Polio, hepatitis, meningitis … Gaza’s humanitarian disaster turns into disease | International

UN agencies and NGOs in Gaza have been warning for months: it is only a matter of time. Devastating sanitary conditions, crowding in tents, serial displacement and lack of food and water will – sooner or later – translate into diseases. Especially those that thrive due to extreme overcrowding or the presence of fecal residues in the water. Last week, health officials announced the first case of polio in Gaza in 25 years, in the town of Deir al Bala, where thousands of people have been displaced. He is a 10-month-old child who was not vaccinated. Not coincidentally, his age coincides with the period of the invasion of Gaza, which has reduced the vaccination rate from 99% to 89% and during which at least 50,000 children have been born, who – between bombs and forced evacuations – may not have received the vaccine. Dose.

Polio is mainly spread by drinking water contaminated with faeces. The virus had already been detected in July in wastewater samples from six points in Khan Yunis and Deir el Bala. To check whether the suspected cases were genuine, the samples had to be taken to Jordan for analysis.

Last week, the World Health Organization (WHO) and the United Nations children’s agency, UNICEF, indicated in a joint statement that they had guaranteed the supply of 1.6 million doses of the type 2 oral vaccine to provide more than 640,000 children under 10 years of age, but that the campaign would only be effective if it reached at least 96%, which would be “impossible” without a “humanitarian pause”.

The vaccines will enter through Ben Gurion Airport, near Tel Aviv, at the end of August, and must travel to Gaza without breaking the cold chain. There must also be enough cash (so people can pay for the trip), fuel and an operational telecommunications network to inform the population about the campaign.

So, the fate of these 640,000 Gazans under the age of 10, condemned to live in the hell of Gaza, largely depends on those who are negotiating the ceasefire these days, even if they live in a completely different world, thousands of kilometers away.

To know what happens outside is to understand what will happen inside, don’t miss anything.

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The dialogue runs through a Deadlock The failed strategy of Antony Blinken, the head of diplomacy of one of the mediating countries (the USA), to allow the Israeli Prime Minister, Benjamin Netanyahu, to modify the agreement, presenting the new draft as a “compromise proposal” in order to put pressure on Hamas to accept it, has led to a failed attempt. However, the aim is to hold the meeting scheduled for this Thursday in Cairo later this week. President Joe Biden (accompanied by Democratic presidential candidate Kamala Harris) spoke with Netanyahu late Wednesday to convey the “urgent need to close” the ceasefire agreement.

For the White House, this “urgency” comes from the proximity of a close presidential election against Donald Trump and the threat of regional war if negotiations fail. But, for humanitarian organisations, it has more to do with preventing an outbreak of polio, which mainly affects children under five, can cause paralysis or deformity and was almost entirely eradicated from the world by mass vaccination four decades ago.

Humanistic pause

Since immediate needs do not fit well with the timeline of political negotiations, discussions are now focused on obtaining a one-week humanitarian pause for vaccinations. This was requested last week by UN Secretary-General Antonio Guterres himself and has been supported by the Ministry of Health of the Hamas government in Gaza. Israel has not formally responded and COGAT (the Defense Ministry body that manages civil affairs in Gaza and the West Bank) is limited to stating that it has coordinated the entry of more than 300,000 vials and that 90% of Gazans have been vaccinated.

Blinken raised the topic in his meeting with Netanyahu, and his vague response on the subject in a press conference in Tel Aviv this Monday does not give much room for hope: “We share the concern about the possibility of a massive reappearance (of polio) and we are working on a detailed plan to make sure that people who need to be vaccinated can do so. “We are working on this with the Israeli government and I think we will be able to move forward on a plan to do that in the coming weeks.”

