Extensive flooding has stranded about 1.8 million people in northeast Bangladesh, following weeks of heavy rains that have submerged homes and devastated farmland, according to state media and humanitarian agencies.

Video shows large swathes of Sylhet city and the nearby town of Sunamganj underwater in the second wave of flooding to hit the region in less than a month, state-run news agency Bangladesh Sangbad Sangstha (BSS) reported Saturday.

The widespread flooding was triggered by prolonged torrential rain and water runoff from the hilly regions upstream on the border with India, which caused four rivers to swell beyond their danger marks, the Water Development Board said last week, according to local media.

Villagers in the hardest-hit low-lying areas of Sylhet could be seen wading through chest-deep water and heaping their belongings into piles to protect them from the muddy waters.

There is concern for those trapped by floodwaters who now face food shortages and a lack of clean water, according to local media.

About 964,000 people in Sylhet and 792,000 in Sunamganj had been affected by the flooding and authorities said they had set up more than 6,000 shelters to help the displaced, BSS reported.

Among them are 772,000 children who were in urgent need of assistance, the United Nations’ Children’s Fund (UNICEF) said Friday. More than 800 schools had been flooded with 500 more used as flood shelters, the agency said.

“As waters rise, children are the most vulnerable, facing heightened risks of drowning, malnutrition, deadly waterborne diseases, the trauma of displacement, and potential abuse in overpopulated shelters,” Sheldon Yett, UNICEF Representative to Bangladesh, said in a statement.

International development organization BRAC said it was helping to deliver emergency food and health support to hundreds of families in Sylhet and Sunamganj. It said about 2.25 million people have been affected by the flash floods, which have left 12,000 people in the region without power.

Khondoker Golam Tawhid, program head of BRAC’s Disaster Risk Management Program said flooding in the country is “becoming more dangerous” with “huge losses to livelihoods, biodiversity and infrastructure — and interruption to schooling and health services.”

“Bangladesh is used to flooding, but climate change is making floods more intense and less predictable, making it impossible for families to stay safe, let alone plan ahead,” Tawhid said.

Meanwhile, fish farmers have faced significant losses as floodwaters wash away thousands of farms and ponds, with local media reporting an economic toll of over $11.4 million.

Densely populated and low-lying Bangladesh is prone to seasonal rains, flooding and cyclones.

But the South Asian country is one of the world’s most vulnerable to the impacts of the human-caused climate crisis, studies show. As extreme weather events become more frequent and severe as a result of the climate crisis, the humanitarian and economic impacts to Bangladesh will continue to deteriorate.

By 2050, 13 million people in Bangladesh could become climate migrants and severe flooding could cause GDP to fall by as much as 9%, according to the World Bank.

The latest bout of heavy rains and floods came as the region had barely recovered from widespread flooding in late May following Tropical Cyclone Remal, which lashed Bangladesh and southern India and impacted about 5 million people.

“For many, this will change the course of their lives, leaving them without homes and schools and forcing them to move to temporary shelters for who knows how long,” said Sultana Begum, Save the Children’s regional humanitarian advocacy and policy manager for Asia, in a statement.

“Everything we are hearing points towards these kinds of extreme weather events getting worse and worse. And we have certainly not seen two bouts of severe flooding happen in such quick succession before. Make no mistake, the climate emergency is already making its mark on India and Bangladesh, and it is robbing children of their homes, families, food, water, and access to education and healthcare.”

Rohingya vulnerable

Monsoon rains and landslides have also affected southern Bangladesh, where about a million people from the Rohingya Muslim community are living in the world’s biggest refugee camps, having fled persecution and violence in neighboring Myanmar.

At least 10 people, including three children, died from mudslides and heavy rainfall in the refugee camps near Cox’s Bazar on Wednesday, according to Bangladesh’s Ministry of Disaster Management and Relief.

Many Rohingya refugees live in bamboo and tarpaulin shelters perched on hilly slopes that are vulnerable to strong winds, rain, and landslides.

