LONDON: More than 1 million children in the Gaza Strip are at risk of contracting polio virus type 2, a highly contagious disease that can lead to paralysis and even death, as displacement and the destruction of sanitation infrastructure leave the population vulnerable to the disease.
The World Health Organization announced plans to send 1.2 million polio vaccines to Gaza after the virus was detected in sewage samples taken last month from camps for displaced people in the northern governorates of Khan Younis and Deir al-Balah .
Although no clinical cases of polio have yet been identified, Hanan Balkhi, the WHO's regional director, warned that the virus could “spread further, including across borders” if agencies do not act quickly to vaccinate the population.
In this photo taken on September 9, 2020, a UNRWA worker administers the polio vaccine to children at a clinic in the Burage refugee camp in the Gaza Strip. Health officials have rediscovered the polio virus in Gaza amid a raging war that has destroyed most of the area's medical facilities. (AFP/File)
However, any mass polio immunization campaign in Gaza targeting 600,000 children under the age of 8 will face many challenges, chief among them the lack of a ceasefire that would allow medics to safely access the displaced.
“We need a ceasefire, even a temporary ceasefire, to carry out these campaigns successfully,” Balkhi told a briefing on Wednesday.
Children under the age of 5, and especially infants, are most at risk of contracting polio, as many missed out on regular vaccination campaigns conducted in Gaza before the conflict began on October 7.
The virus, which is spread by contact with the feces, saliva, or nasal mucus of an infected person, attacks the nerves in the spinal cord and brainstem, causing partial or complete paralysis within hours.
It can also immobilize the chest muscles, causing breathing problems and even death.
PAHO/WHO infographic
Polio was eliminated in Europe in 2003 thanks to an effective vaccination campaign. There have been no confirmed cases of paralysis due to polio in the UK since 1984.
Since 1988, wild polio cases have declined by more than 99 percent, from an estimated 350,000 cases in more than 125 endemic countries to six reported cases in 2021.
Of the three wild polio strains, type 2 was eliminated in 1999, and type 3 was eliminated in 2020. As of 2022, endemic type 1 remained in only two countries—Pakistan and Afghanistan.
In Gaza, overcrowding, a lack of clean water and sanitation, a deteriorating health system and the destruction of sanitation facilities have contributed to the re-emergence of type 2, according to Hamid Jafari, WHO's director of polio eradication, speaking at a press briefing on Wednesday.
The WHO says overcrowding, a lack of clean water and hygiene supplies, a deteriorating health system and the destruction of sanitation facilities have contributed to the resurgence of polio in Gaza. (AFP)
The UN estimates that at least 70 percent of Gaza's water supply and sanitation, including sewage treatment plants and sewage pumping stations, has been damaged or destroyed since the conflict began.
In late July, Gaza's health authorities declared the enclave a “polio epidemic zone”, blaming the resurgence of the virus on Israel's bombing campaign and the resulting damage to the health system.
The Israeli military began bombing the Gaza Strip in retaliation for the Hamas-led attack on southern Israel on October 7. Although the Israeli military insists they are not targeting civilian infrastructure, schools, hospitals and public utilities have been severely damaged.
The more than 490 attacks on medical facilities and personnel documented by the UN in the first six months of the conflict alone have left Gaza's health system in tatters. Only 16 of Gaza's 36 medical facilities remain partially functional.
UNUMBERS
1.2 million Polio vaccines that WHO plans to send to Gaza to prevent an outbreak.
600,000 Children under the age of 8 will be the target vaccination.
70% A portion of Gaza's sanitation facilities have been damaged or destroyed.
1.9 million Palestinians in Gaza have been resettled several times since the beginning of the conflict.
Three of these facilities are located in the north of the country, seven in Gaza City, three in Deir el-Bal, three in Khan Younis and none in the southern city of Rafah, according to the American non-governmental organization Doctors for Human Rights.
Javid Abdelmoneim, head of the medical group Doctors Without Borders, who worked at Nasser Hospital in southern Gaza last month, told the organization that “every day in July was one shock after another.”
Recounting one particularly traumatic incident, he said: “I went behind the curtain and there was a little girl dying alone. And this is the result of the collapse of the health care system. A little 8-year-old girl dies alone in a gurney in the intensive care unit.
“With a functioning health care system, she would have been saved.”
Medical equipment in a hospital in Gaza, which was destroyed by Israeli bombing, is thrown away. (AFP)
Despite calls by the WHO and other aid agencies for the warring parties in Gaza to be allowed “absolute freedom of movement” so that medics can launch a vaccination campaign, a ceasefire does not look any closer.
On Wednesday, the Israeli military issued new evacuation orders for several parts of northern Gaza, including Beit Hanoun, Manshiya and Sheikh Zayed.
Avichai Adrai, a spokesman for the Israeli army, posted the evacuation order on social media platform X. He instructed the residents of Beit Hanoun to “immediately resettle” in Deir Al-Balah and Zaweida.
“The Beit Hanoun area is still considered a dangerous war zone,” he added.
The ongoing evacuation of Palestinian families in the Gaza Strip is hampering the deployment of the vaccination campaign. (AP)
Despite assurances that the areas would be treated as safe zones where civilians could take refuge, both Deir al-Balah and Zaweida have come under regular Israeli attacks in recent months.
The UN said that while nowhere in Gaza is safe, 86 percent of the besieged Palestinian enclave is under Israeli evacuation orders. About 1.9 million of the 2.1 million population of the Gaza Strip have been repeatedly displaced since October 7.
“Nowhere is safe. Everywhere is a potential killing zone,” UN Secretary-General Antonio Guterres said at the opening of the UNRWA Pledging Conference on July 12.
The constant movement of families in Gaza has made finding and identifying unvaccinated children difficult for already underfunded aid organizations struggling to reach the affected population.
In this file photo, a polio patient is fitted with a prosthesis at the Polio Prosthetics and Rehabilitation Center in Gaza City. The war in Gaza has hindered the work of the rehabilitation center. (Getty Images)
WHO polio specialist Jafari warned that the virus could have been circulating in Gaza since September because the enclave had “ideal conditions” for its transmission.
By October 7, polio vaccination coverage in the Occupied Palestinian Territories was 89 percent, according to WHO estimates.
Even if the planned 1.2 million vaccines are successfully delivered to Gaza, it will be a “huge logistical challenge” to ensure their successful deployment, WHO spokeswoman Andrea King told the BBC.
Vaccines must be stored within a limited temperature range from the time of manufacture to the time of administration. Getting these refrigerated vaccines to Gaza and keeping them at the required temperature would be a difficult undertaking at the best of times.
In a time of war, getting refrigerated vaccines to Gaza and keeping them at the required temperature would be a difficult task at the best of times, WHO officials say. (Getty Images)
WHO Director-General Tedros Adhanom Ghebreyesus said on Wednesday that a ceasefire, or at least a few days of calm, was necessary to protect Gaza's children.
As of July 7, the WHO recorded an outbreak of infectious diseases, including 1 million cases of acute respiratory infections, 577 thousand cases of acute watery diarrhea, 107 thousand cases of acute jaundice, and 12 thousand cases of bloody diarrhea.
It said this was primarily due to the lack of clean drinking water and the destruction of the vital water supply in Rafah in southern Gaza.
