05.09.2024

By bomb, bullet, hunger and disease

Israel is trying to drive the Palestinian population to misery, despair and surrender with the overriding aim of ethnic cleansing and, failing that, genocide, writes Ian Spencer

Poliomyelitis, a highly infectious disease, known since antiquity - but until recently close to following smallpox to eradication - has made an unwelcome return.

An unvaccinated 10-month-old child was confirmed as being infected and showing signs of paralysis in the Gaza city of Deir el-Balah on August 16. The outbreak was entirely predictable, as the polio virus had been isolated from water and sewage in June. Analysis of the virus suggests that it could have been introduced into Gaza as early as 2023.¹

The majority of those who contract polio show no or only mild symptoms. However, a small proportion go on to develop paralysis and some of those die because of paralysis of the nerves that control breathing. But, in a population which is seriously weakened by malnutrition and other infections, there is every reason to fear an epidemic. Transmission of the polio virus is direct, person-to-person, by droplets or orally, often in epidemics, due to infected water.

From the outset of its assault on Gaza, the Israel Defence Forces have targeted water purification and desalination plants. According to Oxfam, in a report published in July, Israel has been using the restriction of water as a weapon, with availability having dropped by 94% - people in Gaza have only 4.75 litres or water per person, per day for all uses.² The consequences are that water-borne diseases have been having a devastating impact on the population.

Since October, infections, which can be fatal for the vulnerable, such as the very young and old, have raged throughout the Strip. These have included 575,000 cases with acute watery diarrhoea, acute jaundice syndrome (typically hepatitis A), with 107,000 cases, and bloody diarrhoea (12,000 cases). These have also been accompanied by acute respiratory infections (992,000), as well as a range of other diseases, including measles and meningitis. At least some of these may be due to non-paralytic forms of polio, but testing for them is not available because of the IDF’s destruction of the medical infrastructure.³ Al-Aqsa Martyrs Hospital is the last functioning medical facility in Deir el-Balah.

Prior to the Israeli assault, polio had not been diagnosed in Gaza for 25 years and until this month was only endemic in Afghanistan and Pakistan. Prior to the war, the vaccination rate in Gaza was 99%. Since the outbreak, the World Health Organisation has been trying to bring in a million vaccinations to stop the spread.

WHO has set a target of vaccinating 640,000 children. The type of vaccine being used is an attenuated form of the polio virus, which can be administered orally. This removes the need for sterile syringes and needles, but does require refrigeration, which has been hampered by Israeli restriction on fuel and other supplies to power generators.

The vaccination campaign will involve 2,700 healthworkers, but it has taken the UK government until July to restore funding to the United Nations Relief and Works Agency for Palestinian Refugees, even though a UN report in April showed that there was no evidence to support Israel’s assertion that Unrwa staff had been involved in the Hamas raid on October 7. Even the US restored its Unrwa funding following the report.

Malnutrition

Of the 2.1 million Gaza pre-war population, 1.9 million have been internally displaced, half of them children. The repeated evacuation orders, often to areas no safer than those they were leaving, are part of a calculated policy for uprooting the Palestinian population, as families are forced to move from one ill-equipped refugee camp to another, almost entirely dependent on aid for food and water.

This is exacerbated by the fact that Israel has destroyed swathes of Gazan farmland.⁴ While the vaccination efforts are naturally welcome, a majority of the 40,700 recorded deaths in Gaza have been due to the indiscriminate air strikes and artillery bombardment by the IDF. But many thousands more die from disease, malnutrition and the want of basic medical care, but are not included in the Gaza health ministry statistics - they are regarded as ‘excess deaths’ over what might have been expected under normal conditions (or at least as ‘normal’ as conditions ever were in Gaza!).

As we know from the Lancet report earlier this year, the ‘excess deaths’ may be as high as 186,000.⁵ Contributing to the death rate throughout Palestine has been the worsening nutritional state of the population - 96% in Gaza have faced food insecurity, since from the outset the IDF has targeted bakeries and other food outlets. Palestinians are seeing a drastic reduction in calorie intake - needed to maintain a healthy weight.

Further danger is posed by the limited range of foodstuffs, making iron and vitamin deficiency widespread. This disproportionately affects children and nursing mothers. Malnutrition, plus fat and protein deficiency, makes breastfeeding more difficult, and the chronic shortage of infant formula means that is no substitute. The absence of clean water means that the infant formula that is available is often contaminated - a death sentence for a weakened infant. In May a survey found that as many as 85% of children of all ages did not eat for a whole day at least once in the three days before the survey was conducted. Currently, nine out of 10 children in Gaza lack sufficient food for growth, while one in three are acutely malnourished or suffering from muscle wasting.

