The final phase of a planned polio campaign in northern Gaza has been postponed due to escalating violence in the area, the World Health Organization announced on Wednesday.

“Due to the escalating violence, intense bombardment, mass displacement orders, and lack of assured humanitarian pauses across most of northern Gaza, the Polio Technical Committee for Gaza… and partners have been compelled to postpone the third phase of the polio vaccination campaign, which was set to begin today,” WHO said in a press statement. “This final phase of the ongoing campaign aimed to vaccinate 119 279 children across northern Gaza.”

Since 14 October, the campaign to administer a second oral polio dose (nOPV2) to Gaza children under the age of 10 was rolled out successfully in central and southern Gazan regions, reaching some 442,885 children, WHO said.   It followed a first-dose oral polio vaccine campaign in September that succeeded in reaching 559,161 children, or an estimated 95% of those eligible, during a series of pre-arranged ‘humanitarian pauses’ that both Israel and Hamas observed.

The campaign followed on the identification of vaccine derived poliovirus in sewage over the summer, followed by a confirmed case of the paralytic disease in a ten-month old baby.

Second round faces more challenging circumstances

However, the second and final vaccination round, which began 14 October has taken place under much more challenging circumstances, particularly in northern Gaza where Israel has launched a major new military initiative in and around Jabalia refugee camp, ostensibly to root out Hamas forces that have resumed operations in the area; on 7 October, the anniversary of the first Hamas incursion into southern Israel, a barrage of missiles launched from nothern Gaza triggered sirens in Israel as far as Tel Aviv.  Palestinians and UN human rights agencies, however, have charged that the Israeli bombardment of Jabalia is part of a campaign to “ethnically cleanse” the northern part of the 365 square kilometer enclave, to make way for renewed Jewish resettlement of Gaza.

WHO has said that the escalation in violence made the final phase of the vaccine campaign impossible to execute right now.

“Given that the area currently approved for temporary humanitarian pauses was substantially reduced—now limited only to Gaza City, a significant decrease from the first round—many children in northern Gaza would have missed out on the polio vaccine dose,” WHO said in its statement.

Mass evacuation orders issued by Israel for people still living in Jabalia and other areas outside of Gaza City, would have also impeded the campaign’s reach, WHO said. Some 20,000 people have reportedly fled Jabalya in recent days.

“To interrupt poliovirus transmission, at least 90% of all children in every community and neighbourhood must be vaccinated – a prerequisite for an effective campaign to interrupt the outbreak and prevent its further spread,” WHO said. “Humanitarian pauses are essential for its success, allowing partners to deliver vaccination supplies to health facilities, families to safely access vaccination sites, and mobile teams of health workers to reach children in their communities,” it added warning that, “a delay in administering a second dose of nOPV2 within six weeks reduces the impact of two closely spaced rounds, concurrently boosting the immunity of all children and interrupting poliovirus transmission.”

Barriers to medical evacuations and hospital resupply

The increased violence has also impeded medical evacuations as well as the delivery of vital medical supplies to still partially-functioning hospitals, WHO said in a separate statement on Tuesday.

On a high-risk mission to northern Gaza on 20-21 October, WHO managed to evacuate 14 patiens and 10 caregivers, but was prevented from delivering “critical medical supplies, blood and fuel” to two Kamal Adwan and Al-Awda Hospitals, two partially functioning facilities still serving the area.

“Despite an initial agreement, the delivery of critical medical supplies, blood, and fuel – resources essential for keeping Kamal Adwan and Al-Awda hospitals operational – was denied just a few hours before the mission began on 20 October,” WHO said in a separate statement Tuesday.

The stepped-up fighting in Gaza takes place against the background of escalating violence between Israel and Lebanon, following Israel’s assassination of Hezbollah leader and Hamas ally, Hassan Nasrallah, on 27 September.  That has included heavy Israeli bombing of alleged Hezbollah targets as far north as Beirut, and hundreds of Hezbollah missiles fired into northern and central Israeli cities daily.  Against that landscape, WHO’s Director General Dr Tedros Adhanom Ghebreyesus, last week protested the fact that nearly a dozen hospitals in southern Lebanon have been forced to curtail activities or close, while flight cancellations to Beirut airport have also impeded the delivery of vital aid to the country.

Image Credits: WHO.