Response to Commentary on ‘Water, Sanitation, and Hygiene insecurity and infectious disease outbreaks among internally displaced populations in Gaza: implications of conflict-driven displacement on public health’, http://dx.doi.org/10.2166/washdev.2025.102 Open Access

We concur with your observation regarding the potential impact of psychological distress on health outcomes and the reliability of self-reported data. As you have rightly noted, the inclusion of objective health measures is vital to complement self-reported health data. This aligns with broader efforts to ensure data accuracy and reliability in humanitarian settings. While our study primarily relied on self-reported health outcomes due to logistical constraints in a conflict zone, we acknowledge the importance of integrating objective health assessments in future research. Your reference to Iasiello et al. (2022) is particularly valuable, and we agree that incorporating psychosocial health dimensions would enrich the understanding of the interplay between WASH insecurity and health outcomes among IDPs.

Your emphasis on incorporating broader determinants of health, such as nutrition, access to healthcare, and pre-existing conditions, is well-taken. As you highlighted, malnutrition amplifies vulnerability to infectious diseases, and addressing this requires a holistic approach. In our study, while we focused on WASH insecurity as a critical determinant of health, we agree that integrating these interrelated factors can provide a more comprehensive understanding. This could also guide the design of interventions that tackle the root causes of health disparities in displaced populations. Future studies should adopt a multi-sectoral approach to address these complex interdependencies and confounding variables.

You have aptly noted the challenges posed by political instability and security concerns in Gaza. These barriers significantly hinder the implementation of effective humanitarian interventions. We appreciate your reference to the Al-Haq (2024) report, which underscores the broader socio-political challenges faced by displaced populations. We fully agree that involving trusted local partners is essential for the success of WASH programs. Our study emphasizes the need for localization in humanitarian responses, and we strongly advocate for collaborations with local organizations to ensure culturally sensitive and contextually appropriate interventions. By building trust and leveraging local expertise, the effectiveness and sustainability of these interventions can be enhanced.

Your commentary enriches the discourse on WASH insecurity and public health outcomes among IDPs in Gaza. We appreciate your call for immediate and comprehensive interventions to address these critical issues. Your suggestions for integrating broader determinants of health, addressing data reliability, and navigating the complexities of conflict zones resonate deeply with our objectives.

We are grateful for your valuable contribution and hope that our collective efforts will inspire actionable change for the vulnerable populations in Gaza and beyond. Should you have further insights or wish to collaborate on advancing research or interventions in this area, we would welcome the opportunity to engage with you.

Sincerely,

Kate Zinszer and Samer Abuzerr

All relevant data are included in the paper or its Supplementary Information.

The authors declare there is no conflict.