The second round of polio vaccinations for Gaza’s children are due to begin on Monday – but the World Health Organization’s (WHO) Eastern Mediterranean Region (EMRO) is assessing whether it may be affected by Israel’s renewed military activity in northern Gaza, including evacuation orders for three hospitals over the past 48 hours.

WHO EMRO officials appealed to Israel for a “humanitarian pause” to enable it to complete its polio vaccination campaign at a media briefing on Tuesday.

The first polio case in Gaza in 25 years was identified in a 10-month-old baby in August and the virus has also been detected in wastewater samples. In response, the WHO launched a mass vaccination campaign last month, which reached some 540,000 children under the age of 10 – 90% of all kids in this age group.

However, these children need a second polio vaccine within four weeks.

Dr Rick Brennan, EMRO’s regional emergency director, said that the WHO was still trying to determine how Israel’s new evacuation orders, for both the hospitals and various parts of the territory, would affect the polio vaccination campaign.

“Of course, what we need to successfully conduct the campaign is a pause in military operations. We were able to get that temporary pause for the previous round and we need that again,” said Brennan.

He added that it was “absolutely vital” to both complete the second round of vaccinations and get the cooperation of the relevant authorities to do so.

“We’re working on it very hard right now,” he added.

The WHO has planned its vaccination campaign in three phases – in southern, central and northern Gaza. Brennan estimates each phase will take three days, with an extra day or two to find children who have missed out.

“We’re using a broad combination of measures: vaccinating kids in health facilities, sending teams out to communities, and working with community members to ensure that children are brought to sites where vaccinations are going on.”

Unlike the first vaccinations, children will also get vitamin A. 

“Vitamin A is very important for the immune system, particularly with the high level levels of food insecurity, with 96% of the population in Gaza at crisis levels of food insecurity,” said Brennan, describing “significantly increased rates of acute malnutrition in kids under the age of five”.

Extensive damage to population and health facilities

Less than half of Gaza’s hospitals are functioning due to “damaged infrastructure, lack of fuel, supplies and human resources, and ongoing attacks”, EMRO regional director Dr Hanan Balkhy told the briefing.

Of the 15,600 requests for medical evacuations, only 5,130 have been approved, “leaving thousands of Gazans stranded without essential care”, she added.

“Twelve months of conflict in Gaza has resulted in 6% of the entire population killed or injured. Many of the injured are women and children who now face lifelong disabilities,” Balkhy said.

“Ninety percent of Gaza’s population is displaced and living in overcrowded shelters with limited access to food, water, or health care. And they are repeatedly on the move, with further evacuation orders issued over the past few days,” she added.

Describing health service delivery under such circumstances as “daunting”, Balkhy paid tribute to the health workers of Gaza “who continue to work heroically under unimaginable conditions”.

Almost 1000 health workers have been killed in the year-long conflict, according to the Gaza Health Ministry, while 289 United Nations staff  have also lost their lives in “one of the most dangerous places in which the UN and partners operate”, said Balkhy.

“For the past 12 months, WHO and its partners have repeatedly called for an end to the conflict in Gaza. However, the situation continues to escalate in the occupied Palestinian territory and across the region,” she added.

She also expressed “extreme concern” about the escalation of violence in Lebanon, with “almost 12,000 people killed or injured, and more than 540,000 people internally displaced”.

The WHO EMRO, one of the most conflict-ridden regions of the world where an estimated one in six people need humanitarian assistance, holds its annual regional committee meeting next week.

Image Credits: WHO.