Though tiny, pathogens could become Israel's deadliest weapon in Gaza

After surviving nearly two years of genocide, Palestinians forced into a guarded zone on Rafah's rubble could face infectious disease likely to kill more people than the bombs

Palestinians crowd a coastal path west of Beit Lahia after receiving aid parcels on 29 July 2025, in conditions health experts warn could fuel deadly disease outbreaks (Omar Al-Qattaa/AFP)

Palestinians crowd a coastal path west of Beit Lahia after receiving aid parcels on 29 July 2025, in conditions health experts warn could fuel deadly disease outbreaks (Omar Al-Qattaa/AFP)

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Even as it continues to bomb the Palestinian civilians it is starving, Israel is pushing ahead with what may be its ultimate - or perhaps penultimate - vision for Gaza: the physical confinement of survivors in a guarded zone on Rafah's rubble - an actual concentration camp.

If it is not stopped, pathogens could yet become Israel's deadliest weapon in Gaza.

Disease is often not merely a side effect but a major agent in genocides, from smallpox that devastated the Indigenous peoples of the Americas to the barracks of Auschwitz. Concentration camps in particular have a long and ghastly history as places where, by design or otherwise, disease kills as many as - or even more than - those directly killed by the genocidal regime that confines them.

In the Napoleonic Wars, British soldiers died of infectious disease eight times more often than of combat wounds, while the American Civil War saw some 600,000 deaths from malaria, dysentery and other infectious diseases.

Cramming a demoralised, traumatised and severely malnourished population into a small area with little or no infrastructure makes the spread of disease in conflict settings even more dangerous. This is now taking shape in Gaza, as Israeli forces forcibly concentrate roughly 2.3 million genocide survivors into an ever-smaller area.

Acutely starving survivors of what Amnesty International calls "a live-streamed genocide" are next to be forced into the space until recently occupied by the city of Rafah, once former US President Joe Biden's untouchable "red line" - now 64 sqkm of debris and human remains.

This is not happening incidentally.

Following the broad lines of an idea first floated by Defence Minister Israel Katz, this tiny "humanitarian city" is to contain an initial 600,000 heavily vetted survivors (that is, those not selected at entry for detention, or executed point blank), then the remaining surviving population of Gaza - creating a potential population density of nearly 35,938 people per square kilometre.

In such an environment, even minor infections can become fatal, turning treatable illnesses into mass killers.

Deadly confinement

As reported by Ha'aretz, the confined Palestinians are to be guarded - and fed - by international partners, most likely Israel- and US-backed private security contractors linked to hundreds of deaths and thousands of injuries among aid-seekers.

According to Mondoweiss, citing a 31 July Wall Street Journal report, the plan may also involve Emirati services and the local militia of Abu Shabab - an infamous gang leader reportedly armed and backed by Israel, whose fighters have looted aid trucks in the Rafah area.

They are not to be allowed to leave. Even a glancing familiarity with the history of concentration camps is enough to know that, regardless of the precise details of the ultimate model, infectious disease is now likely to kill vastly more survivors than US and Israeli missiles over 22 months of daily atrocities.

The history of concentration camps shows disease is likely to kill more survivors than US and Israeli missiles over 22 months of daily atrocities

The first sites to receive the name "concentration camp" were established by the British during the Anglo-Boer War in South Africa to confine mostly (but not only) Boer combatants.

Some 28,000 Boer prisoners died of typhoid in these camps, as did Herero and Nama detainees in camps in what is now Namibia during Germany's first genocide.

Japanese-Canadian and Japanese-American detainees imprisoned in camps in the United States and Canada during the Second World War likewise suffered epidemics.

In concentration camps in Nazi-occupied Europe, vast numbers of deaths resulted before and just after liberation from epidemics that raged through close quarters with deliberately appalling conditions. Anne Frank, of course, famously died at Bergen-Belsen of probable typhus shortly before both her 16th birthday and the camp's liberation.

Engineered outbreaks

Through 22 months of Israel's siege, bombardment and ground invasions, infrastructure and personnel of the existing healthcare system have been systematically targeted and destroyed.

Mothers are too malnourished to produce immune-supporting as well as nutritionally vital breastmilk - considered the safest way to protect babies and infants in conflict settings from increased infections - even as Israel prohibits the entry of baby formula.

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Missiles have targeted water desalination plants, wastewater treatment facilities, fuel trucks, solar panels that reduced energy dependency on Israel, and other water, sanitation and energy infrastructure, and the siege denies access to chlorine and materials and equipment to repair damaged infrastructure.

