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By Mahmoud Issa and Emma Farge
GAZA/GENEVA (Reuters) -A campaign to vaccinate a final 200,000 children in north Gaza against polio began on Tuesday although health and aid officials said the operation was complicated by access restrictions, evacuation orders and shortages of fuel.
The campaign in north Gaza, the part of the territory hardest hit by Israel's 11-month military offensive against Hamas militants, follows the vaccination of more than 446,000 Palestinian children in central and south Gaza earlier this month.
Medical staff had started administering vaccines in the north despite a dire need for fuel, among other challenges, said Dr. Moussa Abed of the primary care unit in Gaza's health ministry.
Vaccination centres are in areas that are militarily very active, difficult to reach and isolated if things go wrong, said Sam Rose, a deputy director of the U.N. agency for Palestinian refugees, UNRWA.
"There are some nerves, but we'll have to make it work," he told Reuters by text message.
On Monday, Israel stopped a convoy that included vehicles and fuel for the vaccination campaign as well as a World Health Organization team trying to get to Gaza's Al Shifa hospital and the mission had to be aborted, the WHO's Tarik Jasarevic told reporters in a briefing.
Israel also issued an evacuation order in north Gaza, the first in more than two weeks, that included areas that are part of humanitarian pause zones agreed upon for the polio vaccinations, according to a U.N. update on Monday.
"The centralisation of services in the south makes it extremely difficult for us to get fuel, to get access to vaccinations, and to all other logistics," Mahmoud Shalabi of Medical Aid for Palestinians, a UK-based charity, told Reuters via a spokesperson, adding there was no fuel available for mobile vaccination teams.
'DANGERS OF THE ROAD'
Hossam Medhat Saleh, a Palestinian father, said he had to walk with his three children to reach a vaccination clinic because there was no transportation available.
"The dangers of the road are big - as you can see, the destruction, the streets and infrastructure, in addition to the missiles and cannons (shelling) which continue," he told Reuters, standing on a dusty street surrounded by smashed cars and buildings.
The campaign to vaccinate some 640,000 children in Gaza under 10 years of age began on Sept. 1, following confirmation by the WHO last month that a baby had been partially paralysed by the type 2 polio virus, the first such case in the territory in 25 years.
The campaign in north Gaza aims to conclude a first vaccination round, with a second set to commence after a month.
Israel began its military campaign in Gaza on Oct. 7 last year after Hamas led a shock incursion into southern Israel, killing about 1,200 people and taking about 250 hostages, according to Israeli tallies.
The resulting assault on Gaza has killed more than 40,900 Palestinians, according to the enclave's health ministry, and reduced much of the territory to rubble.
(Reporting by Emma Farge in Geneva, Nidal al-Mughrabi in Cairo and Mahmoud Issa in Gaza; Writing by Aidan Lewis; Editing by Andrew Cawthorne)
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