The UN will start a programme on Sunday to vaccinate about 640,000 Palestinian children in Gaza against polio after Israel agreed to periodic pauses in the war that has all but destroyed the territory's healthcare system.
The campaign, aimed at children under the age of 10, will start in central Gaza, with three consecutive daily pauses in fighting. It will then move to the southern part of the strip, where there would be another three-day pause, followed by the north. The pauses in each zone will be extended to a fourth day, which the World Health Organisation has said would likely be needed.
“We seek to vaccinate 90 per cent of the children in Gaza from the age of one to 10,” Magdy Dahir, head of the campaign's technical committee, told reporters at the Nasser medical complex in Khan Younis, southern Gaza on Saturday.
The campaign in central Gaza will run from September 1 to 4, then move to the south, including Khan Younis and Rafah, for the next four days and then to the north, including Gaza city, from September 9 to 12.
Teams will be based at the health centres affiliated with the ministry and international organisations, including the UNRWA, in addition to mobile teams that will tour the enclave including the camps of the displaced people, Mr Dahir said. Another round will start on September 17 and will revisit the same areas.
Yousef Abu Al Reesh, Gaza's deputy minister of health, said vaccination teams would try to get to as many areas as possible to ensure wide coverage but he said only a comprehensive ceasefire could guarantee enough children are reached.
"If the international community truly wants this campaign to succeed, it should call for a ceasefire, knowing that this virus does not stop, and can reach anywhere," he told reporters at Nasser Hospital in the southern city of Khan Younis.
On Saturday, medics administered vaccines on some of the children on Nasser Hospital wards in a symbolic move before the official campaign begins.
The campaign was triggered by the case of a 10-month-old boy who was paralysed by the Type 2 polio virus, the first instance of the disease in Gaza in 25 years. While Israel's military and Hamas have agreed to three separate, zoned three-day pauses in fighting to allow for the first round of vaccinations, Israeli Prime Minister Benjamin Netanyahu has said the measures were “not a ceasefire”.
Fighting will be paused for at least eight hours on the three consecutive days in each phase. The pauses could be extended for a fourth day in each phase, which the WHO said would likely be needed.
WHO, the UN agency for Palestinian refugees known as the UNRWA, and Unicef, the UN agency for children, will be working together to deliver the polio vaccines. The doses will be given orally by some 2,700 health care workers at medical centres and by mobile teams moving among Gaza's hundreds of thousands of people displaced by the war.
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. The WHO said the presence of a paralysis case indicates there could be hundreds more who have been infected but are not showing symptoms.
Polio is highly infectious and most often spread through sewage and contaminated water – an increasingly common problem in Gaza with much of the territory's infrastructure destroyed by Israel in its war against Hamas. The disease mainly affects children under the age of five. It can cause deformities and paralysis, and can be fatal.
Most people who have polio do not experience symptoms, and those who do usually recover in a week or so. But there is no cure, and when polio causes paralysis it is usually permanent. If the paralysis affects breathing muscles, the disease can be fatal.
The vaccination effort will not be easy: Gaza’s roads are largely destroyed, its hospitals badly damaged and its population spread into isolated pockets. The WHO said that a drop in routine vaccinations in the occupied Palestinian Territories, including Gaza, has contributed to its re-emergence. A successful roll-out requires at least 95 per cent coverage.
Cogat, the Israeli military's humanitarian unit, had said that the vaccination campaign would be conducted in co-ordination with the army “as part of the routine humanitarian pauses that will allow the population to reach the medical centres where the vaccinations will be administered”. A second round is planned in late September.
The Gaza case is seen as a setback for the global polio fight which has driven down cases by more than 99 per cent since 1988 thanks to mass vaccination campaigns. Wild polio is now only endemic in Pakistan and Afghanistan although more than 30 countries are still listed by the WHO as subject to outbreaks, including Gaza's neighbours Egypt and Israel.
The WHO has warned of the further spread of polio within Gaza and across borders given the poor health and hygiene conditions there.
