LONDON: More than one million children in the Gaza Strip are at risk of contracting type 2 poliovirus, a highly contagious disease that can cause paralysis and even death, as displacement and the destruction of sanitation infrastructure leave the population vulnerable to the disease.
The World Health Organization has announced plans to send 1.2 million polio vaccines to Gaza after the virus was detected last month in wastewater samples taken from displacement camps in the northern governorates of Khan Younis and Deir al-Balah.
Although no clinical cases of polio have been detected so far, WHO regional director Hanan Balkhi warned that the virus “may spread further, including across borders” if agencies do not act quickly to vaccinate the population.
In this photo taken on September 9, 2020, UNRWA staff provide polio vaccination to children at a clinic in the Buraij refugee camp in the Gaza Strip. Health officials have found polio again in Gaza amid a raging war that has destroyed most of the region's health facilities. (AFP/File)
However, any mass polio vaccination campaign targeting the 600,000 children under 8 in Gaza will face many challenges, chief among them the lack of a ceasefire that would allow medics to safely access displaced communities.
“We need a ceasefire, even a temporary ceasefire, to carry out these operations successfully,” Balkhi told a news conference on Wednesday.
Children under the age of 5, and infants in particular, are most at risk from polio, as many missed routine vaccination campaigns in Gaza before the conflict began on October 7.
Spread through contact with the feces, saliva, or nasal mucus of an infected person, the virus attacks the nerves in the spinal cord and brain stem, causing partial or complete paralysis within hours.
It can also freeze the chest muscles, cause breathing problems, and even death.
PAHO/WHO infographic
Polio was eradicated from Europe in 2003 due to effective vaccination campaigns. There have been no confirmed cases of paralysis due to polio in the UK since 1984.
Wild poliovirus incidence has declined by more than 99 percent since 1988, from an estimated 350,000 cases in more than 125 endemic countries to six reported cases in 2021.
Of the three types of wild poliovirus, type 2 was eradicated in 1999 and type 3 was eradicated in 2020. By 2022, endemic type 1 remained in only two countries – Pakistan and Afghanistan.
In Gaza, overcrowding, a lack of clean water and hygiene materials, a deteriorating health system, and the destruction of sanitation plants have all contributed to the resurgence of type 2, said WHO polio eradication director Hamid Jafari, speaking on Wednesday. Press briefing.
Overcrowding, a lack of clean water and sanitation, a deteriorating health system and the destruction of sanitation plants have contributed to the resurgence of polio in Gaza, the WHO said. (AFP)
The United Nations estimates that at least 70 percent of Gaza's water and sanitation plants, wastewater treatment facilities and sewage pumping stations have 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 and the damage it caused to the health care system on Israel's bombing campaign.
The Israeli military began bombing the Gaza Strip in retaliation for an October 7 Hamas-led offensive in southern Israel. Although the Israeli military claims it did not target civilian infrastructure, schools, hospitals and utilities have been heavily damaged.
More than 490 attacks on medical facilities and personnel documented by the United Nations in the first six months of the conflict alone have crippled Gaza's health care system. Only 16 of Gaza's 36 health facilities are partially functional.
INnumbers
1.2 million The WHO plans to send polio vaccines to Gaza to prevent an outbreak.
600,000 Children below the age of 8 will be targeted in the vaccination campaign.
70% Proportion of Gaza's sanitation facilities damaged or destroyed.
1.9 million Palestinians have been displaced several times since the conflict in Gaza began.
According to the US-based NGO 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 has been one shock after another,” Javid Abdelmonem, a medical team leader at Medicines Sans Frontieres, who was working at Nasser Hospital in southern Gaza last month, told the organization.
Recalling one particularly poignant incident, he said: “I went behind the curtain, and there was a little girl alone, dying alone. And that is the result of a collapsed health system. An 8-year-old girl dying alone on a trolley in the emergency room.
“With a functioning health system, he was saved.”
Medical equipment lies idle in a Gaza hospital destroyed by Israeli bombardment. (AFP)
Despite calls from the WHO and other aid agencies to allow warring parties in Gaza “full freedom of movement” so doctors can carry out vaccination campaigns, the prospect of a cease-fire does not appear imminent.
On Wednesday, the Israeli military issued new evacuation orders for several parts of northern Gaza, including Beit Hanoun, Mansia and Sheikh Zayed.
Avichay Adraee, a spokesman for the Israeli army, posted the evacuation order on social media platform X. He ordered residents of Beit Hanoun to “immediately relocate” to Deir al-Balah and Zawayda.
“The Beit Hanoun area is still considered a dangerous combat zone,” he added.
The continued evacuation of Palestinian families to the Gaza Strip has hampered the rollout of the vaccination campaign. (AP)
Despite assurances that these areas would be treated as safe zones where civilians could seek shelter, both Deir al-Balah and Zaweda have come under regular Israeli attacks in recent months.
The United Nations says that while nowhere in Gaza is safe, 86 percent of the besieged Palestinian enclave is under Israeli evacuation orders. About 1.9 million of Gaza's 21 million people have been displaced multiple times since October 7.
“Nowhere is safe. Everywhere is a potential killing field,” UN Secretary-General Antonio Guterres said at the opening of the UNRWA pledging conference on July 12.
The constant movement of families into Gaza has made it difficult for aid agencies, who are already short of funds and struggling to reach affected populations, to locate and identify unvaccinated children.
In this file photo, a polio patient is fitted for an artificial leg at the Rehabilitation Center for Prosthetics and Polio Treatment in Gaza City. The war in Gaza has hampered the operations of the resettlement center. (Getty Images)
Jafari, a WHO polio expert, warned that the virus could have spread to Gaza since September, as the enclave offered “ideal conditions” for its transmission.
Before October 7, polio vaccination coverage in the Occupied Palestinian Territories was estimated at 89 percent, according to the WHO.
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 official Andrea King told the BBC.
Vaccines must be stored within a limited temperature range from the moment they are manufactured until they are administered. Getting these cold vaccines into Gaza and keeping them at the required temperature will be a difficult task at the best of times.
As the war rages, getting cold vaccines to Gaza and keeping them at the required temperature will 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 peace, was necessary for the safety of Gaza's children.
As of July 7, the WHO recorded an increase in infectious diseases, including 1 million cases of acute respiratory infections, 577,000 acute watery diarrhea, 107,000 acute jaundice syndrome and 12,000 bloody diarrhea.
It said it was mainly due to the lack of clean drinking water and the destruction of critical water facilities in Rafah, southern Gaza.
