“People in Gaza are facing yet another peril: Hepatitis A is spreading including among children,” Philippe Lazzarini, head of the UN agency that assists Palestine refugees, UNRWA, wrote on social media.

Since the start of the war last October, UNRWA shelters and clinics have reported 40,000 cases of the disease, he said, compared to only 85 in the same period before conflict erupted, representing “a frightening increase”.

Hepatitis A is an inflammation of the liver caused by a virus of the same name that is transmitted through ingestion of contaminated food and water, or through direct contact with an infectious person.

Ideal conditions for disease

“The waste management system in Gaza has collapsed. Piles of trash are accumulating in the scorching summer heat. Sewage discharges on the streets while people queue for hours just to go to the toilets,” said Mr. Lazzarini. When combined, they “make a dangerous recipe for diseases to spread”.

Humanitarians are also preparing for the worst-case scenario of a polio outbreak following the recent discovery of the disease in sewage samples.

The World Health Organization (WHO) said earlier this week that although efforts are ongoing to acquire vaccines, it is not enough just to get them across the border.

WHO called for a ceasefire and at the very least, clear roads and safe access to allow partners to reach every person in Gaza with the necessary vaccinations.

Access impediments

Meanwhile, humanitarians continue to face impediments to aid delivery, including continued hostilities, unexploded ordnance, damaged and impassable roads, attacks on aid convoys, a lack of public order and safety, and not enough border crossings.

The Israeli authorities also continue to impose restrictions on the entry of certain humanitarian supplies into the enclave.

“These factors continue to significantly hinder the entry of aid into Gaza and the delivery of aid and basic services to hundreds of thousands of people across the Strip,” the UN Office for the Coordination of Humanitarian Affairs (OCHA), said.

In July, Israel facilitated just 67 out of 157 aid missions planned to northern Gaza. The others “were either denied, impeded or canceled due to security, logistical or operational reasons,” OCHA added.

‘Tragic and devastating milestone’

This week marked “a tragic and devastating milestone’ for UNRWA as the number of staff killed since the war began rose to 202, Mr. Lazzarini said in a statement on Monday.

This is the largest number of UN personnel killed in a single conflict since the Organization was established in 1945.

He said these fallen colleagues were teachers, doctors, nurses, social workers, engineers, support staff, logisticians, and technology and communications workers.

Most “were killed with their families at home or in a place they thought would be safe”, while several lost their lives in the line of duty, providing humanitarian assistance to people in need.

“I echo the call from the Secretary General: the UN will spare no effort to demand accountability for the deaths of our staff,” he said.

“Over the coming weeks, we will find several occasions to mark this somber memory of our fallen colleagues.”