LONDON: More than a million children in the Gaza Strip are at risk of contracting type 2 polio, a highly contagious disease that can lead to paralysis or even death, as displacement and destruction of sanitation infrastructure leave the population vulnerable to the disease.
The World Health Organization has announced plans to send 1.2 million doses of polio vaccine to Gaza after the virus was detected in wastewater samples collected from refugee camps in the northern governorates of Khan Younis and Deir al-Balah last month.
Although polio has not yet been clinically diagnosed, WHO Regional Director Hanan Balki has warned that the virus could “spread further, including across borders” unless authorities rapidly vaccinate the population.
In this photo taken on September 9, 2020, UNRWA staff vaccinate children against polio at a clinic in Bureij refugee camp in the Gaza Strip. Health workers have detected the polio virus again in the Gaza Strip amid a raging war that has destroyed most health centres in the area. (AFP/File)
However, the massive polio vaccination campaign in Gaza, targeting 600,000 children under the age of 8, will face several challenges, the most significant of which is the lack of a ceasefire that would allow medical personnel to safely reach displaced communities.
“We need a ceasefire, even a temporary one, to make these campaigns successful,” Balki said at a news conference on Wednesday.
Children under the age of five, especially infants, are at highest risk of contracting polio, as many missed out on routine vaccinations in Gaza before the conflict began on October 7.
The virus, which is spread through contact with the feces, saliva or nasal mucus of an infected person, attacks nerves in the spinal cord and brainstem, causing partial or complete paralysis within hours.
It can also cause the chest muscles to become immobile, causing difficulty breathing and possibly death.
PAHO/WHO Infographic
Polio was eradicated in Europe in 2003, thanks to an effective vaccination campaign. Since 1984, there have been no confirmed cases of paralysis caused by polio in the UK.
The number of wild poliovirus cases has fallen by more than 99 percent since 1988, with an estimated 350,000 cases in more than 125 endemic countries, with only six cases reported in 2021.
Of the three wild poliovirus strains, strain 2 was eliminated in 1999 and strain 3 was eliminated in 2020. As of 2022, strain 1 remains in only two countries: Pakistan and Afghanistan.
In the Gaza Strip, overcrowding, a lack of clean water and sanitation facilities, a deteriorating health system and the destruction of sanitation facilities are all contributing factors to a resurgence of polio type 2, WHO polio eradication director Hamid Jaafari told a news briefing on Wednesday.
The World Health Organization says overcrowding, lack of clean water and hygiene supplies, deteriorating health systems and disrupted sanitation are all contributing to a resurgence of polio in the Gaza Strip. (AFP)
The UN estimates that at least 70 percent of Gaza's water and sanitation facilities, as well as wastewater treatment plants and pumping stations, have been damaged or destroyed since the start of the conflict.
In late July, Gaza health officials declared the region a “polio outbreak zone,” blaming the virus' resurgence on Israeli bombing campaigns and damage to the health care system.
The Israeli military launched an offensive on the Gaza Strip in response to a Hamas-led offensive against southern Israel on October 7. Although the Israeli military insists that it did not hit civilian infrastructure, schools, hospitals and other public utilities were severely damaged.
More than 490 attacks on health facilities and staff recorded by the United Nations in the first six months of the conflict alone have left Gaza's health care system in dire straits, with only 16 of Gaza's 36 health facilities still partially functioning.
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1.2 million WHO plans to send polio vaccines to Gaza to prevent outbreak
600,000 Children under 8 years of age will be the target group for vaccination.
70% Proportion of sanitation facilities in Gaza damaged or destroyed
1.9 million Palestinians in the Gaza Strip have been displaced multiple times since the conflict began.
Three of the centers are in the north, seven are in Gaza City, three are in Deir al-Balah, three are in Khan Younis and none are in the southern city of Rafah, according to the US-based NGO Physicians for Human Rights.
“Every day in July is a constant shock,” Javid Abdelmoneim, head of the medical team at Medecins Sans Frontieres, who worked at Nasser Hospital in the southern Gaza Strip last month, told the organization.
He described a particularly horrifying incident: “I went behind the curtain and saw a little girl dying all alone. That’s the result of a broken healthcare system. An 8-year-old girl died all alone in a wheelchair in an emergency room.
“If the health system had worked well, she would have been saved.”
Medical equipment is seen as waste in a hospital in the Gaza Strip, which was destroyed in an Israeli strike. (AFP)
Even as the WHO and other aid agencies urge the warring parties in Gaza to allow “absolute freedom of movement” so that medical teams can administer vaccines, the possibility of a ceasefire is not far off.
On Wednesday, the Israeli military issued new evacuation orders for several areas in the northern Gaza Strip, including Beit Hanoun, Manshiyya and Sheikh Zayed.
Israeli military spokesman Avichay Adraee posted an evacuation order on social media platform X, ordering residents of Beit Hanoun to “immediately relocate” to Deir Al-Balah and Zawayda.
“The Beit Hanoun area remains a dangerous combat zone,” he added.
The ongoing exodus of Palestinian families in the Gaza Strip has hampered the rollout of the vaccination campaign. (AP)
Despite assurances that these areas are safe zones where civilians can take refuge, both Deir Al-Balah and Zawayda have come under regular Israeli attack in recent months.
The United Nations reports that while no place in the Gaza Strip is safe, 86 percent of the besieged Palestinians are under Israeli evacuation orders. Some 1.9 million of Gaza's 2.1 million residents have been displaced multiple times since October 7.
“Nowhere is safe, everywhere is a risk area for violence,” UN Secretary-General António Guterres said at the opening of UNRWA’s pledging conference on July 12.
The constant movement of families in the Gaza Strip has made it difficult for aid agencies, which are short of funds and struggling to reach the affected population, to find and identify unvaccinated children.
In this file photo, a polio patient is fitted with a prosthetic leg at a rehabilitation center for prosthetics and polio treatment in Gaza City. The war in Gaza has prevented the rehabilitation center from operating. (Photo by Getty Images)
WHO polio expert Jaafari has warned that the virus could have been spreading in Gaza since September because the area has a “favorable environment” for transmission.
As of October 7, the World Health Organization estimated that polio vaccine coverage in the occupied Palestinian territories was 89 percent.
Even if the planned 1.2 million doses of vaccines are successfully imported into Gaza, getting them into use remains a “huge logistical challenge,” WHO official Andrea King told the BBC.
Vaccines must be stored within tight temperature limits from the time they are manufactured until the day they are administered. Getting these refrigerated vaccines into Gaza and keeping them at the required temperature can be a difficult task even in the best of times.
The World Health Organization says getting refrigerated vaccines into Gaza and keeping them at the right temperature is a difficult task even in the best of times, given the ongoing war. (Photo: Getty Images)
World Health Organization (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, the World Health Organization has recorded a spike in infectious diseases, including 1 million acute respiratory infections, 577,000 acute diarrhea, 107,000 acute jaundice, and 12,000 bloody diarrhea.
The report said the main causes were a lack of clean drinking water and the destruction of key water facilities in the southern Gaza city of Rafah.
