What are your thoughts on the discovery of the poliovirus in Gaza and its implications for children in the region ?
In August, the Palestinian Health Ministry reported the first confirmed case of polio infection in Gaza in 25 years. A 10-month-old baby in Deir el-Balah was afflicted by the virus, resulting in paralysis. Although there has been only one verified case thus far, it should not be assumed that it is the sole instance or that the virus is contained.
Although polio has the potential to induce paralysis and mortality, a significant proportion of individuals infected with the virus remain asymptomatic. Therefore, testing and medical evaluation are necessary in order to accurately ascertain the extent of the outbreak. However, achieving that goal in Gaza is extremely challenging due to the extensive devastation of its healthcare sector by Israel.
The presence of the type 2 poliovirus (cVDPV) was confirmed in six sewage samples obtained from two separate locations in Khan Younis and Deir el-Balah in July. Following the release of these findings, Tedros Ghebreyesus, the Director-General of the World Health Organization, cautioned that it is “just a matter of time before [the virus] reaches the thousands of children who have been left unprotected”.
Israel declined the United Nations' request for a ceasefire and instead agreed to temporary "humanitarian pauses" in specific areas for only a few days. Simultaneously, it escalated its aerial bombardment of Gaza and carried out large-scale forced displacements of the population. From August 19 to August 24, the Israeli army issued the highest number of evacuation orders in a single week since October 7, causing the United Nations to temporarily suspend humanitarian activities.
However, an official vaccination campaign was initiated on Sunday. The implementation commenced in the central Gaza Strip, namely in the Deir el-Balah governorate. In the upcoming days, it is expected to expand to Khan Younis in the southern Strip, followed by the northern governorates. It is worth noting that Israel has been imposing significant restrictions on aid and movement in these areas.
The UN's ability to achieve its goal of vaccinating 640,000 children remains uncertain due to challenging operational conditions, a significant number of displaced individuals, Israeli limitations on fuel supplies required for generators and vaccine storage refrigerators, and Israel's refusal to completely cease fighting.
To ensure the vaccine's efficacy, it is necessary to administer two doses with a minimum interval of one month between them. There is currently no assurance that the necessary conditions will be established for the implementation of the second phase of the vaccination campaign.
Regrettably, Palestinians in Gaza are confronted with not just a polio outbreak but also other health emergencies. Additional perilous contagious diseases, like hepatitis and meningitis, are also proliferating throughout the Strip. Since October, Gaza has recorded over 995,000 instances of acute respiratory infections and 577,000 episodes of acute watery diarrhea.
Moreover, hundreds of thousands suffering from chronic illnesses are being deprived of the necessary medical attention, resulting in numerous preventable deaths that are not included in the official count of deaths in Gaza.
This situation is a manifestation of Israel's attrition genocide, which refers to the deliberate destruction of the Palestinians' ability to survive as a group through methods of killing that are not as obvious than the widely reported acts of violence we have been seeing for the past 11 months.
According to Raphael Lemkin, a Jewish-Polish lawyer who first developed the concept of genocide in 1944, one of the primary methods of genocide is to put people's health at risk and create living situations that are harmful to their well-being.
Israel has severely damaged Gaza's health system over the past 11 months. The recent data released by the WHO Global Health Cluster provides clear evidence: During the initial 300 days of the war, 32 out of 36 hospitals suffered damage, and 20 out of 36 hospitals, together with 70 out of 119 primary healthcare centers, are currently not operational. A total of 492 instances of aggression against healthcare facilities were documented, leading to the unfortunate demise of 747 people.
The Israeli military has methodically dismantled the water and sewage infrastructure in Gaza. According to a July report by Oxfam, Palestinians in Gaza only have access to 4.74 liters of water per person per day, which they must use for all activities like drinking, cooking, and washing.
This implies a drastic decrease of 94 percent in the quantity of water available prior to October, which falls well below the globally recognized minimal benchmark of 15 liters of water per person per day for basic survival during catastrophes.
Since October, Israel has simultaneously demolished 70 percent of sewage pumps and 100 percent of wastewater treatment systems. The devastation and obstruction of Gaza's water and sanitation infrastructures have had disastrous consequences on public health, undoubtedly resulting in a substantial number of indirect deaths.
Notable public health papers have forecasted alarming scenarios regarding fatalities resulting from the transmission of infectious illnesses in Gaza. A study by the London School of Hygiene and Johns Hopkins University suggests that unreported infectious diseases may have claimed thousands of Palestinian lives in the past 6 months.
Israel justifies these deaths by claiming that Palestinians instigated a horrific humanitarian crisis. The more frank remarks made by Israeli officials have shown, however, that they were not accidental.
Giora Eiland, the former head of Israel's National Security Council and current adviser to Defense Minister Yoav Gallant, stated in a November 2023 Yedioth Aharonoth article that "the international community warns us of a humanitarian disaster in Gaza and of severe epidemics. We must not shy away from this, as difficult as that may be," additionally stating, “After all, severe epidemics in the south of the Gaza Strip will bring victory closer and reduce casualties among army soldiers.”.
Bezalel Smotrich, Netanyahu's minister of finance, tweeted he agreed with "every word" of Eiland's column. To put it simply, the Israeli leadership is considering using infectious diseases as a tool for genocide-by-attrition.
This narrative is not a new story. Israel has already implemented systematic measures that have caused Palestinians to experience slow death and disability, with the most severe instances occurring during the two Intifadas. However, starting from October 7, these policies have escalated to an unprecedented extent, and they satisfy two crucial criteria outlined in the Genocide Convention.
First, Israel is ensuring that Palestinians in Gaza will suffer severe physical and mental trauma by destroying the healthcare sector and blocking the transfer of healthcare supplies and services.
Secondly, the Israeli force has subjected the Palestinians of Gaza to living conditions that are physically detrimental by destroying the water and sewage system almost completely and creating a debilitating environment.
For Israel, this is the method of attrition genocide in Gaza.