![Gazans don't have bare necessities to survive](https://npr.brightspotcdn.com/dims3/default/strip/false/crop/4864x3648+304+0/resize/1300/quality/85/format/webp/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2F7a%2Ff9%2Febf5617c48888bad282d5fa575b5%2Fgettyimages-2154691212.jpg)
Amid Israel's bombardment of Gaza that has followed Hamas' Oct. 7 attack, much of the enclave's already fragile infrastructure — water and electricity, as well as housing, hospitals, and schools — has been either damaged or destroyed.
A joint report by the European Union, the World Bank and the United Nations published in March concluded that as of January, direct damage to Gaza's infrastructure amounted to $18.5 billion.
Only a third of the enclave's hospitals are functioning at all, with those remaining crippled by a lack of fuel to run generators, says Juliette Touma, the communications director for UNRWA, the U.N. agency that delivers aid to Gaza.
Palestinians living in Gaza have instead been forced to rely mostly on makeshift medical clinics, she says, but "it's very basic medical care."
According to Paul Spiegel, a former U.N. official who is now director of the Center for Humanitarian Health at Johns Hopkins University in Baltimore, "There's no water anymore, no sanitation or infrastructure available. Same with housing."
People in Gaza "either live in the open air or they're living in destroyed buildings, which are unsafe," he says.