Save the Children said about 8,000 people in 33 camps have been impacted by the torrential downpours, which have destroyed or damaged more than 1,000 shelters.

The humanitarian group noted that the monsoon season in Bangladesh has only just started and will last for the next two months, with the potential to bring more heavy rains, landslides and flooding.

Landslides, heavy rains and flooding have also hit the neighboring Indian state of Assam, affecting more than 4 million people, according to Save the Children.

At least 31 people have died in the floods and landslides since May 29 in the state, according to local police and disaster management authorities.

Some immediate relief for northeast Bangladesh is in sight, however, as the rains began to ease and there are signs that floodwaters were starting to recede, local media reported.

The Bangladesh Water Development Board said Saturday that water levels of the major rivers in the northeast were falling and the trend could continue over the coming days if further rains hold off.

“Overall improvement of the flood situation in various low-lying areas under districts of the northeastern part of the country may continue in next 72 hours,” it said.

The Israeli military strapped an injured Palestinian man to the hood of a military vehicle during an operation on Saturday in the occupied West Bank.

Video shows the man lying across the front of the Israeli jeep as it drove through a neighborhood of Jenin. The man appeared slumped on the hood of the vehicle as it drove past Palestinian Red Crescent (PRCS) ambulances.

The PRCS said the Israeli military had prevented its crews from providing first aid to an injured man in the Jabarat area of Jenin.

“They then placed the injured person on the front of a military jeep and detained him before later allowing our crews to transfer him to the hospital,” the PRCS said.

The man’s condition and identity are unknown.

In response to questions about the incident, the Israel Defense Forces (IDF) said Saturday that its forces violated “orders and standard operating procedures” and an investigation would be launched.

“The conduct of the forces in the video of the incident does not conform to the values of the IDF. The incident will be investigated and dealt with accordingly,” the IDF said in a statement.

The IDF said the incident happened Saturday morning during counterterrorism operations to apprehend suspects in the Wadi Burqin area west of Jenin. It said the man was a suspect who was injured and apprehended after an exchange of fire.

He was transferred to the Red Crescent to receive medical treatment, the Israeli military added.

There has been an uptick in violence in the occupied West Bank since the start of Israel’s war against Hamas in Gaza began in October, following the militant group’s unprecedented and deadly attacks on Israel.

More than 500 Palestinians, including over 100 children, have been killed in the West Bank since October 7, according to the United Nations Office for the Coordination of Humanitarian Affairs (OCHA).

Almost three quarters of those fatalities took place during operations by Israeli forces, the UN agency said.

As well as Israeli military raids in the West Bank, there has been an increase in violence carried out by Israeli settlers against Palestinians.

More than 700,000 Jewish settlers live in the West Bank and East Jerusalem in settlements that are considered illegal under international law and widely seen as one of the main obstacles to a two-state solution.

Last Friday, the Biden administration imposed sanctions on the Israeli group Tzav 9 for disrupting humanitarian convoys headed to Gaza, the latest punitive measure taken under an executive order targeting those perpetrating violence in the West Bank.

Chinese Premier Li Qiang’s four-day visit to Australia this week was set to be focused on repairing long-strained relations between the two countries. But apparent efforts by Chinese officials to stand in front of an Australian reporter during a press briefing have shone a spotlight back on frictions between the countries.

Cheng Lei, a TV anchor who was held in detention in China for more than three years before her release in 2023, told Sky News Australia the officials went to “great lengths” to block her from the cameras during a press event Monday where Li and Australian Prime Minister Anthony Albanese signed cooperative agreements.

Video footage appears to show two people involved in the incident, with one of them, described by the outlet as a Chinese embassy employee, trying at one point to push closer to a seated Cheng, despite being blocked by another woman, identified by Sky News as an Australian official, who intervenes to give her space.

“I’m only guessing this is to prevent me from saying something or doing something that they think would be a bad look, but that in itself was a bad look,” Cheng told Sky News, where she has been employed as a news presenter and columnist since late last year.

Cheng added that such behavior was “typical” as Chinese officials wouldn’t want “voices of discord or the presence of someone who’s a bit controversial” when they are aiming to present a “friendly facade.”