The prospect of taking weeks to develop a plan is the exact opposite of what the humanitarian sector has to offer. “Now that polio has been confirmed, the response must be measured in hours, not weeks,” said Natalia Anguera, head of Action Against Hunger for the Middle East, in an appeal broadcast this Tuesday by about 40 medical professionals and NGOs, including the Norwegian Refugee Council, CARE or Oxfam.

sewage water and mountains of garbage

It will not be enough to open another dubious “humanitarian corridor”, because everything is connected in an area in which the priority is to obtain water and food and puddles of water with feces and mountains of garbage have become the new daily reality. 70% of sewage pumps have been destroyed and no sewage treatment plant is permanently working.

The toilets are holes in the sand that are marked as such. Since it is not always possible to wash your hands afterwards and water is collected in dirty drums that Gazans carry from one place to another, according to the United Nations, acute diarrhea reached 415,766 in the first seven months of the war, a quarter of them in children under five. And, as many live in crowded tents on the sand and in the stifling heat, cases of scabies, lice, skin rashes, chickenpox and acute jaundice number in the thousands.

On the 12th, the UN World Food Programme said that many community kitchens in central and southern Gaza are facing difficulties due to the instability of humanitarian supplies and the shortage of food and fuel, especially as a result of the latest orders; previously, subject to international condemnation; today, part of the daily lives of Gazans. There were 12 incidents in August, one every two days, affecting about 250,000 people, more than a tenth of the population. The latest, in Khan Younis and Deir al Balah, where some families have spent the night in the streets or on the beach after escaping tank attacks from the east and west. 90% of Gazans today do not live where they did before the war, and most live in tents or in overcrowded apartments in inhumane conditions, even in damaged apartments.

Sofia Piñero has been to Gaza twice as a nursing coordinator for Doctors Without Borders Spain. In the first, between February and March, its mission focused on Rafah, which had yet to be invaded. The second took place last week in Paediatrics and Maternity at Al Nasser Hospital in Khan Younis. He explains that the atmosphere is “very different”. “Before there was a load of refugees, but Rafah was considered a safe zone. And the war was further away. That border has completely blurred,” he says by phone. The army has also reduced the so-called “humanitarian zone” to 11%.

This time Piñeiro has had to face the usual things: simple wounds that eventually become infected and require antibiotics (due to the lack of water and materials to perform simple cleaning at the time), respiratory and skin infections, insect bites… but also with “an overwhelming level” that makes impossible the isolation necessary to prevent the spread of hepatitis A, which already exceeds 100,000 cases, according to UN data.

“We have 180 patients in a 60-bed hospital (…) in a room for four children, seven. We have four-month-old babies lying in the hallway with fever because there is no place to care for them,” he recalls. “In the postpartum period, the women themselves asked you to discharge them. They did not feel safe in the hospital, because others have been attacked,” he explains.

It is a vicious circle. For example, meningitis, like Covid, is transmitted by oral droplets, so isolation is essential, as is ensuring they follow the necessary diet. Since primary care cannot cope, some patients go directly to already overcrowded hospitals, where they are faced with the dilemma of being treated or returning to life in a tent with 14 other people and connected to other tents. Even more so when accessing health care centres is complicated and dangerous (both for families and health professionals) and the population can rarely settle in one place.

There is also a cumulative effect after 10 months of war. Spending so much time in such extreme conditions takes a toll on the body. Children’s immune capacities are reduced after 10 months of “a very basic diet based on carbohydrates,” explains Piñeiro. Israeli Finance Minister Bezalel Smotrich said earlier this month that starving “two million people” (referring to all Gazans) “until the return of Israeli hostages to Hamas” may be justified and ethical, but “nobody” in the world will approve it. “We bring aid (allow access) because we have no choice (…) We need international legitimacy for this war,” he said.

The Israeli army has vaccinated its soldiers after the discovery of the virus in the water. It has done it in its own territory, during permits and replacements. Both for those who are assigned to the interior of Gaza and for those who will arrive there soon. However, this does not solve the risk that rains in the autumn will carry contaminated water into the aquifers from which Israel, Egypt and Jordan also receive water.

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