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"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."
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."
"Let me be clear: It is still possible to stop this freight train of suffering that is charging through Sudan. But only if we respond with the urgency that this moment demands."
In an urgent appeal for financial and other resources, two top United Nations human rights officials on Tuesday condemned the world's inadequate response to a nascent famine in Sudan.
The U.N. Famine Review Committee announced last week that famine now exists in the Zamzam refugee camp near al-Fashir in North Darfur, where hundreds of thousands of displaced Sudanese are sheltering amid 15 months of a civil war that's displaced more than 10 million people and cut off delivery of desperately needed food and other aid.
Other parts of Sudan—including Greater Darfur, South Kordofan, and Khartoum—are at risk of famine.
"This announcement should stop all of us cold because when famine happens, it means we are too late," Edem Wosornu, director of the Operations and Advocacy Division at the U.N. Office for the Coordination of Humanitarian Affairs (OCHA), said Tuesday.
"It means we did not do enough. It means we, the international community, have failed," she added, pointing to the numerous warnings of imminent famine over recent months. "This is an entirely man-made crisis and a shameful stain on our collective conscience."
As U.N. News reported:
The Sudanese National Army and a rival, formerly allied military, known as the Rapid Support Forces (RSF), have been battling since April 2023, pushing "millions of civilians into a quagmire of violence and with it, death, injury, and inhumane suffering treatment."
A staggering 26 million people are facing acute hunger... More than 10 million people have been forced to flee their homes, including some 726,000 displaced from Sennar state following recent RSF advances.
Sudan's once vibrant capital, Khartoum, now lies in ruins, the national healthcare system has collapsed, and recent heavy rains in Kassala and North Darfur have increased the risk of cholera and other waterborne diseases. An entire generation of children is missing out on a second straight year of education.
"Let me be clear: It is still possible to stop this freight train of suffering that is charging through Sudan," Wosornu stressed. "But only if we respond with the urgency that this moment demands."
Justin Brady, who heads OCHA's Sudan office, toldU.N. News on Monday that "if we don't have enough resources and we don't have enough access, it is going to be very difficult to stop famine conditions from taking hold" in other parts of Sudan.
"Access continues to be a major problem," he continued. "And some donors have seen that and said, well, we'll give you funding when you get access."
"Second of all, when we do get access, we need to take advantage of those openings very quickly," Brady added. "If we don't, they will close very quickly. So not having enough resources... Our appeal for this year is only a third funded, under $900 million received."
Echoing Brady, Wosornu said that "we are pushing from every possible angle to stop this catastrophe from getting worse, but we cannot go very far without the access and resources we need."
Wosornu outlined the humanitarian community's four key demands:
"Assistance delayed is assistance denied for the many Sudanese civilians who are literally dying of hunger during the time it takes for clearances to come through, permits to be granted, and flood waters to subside," Wosornu warned.
Both parties in Sudan's civil war are to blame for a looming mass famine, experts say, and the military's blocking of U.N. aid at a border crossing with Chad exacerbates the problem.
Sudan's military is blocking United Nations aid trucks from entering at a key border crossing, causing severe disruptions in aid in a country that experts fear may be on the brink of one of the worst famines the world has seen in decades, The New York Timesreported Friday.
The border city of Adré in eastern Chad is the main international crossing into the Darfur region of Sudan, but the Sudanese Armed Forces (SAF), the state's official military, which is engaged in a civil war with a paramilitary group called the Rapid Support Forces (RSF), has refused to issue permits for U.N. trucks to enter there, as it's an RSF-controlled area.
U.S. and international officials have issued increasingly alarmed calls for steady aid access to help feed the millions of severely malnourished people in Darfur and other areas of Sudan.
Last week, Linda Thomas-Greenfield, the United States ambassador to the U.N., said that the SAF's obstruction of the border was "completely unacceptable."
Both warring parties in Sudan continue to perpetrate brazen atrocities, including starvation of civilians as a method of warfare. This piece focuses on the SAF's ongoing obstruction of essential aid. The situation is catastrophic. The policy is criminal. https://t.co/FKhqQh3EI9.
— Tom Dannenbaum (@tomdannenbaum) July 26, 2024
The Sudanese who've made it out of the country and into Adré reported dire and unsafe conditions in their home country.
"We had nothing to eat," Bahja Muhakar, a Sudenese mother of three, told the Times after she crossed into Chad, following a harrowing six-day journey from Al-Fashir, a major city in Darfur. She said the family often had to live off of one shared pancake per day.
Another mother, Dahabaya Ibet, said that her 20-month-old boy had to bear witness to his grandfather being shot and killed in front of his eyes when the family home in Darfur was attacked by gunmen late last year.
Now the mothers and their families are refugees in Adré, where 200,000 Sudanese are living in an overcrowded, under-resourced transit camp.
In addition to those that have made it out of the country, there are 11 million people internally displaced within Sudan, most of whom have become displaced since the civil war began in April 2023.
An unnamed senior American official told the Times that the looming famine in Sudan could be as bad as the 2011 famine in Somalia or even the great Ethiopian famine of the 1980s.
In April, Reutersreported that people in Sudan were eating soil and leaves to survive, and The Washington Postcalled it a nation in "chaos," reporting that World Food Program trucks had been "blocked, hijacked, attacked, looted, and detained."
In late June, a coalition of U.N. agencies, aid groups, and governments warned that 755,000 people in Sudan faced famine in the coming months.
The U.S. last week announced $203 million in additional aid to Sudan—part of a $2.1 billion pledge that world leaders made in April, which some countries have not yet delivered on.
Some officials including Thomas-Greenfield, who has dubbed the situation in Sudan "the worst humanitarian crisis in the world," have called for the U.N. Security Council to allow aid delivery into the country even in the absence of SAF approval; it's believed that Russia would veto such a measure.
Sudan's civil war has seen a great deal of international interference. Amnesty International on Thursday published an investigatory briefing showing that weapons from Russia, China, Serbia, Turkey, Yemen, and the United Arab Emirates (UAE) had been identified in the country. And The Guardian on Friday reported that the passports of Emirati citizens had been found among wreckage in Sudan, indicating the UAE may have troops or intelligence officers on the ground, though the UAE denied the accusation.
The International Service for Human Rights on Friday warned that both the SAF and RSF were engaged in wrongful killings and arrests, especially targeted at lawyers, doctors, and activists. The group called for an immediate cease-fire.
The SAF and Sudanese government figures have cast doubt on international experts' claims about famine in the country.