Multiple media outlets that were also in attendance at the press conference, including the Guardian and the Daily Telegraph, reported the same details.

China’s security state keeps tight control on media and information within the country, where officials are not subject to the kind of robust questioning common to democratic countries.

Beijing has also long been condemned by Western nations and rights groups for wrongful and arbitrary detentions.

Cheng, previously a business anchor for China’s state broadcaster CGTN, was detained by Chinese authorities in August 2020 on opaque espionage charges that came as diplomatic tensions were escalating between Beijing and Canberra.

The mother of two spent more than three years in detention before being released by Beijing and returned home to her family in October, weeks before Albanese made the first visit of an Australian leader to China in seven years.

Speaking to Sky News ahead of the news conference Monday, Cheng said it was a “very emotional day” for her to be covering the major visit.

“Surely the fact that one minute I’m sitting in incarceration and being raised as a topic at these visits then the next minute I’m actually covering the visit … is testament to how wonderful freedom is and democracy is,” she said.

Cheng’s detention had been a deep point of contention between the two governments, as has the jailing of writer and democracy activist Yang Hengjun, an Australian citizen who earlier this year was handed a suspended death penalty sentence for espionage following years of detention. Yang has denied the charges, which rights groups have said are politically motivated.

Albanese said he raised Yang’s case with Li, but declined to give an update on the health of the democracy activist, who has said he fears he could die in jail due to health issues.

When asked during a press conference later about Cheng being blocked from view by officials during the document signing, Albanese said he didn’t see the incident described but added it was “important that people be allowed to participate fully and that’s what should happen in this building or anywhere else in Australia.”

Pandas and visas

The situation Monday stands as a stark reminder of Beijing-Canberra tensions and deep concerns within Australia, a staunch US ally, about China’s authoritarianism amid a trip that was otherwise meant to instill goodwill.

The four-day visit of Li, China’s No. 2 official, to Australia is the highest-level trip to a US-allied country of any Chinese official in seven years. It comes as the two countries have made strides in mending deep tensions over issues of trade, security and Beijing’s alleged political influence in Australia and the South Pacific.

Speaking alongside Li following the signing ceremony, Albanese called the visit “another important step in stabilizing” the relationship.

The Chinese premier, speaking via a translator, pledged that China would work with Australia in “a spirit of mutual respect, seeking common ground while showing differences and mutual benefit.”

Li announced Sunday that China would provide a new pair of giant pandas to the Adelaide Zoo in southern Australian after its current pair return to China later this year – extending a classic gesture of friendship from China often called “panda diplomacy.”

China would also add Australia to its visa-waiver program, Li said Monday.

Details were not immediately announced but follow similar visa arrangements with other countries in recent months as China struggles to draw in more international tourists to boost its flagging economy following years of Covid-19 border restrictions. Li announced a waiver scheme for New Zealand during a visit there Friday.

The two leaders agreed to greater military-to-military communication, according to Albanese.

The agreement follows recent close encounters of the two powers. In May, a Chinese fighter jet fired flares into the path of an Australian helicopter over the Yellow Sea in a move Albanese condemned at the time as “completely unacceptable.”

Li’s Australia visit comes as China has gradually rolled back a number of crippling trade controls that it placed on key Australian imports including beef, barley, timber, coal and wine from 2020 after then-Prime Minister Scott Morrison called for an international inquiry into the origins of the Covid-19 pandemic in China.

At least eight people were killed and dozens of others injured after a cargo train collided with a passenger train in eastern India on Monday, according to authorities, as a top official ordered a major emergency response.

The Kanchenjunga Express, which runs between the city of Kolkata and Silchar in northeastern Assam state, was struck by a freight train south of the city of Siliguri, according to West Bengal Chief Minister Mamata Banerjee.

Disaster teams have rushed to the crash location, which lies below the foothills that lead to Darjeeling, a popular mountain tourist destination famous for its tea plantations and stunning Himalayan views.

