In August, the Palestinian Ministry of Health announced the first confirmed case of polio in Gaza in 25 years. The virus had infected a 10-month-old baby in Deir el-Balah, leaving him paralyzed. Although only one case has been confirmed so far, this does not mean that it is the only case or that the spread of the virus is limited.
Polio can cause paralysis and even death, but many people infected with the virus show no symptoms. That is why medical tests and evaluations are needed to properly determine the extent of the outbreak. But this is nearly impossible in Gaza, given Israel’s complete destruction of the health sector.
We know that poliovirus type 2 (cVDPV) was identified in six sewage samples, collected from two different sites in Khan Younis and Deir el-Balah in July. Following the release of these results, World Health Organization Director-General Tedros Ghebreyesus warned that it was “only a matter of time before[the virus]reaches the thousands of children who have not been protected.”
Israel has rejected UN calls for a ceasefire and agreed to localized “humanitarian pauses” for only a few days. At the same time, it has intensified its bombing of Gaza and its mass expulsions of civilians. Between August 19 and 24, the Israeli military issued the largest number of evacuation orders in a week since October 7, leading the UN to temporarily suspend its humanitarian operations.
A vaccination campaign was nevertheless officially launched on Sunday. The rollout began in the center of the Gaza Strip – the Deir el-Balah governorate – and is expected to be extended in the coming days to Khan Younis, in the south of the Strip, and then to the northern governorates, where Israel severely limits aid and mobility.
It is uncertain whether the UN will reach its goal of vaccinating 640,000 children, given the difficult operating conditions, the dramatic number of displaced people, Israel’s restriction on the supply of fuel needed to run generators and refrigerators to store vaccines, and Israel’s refusal to completely cease fighting.
For the vaccine to be effective, two doses must be administered at least one month apart. There is no guarantee yet that conditions will be met for the second stage of the vaccination campaign.
Unfortunately, the polio outbreak is not the only health emergency facing Palestinians in Gaza. Other dangerous infectious diseases, including hepatitis and meningitis, are also spreading in the Gaza Strip. More than 995,000 cases of acute respiratory infections and 577,000 cases of acute watery diarrhea have also been recorded in Gaza since October.
Additionally, hundreds of thousands of people with chronic illnesses are not receiving the adequate care they need, leading to many preventable deaths that are not counted in Gaza’s official death toll.
All of this is a reflection of Israel’s genocide of attrition: the destruction of the conditions of survival of Palestinians as a group, through killing techniques less visible than the horrific violence broadcast live that we have witnessed for the past 11 months.
In the words of the Polish Jewish lawyer Raphael Lemkin, who introduced the concept of genocide in 1944, “endangering health” and creating living conditions “hostile to health” constitute one of the main techniques of genocide.
Over the past 11 months, Israel has virtually destroyed Gaza’s health system. Recent data released by the WHO Global Health Task Force speaks for itself: in the first 300 days of the war, 32 out of 36 hospitals were damaged, 20 hospitals (out of 36) and 70 primary health care centres (out of 119) are not functioning. Some 492 attacks on health facilities have been reported, resulting in the deaths of 747 people.
The Israeli military has also systematically destroyed Gaza’s water and sanitation system. According to an Oxfam report published in July, Gazans now have only 4.74 liters of water per person per day for all purposes, including drinking, cooking and washing.
This means a 94 percent reduction in the amount of water available before October, and a level significantly below the internationally accepted minimum standard of 15 liters of water per person per day for basic survival in an emergency.
At the same time, Israel has destroyed 70% of sewage pumps and 100% of treatment plants since October. The destruction and obstruction of Gaza’s water and sanitation infrastructure has had catastrophic effects on public health, certainly causing a significant number of indirect deaths.
Major public health reports have projected horrific scenarios regarding deaths caused by the spread of infectious diseases in Gaza. According to a study by the London School of Hygiene and Johns Hopkins University, thousands of Palestinians may have died in the past six months due to infectious diseases.
To justify these deaths, Israel claims that they are the result of a tragic humanitarian crisis caused by the Palestinians. But they were not unintentional, as more honest statements by Israeli officials have revealed.
In November 2023, former head of Israel’s National Security Council Giora Eiland and current adviser to Defense Minister Yoav Gallant wrote in the Yedioth Aharonoth newspaper that “the international community is warning us of a humanitarian catastrophe in Gaza and of serious epidemics. We must not shy away from this situation, as difficult as it is,” adding that “after all, serious epidemics in the southern Gaza Strip will bring victory closer and reduce losses among army soldiers.”
Netanyahu’s Finance Minister Bezalel Smotrich tweeted that he agreed with “every word” Eiland wrote in his column. In other words, infectious diseases are among the tools of attritional genocide envisioned by Israel’s leaders.
This is not an entirely new story. Israel has already subjected Palestinians to systematic policies of slow death and disability, peaking during the two intifadas. But since October 7, these policies have reached an unprecedented level and meet two key criteria of the Genocide Convention.
First, by destroying the health sector and obstructing the distribution of health supplies and services, Israel is ensuring that Palestinians in Gaza will face severe physical and mental harm.
Second, by almost completely destroying the water and sewage system and creating a debilitating environment, the Israeli military has inflicted living conditions on the Palestinians of Gaza calculated to bring about its physical destruction in whole or in part.
This is how Israel continues its genocide by attrition in Gaza.
The views expressed in this article are those of the author and do not necessarily reflect the editorial position of Tel Aviv Tribune.