Rollout of Gaza polio vaccines will test commitment to humanitarian pauses, says UNRWA

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A polio vaccination campaign to begin in Gaza on Sunday will test whether a commitment to allow humanitarian pauses will work, UNRWA told The National on Friday.

Late on Thursday, the World Health Organisation said it had secured “a preliminary commitment for area-specific humanitarian pauses” in Gaza to allow UN health officials to administer polio vaccinations to thousands of children under the age of 10.

UNRWA, the World Health Organisation and Unicef, the UN agency for children, will be working together to deliver polio vaccinations to 640,000 children in the enclave, which has been under Israeli bombardment for more than 10 months.

UNRWA spokeswoman Juliette Touma said the pauses in fighting will be implemented in specific areas where the vaccine is being delivered and agency staff have been working closely with Unicef and the Israeli authorities. The WHO said the pauses would take place between 6am and 3pm on the agreed days.

UNRWA will launch its polio campaign through its primary healthcare clinics, administering the vaccines inside 10 of the agency’s functional health centres, and with the help of almost 100 mobile health teams moving across different shelters and areas where Gazans have sought refuge, Ms Touma said.

“The idea is to give two doses to every child under the age of 10, which is just over 600,000 kids, as a first round. And then with polio, you have got to do two rounds,” the official said.

The agency plans to do the same at the end of September. “Over 1,000 people will be working with us on the campaign, that includes medical doctors, nurses, drivers, logisticians, and you have the safety guarantees to go around to all these shelters.”

Ms Touma predicts the campaign will last for nine to 10 days, and will cover Gaza in three phases.

“We're going to start first in the middle areas, then move to the south and then to the north. But it's really all going to depend on these pauses and whether they work, whether they come into place, whether they're implemented.”

About 1.2 million vaccine doses have been delivered to Gaza ahead of the campaign starting on Sunday, a WHO official said on Friday.

About 400,000 additional doses are on the way to the territory, said Rik Peeperkorn, WHO representative for the occupied Palestinian territories.

However, security fears will remain a major concern throughout this campaign. The team “always fears an attack”, Ms Touma said, adding that no one and nowhere is safe in Gaza.

A successful delivery of the vaccinations would be a win for every child, she says, even in Israel. “Polio is such a vicious virus that doesn't know borders or checkpoints or lines of fire or lines of control, so we've got to reach every child as soon as possible.”

Determined mothers

For mother-of-five Alaa Fazaa, nothing can stand in the way of vaccinating her five-year-old daughter against the polio virus.

The 42-year-old, who is living in the tented area of Al Mawasi, west of Khan Younis in southern Gaza, told The National: “Even if there's no truce, I will get her vaccinated, even under fire.”

Earlier this month, the battered enclave reported its first polio case in 25 years, promoting widespread fears of a larger outbreak.

The origin of the virus is unclear, with some reports suggesting it might have crossed over from Egypt. However, once it appeared in Gaza it spread due to the breakdown of wastewater treatment infrastructure and the build-up of tonnes of rubbish in overcrowded areas like Al Mawasi, where 30,000 people now live in every square kilometre, according to UN figures.

Fears of the virus rapidly spreading prompted UN agencies to push for a temporary pause in fighting to vaccinate the thousands of children at risk.

“We live under constant bombardment, and we continue with our lives – buying necessities and fetching water – under fire. Now they're waiting for a truce to vaccinate the children? Why are they wasting time? We need to vaccinate the children as soon as possible,” Ms Fazaa said.

Three of Nedaa Al Moghrabi's five children are under 10. “One of my children is two years old, and I'm really afraid – what if he gets the virus? The environment around us is so distressing, and you can imagine life inside a tent,” she told The National.

“We've already suffered so much. What more are we waiting for?"

The 39-year-old said she is trying to shield her children from the disease, but doing so is difficult because the tents are so close together.

Repeated orders by the Israeli army for already displaced Palestinians to leave have resulted in waves of movement from ever-shrinking “safe zones” to overcrowded areas.

Mother of two Dohaa Ahmad is very worried about her daughters' health. She is one of thousands of women who have given birth during the war, in a broken medical system. Her six-month-old daughter has not had all the required vaccinations for a child her age.

“I gave birth during the war and my child suffered from respiratory problems due to inhaling smoke from firewood. Her immune system is weak,” she told The National.

Ms Ahmad lives in a tent in Deir Al Balah, in central Gaza, with two children, both under the age of three.

“Ever since I heard about the virus, I've been researching and reading about it. I want to vaccinate my girls, especially the youngest,” she said.

Vaccination rates in Gaza have plummeted during the war with many parents unable to inoculate their children against preventable illnesses, including polio.

Security fears

The temporary pause in fighting is “not the ideal way forward, but a workable way forward”, Unicef spokesman Jonathan Crickx said on Friday.

“Not doing anything would be really bad. We have to stop this transmission in Gaza, and we have to avoid the transmission outside Gaza,” the official said.

Mr Crickx said three days for each area should be enough to reach the targeted population, according to UN assessments but the agreement stipulates that an extra day can be requested if needed.

Conditions for aid workers are not ideal, and the security situation in Gaza is being “monitored closely”, Mr Crickx said. But the pause should mean that no military activity takes place in areas where the vaccination campaign is being carried out.

On Tuesday, a World Food Programme convoy was shot at 10 times, while it was metres away from an Israeli checkpoint. No injuries were reported but the organisation said it was “temporarily suspending staff movements”. More aid workers have been killed in Gaza than in any other UN mission since the organisation's was founded in 1945.

Due to constant displacement and fighting, NGO workers have also said they lost access to vital facilities that allow them to supply people with much-needed aid, including water.