Local media pictures and video footage from the scene showed at least one train car on its side, parts of it crushed into a mass of twisted metal. Another car can be seen rising into the air at a steep angle above an engine carriage.

Banerjee, the local chief minister, wrote on X that “doctors, ambulances and disaster teams have been rushed to the site for rescue, recovery, medical assistance.”

“Action on war-footing initiated,” she added.

Live images from the site of the crash streamed live by local news channel TV 9 showed people gathered outside the carriages, some filming on their phones.

The crash comes more than a year after India experienced one of the worst train disasters in the country’s history, when more than 280 people were killed in a three-way collision involving two passenger trains and a freight train in eastern Odisha state.

That incident shocked the nation, renewing calls for authorities to confront safety issues in a railway system that transports more than 13 million passengers every day.

India’s extensive rail network, one of the largest in the world, was built more than 160 years ago under British colonial rule. Today, it runs about 11,000 trains every day over 67,000 miles of tracks in the world’s most populous nation.

But decaying infrastructure is often cited as a cause for traffic delays and numerous train accidents. Though government statistics show that accidents and derailments have been on the decline in recent years, they are still tragically common.

More than 16,000 people were killed in nearly 18,000 railway accidents across the country in 2021, according to the National Crime Records Bureau. Most railway accidents were due to falls from trains and collisions between trains and people on the track. Train-on-train collisions are less common.

On Monday, Indian Prime Minister Narendra Modi called the West Bengal crash “saddening” and sent a message of condolence to the affected families.

“I pray that the injured recover at the earliest. Spoke to officials and took stock of the situation. Rescue operations are underway to assist the affected,” Modi wrote on X.

Upgrading India’s transportation infrastructure is a key priority for Modi in his push to create a $5 trillion economy by 2025. His government last year raised capital spending on airports, road and highway construction and other infrastructure projects to $122 billion, or 1.7% of its GDP.

A significant portion of that spending is targeted at introducing more high-speed trains to India’s notoriously slow railways.

This story has been updated with additional developments.

American journalist Evan Gershkovich will stand trial behind closed doors in the Russian city of Yekaterinburg starting on June 26, state-run news agency TASS reported Monday, citing the court’s press service.

Gershkovich, 32, has been imprisoned since he was arrested while on a reporting trip in March last year by the FSB, Russia’s federal security service, which accused him of trying to obtain state secrets. Gershkovich, the US government and his employer, the Wall Street Journal, have vehemently denied the charges against him.

The Russian Prosecutor General’s office said last Thursday it had approved the indictment and referred Gershkovich’s case to a trial court. If convicted, he faces up to 20 years in prison.

The case will be heard in the Sverdlovsk Regional Court, TASS reported Monday.

For more than a year since his arrest, Gershkovich has been imprisoned in Moscow’s notorious Lefortovo Prison, and his pre-trial detention period had been extended numerous times. The trial venue of Yekaterinburg is more than 1,100 miles east of the capital.

Last week, Russian prosecutors said the FSB had “established and documented” that Gershkovich was acting on CIA instructions in the month he was arrested, alleging he had “collected secret information” about a Russian tank factory.

“Gershkovich carried out the illegal actions using painstaking conspiratorial methods,” it said in a statement.

Gershkovich’s detention has been a source of tension between Washington and Moscow, whose relations were already deeply strained due to Russia’s ongoing invasion of Ukraine.

The White House has previously alleged the Kremlin is using Gershkovich, the first American reporter detained in Russia on allegations of spying since the Cold War, as a geopolitical hostage.

On Thursday, US State Department spokesperson Matthew Miller said the allegations against Gershkovich have “absolutely zero credibility.”

“We have been clear from the start that Evan has done nothing wrong. He should never have been arrested in the first place. Journalism is not a crime. The charges against him are false, and the Russian government knows that they’re false. He should be released immediately,” Miller said at a State Department briefing.

Gershkovich is among a number of Americans being held in Russia, including former Marine Paul Whelan, whom the US State Department has also declared as wrongfully detained.

