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U.N. aid agencies plan to begin a massive vaccination drive across Gaza on Sunday to try to protect young children from a rare type of polio, having persuaded Israel to pause combat operations for several hours a day in certain locations.
The effort faces enormous logistical challenges in a war zone where much of the infrastructure has been destroyed. The operation depends on the brief cease-fires holding while rule of law has broken down, hundreds of thousands are living in temporary shelters and many buildings are in ruins.
But it comes too late for at least one infant boy who was diagnosed with poliovirus type-2 earlier this month — the first confirmed case of the disease to surface in Gaza after it was eradicated in most of the world during the 1990s.
The World Health Organization and UNICEF, the U.N. children’s fund, have delivered more than 1.2 million doses of polio vaccination from Indonesia to distribute to about 640,000 children in Gaza under 10 years old. Another 400,000 doses are on their way.
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At least 90 percent of those children need to be vaccinated to stop the disease from spreading, Dr. Rik Peeperkorn, the top W.H.O. representative in Gaza, told reporters on Thursday.
That will take a force of about 2,100 health and community aid workers in Gaza, at some 700 medical facilities, mobile clinics and shelters. They will administer the polio vaccination during a staggered pause in military operations for nine hours a day for three days in designated areas in each of Gaza’s three main regions — north, south and central.
The agreement for the humanitarian pause was reached Thursday after days of tense negotiations with Israeli officials, who insisted that it was not a first step to a cease-fire and that fighting would not be halted across the Gaza Strip.
The first confirmed polio case is a boy named Abdul Rahman Abu Al-Jidyan, who is almost a year old and living with his family in a tent in Deir al Balah in central Gaza.
He was born just before the war between Israel and Hamas began last October, and was unable to get the routine vaccinations that are given to babies, his mother said, because the family was constantly forced to move from one shelter to another to escape violence. Then, about two months ago, Abdul Rahman stopped walking and crawling.
“I found the boy vomiting, he stopped moving and had a fever,” his mother, Nivine Abu Al-Jidyan, said in an interview this week with Reuters. Exams at a hospital in Gaza and a sample sent to a lab in Jordan confirmed heath officials’ fears: He had tested positive for polio.
Some Western diplomats privately voiced skepticism that a pause would hold, although Hamas officials said they would abide by the agreement.
“I think this is a way forward,” Dr. Peeperkorn said. “I’m not going to say this is the ideal way forward, but this is a workable way forward. Not doing anything would be really bad. We have to stop this transmission in Gaza, and we have to avoid the transmission outside Gaza.”
The vaccinations will begin around 6 a.m. Sunday in central Gaza for at least three days, and longer if needed, Dr. Peeperkorn said. When that is complete, the drive will shift to southern Gaza for three days, and later to northern Gaza for three days.
A second, booster round of immunizations will need to be given four weeks after the first dosages, and Dr. Peeperkorn said that was part of the agreement reached on Thursday. “We expect that all parties will stick to that,” he said.
Some of the doses will be administered in shelters run by UNRWA, the main U.N. agency that provides aid to Palestinians in Gaza. Israel has accused UNRWA of being infiltrated by Hamas, a charge it denies.
Dr. Peeperkorn said the vaccine drive was planned in coordination with both UNRWA and COGAT, the Israeli defense ministry’s agency that oversees policy for the Palestinian territories, and “we haven’t encountered any problems.” He also said Israeli authorities had agreed to not issue evacuation orders in the times and places that the inoculations are being administered.
Gazan health officials have reported multiple children with symptoms consistent with polio, likely the result of what UNICEF and W.H.O. officials said was severely unsanitary conditions combined with deteriorating health services across the region. The polio virus has been detected in wastewater samples in Khan Younis, in southern Gaza, and Deir al Balah, both of which have large populations of displaced Palestinians who have fled Israeli airstrikes.
Key Developments
Vice President Kamala Harris said she would continue President Biden’s policies with regard to the war in Gaza. Speaking to CNN on Thursday in her first major interview as the Democratic presidential nominee, Ms. Harris emphasized the need for a cease-fire deal but responded “no” when asked whether she would withhold U.S. weapons shipments to Israel. “I’m unequivocal and unwavering in my commitment to Israel’s defense, and its ability to defend itself, and that’s not going to change,” she said.
