The diagnosis of a 10-month-old boy with polio last week — the first case in Gaza in 25 years — added urgency in a war where deals have otherwise proved elusive.

In an interview with NBC News, the boy’s mother, Naveen Abu Al-Jidyan, said her son, Abdel Raman, should soon be learning to walk, but instead his leg has been paralyzed.

Speaking by the tent where he lives with his wife and 10 children, Amjad Abu Al-Jidyan, Abdel Raman’s father, blamed his family’s poor health on a lack of hygiene.

“There is no hygiene, the hygiene supplies are unavailable,” Abu Al-Jidyan said. “We don’t have chlorine, soap, or anything.”

He said he waits for hours to collect just a gallon of water for his family. “God knows if the water is potable or not,” he added.

While sewage flows through the streets and Palestinians scramble to find clean water, avoiding human waste has become a difficult and potentially life-threatening challenge.

The highly infectious virus attacks the nervous system and can lead to spinal and respiratory paralysis, and even death. In the 20th century, before it was mostly eradicated, polio was among the most feared diseases in the world, killing or paralyzing half a million people a year, according to the World Health Organization. Some experts now fear it may already be widespread in Gaza.

After leaving their homes to escape the conflict, most of the enclave’s 2.2 million people are now confined to a humanitarian area smaller than Manhattan, the majority in makeshift, overcrowded shelters without sanitation infrastructure that safely separates waste from human contact.

Untreated sewage flows openly near these dwellings, where flies travel freely from feces to fluids and food. Waste seeps into the surrounding environment and contaminates the dwindling fresh water supplies.

“There’s people with a hole in the tent and they have to defecate out of that hole,” Petropoulos said. “The same tent where they sleep.”

People are also running out of water to wash their hands or clean themselves, with many resorting to seawater, despite the fact that untreated sewage is being pumped into the Mediterranean Sea with wastewater treatment plants shut down.

“They know the water from the sea is not hygienic in any state,” Louise Wateridge, a spokesperson for UNRWA, the United Nations agency for Palestinian refugees, told NBC News last month. Using it, she said, is “an act of desperation.”

According to Oxfam America, less than 4% of fresh water is now drinkable in Gaza. UNRWA estimates that almost 70% of water and sanitation facilities and infrastructure has been destroyed or damaged in Israel’s bombardment.

Meanwhile, vaccine rates have dropped enough since the start of the war to allow for the re-emergence of polio. In 2022, vaccine coverage was estimated at 99% for two doses, but this has dropped to less than 90%, according to the latest WHO data.

According to UNICEF, poor sanitation conditions mean that at least 95% of children will need to receive two vaccine doses in order to reduce chances of an outbreak in the region.