ILike many in Gaza, Eid al-Attar, a teacher from the northern part of the territory, now spends his days scavenging for enough food and water to keep his family alive. The 42-year-old has been displaced eight times since the war between Israel and Hamas broke out in October and has done his best to protect his five children from the conflict. Now, the Palestinian territory faces a new threat: the highly contagious and potentially deadly disease polio.
“We cannot protect our children. We are exposed to death at any moment due to the constant bombardment and uncertainty. And I cannot protect them from diseases either,” he said in Deir al-Balah on Sunday as a UN-led vaccination campaign got underway.
“We live in a tent that does not protect us from anything, there is no medicine, there is garbage everywhere and the streets are filled with sewage.”
Israeli bombardments in Gaza have decimated the territory’s health care system, with 31 of its 36 hospitals damaged or destroyed, according to the World Health Organization. About 90 percent of the 2.3 million people living in Gaza have been forced from their homes, with most living in extremely overcrowded, unsanitary makeshift camps. Hepatitis, pneumonia and diarrheal diseases such as dysentery, as well as scabies, lice and debilitating skin rashes, are already rife, the WHO said.
The number of deaths from the disease, of more than 40,000 victims that the Health Ministry has recorded in the Hamas-controlled area, is unclear. But one of the worst fears of health workers was confirmed last week when Gaza recorded its first case of type 2 polio in a quarter century. The infectious disease can cause paralysis and death, especially in babies and young children.
Polio was eradicated from the Gaza Strip in 1999, but a strain was found in routine wastewater testing in July. It is thought to have originated from an oral polio vaccine, which contains a weakened live virus and can in rare cases be shed by vaccinated people and evolve into a new, infectious form.
The first case was reported last week in a 10-month-old boy, who is paralyzed in one leg. He did not receive routine childhood vaccinations because of the war. According to the WHO, hundreds of other people are likely already infected but showing no symptoms, putting hundreds of thousands of children in Gaza at risk.
A highly complex vaccination programme is currently underway, led by the UN and local health authorities, to prevent polio from re-emerging in a new generation.
At least 90% of the 640,000 children under 10 in Gaza should be vaccinated with two drops of oral vaccine in two rounds, four weeks apart, to prevent the disease from spreading. This is an ambitious target in an active war zone where circumstances can change quickly.
Hamas and Israel have agreed to a humanitarian pause in fighting between 6 a.m. and 3 p.m. for the next few days. During the pauses, vaccination teams plan to visit 160 sites, starting in central Gaza before moving on to harder-to-reach areas. Damaged or destroyed roads have made it difficult for health workers to move around, and aid workers and shipments have been hit by Israeli bombardments.
Four people were killed in an Israeli airstrike last week that hit the front of a convoy carrying food and fuel to a hospital in Rafah, the American Near East Refugee Aid (Anera) group said. Israel said it had attacked gunmen who seized the convoy, though Anera and witnesses denied that there were any armed fighters in the area.
Israel last month allowed about 1.3 million doses to enter Gaza, which are now being held in refrigerated storage at a warehouse in the central city of Deir al-Balah. Another shipment of 400,000 doses is expected to arrive in the territory soon.
“Israel attaches great importance to preventing a polio outbreak in the Gaza Strip, also to prevent the spread of diseases in the region,” Israeli Prime Minister Benjamin Netanyahu said in a statement last week.
Fuel shortages make powering the generators that keep the vaccines cold another major problem, as existing cold-chain storage facilities have all been destroyed. Dr. Khalil Abu Qasmiya, the director of the Ministry of Health in Deir al-Balah, said he and his team regularly wake up during the night to check that refrigerator temperatures are stable and that the cooling packs haven’t melted. “Since the first case of polio appeared, the Ministry of Health has been bending over backwards to do our part,” he said.
Unlike many other international efforts to alleviate the suffering in Gaza, the rollout of the polio vaccine has been going smoothly so far, with 72,600 children vaccinated on the first day of the operation, according to the Gaza Ministry of Health. It is also hoped that efforts to restore the cold chain system will allow for routine vaccinations once the polio campaign is complete.
Nabil al-Hasanat, 50, a father of two girls aged six and five months, said: “We are all suffering very much. I am happy that I can do one thing to protect my children.”
However, the underlying humanitarian crisis remains and there are no signs of a breakthrough in the ceasefire negotiations anytime soon.
Jose Lainez Kafati, social and behavioural change specialist at UNICEF Palestine, said: “Polio is just one of the many challenges facing children in Gaza.
“Although we have managed to start the polio vaccination, there are other serious problems that are still not solved due to the lack of access to aid. The total collapse of the health system, the almost complete destruction of sanitation and water infrastructure, as well as the living conditions of families who no longer have a home, make them vulnerable to other disease outbreaks.”