Israel told the United States it blamed “a communications error” between military units for an episode in which Israeli troops fired at a World Food Program vehicle, Robert Wood, a U.S. representative to the United Nations, told a U.N. Security Council meeting on Thursday. “We have urged them to immediately rectify the issues within their system that allowed this to happen,” Mr. Wood said. The World Food Program said this week that it was suspending staff movement in the Gaza Strip because of the shooting on Tuesday, noting that it was a marked car that had obtained the necessary security clearances. No staff members were hurt in the shooting, it said.
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Israel’s killing of a young commander of the local branch of Palestinian Islamic Jihad in the West Bank city of Tulkarm is shining a spotlight on the group.
Here’s a closer look.
What is Palestinian Islamic Jihad?
Formally titled the Islamic Jihad Movement in Palestine, the group was founded in the Gaza Strip in the 1980s to fight the Israeli occupation. It has a presence in both Gaza and the West Bank, and dominates the part of Tulkarm that was founded as a refugee camp for Palestinians displaced in the wars surrounding the foundation of Israel.
Like Hamas, it is a Sunni Muslim group, though far smaller. And also like Hamas, the group receives funding and weapons from Shiite Muslim Iran, according to the U.S. State Department, in pursuit of their shared anti-Israel ideology. Israel, the United States and the European Union consider both groups to be terrorist organizations.
The U.S. Counterterrorism Center says Palestinian Islamic Jihad has also received support from Syria and Hezbollah in Lebanon.
The U.S. State Department in 2022 put the group’s membership between 1,000 and several thousand.
Who heads the organization?
Ziyad al-Nakhalah has led the group’s leadership council since 2018. Mr. al-Nakhalah was staying in a guesthouse room next to Ismail Haniyeh, formerly a top leader of Hamas, when Mr. Haniyeh was assassinated earlier this month by a bomb in Tehran.
What is its mission and philosophy?
According to the Council on Foreign Relations, the group “wants to reestablish a sovereign, Islamic Palestinian state,” and views “the Arab-Israel conflict as an ideological war, not a territorial dispute.” Palestinian Islamic Jihad opposes a two-state solution.
While the group holds less sway than Hamas, experts say the group is more extreme in ideology. “Historically, they’ve had a top-down view of establishing an Islamic state,” said Daniel Byman, a counterterrorism specialist at Georgetown University. “You grab power, and then you force people to be good Muslims, as opposed to teaching.”
What is the relationship between Palestinian Islamic Jihad and Hamas?
The two are sometimes allied but operate independently: Islamic Jihad focuses on military attacks and has far fewer political and social institutions than Hamas, which won elections in Gaza in 2006, drove its rivals out of the territory the following year and has ruled there since.
The groups have typically cooperated in their opposition to Israel, but tensions have arisen at times when Hamas has put pressure on Palestinian Islamic Jihad to stop attacks against Israel, experts said. Unlike other militant Palestinian groups, Islamic Jihad has been reluctant to engage in negotiations or be part of a diplomatic solution to the current war with Israel.
Did Palestinian Islamic Jihad play a role in the Oct. 7 attacks?
Yes, the group claimed responsibility for some of the attacks, and a United Nations report published in June said the group had taken part in the violence on Oct. 7.
The report specified that Palestinian Islamic Jihad had participated in these episodes:
An attack on Kibbutz Be’eri, where more than 100 people were killed and about 30 were abducted.
An attack on Kibbutz Nir Or, which left more than 45 dead and saw more than 70 abducted.
Attacks on military bases, including the Nahal Oz outpost, where 66 soldiers were killed.
What are other notable attacks involving Palestinian Islamic Jihad?
The group has attacked both military and civilian targets. In over a three-day span in August 2022, the group launched over 1,000 rockets at Israel in a deadly clash that ended in a cease-fire brokered by Egypt.
U.S. and Israeli intelligence officials also blamed an errant rocket fired by the group for an explosion at Al-Ahli Arab Hospital in Gaza City last October that killed scores of people.
What military capabilities does the group have?
Palestinian Islamic Jihad’s military wing, Al Quds Brigade, has been carrying out small-scale attacks since at least the late 1980s. It conducted suicide bombings over decades, and more recently has used small arms, rockets and mortars against Israel. Mr. Byman said that Palestinian Islamic Jihad tended “to be relatively low-level in terms of technology and in terms of the size of their arsenals.”
