U.N. aid agencies plan to begin a massive vaccination drive across Gaza on Sunday to try to protect young children from a rare type of polio, having persuaded Israel to pause combat operations for several hours a day in certain locations.
The effort faces enormous logistical challenges in a war zone where much of the infrastructure has been destroyed. The operation depends on the brief cease-fires holding while rule of law has broken down, hundreds of thousands are living in temporary shelters and many buildings are in ruins.
But it comes too late for at least one infant boy who was diagnosed with poliovirus type-2 earlier this month — the first confirmed case of the disease to surface in Gaza after it was eradicated in most of the world during the 1990s.
The World Health Organization and UNICEF, the U.N. children’s fund, have delivered more than 1.2 million doses of polio vaccination from Indonesia to distribute to about 640,000 children in Gaza under 10 years old. Another 400,000 doses are on their way.
At least 90 percent of those children need to be vaccinated to stop the disease from spreading, Dr. Rik Peeperkorn, the top W.H.O. representative in Gaza, told reporters on Thursday.
That will take a force of about 2,100 health and community aid workers in Gaza, at some 700 medical facilities, mobile clinics and shelters. They will administer the polio vaccination during a staggered pause in military operations for nine hours a day for three days in designated areas in each of Gaza’s three main regions — north, south and central.
The agreement for the humanitarian pause was reached Thursday after days of tense negotiations with Israeli officials, who insisted that it was not a first step to a cease-fire and that fighting would not be halted across the Gaza Strip.
The first confirmed polio case is a boy named Abdul Rahman Abu Al-Jidyan, who is almost a year old and living with his family in a tent in Deir al Balah in central Gaza.
He was born just before the war between Israel and Hamas began last October, and was unable to get the routine vaccinations that are given to babies, his mother said, because the family was constantly forced to move from one shelter to another to escape violence. Then, about two months ago, Abdul Rahman stopped walking and crawling.
“I found the boy vomiting, he stopped moving and had a fever,” his mother, Nivine Abu Al-Jidyan, said in an interview this week with Reuters. Exams at a hospital in Gaza and a sample sent to a lab in Jordan confirmed heath officials’ fears: He had tested positive for polio.
Some Western diplomats privately voiced skepticism that a pause would hold, although Hamas officials said they would abide by the agreement.
“I think this is a way forward,” Dr. Peeperkorn said. “I’m not going to say this is the ideal way forward, but this is a workable way forward. 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 vaccinations will begin around 6 a.m. Sunday in central Gaza for at least three days, and longer if needed, Dr. Peeperkorn said. When that is complete, the drive will shift to southern Gaza for three days, and later to northern Gaza for three days.
A second, booster round of immunizations will need to be given four weeks after the first dosages, and Dr. Peeperkorn said that was part of the agreement reached on Thursday. “We expect that all parties will stick to that,” he said.
Some of the doses will be administered in shelters run by UNRWA, the main U.N. agency that provides aid to Palestinians in Gaza. Israel has accused UNRWA of being infiltrated by Hamas, a charge it denies.
Dr. Peeperkorn said the vaccine drive was planned in coordination with both UNRWA and COGAT, the Israeli defense ministry’s agency that oversees policy for the Palestinian territories, and “we haven’t encountered any problems.” He also said Israeli authorities had agreed to not issue evacuation orders in the times and places that the inoculations are being administered.
Gazan health officials have reported multiple children with symptoms consistent with polio, likely the result of what UNICEF and W.H.O. officials said was severely unsanitary conditions combined with deteriorating health services across the region. The polio virus has been detected in wastewater samples in Khan Younis, in southern Gaza, and Deir al Balah, both of which have large populations of displaced Palestinians who have fled Israeli airstrikes.
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