_{A Palestinian girl looks out of her home that was damaged by the Israeli military in Operation Cast Lead in 2008. Photo by Libby Powell.}

Thick brown liquid squeezes up between Ali’s toes as he crouches behind a wall, poised to run. His big grin is gappy with missing teeth. As his friend whirls round the corner, he shrieks and flees. Two sets of footprints in the stinking soil. For the boys, the dense maze of urban alleyways of Gaza’s Khan Younis camp may offer a fine warren for hide and seek but, after half a decade of being sealed off, their home has become a perilous and polluted playground.

As the Israeli blockade that began in 2007 passes the five-year mark this month, a report by Medical Aid for Palestinians and Save the Children highlights the impact of the border closures on the health and wellbeing of Gaza’s 819,000 children.

Of these children, more than 50,000 will, like Ali, turn 5 this year along with the blockade. Having lived their whole lives under military control, very few of them will have seen the world beyond the wall that encloses the Gaza Strip.

For most, the outside is represented only by the hulking shapes of Israeli gun ships off their coastline, the tormenting streaks of fighter jets over their heads and the fleeting presence of humanitarian workers who pass with relative ease through the steel doors of the Erez crossing, the hi-tech Israeli checkpoint which controls and completes Gaza’s isolation.

Inside the walls, Gaza’s environment is festering and its children, who make up over 50 per cent of the population, are suffering the worst of the consequences.


^{A sister and a brother from Rafah, a city in the southern Gaza Strip. Photo by Libby Powell.}

Israel’s military assault on Gaza in late 2008 destroyed over 30 km of water networks and an embargo on construction materials has prevented the restoration of a clean water supply. Airstrikes in 2011 destroyed a further $1.3 million worth of water and sanitation infrastructure.

Only 10 per cent of children in Gaza City have access to water every day and a survey in 2010 found bacteriological contamination in 63 per cent of homes. Diseases related to dirty water and poor sanitation have increased steadily. The report shows a 70 per cent rise in acute diarrhoea since 2005 and overstretched UN clinics are reporting a spread of typhoid fever.

Against this backdrop, the report delivers the urgent warning that Gaza’s sole water source, its depleted aquifer, will stop producing water fit for human consumption within five to ten years.

Israel’s ban on building materials going into Gaza has also prevented authorities from constructing and repairing sewers to deal with the 80 million-plus litres of raw sewage that is produced each day in one of the most densely populated areas of the world. This waste is pumped furiously into the Mediterranean Sea and gathers in vast cesspits alongside residential areas. In the first half of 2012, three children drowned in pools of open sewage, two of them in Ali’s neighbourhood of the Khan Younis refugee camp.


^{Kids play in a damaged playground in Gaza. Photo by Libby Powell.}

While the tunnels in Rafah continue to pull up basic food supplies, power cuts of up to eight hours a day hinder the storage and preparation of fresh food. Sugary drinks stand in for clean water and cheap packaged food lasts longer in Gaza’s stiffling summers.

Seventy per cent of families remain reliant on food aid from the UN: a meagre diet of flour, sugar, oil and rice. As a result, stunting and chronic malnutrition now affects 10 per cent of the under-fives and anaemia, caused by a lack of iron-rich food, affects over half of Gaza’s school children. If left untreated, anaemia can have an irreversible impact on a child’s development.

This time next year, Israel will open its borders to young people from across the world as it hosts the 2013 UEFA Under 21 Football Championship. As $75 million worth of building materials for water and sanitation projects in Gaza gather dust in warehouses on the Erez border, construction plows ahead on two new stadiums in Petah Tikva and Netanya to host the games. While the state prepares to welcome the young footballers, Gaza’s children will not be among the crowds.

Despite protests that are gathering momentum across social networking sites, it is likely that the games will go ahead just miles from where hundreds and thousands of children wait for an end to a man-made health crisis.