This study aims to assess the impact of the October 2023 Gaza War on water and sanitation systems and propose actionable solutions for effective management. The study adopted a mixed-methods approach (quantitative and qualitative). Primary data were collected through semi-structured interviews, targeted questionnaires, and direct field observations. Secondary data were gathered from reports by international organizations (UNRWA, OCHA, WHO), Palestinian authorities, academic research, in addition to satellite imagery and Geographic Information System (GIS) data for damage assessment. The results showed that the institutional level of emergency preparedness before the war varied significantly. Despite the existence of pre-developed emergency plans (mean score 3.26, relative weight 65.28%,
p = 0.0355), there were significant shortcomings in practical staff training (mean score 2.64, relative weight 52.83%,
p = 0.006), logistical readiness, and the activation of international partnerships. The study also revealed major challenges faced in providing water and sanitation services during the war, including fuel and resource shortages, safety risks for field teams, weak coordination with security agencies, lack of materials and equipment, insufficient emergency funding, coordination gaps, staff displacement, communication breakdowns, difficulty accessing water sources, area division and blockade, and loss of personnel. Specifically, the inability to access water sources was a critical challenge (mean score 4.30, relative weight 86.04%,
p < 0.0001), as was indiscriminate shelling impacting field team safety (mean score 4.19, relative weight 83.77%,
p < 0.0001) and lack of materials and equipment (mean score 4.15, relative weight 83.02%,
p < 0.0001). Residents reported water availability only every 10–15 days, and over 70% of water and sanitation systems were damaged. While funding proposals were being prepared (mean score 3.26, relative weight 65.28%,
p = 0.02), weaknesses in reporting systems and coordination of roles were observed (mean score 2.55, relative weight 50.94%,
p < 0.0001). The research contributes to guiding local and international efforts towards reconstruction, enhancing resilience, and ensuring the provision of safe drinking water and adequate sanitation for the affected population, thereby reducing the risks of waterborne diseases and improving public health.
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