The US has repeatedly warned American citizens not to travel to Russia.

Thousands of people have been evacuated in southeast China after heavy rains hammered the region over the weekend, triggering floods and deadly landslides, authorities and state media said Monday.

According to state-run broadcaster CCTV, over 35,000 people were evacuated as of Saturday. As of Monday morning, more than 10,000 people were evacuated in Meizhou, the hardest flood-hit city in Guangdong province.

Seventeen waterways in the major Han River basin “recorded flooding above alert level,” including two rivers at record flood levels, according to the Ministry of Water Resources on Monday.

Guangdong province, an economic powerhouse home to 127 million people, is among parts of southern China that are subject to annual flooding from April to September. But the region has faced more intense rainstorms and severe floods in recent years as scientists warn that the climate crisis will amplify extreme weather, making it deadlier and more frequent.

Those warnings were underscored in April, when deadly floods submerged parts of Guangdong after rain poured for multiple days.

On Monday, heavy rains wrought further devastation, with social media videos from the city of Meizhou, eastern Guangdong, showing river water almost overflowing as it lapped at bridges and partially submerged vehicles.

More than 130,000 households in the city and suburbs were without power as of Monday morning, while classes were suspended, CCTV reported.

“Authorities are still trying to reach some towns and villages” in the area, CCTV said.

Further upstream along the Han River, a flood alert was issued in Fujian province due to heavy rainfall, according to its provincial alert center. Four people were killed in a series of landslides in the coastal province, CCTV reported Monday.

Social media footage from Fujian, home to 40 million people, showed flood water rushing through the streets of towns and villages,

Shanghang county in southwest Fujian recorded record rainfall of 375 millimeters (nearly 15 inches) in the past 24 hours, which represents 18% of its average annual rainfall, the province’s meteorological service said in a statement Monday.

China has been grappling with extreme weather this month as heavy rains inundate the south while severe drought and record temperatures scorch the north.

Other parts of China are also facing earlier and longer extreme heat periods and droughts each year, causing widespread power shortages and disruptions on food and industrial supply chains.

A two-day summit in Switzerland dedicated to forging a path forward to end the war in Ukraine concluded with key powers spurning a joint communique agreed to by more than 80 other countries and international organizations.

India, Saudi Arabia, South Africa and the United Arab Emirates, all of whom have important trading relationships with Russia as members of the BRICS economic group, attended the weekend meeting but did not agree to sign the joint statement.

The document reaffirmed the signatories commitment to “refraining from the threat or use of force against the territorial integrity or political independence of any state, the principles of sovereignty, independence, and territorial integrity of all states, including Ukraine, within their internationally recognized borders.”

Ukraine President Volodymyr Zelensky told journalists at a news conference alongside the leaders of the European Union, Ghana, Canada, Chile and Switzerland that it was “important that all participants of this summit support this Ukraine’s territorial integrity because there is will be no lasting peace without territorial integrity.”

More than 100 countries and organizations gathered at an idyllic lakeside resort near Lucerne to drum up support for the 10-point peace plan Zelensky first outlined late in 2022.

That formula includes demands for a cessation of hostilities, the restoration of Ukraine’s territorial integrity, the withdrawal of Russian troops from Ukrainian soil and the restoration of Ukraine’s pre-war borders with Russia – terms Russian President Vladimir Putin is unlikely to ever agree to.

Among the high-level dignitaries in attendance were the leaders of Argentina, Canada, Denmark, Finland, France, Germany, Italy, Japan, the Netherlands, Poland, Sweden and the United Kingdom.

US Vice President Kamala Harris was also in attendance and used the occasion to announce a $1.5 billion aid package that would go toward humanitarian expenditures and help Kyiv rebuilt its battered infrastructure.

“This high level attendance shows one thing. The world cares deeply about the war provoked by Russia’s aggression,” European Commission President Ursula von der Leyen said.

Despite the strong showing among Western democracies, there had been questions ahead of the event as to just how much could be accomplished given that neither Russia nor China, whose increasingly close trading relationship with Moscow has helped the Kremlin survive Western sanctions, were attending.

