From the grey rubble of Gaza’s bombed water treatment plants, a rare and deadly paralytic disease has emerged that has brought a new crisis to a region already devastated by starvation and illness.
An unprecedented surge in acute flaccid paralysis (AFP) – a condition which causes a rapid onset of muscle weakness and paralysis – has seen 110 people diagnosed in the past three months. In previous years, Gaza saw just one or two cases of AFP per year.
The symptoms occur when the body’s immune system is triggered by certain viruses, in some cases causing it to attack its own nervous system. In Gaza, the rapid spread of water-borne infectious diseases has led to a striking rise in AFP cases.
The World Health Organisation (WHO) and Dr Ahmed al-Farra, head of paediatrics at Nasser Hospital in Khan Younis, told The Independent that Israel’s destruction of Gaza’s vital water treatment plants is largely responsible for the spread of these diseases.
“To see 110 cases, this is incredible. This is an outbreak, it is alarming for us to see that number,” Dr Farra said, describing the situation as “one of the most challenging” medical incidents Gaza has seen since 2023.
Acute flaccid paralysis is associated with a variety of causes, including Guillain–Barre syndrome (GBS), a rare autoimmune condition and the main cause of AFP in Gaza. Severe cases of AFP and GBS can cause lifetime paralysis, or respiratory failure, potentially resulting in death.
Gaza’s health ministry says 36 per cent of the reported cases of GBS were in children aged under 15. In Nasser Hospital and Al-Shifa hospital, the hotspots of the outbreak, at least nine people have died of AFP so far.
Senior Palestinian and Israeli medics, along with the WHO, have told The Independent that critical and lifesaving treatments are not available anywhere in the ravaged enclave.
The Israeli military denies that it prevents the entry of medicine into the strip, and says it “continuously and consistently facilitates the operation of medical services” in Gaza. It blames its destruction of water infrastructure on Hamas, which it accused of “embedding its military assets among the civilian population”.
Other factors such as overcrowding in shelters, malnutrition, and restricted access to healthcare have all exacerbated the crisis, a WHO spokesperson said, adding that the abrupt nature of the recent surge in cases is partly due to improved monitoring processes.
Lab testing samples came back positive with enterovirus, a group of viruses which typically spreads through humans or water. Most samples also contained Campylobacter jejuni, a species of bacteria commonly found in animal faeces, Dr Farra said.
The lab findings show that “water that the patients are receiving is completely polluted by sewage” due to the “destruction of the sewage system”, he said.
In July last year, Oxfam reported that Israel had destroyed 70 per cent of all sewage pumps and 100 per cent of wastewater treatment plants in Gaza. It accused Israel of restricting the entry of Oxfam’s water testing equipment.
Medecins Sans Frontieres (MSF) said on Thursday that Israel is “deliberately depriving people of water in Gaza”. Since June 2024, Israel has only approved one in every 10 import requests of items for water desalination, the charity said.
