Towering piles of rubbish, widespread destruction and tents spread out as far as the eye could see greeted UN workers and medical teams as they arrived at Gaza's southern city of Khan Younis for the second stage of a polio vaccination campaign.
The scale of destruction after several Israeli assaults, and the squalid conditions thousands of Palestinians are living in, shocked even local Gazans such as Dr Fady Abed, from the US-based NGO MedGlobal. He was among those who travelled from the central areas of the enclave to carry out the southern phase of the campaign.
"I saw kids playing among piles of garbage taller than the bus we were in," Dr Abed told The National on Friday.
Several UN agencies launched the inoculation drive to curb the spread of the virus, which was eradicated in Palestine 25 years ago. As part of this campaign, an eight-hour humanitarian pause in the fighting is to take effect in areas where vaccine doses are being administered, to allow parents to visit medical centres and enable teams to reach displaced families.
The polio-related pause is the first cessation of hostilities since a week-long truce in December. That allowed for an exchange of hostages in the besieged enclave and Palestinian detainees in Israel, while also giving Gazans a chance to check whether their homes were still standing, even though it put their lives at risk.
The vaccination initiative, which started on Sunday, was launched in central Gaza. Teams moved to south on Thursday and are expected to either extend the vaccine drive in the area or travel north on Saturday, under an agreement with the Israeli army.
Fears over the spread of polio have increased since a child's leg became paralysed after he contracted the virus. The total destruction of wastewater sanitation centres and the complete halt of rubbish collection have exacerbated the problem, especially in southern areas such as Khan Younis and Al Mawasi, where 30,000 people are crowded into every square kilometre.
The UN estimated in July that about 330,000 tonnes of solid waste had been neither buried nor treated in Gaza. A UN official told The National that Israeli forces were blocking access to waste dump sites.
"There's nowhere for us to take the trash," said Louise Wateridge, of the UN agency for Palestinian refugees (UNRWA). She added that people were using parts from old cars to fix sewerage pipes as Israel continues to block the entry of piping equipment and tools.
The arrival of vaccination teams at Khan Younis came after a 22-day Israeli operation in the area. The assault, which ended in August, left a trail of destruction and a video shared by Ms Wateridge showed every building had been damaged by Israeli bombardment and shelling.
Dr Abed noted that parents in the area remained fearful their children could be killed when the bombardment resumed at the end of the humanitarian pause, at 2pm local time. But the vast majority still chose to bring their children to vaccination centres.
More than 10,625 children have been killed in Gaza since the war began on October 7, with the overall death toll in the enclave now more than 40,800. At least 10,000 people are missing.
The majority of Gazans, however, seemed eager to get their children vaccinated against polio, despite the risks. "I was astonished at their resilience," Dr Abed said.
Moamen Abu Daba, 29, told The National that a drone fired on him and seven of his family members as they travelled from Al Mawasi to the Saudi neighbourhood to check on their home during the pause. “Thankfully, the missile didn't hit us directly, but it landed nearby," he said. "It was as if the Israeli army was telling us to go back."
But Mr Abu Daba was not unscathed. "I got injured, along with three other men, including my cousin.”
Mr Abu Daba was treated at At Al Nasser hospital. He has nerve damage in his foot and a bone fracture after being struck by shrapnel. “It could have been much worse," he added. "My only goal was to reach our home, check on it, and tell my father that the hard work he poured into that house was still there."
