Are Environmental Crimes in Gaza Threatening the Global Health System?

The WHO’s Global Polio Eradication Initiative confirmed that tests conducted on July 16 detected Type 2 poliovirus (cVDPV) in six sewage samples collected from two sites in Khan Younis and Deir al-Balah on June 23.


Since October 7, Gaza has been experiencing severe environmental crimes, especially following reports of the discovery of the poliovirus and its variants. The virus, which has the potential of spreading to the Middle East and beyond, has led the Palestinian Ministry of Health in Gaza to declare the region a “polio epidemic zone,” posing a health threat to residents and neighboring countries, and hindering the global polio eradication program.

“I am very worried about an outbreak in Gaza… it could have significant international repercussions,” stated Afadil Saparbekov, WHO’s Emergency Health Team Leader, regarding the poliovirus situation in Gaza.

The Palestinian Ministry of Health previously reported the presence of the poliovirus in sewage samples, based on tests conducted in coordination with UNICEF. They cited inadequate and polluted water supplies, accumulating waste, and the Israeli blockade on cleaning supplies as conducive to the spread of various epidemics.

The WHO’s Global Polio Eradication Initiative confirmed that tests conducted on July 16 detected Type 2 poliovirus (cVDPV) in six sewage samples collected from two sites in Khan Younis and Deir al-Balah on June 23.

Saeb Lavan, Media Director at the Municipality of Khan Younis, told Daraj that cases of polio have been officially recorded, according to Palestinian Ministry of Health reports.

The International Federation of Red Cross and Red Crescent explains that Type 2 polio (cVDPV) is derived from the oral polio vaccine and can spread through feces from vaccinated individuals. In 2023, 524 polio cases were reported in 32 countries, all resulting from the vaccine itself.

Ten Months of Siege

Infections have not been reported in Gaza for 25 years, making the current outbreak “catastrophic,” Ahmad Al-Farra, head of the Pediatric Department at Nasser Medical Complex and director of Al-Tahrir Hospital for Children and Maternity, told Daraj. He emphasized the need for booster doses for all residents, which are currently unavailable due to the conditions of displacement.

In 2022, 99 percent of Gaza’s children received the polio vaccine, but vaccination rates dropped to 89 percent in 2023. Since the war began, at least 20,000 children have been born in Gaza, and the CDC recommends four vaccine doses for children, starting at 2 months, 4 months, 6-18 months, and finally at around 5 years old.

The WHO highlights that the weakened virus (which the vaccine contains) can spread within inadequately vaccinated communities. Al-Farra explained that the vaccine is highly sensitive and requires constant refrigeration, becoming ineffective if not properly stored.

“Polio is incurable, causing chronic paralysis, often in the lower limbs, and can lead to respiratory system paralysis, resulting in breathing failure and the death of the child,” Al-Farra explained.

The WHO reported no new cases recently. Daraj contacted the organization but received no response by the time of publication. However, Al-Farra added that Gaza’s sewage system is dysfunctional, with sewage disposed of in streets and near camps, contaminating groundwater used for drinking and hygiene, thereby increasing the risk of infection.

The health sector has collapsed due to current hostilities, with 20 hospitals out of service in Gaza. The lack of testing tools and the poverty driving people to suffer in silence in tents and homes exacerbates the situation. Most polio-infected individuals show no symptoms but can silently transmit the virus to thousands of others. “It’s a real nightmare,” said Dr. Javed Ali, head of emergency response in Gaza for International Medical Corps.
The Perfect Environment for Diseases and Epidemics to Spread

Children searching for food among the heaps of decaying waste, exacerbated by food shortages since October 7, paint a dire picture. A child from Khan Younis pleaded: “We urge everyone to remove the garbage from here,” referring to the waste dump next to the tents containing over 70,000 tons of waste.

Saeb Lavan explained that the Israeli army’s blockade has prevented municipal vehicles from reaching the main dump, leading the municipality to create two temporary dumps near shelters and displacement camps, which lack basic health safety measures, raising concerns about leachate contaminating the groundwater.

PAX reported that there are currently about 225 waste dumps in Gaza, with 270,000 tons of accumulated waste near homes, tents, and water stations posing a greater threat to residents than the armed conflict itself. Untreated waste is seeping into the groundwater, which raises the potential for the spread of diseases and epidemics. The collapse of Gaza’s waste management sector is attributed to the Israeli bombardment of waste collection equipment, fuel shortages, and obstructed traffic, which have halted the transportation of waste from the streets to newly established sanitary landfills.

Medical waste has also increased due to the rise in casualties, heightening the risk of disease transmission from untreated medical waste accumulating near hospitals.

British researchers conducted a study on household and medical waste, finding that blood-stained waste tested positive for hepatitis. The study also revealed that the poliovirus was found in diapers discarded in the waste samples that were analyzed.

The previously mentioned situation increases the likelihood of virus spread among residents and displaced persons, particularly in densely populated areas. This is exacerbated by continuous proximity to untreated dumps that attract mosquitoes, flies, rodents, and scorpions, which can transfer the poliovirus from feces to food.

Gaza has become unlivable with its “horrific” living conditions. Even before the war, 26 percent of diseases in the sector were waterborne. Israeli attacks on treatment plants have led to the spread of sewage between homes and displaced persons’ tents, weakening residents’ immunity against the poliovirus. The Palestinian Ministry of Health stated that drinking water is also at risk of virus contamination.

In Khan Younis, for instance, where traces of the virus were found, the municipality’s media director told Daraj that the municipality is “devastated in all sectors, and its streets are flooded with sewage because its treatment plants are completely destroyed.”

Forced displacement, pressure on sanitation infrastructure, and the weaponization of the water sector in war contribute to the spread of diseases and epidemics. Oxfam reported that in the Mawasi area, there are only 121 toilets for over 500,000 people, meaning 4,130 people share each toilet, facilitating disease spread, as toilets are another source of infection.

The environmental impact of armed conflicts is often overlooked, but the destruction of the environment has long-term health consequences. This isn’t the first time polio has spread during armed conflicts; cases were recorded in Syria, Afghanistan, Pakistan, and during the Somali civil war, where the disease spread significantly, leading to new strains of the disease. Since 2017, these variants have been spreading globally, with the CDC linking the virus found in Gaza to a strain that spread in Egypt last year.

The WHO’s emergency health team leader in the occupied Palestinian territories, Ayadil Saparbekov, suggested that the virus might have been brought in by anyone, such as smugglers or truck drivers, and could have reached Gaza even before the conflict began.

Polio is not the only disease posing a threat in Gaza; “environmental pollution is threatening public health due to the spread of contagious skin diseases,” according to Lavan.

Dr. Amer al-Masri, a doctor working in Gaza, told Daraj: “I have been a doctor for 20 years, and this is the first time I’ve seen patients in this condition, with new diseases and others resulting from new bacterial infections.”

No one will escape the environmental crimes committed in Gaza: “Hospitals are overcrowded and suffering from shortages in medical supplies and fuel even before this epidemic, so what will happen if it spreads?” said Dr. Al-Farra. The attacks on Gaza’s environment threaten Palestinians’ right to health and to live in a safe and healthy environment. Will the international community take action to push Israel to end its war on Gaza, fearing a repeat of the economic devastation witnessed during the COVID-19 pandemic?