As the first phase of a polio vaccination campaign in Gaza ends, the effort has an air of futility, even absurdity, for many families there. They can shield their children from a potentially crippling disease, but not from a far more immediate and deadly threat: daily Israeli bombing.
“Whether we vaccinate or not, it doesn’t make any difference,” said Mohammed al-Sabti, 32, in Nuseirat, a town in the central Gaza Strip. “Death and danger are chasing us at every second.”
On Wednesday, an airstrike in the central Gazan town of Nuseirat, on a United Nations school complex sheltering displaced Palestinians, killed 18 people, including women and children, and wounded a similar number, Palestinian officials said. Israel said nine of the dead were Hamas militants using the site as a command-and-control post. The main U.N. relief agency in Gaza, known as UNRWA, said six of them were its employees.
Last week, the site was being used for polio inoculations, UNRWA said. The day the complex was struck, UNRWA said that the campaign had given a first dose of polio vaccine to some 530,000 children, nearing the target of 640,000.
The campaign, which UNRWA undertook in collaboration with local health authorities, the W.H.O. and other partners, finished its first round on Thursday, successfully reaching its goal of 90 percent vaccine coverage, UNRWA said in a social media post on Friday.
It has required Israel and Hamas to agree to staggered temporary truces in the areas health workers were vaccinating. The two parties will have to agree to similar “humanitarian pauses” for a second and final dose for each child next month, health care workers say, for the campaign to be a success.
More than 40,000 Gazans have been killed in the 11-month war, according to the local health ministry, which does not distinguish between civilians and combatants. Even those areas Israel has declared as safer “humanitarian zones” for people forced from their homes are far from immune from attack.
About 90 percent of Gaza’s more than two million people have been displaced, many of them multiple times, the United Nations says. Israeli attacks have put much of Gaza’s sewage and water systems out of commission, and many people live in makeshift shelters and tents, clustered in encampments that lack enough sanitation, clean water, food and medical care.
Diseases thrive in such conditions, and alarm rippled among health experts around the world after the poliovirus — the focus of a long and mostly successful global vaccination campaign over decades — was found circulating in Gaza wastewater in July.
Critics see a paradox in the international community’s ability to pressure Israel and Hamas into brief, daily truces to vaccinate against a highly contagious disease that health experts warn could easily spread beyond Gaza, while failing to bring the two to agree a cease-fire that would stop the war.
“Gazans are absolutely right to be appalled and devastated that we care more about the threat of diseases that pose a threat to Western countries than the devastating war that literally shreds children,” said Annie Sparrow, an international public health activist and doctor who trains medics in war zones and worked on polio vaccine efforts during the war in Syria.
The spread of polio in Gaza, where the first confirmed case in 25 years was recorded last month, poses a serious risk to Israel, Dr. Sparrow said, due to low vaccination rates in its ultra-Orthodox community. Israel has offered booster shots to soldiers operating in Gaza since July.
Amid the focus on polio, aid agencies have stressed that the vast scale of destruction to infrastructure, particularly to water and sewage treatment, still leaves Gazans exposed to countless other disease risks.
And with Israel still restricting the delivery of humanitarian aid, hunger is also a threat, both directly — some 50,000 children in Gaza are suffering acute malnutrition, the United Nations said last week — and indirectly, by weakening people and hampering their ability to fight disease.
Despite all the challenges, Gazan families have largely followed the calls to vaccinate. Diya Nassar, a 29-year-old father sheltering in central Deir el-Balah, said he took his baby to be vaccinated on the second day of the campaign.
“I have to do what I have to do to maintain the best possible future for my baby” he said. “Whether he lives or not, I have no say in that. But if he lives, I want him to live healthy.
“If he is to die, that is not something I can stop in today’s circumstances.”
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