Al-Zawayda, Gaza – Inside a tent near al-Zawayda town in central Gaza, 35-year-old Nevin Abu al-Jidyan sat on the floor next to her youngest child, Abdul Rahman, who lay in a plastic baby seat.

She looked pale as she gently touched his face, and fanned him with a piece of cardboard.

He was sleeping after a bout of crying. It was a disturbed sleep, and the child, dressed in dusty clothes, moved his head from time to time. Nevin’s eight other children sat quietly in the small space, furnished with some mattresses, cooking utensils and other belongings in a corner.

The once-vibrant child, who had just started to take his first steps, used to play and fill the camp with his spirited energy, but he is now bedridden.

Abdul Rahman, who turned one on September 1, is the first child confirmed to have contracted polio in Gaza in 25 years.

“Not long ago, my son was constantly moving,” Nevin says, tears welling up in her eyes. “He was so active that his father bought him a small plastic cart to ride. He was so restless he broke it from all his … playing.”

Her voice breaks as she continues, gently rocking Abdul Rahman. “Now he can’t move at all. My heart is shattered. I can hardly believe this is happening.”

Children are vaccinated against polio at Al-Aqsa Martyrs Hospital [Abdelhakim Abu Riash/Al Jazeera]

‘The world collapsed’

About two months ago, Abdul Rahman developed a high fever and began vomiting constantly. Worried, Nevin rushed him to Al-Aqsa Martyrs Hospital, the last functioning medical facility in central Gaza, never imagining how serious his illness was.

For two weeks, he was barely awake and rather than breastfeeding as usual, he was fed through a drip. After spending two weeks in hospital, Nevin brought her son, who had started eating again but with difficulty, back to the family’s tent.

Doctors suspected a serious illness and sent samples to Jordan for testing. A month later, Nevin received the devastating news over the phone: Abdul Rahman had polio.

“It was like the world collapsed around me,” she recalls. “I couldn’t believe it. The doctors confirmed the diagnosis and told me to prepare all my children for immediate vaccination.”

She was stunned, and although she could barely comprehend what was happening, she remembers being terrified that her other children could develop the same illness.

A few hours later, medical teams arrived to vaccinate her children and their neighbours, fearing the virus might spread in the crowded tents.

“Everything was a blur,” Nevin tells Al Jazeera. Questions raced through her mind: “My child has polio? Will he be paralysed? What can I do? How do I protect my nine children?”

A child in Gaza receives oral drops of the polio vaccine [Abdelhakim Abu Riash/Al Jazeera]

Missed vaccinations

Since Abdul Rahman fell sick, he has been unable to stand or move his legs and sometimes has spasms. He also has trouble moving his left arm.

Initially, Nevin thought this was due to exhaustion from being ill. Now she knows polio has left her son paralysed in both legs.

Nevin was displaced from northern Gaza with her family after Israeli orders to evacuate. Since then, she and her family have faced one upheaval after another in the past 11 months since Israel began its bombardment of Gaza and killed more than 40,800 Palestinians.

The family of 11 has been forced to move five times. The constant displacement, she believes, prevented Abdul Rahman from getting his critical vaccinations, leading to him contracting polio.

“The virus hit my son hard,” Nevin explains. “When we were displaced, he was only a month old and missed his vaccinations. We were constantly moving, and that was an obstacle.”

She also believes the poor living conditions contributed to his illness. “The dirty water and lack of nutritious food are what made Abdul Rahman sick. I think contaminated water, the kind they distribute to us, is the main reason for the spread of polio.”

Polio can spread quickly in unhygienic conditions through contact with excrement, or in less common cases, through sneezing or coughing. It can lead to mild, flu-like symptoms but in some cases can affect the brain and nerves, leading to irreversible paralysis and sometimes death.

The United Nations, along with Gaza health authorities, has begun a vaccination campaign to give oral polio vaccines to about 640,000 children.

The poliovirus present in Gaza is believed to be vaccine-derived, that is, weakened viruses from oral vaccines have mutated to cause infections and spread due to Israel’s destruction of sanitation infrastructure. Unvaccinated or partially vaccinated children below the age of five are most at risk. There is no cure for polio.

Abdul Rahman is fanned by his sister inside their tent in the central Gaza Strip [Ramadan Abed/Reuters]

‘His condition is only getting worse’

It pains Nevin to see how listless and tired her once-animated son has become. Abdul Rahman used to love playing – he now barely smiles when played with.

Nevin’s only hope now is to get her son out of Gaza for treatment.

“My husband and I dream of going abroad when the Rafah crossing reopens,” she says. “Abdul Rahman needs supplements … but his condition is only getting worse.”

Nevin spends her days by her son’s side, tending to him. She cries often, and the family is grieving. Still, Nevin does what she can, massaging his legs daily, hoping they might respond, and feeding him despite his lack of appetite.

But living in poverty and displacement, Nevin struggles to provide the most basic necessities.

“My son needs clean, filtered water, but with my large family, I can’t afford to buy bottled water regularly,” she shares.

Through her tears, Nevin says, “I just want my son to recover, whether it’s through treatment abroad or here in Gaza. But no one seems to care right now, and I’m helpless as a mother. All I can do is hope that somehow he will regain his health.”