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Palestinians inspect the site of an Israeli strike on the courtyard of Al-Aqsa Martyrs hospital, where displaced people were taking shelter in tents, in Deir Al-Balah in the central Gaza Strip on Sept. 5.Ramadan Abed/Reuters

Crowds of Palestinians gathered at medical centres in the south of the embattled Gaza Strip on Thursday for their children to be vaccinated against polio in the second stage of a campaign that has so far seen 187,000 youngsters inoculated.

The U.N. Palestinian refugee agency UNRWA said the campaign, taking place after Hamas and Israel agreed on limited pauses in their fighting, was so far successful but complex.

But the war continued elsewhere in the enclave, with Gaza health authorities reporting several people killed in Israeli air strikes, including a hit on a hospital in central Gaza.

And despite the success of the polio campaign, diplomatic efforts to secure a permanent ceasefire in the war, the release of hostages held in Gaza, and the return of Palestinians jailed by Israel have faltered.

On Thursday, vaccinations began in Rafah and Khan Younis in the south of Gaza, both areas that have been battered by the war and that have hosted tens of thousands of people who have fled other parts.

One displaced Palestinian, Ikram Nasser, queuing with her son at a vaccination point, said the threat of polio had only increased people’s fears.

“We live based on fear, from the bombing, from the terror, from the destruction, from the injuries. We add to that the fear of diseases that have spread, such as skin diseases, from the lack of cleanliness and the crowding,” she said.

UNRWA said in a statement the vaccination campaign had moved to southern areas with teams mostly in Khan Younis.

“At this critical time, area pauses must be respected to protect families and humanitarian workers,” it said.

Recipients will include people who had been forced by the Israeli military to leave Rafah, near the border with Egypt, where Israeli forces have been operating since May to hunt down Hamas fighters.

Later on Thursday, the Gaza health ministry said Israel refused to allow medical teams to areas east of the Salahuddin road to vaccinate children living in the eastern communities of the southern cities. The Israeli military said it was checking the report.

Health officials aim to reach 640,000 Gaza children for vaccination against polio in the campaign, which was launched after the discovery of a case of a one-year-old baby who was partially paralyzed.

This was the first known case of the disease in Gaza – one of the world’s most densely populated places – in 25 years. It re-emerged as Gaza’s health system has virtually collapsed and many hospitals have been knocked out of action due to the war.

Footage circulated by the Gaza health ministry showed large crowds of Palestinians arriving at medical facilities in Khan Younis to get their children vaccinated.

“My message to the world is that just as you provided us with vaccination so that our children would be safe, you must provide us with a ceasefire and a stop to this war, as this war is a real catastrophe for us,” said Gaza resident Osama Brika as he accompanied his nephew into the medical facility.

UNRWA said on Wednesday good progress was being made in rolling out the polio vaccine to children but a permanent ceasefire in the 11-month-old war was needed to ease humanitarian suffering.

Meanwhile, Israeli forces pressed on with operations in several areas across the Palestinian enclave, battling fighters from Hamas and the Islamic Jihad militant group.

Gaza health officials said an Israeli air strike killed five Palestinians at the Al-Aqsa Hospital in Deir Al-Balah in the central Gaza Strip on Thursday.

The victims were in a tent encampment inside the hospital compound where displaced people had sought shelter, they said.

The Israeli military said the air strike hit a command centre there used by Hamas and the Islamic Jihad to plan and direct attacks against Israeli forces.

On the diplomatic front, the United States was trying to put forward a new proposal for a ceasefire and the release of hostages held by Hamas in the coming days, two U.S. officials, two Egyptian security sources, and an official with knowledge of the matter told Reuters.

The proposal aims to work out the major sticking points behind a months-long impasse in talks mediated by the United States, Qatar, and Egypt, the U.S. officials said.

Israeli Prime Minister Benjamin Netanyahu says the war can only end when Hamas is eradicated. Hamas wants any agreement ending the war to include a withdrawal of all Israeli forces from Gaza.

The war in Gaza was triggered by Hamas’ Oct. 7 attack on southern Israel, when its fighters killed 1,200 people and captured more than 250 hostages, according to Israeli tallies.

Since then, more than 40,800 Palestinians have been killed in Gaza, according to the enclave’s health ministry.

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