The communique published on Sunday said that signatories had struck several other agreements. Among them were the principle that Ukraine to should be allowed its own nuclear power plants – including the Russian-occupied Zaporizhzhia Nuclear Power Plant – and that the Kremlin refrain from both the use of and the threat of using nuclear weapons. The sides also said that all children and civilians that were unlawfully displaced must be returned to Ukraine.

On Friday, the day before the summit was set to kick off, Russian President Vladimir Putin restated the Kremlin’s own peace plan, which calls for Ukrainian troops withdraw from four southern and eastern regions of Ukrainian territory that Moscow said it would annex in violation of international law and demands Kyiv abandon its bid to join NATO.

While Russian forces have made modest gains in two of the regions – Donetsk and Luhansk – in recent months, they are far from occupying all four, which include Kherson and Zaporizhzhia.

US National Security Advisor Jake Sullivan, who traveled with Harris to Switzerland, told reporters at the summit that Putin’s framework “defies basic morality.”

“He (Putin) said, not only does Ukraine have to give up the territory Russia currently occupies, but Ukraine has to leave additional sovereign Ukrainian territory before Russia will negotiate. And Ukraine must disarm so that is vulnerable to future Russian aggression down the road. No responsible nation could say that is a reasonable basis for peace,” Sullivan said.

Editor’s Note: This article contains a distressing image. The girl’s mother gave permission to use it to show the world what her daughter was going through.

Hanan Aqel and her sister had one shekel each in their hands, a gift from their grandfather to go and buy sweets.

It was a glimmer of familial normality in Gaza for a nine-year-old and her younger sibling that ended in tragedy.

“I didn’t hear its whizzing or anything, I only saw a red light when the missile fell,” Hanan recalls from her hospital bed in Al-Aqsa Martyrs Hospital in central Gaza.

Her voice is hoarse and cracked, following reconstructive surgery to her face. She has 20% burns to her face, hands, chest, and leg. Her sister, five-year-old Leene, who was walking ahead of her, escaped injury.

“There was a man next to me dismembered and bleeding and a block of building cement fell on me,” Hanan says.

Hanan is one of thousands of critically ill patients waiting for medical evacuation from Gaza but unable to leave following the closure of the Rafah crossing to Egypt in early May.

After the airstrike, her father rushed her to hospital, where she also had surgery to remove shrapnel from her face. Her doctor, Mahmoud Mahane, specializes in burns and eye injuries, but says there is nothing more they can do for her inside Gaza.

“Most children need medical transfers,” he says, “for a more qualified treatment than here, as we don’t have the treatment or tools and we don’t have the supplies, we lack these supplies.”

Eight months of war have decimated the Gazan health system. Tens of thousands of injured Palestinians and a severe lack of medicine, doctors, and electricity, have proved a lethal combination.

The only hope for many is to be evacuated through the Rafah crossing into Egypt and get treatment in neighboring countries. That lifeline has been cut off since May 7 when the Israeli military took control of the crossing and closed it.

Egypt says it will not open the crossing until the Israeli military withdraws. It cites security reasons – one Egyptian soldier was killed last month in fighting along the border.

Israel says it will not hand over control of the crossing to Palestinian authorities, fearing Hamas would use the area to smuggle in weapons.

10,000 need evacuating

Rik Peeperkorn is the World Health Organization’s representative for the West Bank and Gaza.

He says there are at least 10,000 urgent cases that need to be evacuated from Gaza for treatment, adding this is likely an under-estimate given the difficulty getting accurate data.

“The biggest group is the war injuries and war-related … the severe trauma, spinal injury, etc. The other biggest group is, of course, chronic conditions – oncology, cardiovascular, respiratory as well.”

Before the war, Peeperkorn says between 50 and 100 patients would leave daily to be treated in Jerusalem and the West Bank. Since May 7, not one single case has been able to leave through Rafah, creating a backlog of desperation and severe cases.

