The war in Gaza has created a dangerous situation where the threat of polio is rising rapidly, prompting aid groups to demand an immediate pause in the fighting to allow for a crucial vaccination drive. With at least one confirmed case, several suspected cases, and the virus detected in wastewater, a full-blown outbreak is a growing concern.
Polio was eradicated in Gaza 25 years ago, but the war, which started 10 months ago, has led to a dramatic decline in vaccination rates, creating a fertile environment for the virus to spread. Hundreds of thousands of displaced Palestinians are crammed into overcrowded tent camps with inadequate sanitation and lack of clean water, further exacerbating the situation.
To prevent a widespread outbreak, aid groups are preparing to administer polio vaccines to over 600,000 children in the coming weeks. However, these ambitious plans are contingent on a ceasefire to ensure the safety of health workers and the accessibility of the population.
“We are anticipating and preparing for the worst-case scenario of a polio outbreak in the coming weeks or month,” said Francis Hughes, the Gaza Response Director at CARE International.
The World Health Organization (WHO) and UNICEF, the UN children’s agency, have jointly called for a minimum seven-day ceasefire to facilitate a mass vaccination campaign. Their goal is to bring 1.6 million doses of polio vaccine into Gaza, where essential sanitation and water systems have been destroyed, leaving open pits of human waste in crowded camps. Families lack access to clean water, even basic hygiene items like soap, and resort to using wastewater for drinking, cleaning clothes, and washing dishes, posing significant health risks.
The dire situation is exacerbated by the emergence of over 225 informal waste disposal sites and landfills in Gaza, many located near crowded shelters. This poses a major threat for the spread of diseases like polio, which is highly contagious and primarily spreads through contaminated feces, water, and food. Polio can cause difficulty breathing and irreversible paralysis, especially affecting young children, and can be fatal.
The aid group Mercy Corps estimates that approximately 50,000 babies born since the war began have not been immunized against polio.
The urgency of the situation is underscored by the fact that three children are suspected of being infected, and their stool samples are being analyzed by a laboratory in Jordan. Late Friday, the Ministry of Health in Ramallah, West Bank, confirmed that tests in Jordan verified one case in a 10-month-old child in Gaza.
Aid workers anticipate an increase in suspected cases and are deeply concerned about the potential for an uncontrolled outbreak without immediate intervention. “We are not optimistic because we know that doctors could also be missing the warning signs,” said Hughes of CARE International.
Health workers in Gaza are preparing for a mass vaccination campaign to begin at the end of August and continue through September. The WHO’s goal is to immunize 640,000 children under the age of 10 over two rounds of vaccinations.
The Israeli military body responsible for Palestinian civilian affairs, COGAT, has stated they are “preparing to support a comprehensive vaccination campaign.” Hamas has also expressed support for a seven-day truce to facilitate the vaccinations. Ceasefire talks are scheduled to resume in Cairo next week.
The alarm bells about polio were first raised in July when the WHO announced that sewage samples collected from six locations in Khan Younis and Deir al-Balah, in southern and central Gaza, tested positive for a variant of the virus used in vaccines. The weakened form of the virus used in vaccines can mutate into a stronger version, leading to outbreaks in areas with insufficient immunization.
The only countries where polio is endemic are Afghanistan and Pakistan. However, outbreaks of the vaccine-derived virus have occurred in war-torn Ukraine and Yemen, where the situation is not as dire as in Gaza.
A major challenge in Gaza, where polio has been absent for 25 years, is to raise awareness so that health workers can accurately recognize the symptoms. The territory’s already-fragile healthcare system has been devastated by the war, with overwhelmed workers struggling to treat the wounded, patients with diarrhea and other illnesses, and a growing number of polio cases.
Before the war, 99% of Gaza’s population was vaccinated against polio. According to the WHO, that figure has dropped to 86%. The goal is to restore polio immunization levels in Gaza to over 95%.
While over 440,000 doses of polio vaccine were brought into Gaza in December, the supply has dwindled to just over 86,000, according to Hamid Jafari, director of polio eradication for the WHO Eastern Mediterranean Region. The 1.6 million oral doses being brought into Gaza are a more advanced version of the vaccine, less prone to mutation into an outbreak.
Getting the vaccine into Gaza is just the first step. UN workers face significant challenges retrieving medical supplies and aid due to Israel’s military assaults, fighting between troops and Hamas, and escalating lawlessness that has led to the looting of convoys. Furthermore, the vaccines must be kept refrigerated, which has become difficult in Gaza due to electricity shortages.
Approximately 15-20 refrigerated trucks serve all of Gaza, and they are also used for transporting food and other medical supplies, according to a senior Israeli army official with COGAT who spoke on condition of anonymity.
Palestinians also face difficulties getting around. The destroyed roads and the presence of Israeli drones, which often carry out strikes, further hinder their ability to reach health facilities, posing additional obstacles to the vaccination campaign. Israel maintains that its strikes target Hamas militants.
The WHO has emphasized that a pause in the fighting is essential to enable “children and families to safely reach health facilities and community outreach workers to get to children who cannot access health facilities.”
Only about a third of Gaza’s 36 hospitals and 40% of its primary healthcare facilities are currently operational. However, the WHO and UNICEF have announced that their vaccination campaign will be carried out in every municipality in Gaza, with the support of 2,700 workers.
The dire situation in Gaza highlights the urgent need for a ceasefire to allow for a successful vaccination campaign, preventing a potentially devastating polio outbreak. The fate of thousands of children hinges on the immediate action of all parties involved.
