Devi Sridhar writes:

In August, a 10-month-old baby in Gaza was partly paralysed from polio, the first confirmed case there in 25 years. The paralysis is probably permanent, and there are no treatments for polio. We have a safe and effective vaccine to prevent serious disease, but the ongoing war in the region has meant vaccination campaigns have stopped. A polio outbreak seems inevitable given that the disease spreads through dirty water and rubbish, which surrounds those living in tents in camps.

Fortunately, a series of nine-hour pauses over sequential days has been agreed so that children can be vaccinated as part of an emergency UN health campaign. The first of these three-day periods concluded on Tuesday; the next will continue to the end of the week. But whether the fighting will stop completely is a major worry: Israeli forces have attacked hospitals, schools, aid trucks and UN workers in the past. UN agencies like the World Food Programme are no longer sending staff into Gaza after Israeli forces opened fire on a marked World Food Programme truck – even after the vehicle had received clearances from Israeli authorities. It’s all very well agreeing a pause on paper; the true test will be whether it is honoured in real life.

The discovery of polio in Gaza reminds us that it’s becoming increasingly difficult to assess the true cost of the war. We don’t have a sense of how widespread disease and starvation are – so called “indirect deaths” – and we are in the dark in terms of total number of deaths. Usually, data is collected from hospitals and morgues, which certify each death and notify the health ministry. Yet these civil registration systems have broken down in Gaza, meaning there is no accurate data on how many deaths have occurred. The health ministry has been trying to put together figures using media reports, which isn’t a reliable way to capture the full picture. It is estimated that there are more than 10,000 bodies buried under rubble still (meaning they can’t be counted), as well as a rising number of unidentifiable bodies. [Continue reading…]