LONDON: More than a million children in the Gaza Strip are at risk of contracting the highly contagious poliovirus type 2, which can cause paralysis and even death. Displacement and the destruction of sanitation infrastructure have left people vulnerable to the disease.
The World Health Organization (WHO) announced plans to send 1.2 million doses of polio vaccine to the Gaza Strip last month after the virus was detected in wastewater samples taken from refugee camps in Khan Yunis and the northern area of Deir el-Bala.
So far, no clinical cases of polio have been diagnosed, but WHO regional director Hanan Balki warned that if agencies do not act quickly to vaccinate the population, the virus “could spread further across borders.”
But implementing a mass polio vaccination campaign in Gaza, targeting 600,000 children under the age of eight, will face numerous challenges, the most significant of which is the lack of a ceasefire that would allow medical personnel safe access to the refugee community.
“To make this campaign successful, we need a ceasefire, even a temporary ceasefire,” Balki said at a news conference Wednesday.
Children under five, especially infants, are most vulnerable to polio, as many missed routine vaccination campaigns in Gaza before the conflict began on October 7.
The virus, which spreads through contact with the stool, saliva, or nasal mucus of an infected individual, attacks the nerves of the spinal cord and brain stem, causing partial or complete paralysis within hours.
It can also paralyze the chest muscles, causing breathing difficulties and even death.
Polio was eradicated in Europe in 2003 thanks to an effective vaccination campaign. No case of paralysis caused by polio has been confirmed in the UK since 1984.
Cases of wild poliovirus infection have fallen by more than 99% since 1988, from about 350,000 cases reported in more than 125 endemic countries to just six in 2021.
Of the three strains of wild poliovirus, type 2 was eradicated in 1999 and type 3 in 2020. As of 2022, the endemic type 1 remains in only two countries: Pakistan and Afghanistan.
Hamid Jafari, WHO's polio eradication chief, told a news conference Wednesday that type 2 polio has resurfaced in Gaza due to factors including overcrowding, lack of clean water and sanitation, a deteriorating health system and breakdown of sanitation facilities.
The United Nations estimates that more than 70 percent of the Gaza Strip's water and sanitation infrastructure, including wastewater treatment plants and sewage pumping stations, have been damaged or destroyed since the conflict began.
In late July, Gaza health authorities declared the area a “polio-endemic area,” blaming the resurgence of the virus on Israeli bombing campaigns and the resulting damage to the health-care system.
The Israeli military began bombing the Gaza Strip on October 7 in retaliation for a Hamas-led attack on southern Israel. The Israeli military claims it does not target civilian infrastructure, but schools, hospitals and public facilities have been heavily damaged.
Gaza’s health system is in shambles, with the UN documenting more than 490 attacks on health facilities and personnel in the first six months of the conflict. Only 16 of Gaza’s 36 health facilities are partially functional.
innumber
1.2 million Polio vaccines that WHO plans to send to the Gaza Strip to prevent a polio outbreak.
600,000 Vaccination is performed on children under 8 years of age.
70% The percentage of sanitation facilities in the Gaza Strip that are damaged or destroyed.
1.9 million people Since the conflict began, Palestinians in the Gaza Strip have been forced to flee their homes and become refugees several times.
According to the U.S.-based nongovernmental organization Physicians for Human Rights, three of these facilities are in the north, seven in Gaza City, three in Deir al-Balah, three in Khan Yunis and none in the southern city of Rafah.
“Every day in July was a day of shock,” Javid Abdelmoneim, a medical team leader for Doctors Without Borders who worked at Nasser Hospital in southern Gaza last month, told the group.
Recalling one particularly shocking incident, he said: “I went behind the curtain and there was a little girl dying alone. And that's the result of a broken health system. An eight-year-old little girl dying alone on a trolley in the emergency room.
“If the health system had worked properly, she would have lived.”
A ceasefire appears unlikely, despite calls from the WHO and other aid agencies for warring parties in Gaza to allow “full freedom of movement” to allow medical personnel to carry out vaccination campaigns.
On Wednesday, the Israeli military announced new evacuation orders for several areas in northern Gaza, including Beit Hanoun, Manshiyah and Sheikh Zayed.
Israeli military spokesman Avichai Adri posted an evacuation order on social media platform X, ordering Beit Hanoun residents to “move immediately” to Deir al-Balah and Zawadah.
“The Beit Hanoun area is still considered a dangerous combat zone,” he added.
Despite the area being declared a safe zone for civilians, Deir al-Balah and Zawadah have come under regular Israeli attack in recent months.
The UN reports that no part of Gaza is safe, but that 86 percent of besieged Palestinian areas are under Israeli evacuation orders. About 1.9 million of Gaza’s 2.1 million people have been displaced at various times since October 7.
“Nowhere is safe. Everywhere is a potential killing zone,” UN Secretary-General António Guterres said at the opening of the UNRWA commitment conference on July 12.
As families continue to move across the Gaza Strip, aid agencies, already underfunded and struggling to reach affected populations, are struggling to identify and identify unvaccinated children.
WHO polio expert Jafari warned that the virus may have been circulating in Gaza since September because the area provides “ideal conditions” for its spread.
According to WHO, as of October 7, polio vaccination coverage in the occupied Palestinian territories was estimated at 89%.
WHO official Andrea King told the BBC that even if the planned 1.2 million doses of vaccine were successfully delivered to Gaza, ensuring their successful distribution would be a “huge logistical challenge”.
Vaccines must be stored within a limited temperature range from the time they are manufactured until they are administered. Getting these refrigerated vaccines into the country and keeping them at the required temperatures is a challenge at best.
WHO Director-General Tedros Adhanom Ghebreyesus said on Wednesday that a ceasefire, or at least a few days of calm, was essential to protect children in Gaza.
As of July 7, WHO recorded a surge 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.
The report said this was mainly due to a lack of clean drinking water and the destruction of a vital water supply facility in Rafah, southern Gaza.
