Two days into the second round of vaccinating children against polio in Gaza, World Health Organization’s (WHO) Director-General Dr Tedros Adhanom Ghebreyesus made an urgent appeal for a political solution to the war.

“People we have saved today or vaccinated today, end up being killed tomorrow, so what’s the point?” Tedros asked at a media briefing on Wednesday.

“The level of destruction, especially in Gaza, is just unbelievable. I don’t know if [Gaza] can be inhabitable. More than 70% of its infrastructure is gone. So I don’t think aid is the issue. To be honest, the focus should be on addressing the conflict politically and focusing on bringing peace.”

The WHO and UNICEF are in ongoing negotiations with Israeli authorities for “area-specific humanitarian pauses” to enable the polio vaccination campaign, said WHO’s Gaza representative Dr Rik Peeperkorn.

At least 90% of children need to be vaccinated against polio for there to be community protection, a target that was achieved a month ago in the first round – but before Israel intensified its attacks on northern Gaza.

“You need an area-specific humanitarian pause because you will have 60 to 70 fixed [vaccination] sites and hundreds of mobile teams, which need to move around. But most important, the parents need to be able to bring the children in all safety to those mobile teams and those fixed sites,” said Peeperkorn.

Pathways for medical evacuations

However, Peeperkorn said there was a need to move out of the “polio bubble” to address the multiple of other health needs in Gaza.

Since May, only 282 patients have been medically evacuated (medivaced) to other countries – primarily the United Arab Emirates (UAE) for treatment, said Peeperkorn.

“We estimate that more than 12,000 critical patients need to be medivaced outside Gaza, so we need regular, sustained medivac procedures. 

“We need medical corridors, and the first one to be restored is a traditional referral pathway, which is from Gaza to East Jerusalem and the West Bank. That should be restored. The hospitals in the West Bank and East Jerusalem are ready to receive those patients,” he said, pointing out that, in the past, the majority of patients seeking treatment at these hopitals were canver patients.

“The second corridor is to Egypt and to Jordan, and from there, to other countries [if they] are willing to accept those specific cases as needed.”

Peeperkorn noted that a quarter of the 98,000 injured Gazans – some 24,000 to 25,000 people – “will need lifelong assistive support, rehabilitation services, and many of them will need also additional specialized surgical operation.

“So also a huge [number] of them need to be medivaced outside of Gaza, including, of course, the trauma cases.”

Slow pace of aid

“In the first half of October, only one UN mission out of 54 to northern Gaza was successfully facilitated. The rest were denied, canceled or impeded,”said Tedros.

“We asked Israel to give WHO and our partners access to the north so we can reach those who desperately need aid.”

After nine failed attempts, the WHO and partners were finally able to deliver medical supplies and fuel to the Kamal Adwan and Al-Sahaba hospitals in northern Gaza on Saturday, added Tedros.

“On Monday, the courtyard of Al Aqsa Hospital in Deir al Balah was hit by an air strike, the eighth time that Al Aqsa hospital compound has been attacked since March this year. Under international humanitarian law, all actors have a duty to ensure health care is protected and not attacked,” said Tedros.

Israel has repeatedly claimed that Hamas military forces frequently operate from Gaza’s hospitals, as well as holding Israeli hostages in some hospital wards, in earlier periods of the war. In the case of the Al Aqsa debacle, the army acknowledged shelling the compound, which reportedly killed three people and wounded 40, saying it was targeting a meeting of Hamas commanders. Overnight Friday, Israel also reportedly cut off the electricity and fired into the upper floors of the Indonesian hospital, in northern Gaza, killing at least two people, according to the Palestinian Wafa news agency. Further weekend attacks were reported around northern Gaza’s Kamal Adwan and al-Awda hospitals, hobbling their services as well.

At the WHO briefing, WHO’s Principal Legal Officer, Steven Solomon, reiterated that, in terms of International Humanitarian Law, “all combatants should understand that health facilities and health workers are off limits. Targeting them or militarizing them are both prohibited.”

‘Similar story in Lebanon’

“It’s a similar story in Lebanon, where, since the escalation of hostilities began one month ago, WHO has verified 23 attacks on health care that have led to 72 deaths and 43 injuries among health workers and patients,” said Tedros.

“Hospitals are already under massive strain as they deal with an unprecedented influx of injuries while trying to sustain essential services.

“A growing number of health facilities have had to shut down, particularly in the south, due to intense bombardment and insecurity. Almost half of all primary health care centers in conflict-affected areas are now closed, while six hospitals have been fully evacuated and another five partially evacuated today,” said Tedros.

Lebanon’s Ministry of Public Health has confirmed a case of cholera in north, and WHO has “activated the cholera preparedness and response plan to strengthen surveillance and contact tracing, including environmental surveillance and water sampling”, added Tedros.

In August, Lebanon’s Health Ministry commenced a cholera vaccination campaign targeting 350,000 people living in high risk areas, but this was “interrupted by the escalation in violence”, Tedros noted.

–Updated 20.10.2024 with weekend reports of conflicts around northern Gaza hospitals.