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 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, WHO regional director Hanan Balkhy 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 employee provides polio vaccine to children at a clinic in the Bureij refugee camp in the Gaza Strip. Health officials have again detected polio in Gaza amid a war that has destroyed most of the area's health facilities. (AFP/File)
However, any mass polio immunization campaign in Gaza, targeting 600,000 children under the age of 8, would face a number of challenges, chief among them the absence of a ceasefire that would allow doctors to access displaced communities safe.
“We need a ceasefire, even a temporary ceasefire, to successfully undertake these campaigns,” Balkhy told a news conference on Wednesday.
Children under 5, and especially infants, are most at risk of polio, as many missed the regular vaccination campaigns that took place in Gaza before the conflict began on 7 October.
The virus, which is spread through contact with an infected person's feces, saliva or nasal mucus, attacks the nerves in the spinal cord and brain stem, leading to partial or total paralysis within hours.
It can also immobilize the chest muscles, causing breathing problems, even leading to death.
Polio was eradicated in Europe in 2003 thanks to an effective vaccination campaign. There have been no confirmed cases of paralysis from polio caught in the UK since 1984.
Cases of wild poliovirus have declined by more than 99% since 1988, from approximately 350,000 cases in more than 125 endemic countries to six reported cases in 2021.
Of the three wild poliovirus strains, 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 materials, the deterioration of the health system and the destruction of sanitation stations have contributed to the re-emergence of type 2, said Hamid Jafari, WHO's director of polio eradication, speaking at the meeting on Wednesday. press briefing.
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 beginning of the conflict.
In late July, the Gaza health authority declared the enclave a “polio epidemic zone”, blaming the resurgence of the virus on Israel's bombing campaign and the subsequent damage it caused to the health system.
The Israeli military began its bombardment of the Gaza Strip in retaliation for the October 7 attack by Hamas on southern Israel. Although the Israeli military insists it is not targeting civilian infrastructure, schools, hospitals and utilities have suffered major damage.
The more than 490 attacks on medical institutions 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 health facilities remain partially functional.
INNUMBERS
1.2 million The polio vaccines WHO plans to send to Gaza to prevent the outbreak.
600,000 Children under the age of 8 will be targeted in the vaccination campaign.
70% Proportion of sanitation in Gaza has been damaged or destroyed.
1.9 million Palestinians in Gaza have been displaced several times since the beginning of the conflict.
Three of those 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 non-governmental organization Physicians for Human Rights.
Javid Abdelmoneim, a medical team leader for Doctors Without Borders who was working last month at Nasser Hospital in southern Gaza, told the organization that “every day in July was shock after day.”
Recounting one particularly traumatic incident, he said: “I went behind a curtain and there was a little girl alone, dying alone. And this is the result of a broken health care system. An 8-year-old girl, dying alone on a gurney in the emergency room.
“In a functioning health care system, she would have been saved.”
Despite calls from the WHO and other aid bodies for the conflicting 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 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 orders on social media platform X. He instructed residents of Beit Hanoun to “move immediately” to Deir Al-Balah and Zawayda.
“The Beit Hanoun area is still considered a dangerous battle zone,” he added.
Despite assurances that these areas would be treated as safe areas where civilians could take shelter, both Deir Al-Balah and Zawayda have come under regular Israeli attack in recent months.
The UN 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 population of 2.1 million have been displaced multiple times since October 7.
“Nowhere is safe. Everywhere is a potential killing zone,” UN Secretary-General Antonio Guterres said at the opening of the UNRWA Conference on 12 July.
The continued movement of families from Gaza has made it difficult for aid agencies, already strapped for funds and struggling to reach affected populations, to locate and identify unvaccinated children.
WHO polio specialist Jafari warned that the virus could have been circulating in Gaza since September because the enclave offered “ideal conditions” for its transmission.
Before 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 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 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 undertaking 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 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.
This is said to be primarily due to the lack of clean drinking water and the destruction of a critical water facility in Rafah, southern Gaza.
