Deir el-Balah, Gaza – Maha Abu Shamas, 27, has been getting her four children, all under the age of 10, ready to get their polio vaccines since the early hours of the morning.

Maha, a mother of five, has been living in a classroom in Deir el-Balah’s central Gaza Strip since the family was displaced from Beit Hanoon in the north last November.

“When I heard about the threat of polio spreading, I was terrified for my children. When I learned of a confirmed case of paralysis, I felt like my world had collapsed,” said Maha, holding her nine-month-old boy inside the busy paediatric ward of Al-Aqsa Martyrs Hospital, the last functioning medical facility in Deir el-Balah.

Gaza’s Ministry of Health last month confirmed the first case of polio – a 10-month-old boy, now paralysed in the leg – in the enclave after 25 years, following the detection of poliovirus in wastewater. The United Nations, along with Gaza health authorities, has begun a vaccination campaign to protect children against polio, which can cause irreversible paralysis of the limbs or even death. About 640,000 children under 10 years old will receive oral drops of the vaccine to protect against the virus which primarily affects children under the age of five, is highly contagious and has no cure.

The threat of polio has only compounded Maha’s worries. Displaced parents like her already contend with harsh, unsanitary conditions at shelters like the school where Maha and her children live, and in Gaza’s tent camps, as they try to survive Israel’s war on Gaza which has killed more than 40,700 Palestinians.

“The lack of hygiene is the main feature due to overcrowding, a collapsed infrastructure and a catastrophic health situation,” she explains.

“The school I live in is full of pools of sewage and wastewater,” Maha adds. “I can’t maintain my children’s cleanliness or health in these conditions.”

In addition to taking her children to Al-Aqsa Hospital to be vaccinated, Maha had to bring her youngest child to the paediatric ward after three days of having a high fever and vomiting.

“This is how most of my days pass in the war – rushing my sick children to the hospital for treatment due to the spread of diseases, if it’s available,” she says. “If this is how we struggle with minor illnesses like stomach flu, how can we fight serious diseases like polio?”

Maha’s life took a devastating turn last month when her husband was killed in an Israeli air strike near their shelter. “Now, I’m the sole caregiver for five children. It’s overwhelming, but like thousands of mothers in Gaza, I have no choice but to push forward.”

While she welcomes the polio vaccination drive, she points out that this addresses just one threat posed by the dire living conditions. “Malnutrition, hepatitis, skin diseases, exhaustion – our children face a range of threats. The real solution lies in improving living conditions and ending the war,” she says. “We’ve endured enough.”

Hanin Abdullah lives in a crowded classroom with her husband and children. She says many parents worry about the UN vaccination drive because the war has eroded their trust in the international community [Abdelhakim Abu Riash/Al Jazeera]

Loss of faith in the international community

For 31-year-old Hanin Abdullah, the decision to vaccinate her children against polio was fraught with hesitation.

Hanin, a mother of three young children, was displaced with her family from Jabalia in northern Gaza, and they now share a cramped space with 25 members of her family.

“In the same classroom, about 40 others are packed in,” she says, speaking at Al-Aqsa Hospital, describing her situation as tragic.

The college where she lives is crowded, sewage pools throughout and there are long queues for the toilets. The outside walls are black from the wood fires used for cooking.

She says she no longer trusts any action undertaken by international organisations when it comes to the health of children in Gaza.

“Our children are being killed daily by bombs and missiles, even in supposedly safe areas. Some are decapitated,” she says bitterly.

“This madness is still ongoing and yet, they’re talking about fears of polio only?”

Like many displaced families in her shelter, Hanin initially resisted vaccinating her children.

“People here have lost faith in anything global or Western,” she explains.

“Some displaced people around believe conspiracy theories that the vaccines contain substances planted by Israel and the US to weaken our children.”

Despite her doubts, she ultimately felt she couldn’t risk her children’s health, especially after hearing about a confirmed polio case in Gaza, so she brought them to the hospital.

“I understand the despair families feel living under war conditions. We are like the living dead, trapped in unbearable conditions,” she says, holding her baby boy.

“I gave birth to my child last November and since then he has been living a tragic childhood in the shelter,” she says, frustrated.

“He has no proper nutrition, no clothes, no toys. He suffers from skin rashes and constant fatigue.”

For Hanin, the fight against polio is just one small part of a larger struggle.

“Protecting our children from polio is important, but the real fight is against the living conditions imposed by war. These conditions are destroying their mental and psychological health and even their future,” she argues.

“What is the point of vaccinating children and protecting them from disease, while the war that kills them every day continues? This is nonsense.”