Infectious diseases are being allowed to run rampant in Gaza

The multi-pronged public health and sanitation disaster, including destruction of water and sanitation infrastructure in Gaza, has strained the health system and resulted in the rapid spread of infectious diseases. More than 63% of buildings and 70% of sewage pumps1 have been damaged or destroyed, and no wastewater treatment plants are working.2 Most of the 1.9 million people who have been internally displaced3 are living in tents or sheltering in bombed-out buildings, with limited access to safe drinking water and facilities, and in streets full of untreated wastewater and sewage.

Particularly worrying has been the re-appearance of polio. This June, variant poliovirus (cVDPV2) was detected in six sewage samples from different sites in Khan Yunis and Deir al-Balah, and, on 16 August, the Palestinian Ministry of Health confirmed the first case of polio in Gaza in a 10 month old baby in Deir al-Balah. Polio is a huge concern as it is extremely difficult to mitigate this highly contagious disease, particularly when waste and sewage are everywhere. Before Israel’s military offensive, polio vaccination coverage was at 99%, and the last recorded case was in 1984, but now that rate has dropped to a dangerous level of 86%.2

Israel’s military offensive has created the conditions for polio to spread rapidly, posing a dangerous threat to Gaza’s more than one million children. There are many young, malnourished,4 and injured children who haven't been vaccinated for polio or other diseases, with children under 5 years old particularly vulnerable. Polio can lead to paralysis of the limbs and other complications for which there is no easy access to treatment in Gaza.

But polio is just one of a myriad of infectious diseases that have drastically risen in prevalence in the past 11 months. Since October, there have been 40 000 recorded cases of hepatitis A in Gaza (compared with around 85 in the same period before the conflict erupted).5 The World Health Organization has recorded nearly a million acute respiratory tract infections, half a million cases of acute diarrhoea, and over 100 000 cases of jaundice.67 Skin infections such as scabies and bullous impetigo are also on the rise. Over the past two months, Medical Aid for Palestinians’ 12 medical points across Gaza have screened some 31 000 people for skin diseases, of whom over 4000 were positive for skin infections.

To be able to counter polio and other infectious diseases, the swift and safe delivery of vaccines is vital. There have been efforts made by the United Nations8 and WHO to vaccinate for a range of diseases in Gaza since Israel’s military attacks began, but these have been hampered by the blocking of aid and attacks which make distribution and access to medical points extremely difficult and dangerous. There is also no electricity in Gaza and a lack of fuel, which makes keeping vaccines refrigerated almost impossible.

Even if vaccines are provided, this does not tackle the live virus that is in the sewage system already. This is a problem that requires repair of the sewage and water supply systems, cleaning tonnes of waste from Gaza’s streets, and rebuilding roads—none of which is possible during Israel’s ongoing military attacks. It is also not a short term issue: Gaza has been under Israel’s illegal blockade for 17 years, hindering the development of the health and sanitation systems.

The Israel’s military escalation of its attacks on Lebanon, where around 250 000 Palestinian refugees are residing, threaten to worsen an already dire situation. Palestinian refugees in Lebanon live in overcrowded camps with limited access to healthcare and sanitation. Further attacks on Lebanon could exacerbate the spread of infectious diseases in these camps and pose a risk to the health and dignity of Palestinians there.

Immediate action must be taken now to prevent the further spread of the polio virus and other infectious diseases. Without an immediate and permanent ceasefire and unrestricted access to humanitarian aid for all of Gaza—including a vaccination campaign focused on young children, and the protection and rebuilding of the health system—people will continue to die from preventable diseases and treatable injuries.