LONDON: More than 1 million children in the Gaza Strip are at risk of contracting poliovirus type 2, a highly infectious disease that can lead to paralysis and even death, as displacement and destruction of sanitation infrastructure leave the population 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 Balkhy, WHO's regional director, warned that the virus could “spread further, including across borders” unless authorities act quickly to vaccinate the population.
In this photo taken on September 9, 2020, a UNRWA staff member provides polio vaccine to children at a clinic in Bureij refugee camp in the Gaza Strip. Health officials have re-detected the polio virus in Gaza amid a raging war that has destroyed most health centers in the area. (AFP/File)
But any mass polio vaccination campaign in Gaza, targeting 600,000 children under the age of 8, would face a host of challenges, chiefly the lack of a ceasefire that would allow doctors to safely access displaced communities.
“We need a ceasefire, even a temporary ceasefire, to successfully carry out these campaigns,” Balkhy told a press briefing on Wednesday.
Children under the age of 5, and especially infants, are most at risk of contracting polio, as many missed out on the regular vaccination campaigns that had taken place in Gaza before the conflict began on 7 October.
The virus, which is spread through contact with the feces, saliva or nasal mucus of an infected individual, attacks nerves in the spinal cord and brainstem, leading to partial or total paralysis within hours.
It can also immobilize the chest muscles, cause breathing difficulties, even lead to death.
PAHO/WHO infographic
Polio was eradicated in Europe in 2003 thanks to an effective vaccination campaign. There have been no confirmed cases of paralysis due to polio caught in the UK since 1984.
Cases of wild poliovirus have 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 strains of wild poliovirus, type 2 was eradicated in 1999 and type 3 was eradicated 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 hygiene supplies, a deteriorating health system and the destruction of sanitation facilities have all contributed to the resurgence of type 2, according to Hamid Jafari, WHO's director of polio eradication, speaking Wednesday. press conference.
WHO says overcrowding, lack of clean water and hygiene supplies, a deteriorating health system and the destruction of sanitation facilities have all contributed to the resurgence of polio in Gaza. (AFP)
The UN estimates that at least 70 percent of Gaza's water and sanitation facilities, including sewage treatment plants and sewage pumping stations, have been damaged or destroyed since the conflict began.
In late July, the Gaza health authority declared the enclave a “polio epidemic zone”, blaming the emergence of the virus on Israel's bombing campaign and the subsequent damage this had caused to the health care system.
The Israeli military began bombarding the Gaza Strip in retaliation for the October 7 Hamas-led attack on southern Israel. Although the Israeli military insists it does not target civilian infrastructure, schools, hospitals and utilities have suffered extensive damage.
The more than 490 attacks on medical facilities and personnel, documented by the United Nations in the first six months of the conflict alone, have left Gaza's medical system in ruins. Only 16 of Gaza's 36 health facilities are still partially functional.
INSPEECH
1.2 million Polio vaccines WHO plans to send to Gaza to prevent outbreak.
600,000 Children under the age of 8 must be targeted for vaccination.
70% Proportion of Gaza sanitation facilities damaged or destroyed.
1.9 million Palestinians in Gaza have been displaced several times since the conflict began.
Three of these facilities are 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.
Javid Abdelmoneim, a MSF medical team leader who worked at Nasser Hospital in southern Gaza last month, told the organization “every day in July has been one shock after another.”
Recounting one particularly traumatic incident, he said: “I went behind a curtain and there was a little girl alone dying by herself. And that's the result of a collapsed health system. A little 8-year-old girl, dying alone on a trolley at the emergency.
“In a functioning health system, she would have been saved.”
Medical equipment is laid waste at a hospital in Gaza that had been destroyed by Israeli bombardment. (AFP)
Despite calls by the WHO and other aid agencies for the warring parties in Gaza to allow “absolute freedom of movement” so that doctors can roll out a vaccination campaign, the possibility of a ceasefire does not seem any closer.
On Wednesday, the Israeli military issued new evacuation orders for several parts of northern Gaza, including Beit Hanoun, Manshiyya and Sheikh Zayed.
Avichay Adraee, the Israeli army spokesman, posted the evacuation order on the social media platform X. He instructed the residents of Beit Hanoun to “move immediately” to Deir Al-Balah and Zawayda.
“The Beit Hanoun area is still considered a dangerous combat zone,” he added.
The constant evacuation of Palestinian families in the Gaza Strip has hindered the expansion of a vaccination campaign. (AP)
Despite assurances that these areas would be treated as safe zones where civilians could take refuge, both Deir Al-Balah and Zawayda have come under regular Israeli attacks in recent months.
The United Nations reported 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 2.1 million population have been displaced several times since October 7.
“Nowhere is safe. Everywhere is a potential death zone,” UN Secretary-General Antonio Guterres said at the opening of UNRWA's pledging conference on 12 July.
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 for an artificial limb at a rehabilitation center for prosthetics and polio treatment in Gaza City. The war in Gaza has hampered the operation of the rehab center. (Getty Images)
WHO polio specialist Jafari warned that the virus could have been circulating in Gaza since September, as the enclave offered “ideal conditions” for its transmission.
Prior to October 7, polio vaccine 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 brought into Gaza, it will be a “major logistical challenge” to ensure their successful deployment, WHO official Andrea King told the BBC.
The vaccines must be stored within a limited temperature range from the time they are manufactured until they are administered. Getting these refrigerated vaccines into Gaza and keeping them at the required temperature would be a difficult task at best.
With a war going on, bringing refrigerated vaccines to Gaza and keeping them at the required temperature would be difficult at best, WHO officials said. (Getty Images)
WHO Director-General Tedros Adhanom Ghebreyesus said on Wednesday that a ceasefire or at least a few days of calm was essential to protect Gaza's children.
As of July 7, the WHO has recorded an increase in infectious diseases, including 1 million cases of acute respiratory infections, 577,000 of acute watery diarrhea, 107,000 of acute jaundice syndrome, and 12,000 of bloody diarrhea.
It says this is mainly due to the lack of clean drinking water and the destruction of a critical water facility in Rafah, southern Gaza.