“The Rafah crossing should be reopened as quickly as possible,” Peeperkorn says, “or there should be an alternative crossing or mechanism actually applied because we cannot leave these critical patients. We have no estimation at the moment how many of the patients which should have left actually have already passed away.

Before the crossing was closed on May 7, various countries – including Qatar, Jordan, Egypt, the UAE, Turkey, and parts of the European Union – had taken in critically ill cases. Some patients also continued to be transferred for treatment in Israeli hospitals after the war began, according to COGAT, Israel’s body overseeing the Palestinian Territories. Peeperkorn says many have said they are ready to welcome more.

But with the crossing shut, and Israel and Egypt continuing to blame each other for its continued closure, time is running out for some.

In the pediatric department of Nasser Medical Complex in southern Gaza, the sounds of the ICU are overwhelming; a constant cacophony of beeping machines keeping newborn patients alive.

Her doctor says Malak has a heart defect and needs a complex operation considered beyond the capabilities of his hospital with its lack of fuel for generators and medicine.

“The doctors did what was necessary,” al-Sharqi says, “but they said that she must be transferred (out of Gaza) quickly.”

With tears running down her face she adds, “One of the doctors told me not to have high hopes. That sentence is so difficult to hear.”

Cases of a dangerous and highly fatal bacterial infection have reached record levels in Japan, official figures show, with experts so far unable to pinpoint the reason for the rise.

As of June 2, Japan’s Health Ministry had recorded 977 cases of streptococcal toxic shock syndrome (STSS), which has a mortality rate of up to 30%. Some 77 people have died from the infection between January and March, the latest figures available.

The ongoing outbreak in Japan has already surpassed last year’s previous record of 941 preliminary infections – the highest since statistics began in 1999. Japan’s National Institute of Infectious Diseases reported 97 deaths due to STSS last year, the second-highest number of fatalities in the past six years.

STSS is a rare but serious bacterial infection that can develop when bacteria spread into deep tissues and the bloodstream. Patients initially suffer from fever, muscle pain and vomiting but symptoms can quickly turn life threatening with low blood pressure, swelling, and multiple organ failure as the body goes into shock.

“Even with treatment, STSS can be deadly. Out of 10 people with STSS, as many as three people will die from the infection,” according to the US Centers for Disease Control and Prevention (CDC).

Most STSS cases are caused by the group A streptococcus (GAS) bacteria, which mainly produces fever and throat infections in children. In rare circumstances, strep A can become invasive when bacterium produces a toxin that enables it to gain access to the bloodstream, causing serious illnesses such as toxic shock.

Strep A can also cause “flesh-eating” necrotizing fasciitis, which can lead to loss of limbs. However, most patients who contract that disease have other health factors that may lower their body’s ability to fight infections, such as cancer or diabetes, according to the CDC.

Invasive group A strep infections were largely curbed by Covid-19 controls, such as masking and social distancing, but after those measures were relaxed many countries reported a rise in cases.

In December 2022, five European countries reported to the World Health Organization an increase in invasive group A streptococcus (iGAS), with children under 10 the most impacted. The CDC said it was also investigating an apparent increase in the disease at the time.

In March, Japanese authorities warned of a jump in STSS cases. Japan’s National Institute of Infectious Diseases released a risk assessment saying the number of STSS cases caused by iGAS “has increased since July 2023, especially among those under 50 years of age.”

The CDC says older people with an open wound are at increased risk of contracting STSS, including those who have recently had surgery.

“However, experts don’t know how the bacteria got into the body for nearly half of people who get STSS,” the CDC said on its website.

The reason for this year’s rise in cases of STSS in Japan remains unclear, according to Japanese public broadcaster NHK.

Professor Ken Kikuchi, of Tokyo Women’s Medical University, told NHK the rise could be due to people’s weakened immune systems following Covid.

“We can boost immunity if we are constantly exposed to bacteria. But that mechanism was absent during the coronavirus pandemic,” Kikuchi said. “So, more people are now susceptible to infection, and that may be one reason for the sharp rise in cases.”

