Health workers warn of challenges to looming Gaza polio vaccine rollout

There were reports of both continued fighting and unusual calm in different parts of Gaza on Friday after the World Health Organization said Israel had made "a preliminary commitment for area-specific humanitarian pauses " to facilitate an upcoming polio vaccination campaign aimed at stemming the spread of the debilitating illness among children in the war-torn enclave .

An infant boy has been left partially paralyzed after being diagnosed with polio earlier this month, in what the WHO reported as the first case in Gaza in 25 years. Abdul Rahman's mother spoke with CBS News this week in the tent where she and her family now live. She begged for help for her son , saying there was no treatment available in the camp and lamenting the dire sanitary conditions there.

Health workers have said the closure of many hospitals in Gaza, due to destruction from Israeli strikes and extremely limited fuel supplies, was contributing to lower than normal vaccination rates in the territory since the Israel-Hamas war began in October.

"Without humanitarian pauses, as we call it at the U.N., a campaign delivery which is already implemented in incredible constraints, complex environments, will not be possible," Rik Peeperkorn, a senior WHO official for the Palestinian territories, said during a Thursday briefing.

Peeperkorn said the vaccination campaign would take place over phases of three days each, beginning in central Gaza, then moving to the south and the north of the territory. It will aim to provide two drops of the oral polio vaccine to more than 640,000 children under the age of 10. The WHO said for the rollout to be successful and to prevent international spread, there needs to be at least a 90% vaccine coverage in that age group.

U.N. aid workers said 2,700 health care workers at medical centers and mobile units would deliver and administer the vaccines from Sunday.

Peeperkorn said the WHO and partner agencies were "ready to deliver the campaign" and that preparations had been completed, with 1.26 million vaccine doses and 500 vaccine carriers delivered to Gaza. He said 400,000 additional doses would "arrive to Gaza soon."

"Due to the insecurity, the damage, the road infrastructure and population displacement, but also based on our experience with this kind of campaigns globally and worldwide, the three days might not be enough to achieve adequate vaccination," he said. "When needed, the campaign will be extended by one day per zone or even more when necessary."

One concern voiced by a medical professional on the ground in Gaza has been how to keep the vaccines chilled. Polio vaccines need to be kept continually refrigerated before use, in what's called cold chain storage, or they go bad.

Dr. Majed Jaber, who works in Gaza's coastal Al-Mawasi district, an Israeli-designated evacuation zone where tens of thousands of displaced Palestinians have sought shelter, said earlier this week that only about nine health care facilities across Gaza were still able to facilitate cold chain storage. He said there was no refrigeration in the tent camps or at most local medical facilities in the enclave, and that with each new mass displacement under Israeli evacuation orders, it becomes harder for medical professionals to organize care.

"What are we supposed to do? It feels really helpless," he said.

The Palestinian Ministry of Health said Friday that cold chain equipment would be transferred from one region to another as the polio vaccination program gets underway. The ministry published maps of the locations of vaccination centers and said it had sent text messages to Palestinians in Gaza informing them of vaccination dates.

The WHO's Peeperkorn said Friday that cold chain equipment, including generators, had arrived in Gaza along with the polio vaccines.

"The microplanning is the most important part of any polio campaign, and it seems easy, but it's very complex," he said, explaining that there would be fixed location teams, outreach teams, community points, mobile teams, special teams and transport teams as part of the vaccine drive.

"That shows a little bit about the complexity of the operation, and I also want to stress that it's also part of the vulnerability of this operation," Peeperkorn said. "We need definitely that all the parties... stick to the agreement we have, the humanitarian pauses, to ensure that people can move, that they can bring their children, that all those teams can do their work. We talk about hiring vehicles, hiring trucks, motorcycles etc. It's all part of the campaign. When this is all linked, I think we have a good chance to get a successful campaign. So again, we call on all parties to help ensure that this happens as it is being planned."

Separately, the Israel Defense Forces said Friday that it had ended its months-long operation in southern and central Gaza, which it said had killed 250 Hamas fighters. An Israeli military spokesperson told the AFP news agency that there were currently no operations in the Khan Younis and Deir el-Balah areas.

An AFP journalist reported that Israeli artillery pounded western parts of Gaza City on Friday, however, while a medical source told the news agency an Israeli strike near Khan Younis had killed three people.

WHO Director General Dr. Tedros Adhanom Ghebreyesus said Friday, speaking about the upcoming vaccination campaign, that the best thing for the health of children in Gaza would be a complete cease-fire.

"The best medicine is peace," he said.