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 the destruction of sanitation infrastructure leaves 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 displaced camps in the northern governorates of Khan Younis and Deir Al-Balah.
Although no clinical cases of polio have yet been diagnosed, Hanan Balkhy, WHO's regional director, warned that the virus could “spread further, even across borders” if agencies do not act quickly to vaccinate the population.
However, any mass polio immunization campaign in Gaza, targeting 600,000 children under the age of 8, would face a number of challenges, not the least of which is the absence of a ceasefire to allow health workers safe access to displaced communities.
“We need a ceasefire, even a temporary ceasefire, to successfully undertake these campaigns,” Balkhy told a news conference on Wednesday.
Children under 5, and infants in particular, are most at risk of polio, as many missed out on regular vaccination campaigns that took place in Gaza before the conflict broke out on October 7.
Spread through contact with the feces, saliva, or nasal mucus of an infected individual, the virus attacks nerves in the spinal cord and brainstem, leading to partial or complete paralysis within hours.
It can also immobilize the chest muscles, causing breathing difficulties, even leading to death.
Polio was eradicated in Europe in 2003 thanks to an effective vaccination campaign. Since 1984, there have been no confirmed cases of paralysis due to polio in the UK.
Wild polio cases 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, only two countries—Pakistan and Afghanistan—remain endemic of type 1.
In Gaza, overcrowding, a lack of clean water and hygiene materials, a deteriorating health system and the destruction of sanitation facilities have contributed to the resurgence of type 2, Hamid Jafari, WHO's polio eradication director, told a meeting on Wednesday. press briefing.
The UN estimates that at least 70 percent of Gaza's water and sanitation facilities, including sewage treatment facilities 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” and blamed the resurgence of the virus on Israel's bombing campaign and the subsequent damage it caused to the health system.
The Israeli military launched a bombardment of the Gaza Strip in retaliation for an October 7 attack by Hamas on southern Israel. Although the Israeli military insists it is not targeting civilian infrastructure, schools, hospitals and public services have suffered extensive damage.
The more than 490 attacks on medical facilities and personnel documented by the UN in just the first six months of the conflict have left Gaza's health system in ruins. Only 16 of Gaza's 36 health facilities remain partially functional.
INNUMBERS
1.2 million Polio vaccines WHO plans to send to Gaza to prevent outbreak.
600,000 Children under the age of 8 will be targeted for vaccination.
70% Some of Gaza's sanitation facilities are damaged or destroyed.
1.9 million Palestinians in Gaza have been displaced several times since the beginning of the conflict.
According to the American 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 Younis and none in the southern city of Rafah.
Javid Abdelmoneim, MSF's medical team leader 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 alone, dying alone. And this is the result of a broken health care system. A little 8-year-old girl dying alone on a gurney in the emergency room.
“In a functioning health system, she would have been saved.”
Despite calls from the WHO and other humanitarian organizations for the warring parties in Gaza to allow “absolute freedom of movement” so that health workers can begin 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, a spokesman for the Israeli army, posted the evacuation orders on the 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 combat zone,” he added.
Despite assurances that the areas would be treated as safe zones in which civilians could hide, both Deir Al-Balah and Zawayda have come under regular Israeli attack 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 Gaza's 2.1 million residents 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 Pledge Conference on 12
The constant movement of families in Gaza makes it difficult for aid agencies, already underfunded and struggling to reach affected populations, to find and identify unvaccinated children.
WHO polio specialist Jafari warned that the virus may 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 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 time of production until administration. Bringing these refrigerated vaccines to Gaza and keeping them at the required temperature would be a difficult task at the best of times.
WHO Director-General Tedros Adhanom Ghebreyesus said on Wednesday that a ceasefire, or at least a few days of calm, was necessary to protect children in Gaza.
As of July 7, the WHO noted a sharp increase in infectious diseases, including 1 million cases of acute respiratory infections, 577,000 acute watery diarrhea, 107,000 acute jaundice and 12,000 bloody diarrhea.
They say this is mainly due to the lack of clean drinking water and the destruction of a critical water facility in Rafah in southern Gaza.