Raw sewage, swarms of flies and mosquitoes, garbage piled high in the streets. As the heat of summer gathers, hundreds of thousands of people in Gaza are contending with a crisis in sanitation.

“The municipalities are not working, and waste in large piles is on our doorsteps and on the roads,” he said.

“We are seeing large quantities of flying insects for the first time… Frankly, we have insects that we see for the first time and we do not know their names, and they sting our bodies and the bodies of our children.”

Israel’s relentless bombardment of Gaza – launched in the wake of the October 7 attacks – is now into its eighth month and has triggered a spiraling humanitarian crisis.

Human rights groups have repeatedly sounded the alarm over “unspeakable” living conditions for Palestinians, as Israel’s military campaign has pulverized neighborhoods, damaged health infrastructure and depleted food, water and fuel supplies.

There is little sign of a resolution to the protracted and bloody conflict. A US-backed ceasefire plan was overwhelmingly approved by the United Nations Security Council (UNSC) this week. But neither side has accepted it. Israeli Prime Minister Benjamin Netanyahu has repeatedly stated that he will continue until Hamas is destroyed and the remaining hostages are freed.

In an assessment this week, the UN Office for the Coordination of Humanitarian Affairs (OCHA), stated that in Deir al Balah in central Gaza, where thousands of displaced are sheltering, families say that shelters are overcrowded. They have reported a range of health issues, such as hepatitis A, skin diseases, and respiratory illnesses and say that access to water is also critically low.

At one displacement site, the average amount of water available per day was less than one liter per person, well below the internationally recognized minimum requirement for survival of three litres per day, according to OCHA.

A safe water supply is essential not just for drinking and cooking, but to prevent the spread of disease.

OCHA reported this week that more than two-thirds of water and sanitation facilities and infrastructure in Gaza have been destroyed or damaged due to the conflict. It added many other facilities are out of service due to challenges including “insecurity, access impediments, and lack of power and fuel to operate generators.”

OCHA said that people’s coping mechanisms are “heavily stretched,” with the most vulnerable collecting water from unreliable sources in inadequate containers, while lacking basic hygiene items like soap.

The average high temperature in Gaza in the coming week is expected to be in the low 30 degrees celsius, with warmer weather likely to worsen what is already a crisis in sanitation.

Roads ‘full of sewage’

Zayda, the Gaza City resident, told how an out-of-service swimming pool in his had become a magnet for insects.

“During the day, flies come, and at night, mosquitoes spread… We light fires at night and burn garbage until the flying insects disappear.”

Zayda spends much of the day wearing a mask, partly because some vehicles run on burned frying oil as an alternative to diesel, making breathing difficult.

“The roads are full of sewage running through the streets, waste and rubble from the bombing,” he said.

The treatment of sewage amid damage to infrastructure and a lack of fuel has become an enduring problem in Gaza.

Carl Skau, Deputy Executive Director of the World Food Programme, said after a tour of Gaza this week that a million people have been pushed out of Rafah and are now “trapped” in a “highly congested area along the beach in the burning summer heat.”

“We drove through rivers of sewage,” he said.

According to the OCHA, the delivery of some fuel supplies has helped reduce the level of accumulated wastewater in the Sheikh Radwan area in Gaza City, but “the lack of a steady flow of fuel creates a continued risk of sewage overflow into neighbouring areas.”

“There is significant damage to the sewer lines and sewage pumps, this has led to the leakage of sewage and wastewater throughout the city.”

He estimated that more than 4 kilometers of water pipelines had been destroyed or damaged, an immense stretch to repair in the middle of a war.

According to assessments by UN agencies and partner organizations published in the last week, 67% of water and sanitation facilities and infrastructure in Gaza have been destroyed or damaged due to conflict.

There are sporadic efforts to repair infrastructure. The Coastal Municipalities Water Utility, in partnership with the International Committee of the Red Cross, has restored several wells in Khan Younis, Deir Al Balah and Nuseirat.

But the scale of the task, without a ceasefire and with limited fuel supplies and equipment, is far beyond the capability of local authorities in Gaza.