Polio vaccines arrived in Gaza on Monday amid growing alarm over at least one confirmed case of the previously eradicated disease, but public health officials in the besieged enclave said they face serious challenges with actually inoculating children there due to Israel's relentless bombardment.
With Israel's latest evacuation order forcing Palestinians to flee al-Aqsa Martyrs Hospital in Deir al-Balah—the last functioning hospital in central Gaza—and bombings reported in Gaza City, the Gaza Health Ministry reiterated its call for "an urgent cease-fire" to ensure medical teams can spread out across the enclave to vaccinate 640,000 children from the disease.
The Israel Defense Forces' (IDF) continued attacks "on healthcare infrastructure and water supplies and ongoing aid obstruction are contributing to a potentially catastrophic polio outbreak in Gaza," Human Rights Watch (HRW) said Monday.
The disease was first detected in wastewater in July, and less than a month later, a 10-month-old child was confirmed to have the first case of polio in Gaza in 25 years. The World Health Organization confirmed last week that the child's left leg had been paralyzed by the disease, which can invade the nervous system. The WHO also reported on August 16 that three other children "were showing symptoms of acute flaccid paralysis, raising concern that the virus could be spreading among children in Gaza."
Julia Bleckner, senior health and human rights researcher at HRW, said that "if the Israeli government continues to block urgent aid and destroy water and waste management infrastructure, it will facilitate the spread of a disease that has been nearly eradicated globally.
"Israel's partners should press the government to lift the blockade immediately and ensure unfettered humanitarian access in Gaza to enable the timely distribution of vaccines to contain the unfolding polio outbreak," said Bleckner.
As Jeremy Stoner, Middle East regional director for Save the Children, said last week, the fact that aid workers as well and other civilians are "constantly pinballed from one place to the next" by Israel's attacks and evacuation orders is part of why humanitarian aid can't reach those who need it.
The same will be true of the vaccination campaign, said humanitarian experts, unless Israel and Hamas agree to a weeklong pause in fighting to allow families to get to medical facilities and mobile clinics.
Journalist Séamus Malekafzali condemned the Coordination of Government Activities in the Territories (COGAT), Israel's humanitarian aid agency, for promoting on social media its cooperation with WHO and the U.N. Children's Fund (UNICEF) in delivering polio vaccines to Gaza, "all while emptying al-Aqsa Martyrs Hospital where they could be distributed."
Bleckner said Israel's allies, including the U.S.—the largest international funder of the IDF, which on Monday sent its 500th military supply shipment since last October—must "unequivocally press for an end to the siege of Gaza."
"Children in Gaza are already suffering from starvation and rampant infectious disease as a result of Israel's blockade and attacks on civilian infrastructure and are now facing an unprecedented polio outbreak without vaccines to protect them," said Bleckner.
HRW called on countries including the U.S. to "use leverage such as targeted sanctions and embargoes to press the Israeli government."
Dr. Hamid Jafari, polio eradication director for the eastern Mediterranean region for WHO, told HRW that "the impact on [the] health system, insecurity, inaccessibility, population displacement, and shortages of medical supplies have contributed to reduced routine immunization rates," with polio vaccination rates falling below 90%.
Over 99% of people in Gaza were vaccinated against the disease as of 2022, the "optimal" level, according to public health officials.
Israel's obstruction of humanitarian aid and relentless bombings of civilian infrastructure, including roads, have also "severely hampered" the World Food Program's (WFP) ability to deliver relief to people who have been deprived of clean drinking water and sufficient food.
WFP said roads across Gaza "will become unusable" in the next two months unless repairs can be made.
"Transporting food, water, medicine, and hygiene equipment is critical for the survival of communities in Gaza today and will be needed for months to come," said Antoine Renard, WFP country director for Palestine.
Israel first banned all humanitarian aid from entering Gaza before "imposing onerous restrictions," as HRW said.
The U.N. Office for the Coordination of Humanitarian Affairs reported earlier this month that aid entering Gaza has plummeted by more than 50% since April, with Israeli authorities denying access to Gaza to about a third of humanitarian missions this month.
HRW pointed to the International Criminal Court's current consideration of arrest warrants for top Israeli officials for depriving civilians in Gaza of supplies that are "indispensible to human survival," including clean water.
"Intentionally depriving civilians of clean water is a war crime," said HRW. "The Israeli government should immediately end its blockade of Gaza and ensure full and unfettered humanitarian access, including access to vaccines and medicines."
