Fear and anxiety dominate the thoughts of Palestinian mother Sajaa Al-Dali. Confined to a room in a wrecked home in central Khan Younis, she cradles her newborn baby, Akram, hoping her embrace and solitude will keep polio away from his frail body.
Born on 1 March, Akram has missed all three rounds of polio vaccinations, which were suspended due to Israel’s tight blockade. Too scared that he might contract the illness, Sajaa avoids visits from family members or any potential source of infection.
“I’m extremely worried. Just hearing the Health Ministry confirm that polio is present and contagious while my baby is unvaccinated fills me with dread,” she tells The New Arab.
After months of only allowing a trickle of much-needed assistance into Gaza, Israel re-imposed a total siege on 2 March, blocking the entry of essential supplies, including food and medicine. The siege is part of its ongoing genocide on Gaza, which has killed over 60,000 people, according to some estimates.
Yet amid the devastation, a baby is born in Gaza every ten minutes, in a population where the average age is under 15.
Sajaa is also the mother of an 18-month-old baby, who has received only two out of three vaccine doses. While vigilant about hygiene, she can only do so much in a heavily contaminated area surrounded by sewage, rubbish, dust, and filth, with minimal access to sanitation.
Her home was destroyed by Israeli bombardment, and she has been displaced since December 2023.
Adding to her distress, Sajaa has been unable to breastfeed her newborn son due to chronic hunger and poor postnatal nutrition, which have weakened her immune system and compromised her milk supply.
The UN agency for Palestinian refugees (UNRWA) recently accused Israel of causing “manmade and politically motivated starvation in Gaza”, calling it “an expression of absolute cruelty.”
Dangerous delays
Israel’s destruction of essential infrastructure across Gaza — from sewage systems to healthcare facilities — has turned the small, crowded enclave into a breeding ground for deadly but preventable diseases. In addition to polio, outbreaks of pneumonia, cholera, tetanus, and dysentery are becoming increasingly common.
However, as Israel continues to block vaccine and medical shipments, these illnesses are allowed to spread unchecked.
“It’s effectively targeting children and facilitating outbreaks,” says Gaza’s Director of Public Health, Dr Nidal Ghoneim, who confirms that the health ministry has recently recorded the first cases of tetanus in two decades.
He explains that the last sewage sample tested was collected on 7 March and sent to labs in Israel and Jordan. Results returned in mid-April confirmed the presence of the polio virus, which should have triggered a fourth round of vaccinations. But no vaccines are currently available.
According to Dr Nidal, the virus was first detected in June 2024, prompting a vaccination campaign that began in September. During the first phase, 559,000 children aged zero to ten were vaccinated.
Two further cycles in October 2024 and February 2025 saw an additional 551,000 and 602,000 children vaccinated, respectively.
Dr Nidal attributes the higher numbers in the third round to a temporary ceasefire, unlike the earlier phases, which were conducted amid intense fighting. But the fourth round never came.
“Roughly 40,000 children received only one dose, and tens of thousands more were born after the third cycle ended,” he says.
The blockade isn’t just stopping newborns from getting their much-needed first dose, but it is jeopardising the efficacy of the vaccines already administered.
“If the interval between doses exceeds six weeks, prior doses may lose effectiveness,” the health chief warns. “The last round was on 26 February, meaning the next should have been mid-April — that didn’t happen.”
He adds, “These unvaccinated children can become carriers, spreading the virus. A fourth phase is essential, especially as lab tests confirmed the virus is concentrated in Khan Younis, where polio could cause permanent paralysis or even death.”
Visibly angered by how avoidable the current crisis could have been, Dr Nidal continues: “Our children face death from preventable diseases. Blocking them is part of Israel’s deliberate policy to kill children — through bombing, starvation, and now denial of vaccines and medical care.”
Long-term consequences
According to Professor Abdel-Raouf Al-Manaama, a microbiologist at the Islamic University of Gaza, the current outbreak is undoing years of progress in the fight to eradicate polio and other infectious diseases.
“This undermines decades of global efforts,” he explains.
Recalling the history of polio, Abdel-Raouf explains that it was once one of the deadliest diseases in the world, killing over half a million people each year in the mid-1900s. However, vaccination campaigns led by the World Health Organisation significantly reduced its spread — including in Gaza.
“Gaza had been polio-free for 25 years thanks to high vaccination coverage — until this war,” Abdel-Raouf says, warning of the long-term consequences.
“The absence of vaccines poses a real threat to both current and future generations. And Gaza’s conditions — polluted water, poor nutrition, psychological trauma — make it ideal for outbreaks.”
Echoing Dr Nidal’s concerns, he stresses that “a single dose may offer some protection, but not full immunity. Those with partial immunity can still carry and spread the virus, even without symptoms.”
“That’s why widespread vaccination is essential to achieving herd immunity,” he concludes.
Diseases without borders
Before 8 October 2023, Gaza had nearly 100% vaccine coverage, and vaccine-preventable diseases were no longer a major concern. But the genocide has destroyed the infrastructure needed to maintain immunisation programmes.
Constant power outages, attacks on health facilities, and widespread displacement have all crippled cold-chain storage and public access to vaccination centres.
Abdel-Raouf fears that the collapse of immunisation efforts in Gaza could trigger fresh outbreaks of measles, tuberculosis, pertussis, meningitis, and more.
“All this is due to the current genocide, which has wrecked the foundations of Gaza’s health system,” he says.
As the world watches, largely silent, while the health system collapses and immunisation rates plummet, the professor expresses dismay at the international community’s short memory — barely a few years after a global pandemic.
“Health and human rights organisations, as well as governments around the world, must act now to bring vaccines and food into Gaza,” he warns.
Unlike the Palestinians themselves, diseases can easily cross borders.
“It could become a biological time bomb that blows up in everyone’s faces.”
Mohamed Solaimane is a Gaza-based journalist with bylines in regional and international outlets, focusing on humanitarian and environmental issues
This piece is published in collaboration with Egab