In August, an unvaccinated 10-month-old Gazan baby was partially paralyzed by polio, the first confirmed case in the Gaza Strip in 25 years. The paralysis is likely permanent, and there is no cure for polio. We have a safe and effective vaccine to prevent this serious infectious disease, but the ongoing war has halted vaccination campaigns. Today, a polio outbreak in the Palestinian territory seems inevitable, as the disease spreads through the dirty water and waste surrounding displaced people living in tents in unsanitary camps.
Fortunately, a series of humanitarian pauses of nine hours a day were agreed so that children could be vaccinated as part of a UN emergency health campaign. The campaign ends this week in the northern part of Gaza, the area most affected by the conflict, and has taken place without serious incidents: some 530,000 children under the age of ten have been vaccinated.
The main concern, however, is whether the fighting will stop completely: Israeli forces have attacked hospitals, schools, aid trucks and aid workers over the past 11 months. UN agencies such as the World Food Programme (WFP) are no longer sending staff to Gaza after Israeli forces opened fire on a clearly marked convoy, even though the vehicle had received permission from Israeli authorities.
This week, a 12-person UN team that had obtained permission from the Israeli military was detained as it headed north to Gaza to support the third phase of the vaccination campaign. According to the UN, the convoy was held up for more than seven hours by Israeli troops, who targeted its members and interrogated two of them separately. They were eventually allowed to leave and return to base, but without having completed their mission.
It’s all well and good to accept a breakup on paper, but the real test will be whether it works in real life.
We have no idea of the extent of disease and hunger – so-called “indirect deaths” – and we do not know the total number of deaths.
The resurgence of polio in Gaza is a grim reminder that it is increasingly difficult to assess the true cost of war. We have no idea of the extent of disease and hunger – so-called “indirect deaths” – and we do not know the total number of deaths. Typically, data is collected from hospitals and morgues, which certify each death and report it to the Ministry of Health.
However, these civil registration systems are no longer functioning in Gaza, meaning there is no accurate data on the number of deaths that have occurred. It is estimated that there are still over 10,000 bodies buried under the rubble – and therefore impossible to count – as well as a growing number of unidentified bodies.
It is important to have a recognised and reliable process for estimating a toll from outside that is close to reality. Methods have been developed for decades to create data sets in situations where health and surveillance systems are poor or failing. The Global Burden of Disease study is a framework of excellence and reference. Funded by the Bill and Melinda Gates Foundation, its aim is to create a process for estimating deaths, and then triangulate across research groups and methods to see if a robust and universally accepted figure can be agreed. This is a process of review and consultation among scientists.
On the other hand, the scientific journal The Lancet recently published an estimate of the deaths in Gaza by several prestigious scientists, explaining what criteria they used to calculate the deaths (compared to similar conflicts) and the final figures. They estimate that by mid-June, the conflict in Gaza had caused about 186,000 deaths, which represents about 7.9% of the Gazan population. If deaths continue at this rate, about 23,000 per month, there will be 149,500 additional deaths by the end of the year, about six and a half months after the initial estimate of mid-June. According to this method, a total of 335,500 people have died since the conflict began in October.
If deaths continue at this rate, about 23,000 per month, there would be 149,500 additional deaths by the end of the year.
According to data from the Palestinian Ministry of Health, in September the number of deaths exceeded 40,000, all identified. But there may be more unidentified, missing or dismembered bodies.
Similarly, last winter, I made a rough estimate by analyzing other conflict situations and assessing the number of deaths that would occur if the fighting continued without international intervention. By December 2023, my estimate was about half a million dead without a ceasefire; this roughly coincides with the estimates of The Lancet –The scientists used a very conservative method but admitted that the figure could be much higher. It also shows what could have happened if the international community had not acted and taken advantage of the brief periods available to provide aid and medical care. Many people were saved thanks to pauses in the fighting and humanitarian interventions, even irregular ones.
It is easy to get lost in these numbers and forget the name and face behind the numbers. While the situation in Gaza may seem hopeless, it is not. UN attempts to gain access to the Gaza Strip, such as the one that has enabled humanitarian pauses to vaccinate children against polio, are saving lives. They are making a difference to hundreds of thousands of families, even in the abject horror of war. This is not a political discussion or debate: the collaboration of scientists to establish reliable facts and data is crucial to documenting what is happening in the conflict and will help those working to find solutions that preserve the lives and health of Gazans.
Text translated by Emma Reverter and updated by elDiario.es