Given the importance of brain development in the first two years of life, this ensures that, even if the slaughter were to end tomorrow, there will be lasting developmental and psychological effects for generations. More than one million of Gaza’s inhabitants face the most extreme form of malnutrition, classified as ‘catastrophe or famine’: the deaths of more than 30 children have already resulted officially from malnutrition - mostly in northern Gaza, which has borne the brunt of the IDF assault.⁶ However, that is just the tip of the iceberg, as malnutrition severely reduces the body’s capacity to fight off infection and repair damaged tissues.

West Bank

Israel’s modus operandi in Gaza is now being extended to the occupied West Bank. Jenin has been under siege, cutting off food, water and electricity supplies. The IDF bulldozed nearly 70% of the city’s streets and 20 kilometres of its water and sewage networks since it launched its attack on August 28. As a result, 80% of the Jenin refugee camp, home to 23,628 people, is without water, according to the Jenin municipality. Water is being weaponised, just as it has been in Gaza, and this constitutes a war crime.

At least 675 Palestinians in the occupied West Bank have been killed since October 7, including 142 children. A further 5,670 have been injured and more than 10,300 arrested and detained by Israeli forces, some of whom have died in custody.⁷ As in Gaza, the IDF has carried out attacks on health facilities, killing 23 and injuring 100 across 54 health facilities affected, with the widespread obstruction of access to hospitals and the detention of personnel.⁸

Paramedics are being prevented from entering the Jenin refugee camp, while air strikes on refugee camps - a feature of IDF action in Gaza - are now being expanded to the West Bank. Five people, including two children, were killed in an airstrike on the Nur Shams camp, near the city of Tulkarem, home to 13,519 registered refugees. The IDF confirmed the attack, in its now customary fashion, saying it was a strike against the “command room of a terror cell”, but the UN has reported that 128 Palestinians, including 26 children, have been killed by Israeli air strikes since October 7. Four people were also killed by the IDF in the Far’n refugee camp near Tubas, home to 10,868 people. The Palestinian Red Crescent reported that they were having trouble reaching the injured, as the IDF were preventing ambulances entering the area - again a tactic all too familiar in Gaza.

The intensifying violence in the West Bank has come from both the IDF and groups of settlers. Meanwhile, arbitrary obstructions and the closure of entire towns, such as Tulkarem, Tubas and Nablus, has restricted access to healthcare facilities. Palestinians are being routinely prohibited from reaching the most advanced facilities, such as in East Jerusalem, where just six hospitals provide most specialist services. Between October 2023 and May 2024, 44% of 28,292 patient applications to seek treatment in East Jerusalem have been refused.

On top of this, the economic chaos has had a disastrous effect on the health of Palestinians in the West Bank - made worse by Israel’s withholding tax revenues for the Palestinian territory. Many health facilities report medicines in exceedingly short supply, with 45% of essential medicines out of stock. Consequently, hospitals and health centres are operating only at 70% of capacity.⁹

There are an estimated 80,000 Palestinians in the West Bank areas where military operations are continuing. The number of raids on the West Bank has more than tripled since the war on Gaza began in October. Israeli minister of foreign affairs Israel Katz called on the army to evacuate Palestinians from the West Bank in a post on X. He said; “We must deal with the threat in the West Bank as we are doing in Gaza, including the temporary evacuation of Palestinian residents and whatever other steps are required. This is a war for everything, and we must win it.”

So, while the world is distracted by the ongoing horror in Gaza, the same methods are to be applied in the north of the West Bank to force out the population and kill those who do not move. Israeli forces have been closing the roads leading to Jenin, Tulkarem and Far’a camps. In the Nur Shams camp, residents were given three hours to leave. In Jenin the director of one of the city’s hospitals was told the Israeli army intended to raid the medical facility and ordered them to leave. The hospital has 200 employees and 150 patients.¹⁰ We await with interest the IDF announcement that there is a terrorist command cell operating in the hospital.

Our response

Meanwhile, in Israel itself the crisis is deepening. The hand of the Zionist extreme right is being strengthened with no force able to counter it. The people of Palestine and the workers of the world can expect no salvation from token strikes by Zionist workers to ‘bring home the hostages’. Nor can they expect anything from the Iranian so-called ‘Axis of Resistance’, from whoever wins the race to the White House in November, let alone from a Labour government that makes token gestures to rescind 30 export licences for weapons being used to liquidate the Palestinian population, while leaving some 350 in place.

For nearly 11 months we have been forced to watch genocide in real time and we are about to witness the next brutal chapter. In the UK we bear an enormous responsibility to force a self-proclaimed “Zionist” prime minister to end all arms sales to Israel. Workers must lead a movement for boycott, divestment and sanctions and for trades unionists everywhere to act in solidarity with the people of Palestine.