It was concentration camp proponent Katz, then Israel's minister of energy and infrastructure, who wrote on 13 October 2023 of the civilian population of Gaza: "They will not receive a drop of water or a single battery until they leave the world."

As a result, epidemics have swept through the population of Gaza, including viruses, bacteria and fungal infections; water-borne, air-borne, and transmitted by physical contact.

The World Health Organization (WHO) warned in December 2023 that diseases might end up killing more people than bombs and missiles, with spokesperson Margaret Harris stating: "Eventually, we will see more people dying from disease than we are even seeing from the bombardment if we are not able to put back [together] this health system and provide the basics of life: food, water, medicines and of course fuel to operate the hospitals."

Infections seen from early on have included waves of SARS-CoV-2, gastrointestinal infections causing diarrhoea, skin diseases, and a resurgence of vaccine-derived polio.

International researchers and healthcare organisations alike repeatedly note the risk of cholera outbreaks.

To prevent polio's spread beyond Gaza, Israel assented to pauses in the bombings killing children daily so those children might be vaccinated - but used a quadcopter to drop a stun grenade beside a polio vaccination clinic during one such humanitarian pause, injuring six people, including four children.

Healthcare collapse

At this point, healthcare workers are themselves literally collapsing from hunger, dehydration and malnutrition. Illness, lack of pay or meagre food rations previously received have not been reasons to miss work. A surgeon reported operating while suffering gastroenteritis.

Antimicrobial resistance is a large and growing issue in Gaza. In April 2024, Save the Children had already warned that malnourishment (acute even in the first four months of Israel's war on Gaza) was leading to diseases that could be fatal in children, whose immune systems shut down in the face of starvation, with lack of protein and specific nutrients increasing vulnerability to infection.

How can Palestinian medics 'cooperate' with Israeli health bodies during a genocide?

The WHO warned this year that infectious diseases like measles, pneumonia or pathogens that cause diarrhoea become part of a cycle: malnourishment makes it hard for young bodies to fight off infections, while infections increase unachievable nutritional needs.

According to Oxfam, Gaza has thus become "a petri dish of disease", with a recent doubling of acute jaundice, a 302 percent increase in bloody diarrhoea, and water-borne diseases up by 150 percent from already frightening rates.

Specific factors that could accelerate deadly disease outbreaks are already at play in Gaza. Extreme temperatures, lack of protection from the elements, inadequate latrine access, bacterially contaminated food supplies, persistence of pests like insects and rats, and shared utensils are all factors documented as contributing to infectious disease at the Auschwitz-Birkenau concentration camp.

These included typhus, typhoid, dysentery, malaria, tuberculosis, diphtheria, infectious diarrhoea, scabies and a range of purulent skin diseases.

Many of these have already been reported, some at epidemic levels, in Gaza today. Watery and bloody diarrhoea have been rampant in the overcrowded tent camps of displaced people, along with jaundice, acute hepatitis, and respiratory infections from early in the genocide, as well as skin infections.

A drastic drop in vaccination rates in previously highly vaccine-compliant Gaza (polio vaccination rates were over 99 percent, for example) makes it far more likely that infections will become epidemic.

Horrific outcome

On 12 July, UN bodies warned that Israel's siege-induced collapse of remaining fuel supplies, critical to what remains of clean water and sanitation systems, threatens to further spread disease.

By June 2025, 77 percent of water and sanitation facilities were off limits to Palestinians, being either under evacuation orders or in Israeli militarised zones, like 82.6 percent of Gaza's physical territory.

Without comprehensive nourishment, sanitation and care, pathogens will carry out Israel's genocidal dirty work

It will not be enough to stop bombing Gaza, nor to flood the territory with food and potable water.

Any plan that does not include careful, closely monitored re-feeding of starving people and regular nourishment that addresses months of protein and essential vitamin and mineral deficiencies will not be good enough.

A response that omits attentive wound care, re-establishment of extensive sanitation infrastructure, and access to hygiene for a population no longer strong enough to travel even short distances to keep clean or access toilet facilities will also fail.

Most of all, the horrific history of sites that involve enforced detention and concentration of human beings tells us that any such plan is a programme under which pathogens will carry out Israel's genocidal dirty work.

The views expressed in this article belong to the author and do not necessarily reflect the editorial policy of Middle East Eye.

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