"What are we supposed to do in this life?"
At a hospital in the central Gaza city of Deir al-Balah, a mother sits with her sick child as he weeps.
Elham Nassar's son has a skin disease and is receiving treatment at al-Aqsa Martyrs Hospital. She is struggling to find adequate care.
Concern spread among Gaza mothers like her after , which is already facing a severe shortage of medicines and medical supplies.
"We're tired of this life, we're tired of the life we are living — no food, no drink, no medicines," she told the Reuters news agency in Arabic.
"At the least, we need medicines for our children, and to protect our children and prevent them from being infected with the polio virus that's now spreading across Gaza."
Polio was all but forgotten in Gaza until the World Health Organization (WHO) reported in July that the virus had been detected in six environmental samples from Khan Younis and Deir al-Balah in the Gaza Strip.
The health ministry in Gaza has confirmed at least one case in an unvaccinated 10-month-old child in Deir al-Balah this month, while other cases are suspected.
WHO director-general Tedros Adhanom Ghebreyesus confirmed on Friday that the affected infant had been partly paralysed from the virus, losing movement in his lower left leg.
This week, a group of aid agencies and medical professionals warned that without urgent action, a mass outbreak could endanger a generation of children in Gaza already suffering through the ongoing Hamas-Israel war.
The United Nations (UN) expects to launch a two-phase vaccination campaign at the end of this month.
The group is calling for an immediate and sustained ceasefire to allow for lifesaving vaccines to be given to around 640,000 children aged under 10 years old.
What is polio?
Polio (or poliomyelitis) is a highly infectious disease caused by a virus. It invades the nervous system and, in around one in 200 infections, can cause total paralysis in a matter of hours, according to the WHO.
The virus transmits mainly through contact with contaminated faeces, water or food.
Initial symptoms include fever, fatigue, headache, vomiting and limb pain.
Polio mainly affects children under five years old but can be contracted by anyone who is not vaccinated.
There is no cure — it can only be prevented with a vaccine that is able to protect a child for life.
Decades ago, there were an estimated 350,000 cases of polio in more than 125 endemic countries. Infections due to wild poliovirus dropped by over 99 per cent after the World Health Assembly adopted a resolution to eradicate it in 1988. As of last October, there were just two countries where the virus is still endemic.
The group of aid agencies and doctors claim the re-emergence of the virus in Gaza is a "direct result of the destruction of water and sanitation infrastructure and the government of Israel's restrictions on repairs and supplies".
"Coupled with overcrowding, displacement, and a crippled healthcare system, these actions have created an environment ripe for the spread of the virus in Gaza," they said in a statement on Wednesday.
Municipalities in Gaza are unable to remove garbage heaps and treat wastewater due to fuel shortages. Source: Getty / Anadolu/Anadolu
António Guterres, UN secretary-general, said Gaza is in a "humanitarian freefall".
"Just when it seems the situation could not get worse for Palestinians in Gaza, the suffering grows and the world watches," he told a press briefing last week.
"Polio does not care about dividing lines — and polio does not wait."
What needs to happen now?
Guterres said preventing and containing the spread of polio will take a "massive, coordinated and urgent effort".
Jeremy Stoner, Save the Children's regional director for the Middle East, said the response must be "measured in hours, not weeks".
"Without immediate action, an entire generation is at risk of infection, and hundreds of children face paralysis by a highly communicable disease that can be prevented with a simple vaccine," he said.
"These children do not have the luxury of time."
Families wait to have their children receive the polio vaccine as part of routine campaign at Al Amal Hospital in southern Gaza's Khan Younis city. Source: Getty / Anadolu/Anadolu
UNRWA, the UN's largest primary healthcare provider in Gaza, has medical teams ready to administer them.
The vaccination effort would include over 700 teams at hospitals and primary healthcare centres — many of which are barely functioning — and over 300 community outreach teams throughout Gaza, Guterres said.
"But the challenges are grave," he said.
"Health, water, and sanitation systems in Gaza have been decimated. The majority of hospitals and primary care facilities are not functional. People are constantly on the run for safety."
Calls for an immediate ceasefire in Gaza
Polio vaccines are in the region and ready to be distributed this month and next, the aid groups and doctors said.
"But this requires full access for humanitarian supplies into Gaza from all border crossings, and safe, unhindered movement within the Strip," they said.
"This can only be achieved with an immediate end to hostilities."
Guterres said an immediate humanitarian ceasefire is the "ultimate vaccine for polio", but "in any case, a polio pause is a must".
"It is impossible to conduct a polio vaccination campaign with war raging all over," he said, adding each round of the campaign must reach at least 95 per cent of targeted children to be effective.
The aid groups and doctors said any ceasefire or pause requested by the UN must be used to facilitate full humanitarian access, not just for the passage of vaccines.
The United States and Israeli delegations started a new round of meetings in Cairo on Thursday aimed at resolving differences over a truce proposal to end more than 10 months of the war.
The Israeli military "preparing to support a comprehensive vaccination campaign".
Hamas has said it would support a seven-day truce for vaccinations.
The Coordination of Government Activities in the Territories (COGAT), a unit of the Israeli military that says it is responsible for "coordinating and facilitating humanitarian aid for Gaza" said more than a million polio vaccines were delivered to Gaza via the Kerem Shalom crossing on Monday.
In a tweet, it said: "In the coming days, international and local medical teams will vaccinate children who have not yet been vaccinated against polio at various locations in Gaza.
"The vaccination campaign in Gaza led by WHO and UNICEF will be conducted in coordination with the IDF through COGAT, as part of the routine humanitarian pauses that will allow the population to reach the medical centers where the vaccinations will be administered."
'We want you to save us before it's too late'
At al-Aqsa Martyrs Hospital, Nassar pleads for a solution.
"We need a vaccine to it [polio], we need medicine, we need proper sanitation. We want you to save us before it's too late, or how long are we supposed to wait?
"Should we wait until we watch our children die and become paralysed and then become helpless to do anything for them?"
With additional reporting from Reuters.
