LONDON: More than a million children in the Gaza Strip are at risk of contracting poliovirus type 2, a highly contagious disease that can lead to paralysis and even death, as displacement and the destruction of sanitation infrastructure leave residents vulnerable to disease.
The World Health Organization has announced plans to send 1.2 million polio vaccines to Gaza after the virus was detected in sewage samples taken last month from displacement camps in the northern governorates of Khan Younis and Deir al-Balah.
Although no clinical cases of polio have been diagnosed so far, Hanan Balkhi, WHO's regional director, warned that the virus could “spread more widely, including across borders” unless agencies move quickly to vaccinate the population.
In this photo taken on September 9, 2020, an UNRWA staff member administers polio vaccine to children at a clinic in the Bureij refugee camp in the Gaza Strip. Health officials have discovered the polio virus in Gaza again amid a raging war that has destroyed most health centres in the area. (AFP/File)
But any mass polio vaccination campaign in Gaza targeting 600,000 children under the age of eight will face a host of challenges, most notably the absence of a ceasefire that would allow medical workers to safely reach displaced communities.
“We need a ceasefire, even if it is temporary, to carry out these campaigns successfully,” Balkhi said at a news conference on Wednesday.
Children under five, especially infants, are most at risk of polio, as many of them missed regular vaccination campaigns that took place in Gaza before the conflict began on October 7.
The virus, which is spread through contact with the stool, saliva or nasal mucus of an infected person, attacks the nerves in the spinal cord and brain stem, leading to partial or complete paralysis within hours.
It can also paralyze the chest muscles, causing difficulty breathing and even death.
PAHO/WHO infographics
Polio was eradicated in Europe in 2003 thanks to an effective vaccination campaign. No cases of paralysis due to polio have been confirmed in the UK since 1984.
Wild poliovirus cases have fallen by more than 99 percent since 1988, from an estimated 350,000 cases in more than 125 endemic countries to six cases reported in 2021.
Of the three wild poliovirus strains, type 2 was eradicated in 1999 and type 3 in 2020. As of 2022, endemic type 1 remained in only two countries – Pakistan and Afghanistan.
In Gaza, overcrowding, lack of clean water and hygiene supplies, a deteriorating health system and the destruction of sewage plants have contributed to the resurgence of type 2 polio, according to Hamid Jafari, director of the World Health Organization's polio eradication programme, at a news conference on Wednesday.
The World Health Organization says overcrowding, lack of clean water and hygiene supplies, a deteriorating health system and the destruction of sewage plants have all contributed to the resurgence of polio in Gaza. (AFP)
The UN estimates that at least 70% of Gaza’s water and sanitation facilities, including sewage treatment facilities and sewage pumping stations, have been damaged or destroyed since the conflict began.
In late July, the Gaza health authority declared the territory a “polio epidemic zone,” blaming the resurgence of the virus on the Israeli bombing campaign and the damage it caused to the health system.
The Israeli military began bombing the Gaza Strip in response to a Hamas attack on southern Israel on October 7. Although the Israeli military insists that it is not targeting civilian infrastructure, it has caused extensive damage to schools, hospitals and public facilities.
The more than 490 attacks on medical facilities and personnel documented by the UN in the first six months of the conflict alone have devastated Gaza’s health care system, leaving only 16 of Gaza’s 36 health facilities partially functioning.
innumbers
1.2 million Polio vaccines that the World Health Organization plans to send to Gaza to prevent the spread of the disease.
600000 Children under 8 years of age will be targeted in the vaccination campaign.
70% Percentage of damaged or destroyed sanitation facilities in Gaza.
1.9 million Palestinians in Gaza have been displaced several times since the conflict began.
Three of these facilities are located in the north, seven in Gaza City, three in Deir al-Balah, three in Khan Younis, and none in the southern city of Rafah, according to the US-based NGO Physicians for Human Rights.
“Every day in July was one shock after another,” Javid Abdel Moneim, a medical team leader with MSF who was working at Nasser Hospital in southern Gaza last month, told the organization.
Recounting a particularly poignant incident, he said: “I went behind a curtain, and there was a little girl alone, dying alone. This is the result of a broken health system. A little girl, 8 years old, dying alone on a gurney in the emergency room.
“If there had been a functioning health system, she could have been saved.”
Medical equipment is thrown away at a hospital in Gaza City after it was destroyed by Israeli shelling. (AFP)
Despite calls from the World Health Organization and other aid agencies for the warring parties in Gaza to allow “absolute freedom of movement” so that doctors can carry out a vaccination campaign, the possibility of a ceasefire does not appear any closer.
The Israeli army issued new evacuation orders on Wednesday for several areas in the northern Gaza Strip, including Beit Hanoun, Al-Manshiya, and Sheikh Zayed.
The spokesman for the occupation army, Avichay Adraee, published the evacuation orders on the social networking site “X”. He instructed the residents of Beit Hanoun to “move immediately” to Deir al-Balah and Zuwayda.
“The Beit Hanoun area is still considered a dangerous combat zone,” he added.
The ongoing eviction of Palestinian families in the Gaza Strip has hampered the launch of a vaccination campaign. (Associated Press)
Despite assurances that these areas would be treated as safe zones where civilians could seek refuge, Deir al-Balah and al-Zawiya have come under regular Israeli attack in recent months.
The United Nations said that while there is no safe place in Gaza, 86 percent of the blockaded Palestinian territory is under Israeli evacuation orders. Some 1.9 million of Gaza’s 2.1 million people have been displaced multiple times since October 7.
“Nowhere is safe. Everywhere is a potential killing zone,” UN Secretary-General António Guterres said at the opening of a pledging conference for UNRWA on July 12.
The constant movement of families in Gaza has made it difficult for aid agencies, already strapped for cash and struggling to reach affected populations, to locate and identify unvaccinated children.
In this file photo, a polio patient is fitted with a prosthetic limb at the Prosthetics and Polio Rehabilitation Center in Gaza City. The war in Gaza has hampered the rehabilitation center's work. (Getty Images)
Al-Jaafari, a polio specialist at the World Health Organization, warned that the virus may have been spreading in Gaza since September, as the Strip provides “ideal conditions” for its transmission.
Prior to October 7, polio vaccination coverage in the occupied Palestinian territory was estimated at 89%, according to the World Health Organization.
Andrea King, a WHO official, told the BBC that even if the planned 1.2 million vaccines were successfully introduced into Gaza, there would be a “huge logistical challenge” to ensure their successful deployment.
Vaccines must be stored within a specific temperature range from the moment they are manufactured until they are distributed. Bringing these refrigerated vaccines into Gaza and keeping them at the required temperature would be a difficult task at best.
With the war still ongoing, bringing refrigerated vaccines into Gaza and keeping them at the required temperature will be a difficult task at best, WHO officials say. (Getty Images)
A ceasefire or at least a few days of calm is essential to protect Gaza's children, World Health Organization Director-General Tedros Adhanom Ghebreyesus said on Wednesday.
By July 7, WHO had recorded a sharp rise in infectious diseases, including 1 million cases of acute respiratory infections, 577,000 cases of acute watery diarrhea, 107,000 cases of acute jaundice syndrome, and 12,000 cases of bloody diarrhea.
She says the main reason for this is the lack of clean drinking water and the destruction of a vital water facility in Rafah, in the southern Gaza Strip.
