In the war last year, up to 30 per cent of the water pipes in Gaza were destroyed or damaged and 23 municipal-run wells and 500 septic tanks were destroyed.
With 96 per cent of the drinking water unsafe for human consumption, an estimated 120 water desalination plants - many of them are unlicensed and illegally drawing water from wells - are doing their best to meet the demand.
However, the small private companies delivering desalinated water are not necessarily providing a safe alternative.
Clean water has become a precious commodity in a city devasted by war.
On a dirt road, three men take turns trying to get at a diesel-powered pump.
The water tanker they arrived in sits at the side of the road while through double metal gates to a two-storey house where five families live, seven tanks wait to be filled, five on the ground and two on the roof.
After 10 minutes of the men pulling and tugging, the pump coughs and comes to life and water starts flowing.
For the families living at the property in al-Mansara, part of Gaza City's Shejaiya neighbourhood, this is a process that happens twice a month - desalinated water, at 15 shekels ($5.19) a 500-litre tank, is delivered to make sure they have water to bathe, cook and drink.
"The tap water stopped and sometimes it comes and when it does it's yellow or brown and it's either sweet or salty - it's not safe to drink," says Fayez Harazin, 59, the head of one of the families living in the house.
Across the Gaza Strip families face a similar ordeal to get clean water.
In the war last year, up to 30 per cent of the water pipes in Gaza were destroyed or damaged and 23 municipal-run wells and 500 septic tanks were destroyed.
With 96 per cent of the drinking water unsafe for human consumption, an estimated 120 water desalination plants - many of them are unlicensed and illegally drawing water from wells - are doing their best to meet the demand.
However, the small private companies delivering desalinated water are not necessarily providing a safe alternative.
Monther Shoblak, director of Gaza's Coastal Municipalities Water Utility, says the water being sold is just as dangerous and polluted as the water from Gaza's contaminated and over-extracted aquifer. "We are disinfecting the water, we put chlorine in it, but the private vendors don't - it is exposed to germs and bacteria."
Just a short distance down the road in al-Mansara a group of children crowd around a USAid water distribution centre. A giant yellow bladder holding water sits inside a small concrete room. Each day it is filled with 9 million cubic metres of desalinated water from a private vendor and services up to 400 people from the southern Shejaiya area.
Among the steady stream of people coming to collect water is Bashar, a 15-year-old boy, who fills a yellow plastic container. His family get water at the station for free because they can't afford to pay for water to be delivered and there is no tap water where they live after pipes were destroyed last year.
While a shortage of clean drinking water poses many risks, raw sewage poses many more.
While surfers make the most of Gaza's beaches despite reports of raw sewage flowing into the sea, people such as Fayez Harazin rely on deliveries of desalinated water. Photo / Heidi Levine
Seven pipes along Gaza's golden coastline pump over 24 million gallons of raw sewage from central Gaza into the Mediterranean Sea each day as there is no functioning wastewater treatment plant in the area.
Close to the coastline in the middle of a rubbish dump and wetland that's been turned into a sewage wasteland, about 12 Bedouin families live in makeshift houses. The stench is overpowering. "In the winter the whole area was flooded, many of my goats died," said Majed Ali Rasheed. The 53-year-old Bedouin who works as a farm labourer, tells the New Zealand Herald that he lives with his wife and four children in a structure made from pieces of tin shed propped against each other and tied with wire. He tends a small herd of goats and has eight camels but says the area is unsafe.
"The smell here is really bad and it's dangerous living in this area - there are mosquitoes all the time and they are causing illnesses and disease."
The makeshift houses do have running water, however, but only several times a week and, according to world health standards, it is unsafe.
If the wastewater isn't sent into the sea it's leaking into the coastal aquifer - the only source of freshwater in Gaza.
The sewage also makes swimming, a popular pastime among Gazans, dangerous and creates hazards for the more than 3500 fishermen in Gaza who are already restricted by Israel's maritime blockade of three nautical miles.
Even though 72 per cent of Gazans are connected to a sewage network, all the waste is not able to be treated. Gaza's largest treatment plant, Sheikh Eijlin, operates only when it gets power, a maximum of four hours a day.
Meanwhile, there are three waste water treatment plants that, thanks to substantial funding from overseas donors, are close to replacing four plants that are not fully operational but cannot be completed until Israel allows the entry of final materials.
"To me it looks like global punishment of the people of Gaza - delays mean donors decide to withdraw from Gaza," says Shoblak. "This has had a huge impact on the water sector."
Gazans who weren't connected to sewerage systems did what they could but often didn't follow any sort of safety standards, he said. Septic tanks were often unlined and some communities used large sewage ponds or cesspits.
Back in Shujaiya 65-year-old grandmother of 10 Subha Shamali stands outside her partially destroyed house in a long pink gown made of polar fleece material.
Inside one of her granddaughters is being bathed in water bought from a private plant. Plastic buckets line the floor and a hose has been fed in the window from the black water tank outside.
"We get water once every 10 days and we run out of water a lot," she said. "During and after the war there was no water at all, we had to escape from here." It wasn't always that way, however.
"The water before the war was good," she said. "Day after day we had water and we had enough electricity to push it up on to the roof."
