Chapter 1: The Resurgence of Polio

On August 16, Gaza reported its first poliomyelitis case in a quarter of a century, marking a tragic consequence of an eleven-month-long war that has devastated its healthcare system and displaced millions.

According to the Palestinian health ministry, the confirmed case involves a ten-month-old infant from Deir al-Balah, who has suffered paralysis in the left leg but is currently stable.

Poliomyelitis, commonly referred to as polio, is a viral neurological illness that causes muscle paralysis. It predominantly affects children under five and can lead to paralysis of limbs or respiratory muscles, depending on whether the virus impacts motor neurons in the spinal cord or the brain.

Among those who do experience paralysis, 5 to 10% may succumb to respiratory or cardiac failure. Notably, severe neurological complications occur in less than one percent of all poliovirus infections, making the virus particularly insidious. The majority of those infected either show no symptoms or present with mild, non-specific ailments, such as fever and headaches. This implies that for every diagnosed case, there could be dozens of undetected infections.

The emergence of this single case in Gaza poses a significant risk to the broader Middle East, including Israel, due to the highly contagious nature of polio. In unvaccinated communities, each infected individual can potentially spread the virus to five to seven others.

The neurological impact of a poliovirus infection is believed to be an unintended consequence of the virus’s lifecycle, as it does not enhance the virus's transmissibility. Initially, the poliovirus infects the gastrointestinal tract, particularly the oropharynx and intestinal lining, before entering the bloodstream and affecting muscle and nerve tissues.

Despite this, the primary mode of transmission is through fecal matter. The poliovirus is typically spread through contaminated food, water, and soil.

In Gaza, access to clean water is severely compromised due to damage to infrastructure and fuel shortages, leading to a situation where water production has dropped to 84%, according to Oxfam. The absence of operational wastewater treatment facilities forces residents to rely on unsafe water sources, increasing the risk of dehydration and the spread of diseases like polio and hepatitis A.

As of July, the presence of the poliovirus has been confirmed in sewage samples from Gaza, underscoring the grave public health threat posed by the lack of sanitation.

While there is no cure for polio, two effective vaccines are available. The oral polio vaccine (OPV), which uses a weakened strain of the virus, is the most widely used, alongside the injectable inactivated polio vaccine (IPV). Before the conflict, vaccination rates in Palestine stood at approximately 89%, but the ongoing war has disrupted these efforts.

To avert an outbreak, the Palestinian health ministry, with support from various United Nations agencies, has initiated a three-phase vaccination campaign targeting over 640,000 children under ten. The campaign, which began on September 1, aims to administer two doses of the novel oral polio vaccine (nOPV2) against the type 2 poliovirus detected in sewage.

On its first day, the campaign successfully vaccinated 87,000 children, facilitated by a temporary cessation of hostilities between Israel and Hamas. This allowed families to access vaccination services safely.

However, challenges remain. UNICEF estimates that approximately 95% of children in Gaza must receive both vaccine doses for the campaign to succeed. The ongoing conflict has rendered 21 of the 36 hospitals inoperable and damaged 65% of the road infrastructure.

Despite these hurdles, as of September 6, the United Nations reported that over 350,000 children have already been vaccinated, with a third phase currently underway in Northern Gaza.

The first video discusses the reasons behind the resurgence of polio in Gaza after 25 years, highlighting the impact of the region's health crisis.

Chapter 2: The Consequences of Health Infrastructure Collapse

The second video examines how Gaza's first polio case in 25 years underscores the total collapse of its health infrastructure, illustrating the urgent need for intervention.