Balah, Gaza Strip. AP correspondent Julia Frankel in Jerusalem contributed to this report.

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Displaced child Toleen Marshoud, who suffers from skin disease, sits at a makeshift tent camp in Deir al-Balah, central Gaza Strip, Monday, July 29, 2024. Skin diseases are running rampant in Gaza, health officials say, from appalling conditions in overcrowded tent camps housing hundreds of thousands of Palestinians driven from their homes. (AP Photo/Abdel Kareem Hana )

Displaced child Mohammed Abu Obaid, who suffers from skin disease, is seen carried by his sister, at a makeshift tent camp in Deir al-Balah, central Gaza Strip, Monday, July 29, 2024. Skin diseases are running rampant in Gaza, health officials say, from appalling conditions in overcrowded tent camps housing hundreds of thousands of Palestinians driven from their homes. (AP Photo/Abdel Kareem Hana )

Displaced child Mohammed Abu Obaid, who suffers from skin disease, shows scars on his skin, at a makeshift tent camp in Deir al-Balah, central Gaza Strip, Monday, July 29, 2024. Skin diseases are running rampant in Gaza, health officials say, from appalling conditions in overcrowded tent camps housing hundreds of thousands of Palestinians driven from their homes. (AP Photo/Abdel Kareem Hana )

Displaced child Mohammed Abu Obaid, who suffers from skin disease, poses for a picture next to his father, at a makeshift tent camp in Deir al-Balah, central Gaza Strip, Monday, July 29, 2024. Skin diseases are running rampant in Gaza, health officials say, from appalling conditions in overcrowded tent camps housing hundreds of thousands of Palestinians driven from their homes. (AP Photo/Abdel Kareem Hana )

Displaced child Sham al-Hessi, who suffers from skin disease, sleeps at a makeshift tent camp in Deir al-Balah, central Gaza Strip, Monday, July 29, 2024. Skin diseases are running rampant in Gaza, health officials say, from appalling conditions in overcrowded tent camps housing hundreds of thousands of Palestinians driven from their homes. (AP Photo/Abdel Kareem Hana )

Palestinian Manar al-Hessi, who was displaced by the Israeli bombardment of the Gaza Strip, sits next to her children, at a makeshift tent camp in Deir al-Balah, central Gaza Strip, Monday, July 29, 2024. Skin diseases are running rampant in Gaza, health officials say, from appalling conditions in overcrowded tent camps housing hundreds of thousands of Palestinians driven from their homes. (AP Photo/Abdel Kareem Hana )

Displaced child Sham al-Hessi, center, who suffers from skin disease, is covered with skin cream as she poses for a picture, at a makeshift tent camp in Deir al-Balah, central Gaza Strip, Monday, July 29, 2024. Skin diseases are running rampant in Gaza, health officials say, from appalling conditions in overcrowded tent camps housing hundreds of thousands of Palestinians driven from their homes. (AP Photo/Abdel Kareem Hana )

MADISON, Wis. (AP) — Donald Trump's fourth scheduled stop in eight days in Wisconsin is a sign of his increased attention as Republicans fret about the former president's ability to match the Democrats' enthusiasm and turnout machine.

“In the political chatter class, they’re worried," said Brandon Scholz, a retired Republican strategist and longtime political observer in Wisconsin who voted for Trump in 2020 but said he is not voting for Trump or Democratic nominee Kamala Harris this year. “I think Republicans are right to be concerned.”

Trump's latest rally was planned for 2 p.m. Central time Sunday in Juneau in Dodge County, which he won in 2020 with 65% of the vote. Jack Yuds, chairman of the county Republican Party, said support for Trump is stronger in his part of the state than it was in 2016 or 2020. “I can’t keep signs in,” Yuds said. “They want everything he’s got. If it says Trump on it, you can sell it.”

Wisconsin is perennially tight in presidential elections but has gone for the Republicans just once in the past 40 years, when Trump won the state in 2016. A win in November could make it impossible for Harris to take the White House.

Trump won in 2016 over Democrat Hillary Clinton by fewer than 23,000 votes and lost to Democrat Joe Biden in 2020 by just under 21,000 votes.

On Tuesday, Trump made his first-ever visit to Dane County, home to the liberal capital city of Madison, in an effort to turn out the Republican vote even in the state's Democratic strongholds. Dane is Wisconsin’s second most-populous and fastest-growing county; Biden received more than 75% of the vote four years ago.

“To win statewide you’ve got to have a 72-county strategy,” former Gov. Scott Walker, a Republican, said at that event.

Trump’s campaign and outside groups supporting his candidacy have outspent Harris and her allies on advertising in Wisconsin, $35 million to $31 million, since she became a candidate on July 23, according to the media-tracking firm AdImpact.

Harris and outside groups supporting her candidacy had more advertising time reserved in Wisconsin from Oct. 1 through Nov. 5, more than $25 million compared with $20 million for Trump and his allies.

The Harris campaign has 50 offices across 43 counties with more than 250 staff in Wisconsin, said her spokesperson Timothy White. The Trump campaign said it has 40 offices in the state and dozens of staff.

Harris rallied supporters in Madison in September at an even that drew more than 10,000 people. On Thursday, she made an appeal to moderate and disgruntled conservatives by holding an event in Ripon, the birthplace of the Republican Party, along with former U.S. Rep. Liz Cheney of Wyoming, one of Trump’s most prominent Republican antagonists.

Harris and Trump are focusing on Wisconsin, Michigan and Pennsylvania, the “blue wall” states that went for Trump in 2016 and flipped to Biden in the next election.

While Trump’s campaign is bullish on its chances in Pennsylvania as well as Sunbelt states, Wisconsin is seen as more of a challenge.

“Wisconsin, tough state,” said Trump campaign senior adviser Chris LaCivita, who worked on Republican Sen. Ron Johnson’s winning reelection campaign in 2022.

“I mean, look, that’s going to be a very tight — very, very tight, all the way to the end. But where we are organizationally now, comparative to where we were organizationally four years ago, I mean, it’s completely different,” LaCivita said.

He also cited Michigan as more of a challenge. “But again, these are states that Biden won and carried and so they’re going to be brawls all the way until the end and we’re not ceding any of that ground.”

The candidates are about even in Wisconsin, based on a series of polls that have shown little movement since Biden dropped out in late July. Those same polls also show high enthusiasm among both parties.

Mark Graul, who ran then-President George W. Bush’s 2004 campaign in Wisconsin, said the number of campaign visits speaks to Wisconsin’s decisive election role.

The key for both sides, he said, is persuading infrequent voters to turn out.

“Much more important, in my opinion, than rallies,” Graul said.

Associated Press writers Thomas Beaumont in Des Moines, Iowa, and Jill Colvin in Butler, Pennsylvania, contributed to this report.

Republican presidential nominee former President Donald Trump arrives at a campaign event at Dane Manufacturing, Tuesday, Oct. 1, 2024, in Waunakee, Wis. (AP Photo/Charlie Neibergall)

Republican presidential nominee former President Donald Trump speaks at a campaign event at Dane Manufacturing, Tuesday, Oct. 1, 2024, in Waunakee, Wis. (AP Photo/Charlie Neibergall)

Republican presidential nominee former President Donald Trump arrives for a campaign event Saturday, Sept. 28, 2024, in Prairie du Chien, Wis. (AP Photo/Morry Gash)