When health authorities announced Sunday that the polio vaccination booster would be available the next day in central Gaza, word travelled fast.
On Monday morning, “the clinic opened at 8am, but people were coming at 7am,” said Nahed Abu Iyada, senior health programme officer with humanitarian organisation CARE, which runs a health centre in the coastal city of Deir al-Balah in central Gaza.
“Since we finished the first round, the families kept asking about the second round,” she said. “They were insisting to know when the second round would begin.”
The first round of the polio vaccination campaign in Gaza was conducted last month and was widely regarded as a success. Around 560,000 children under 10 years old got their first shot in September, according to the WHO.
But just a few weeks later, conditions in the besieged Palestinian enclave had worsened.
On the morning the second vaccination round was scheduled to start, the UN reported that 22 people had been killed the previous night by an Israeli strike on a school intended for use as a vaccination site in Nuseirat, around 6km up the coast from Deir el Balah.
Authorities forecast that the polio booster campaign in Gaza would be more challenging than the first round.
But the people of Gaza, battered and devastated after more than a year of a calamitous war and heavy Israeli bombardments, showed out in force.
Around 181,000 children in central Gaza received a booster dose of the polio vaccine this week, the head of the World Health Organization (WHO) said Thursday, as the first phase of the second vaccination campaign drew to a close.
‘Strong demand for the vaccine’
The UN and health partners in Gaza aim to vaccinate around 559,000 children under 10 years of age with a booster dose of the polio vaccine over a 12-day period. The campaign began on Monday October 14 in central Gaza.
“It was successful”, Iyada said. “In the last three days, I saw happiness in the eyes of the families when they came and gave their children the vaccines.”
In her clinic, two members of staff vaccinated 2,511 children against polio in three days, and gave out 2,106 doses of vitamin A – generally prescribed alongside the polio vaccine to boost overall immunity among children.
A total of 148,064 children in Gaza received vitamin A supplements this week, the WHO said.
“The campaign was well-organised, and there was a strong demand for the vaccine,” said Maram Al Shurafa, who also works in Deir al-Balah as a health statistician for the charity Medical Aid for Palestinians (MAP).
Al Shurafa’s role during the booster campaign included overseeing vaccination sites, tracking vaccination coverage and gathering data to assess the effectiveness of the campaign.
Her team spent the first day vaccinating in fixed locations before splitting into mobile teams of two – one vaccinator and one registrar – to reach more remote communities. Monitors worked alongside medical staff to help with logistics such as making sure vaccine supplies were within date and “identifying any missing children so they can be located and reached later”, Al Shurafa said.
Mobile teams in particular faced logistical challenges travelling between sites “due to traffic and difficult road conditions”, she said.
They also had to contend with a lack of general medical supplies.
“The vaccination centres are supplied with only minimal resources, such as hand sanitisers and gloves, due to the ongoing blockade,” she said.
Since September, virtually no aid trucks have been allowed into Gaza to deliver necessities such as fuel, food and medical supplies.
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‘No safe place in Gaza’
Vaccinations were given during daily nine-hour humanitarian pauses targeted in specific regions. But security for staff and families in Gaza is never guaranteed.
“We have protocols in place to protect our team,” Al Shurafa said, “[But] my feelings of safety can vary significantly due to security issues in the area.”
At the medical centre where Iyada works, “we do our best to share our location with the Israeli side to give us safety for this place because we are providing health services, but we come to work and we don’t know,” she said. “There is no safe place in Gaza.”
A question looms over whether the next vaccination phase in north and south Gaza, which is scheduled to begin on October 21, will go ahead at all.
An Israeli military blockade is underway in northern Gaza, leaving thousands trapped in the Jabalia area amid increased bombardment and fighting on the ground.
Israel has not confirmed it will respect calls for a humanitarian pause in order for booster doses to be safely administered in the north.
“We are still unsure of how the polio vaccination campaign is going to be conducted in the north of Gaza,” said Mahmoud Shalabi, MAP’s deputy director of programmes, who is currently displaced in northern Gaza.
“The area is currently a red zone where Israeli military airstrikes, shelling and the destruction of human lives and infrastructure are not stopping.”
“I will not send my colleagues to red zones as it is too dangerous,” he added. “We need a ceasefire and assurances that humanitarian workers will not be targeted. This is more important than just the polio vaccination right now”.
‘The situation is dire’
In central Gaza, the success of the polio booster campaign provided a rare positive moment for healthcare workers.
“What gives me hope is how many people and families want their children to be vaccinated,” Al Shurafa said. “Also, the commitment and dedication of healthcare workers who are delivering the campaign.”
But Gaza’s healthcare system is in critical condition. Iyada’s clinic received enough medical supplies for the vaccination campaign, but lacks supplies to carry out its regular functions providing general medical care, psychological care and sexual and reproductive healthcare.
“We need more and more supplies,” she said. “These hygiene materials are not only for the polio vaccine work, but we need them inside the clinic for wound dressing and other treatments.”
Families who came to the clinic for polio vaccines often raised other health issues while they were there. Skin diseases are now common, she says, “because we lack of good sanitation and sewage is everywhere in and around the [refugee] camps”.
But staff have dwindling resources to treat such maladies and few places to refer patients in need.
“Most of the qualified doctors left Gaza and some are inside north Gaza. We lack specialised services, specialised doctors and highly skilled doctors,” Iyada said.
There are also fewer health centres overall. The UN said in July that there had been more than 1,000 attacks by Israel on healthcare facilities in Gaza and the West Bank since Hamas’s October 7 terror attack in Israel.
“Many hospitals and primary care centres are non-operational. This has made it increasingly difficult to provide essential services,” Al Shurafa said. “The situation is dire”.
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