Palestinians Across the Middle East Mark the Original ‘Nakba’ with Eyes on War in Gaza 

Displaced Palestinians, who fled their house due to Israel's military offensive, shelter in a tent, in Rafah, in the southern Gaza Strip May 13, 2024. (Reuters)
Displaced Palestinians, who fled their house due to Israel's military offensive, shelter in a tent, in Rafah, in the southern Gaza Strip May 13, 2024. (Reuters)
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Palestinians Across the Middle East Mark the Original ‘Nakba’ with Eyes on War in Gaza 

Displaced Palestinians, who fled their house due to Israel's military offensive, shelter in a tent, in Rafah, in the southern Gaza Strip May 13, 2024. (Reuters)
Displaced Palestinians, who fled their house due to Israel's military offensive, shelter in a tent, in Rafah, in the southern Gaza Strip May 13, 2024. (Reuters)

Palestinians across the Middle East on Wednesday are marking the anniversary of their mass expulsion from what is now Israel with protests and other events across the region at a time of mounting concern over the humanitarian catastrophe in Gaza.

The Nakba, Arabic for “catastrophe,” refers to the 700,000 Palestinians who fled or were driven out of what is now Israel before and during the war surrounding its creation in 1948.

More than twice that number have been displaced within Gaza since the start of the latest war, which was triggered by Hamas' Oct. 7 attack into Israel. UN agencies say 550,000 people, nearly a quarter of Gaza's 2.3 million people, have been newly displaced in just the last week, as Israeli forces have pushed into the southern city of Rafah and reinvaded parts of northern Gaza.

“We lived through the Nakba not just once, but several times,” said Umm Shadi Sheikh Khalil, who was displaced from Gaza City and now lives in a tent in the central Gaza town of Deir al-Balah.

The refugees and their descendants number some 6 million and live in built-up refugee camps in Lebanon, Syria, Jordan and the Israeli-occupied West Bank. In Gaza, they are the majority of the population, with most families having relocated from what is now central and southern Israel.

Israel rejects what the Palestinians say is their right of return, because if it was fully implemented it would likely result in a Palestinian majority within Israel's borders.

PAINFUL MEMORIES The refugee camps in Gaza have seen some of the heaviest fighting of the war. In other camps across the region, the fighting has revived painful memories from earlier rounds of violence in a decades-old conflict with no end in sight.

At a center for elderly residents of the Shatila refugee camp in Beirut, Amina Taher recalled the day her family’s house in the village of Deir al-Qassi, in what is now northern Israel, collapsed over their heads after being shelled by Israeli forces in 1948. The house was next to a school that was being used as a base by Palestinian fighters, she said.

Taher, then 3 years old, was pulled from the rubble unharmed, but her 1-year-old sister was killed. Now she has seen the same scenes play out in news coverage of Gaza.

“When I would watch the news, I had a mental breakdown because then I remembered when the house fell on me,” she said. “What harm did these children do to get killed like this?”

Daoud Nasser, also now living in Shatila, was 6 years old when his family fled from the village of Balad al-Sheikh, near Haifa. His father tried to return to their village in the early years after 1948, when the border was relatively porous, but found a Jewish family living in their house, he said.

Nasser said he would attempt the same journey if the border were not so heavily guarded. “I would run. I’m ready to walk from here to there and sleep under the olive trees on my own land,” he said.

NO END TO WAR The latest war began with Hamas' rampage across southern Israel, through some of the same areas where Palestinians fled from their villages 75 years earlier. Palestinian gunmen killed some 1.200 people that day, mostly civilians, and took another 250 hostage.

Israel responded with one of the heaviest military onslaughts in recent history, obliterating entire neighborhoods in Gaza and forcing some 80% of the population to flee their homes.

Gaza's Health Ministry says over 35,000 Palestinians have been killed, without distinguishing between civilians and combatants in its count. The UN says there is widespread hunger and that northern Gaza is in a “full-blown famine.”

Israel says its goal is to dismantle Hamas and return the estimated 100 hostages, and the remains of more than 30 others, still held by the group after it released most of the rest during a ceasefire last year.

Israeli troops pushed into Rafah last week. Prime Minister Benjamin Netanyahu has portrayed the city on Gaza's southern border with Egypt as Hamas' last stronghold, promising victory.

But the militants have regrouped elsewhere in Gaza, even in some of the hardest-hit areas, raising the prospect of a prolonged insurgency.

The fighting in Rafah has made the nearby Kerem Shalom crossing — Gaza's main cargo terminal — mostly inaccessible from the Palestinian side. Israel's capture of the Gaza side of the Rafah crossing with Egypt has forced it to shut down and sparked a crisis of relations with the Arab country. Aid groups says the loss of the two crossings has crippled efforts to provide humanitarian aid as needs mount.

In a statement on Tuesday, Egyptian Foreign Minister Sameh Shoukry accused Israel “distorting the facts” and condemned its “desperate attempts” to blame Egypt for the continued closure of the crossing. Egyptian officials have said the Rafah operation threatens the two countries’ decades-old peace treaty.

Shoukry was responding to remarks by Israeli Foreign Minister Israel Katz, who said there was a “need to persuade Egypt to reopen the Rafah crossing to allow the continued delivery of international humanitarian aid to Gaza.”

Egypt has played a key role in months of mediation efforts aimed at brokering a ceasefire between Israel and Hamas and the release of hostages. The latest round of talks ended last week without a breakthrough.



New Mpox Strain Is Changing Fast; African Scientists Are ‘Working Blind’ to Respond 

Dr. Robert Musole, medical director of the Kavumu hospital (R) consults an infant suffering from a severe form of mpox at the Kavumu hospital, 30 km north of Bukavu in eastern Democratic Republic of Congo, August 24, 2024. (AFP)
Dr. Robert Musole, medical director of the Kavumu hospital (R) consults an infant suffering from a severe form of mpox at the Kavumu hospital, 30 km north of Bukavu in eastern Democratic Republic of Congo, August 24, 2024. (AFP)
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New Mpox Strain Is Changing Fast; African Scientists Are ‘Working Blind’ to Respond 

Dr. Robert Musole, medical director of the Kavumu hospital (R) consults an infant suffering from a severe form of mpox at the Kavumu hospital, 30 km north of Bukavu in eastern Democratic Republic of Congo, August 24, 2024. (AFP)
Dr. Robert Musole, medical director of the Kavumu hospital (R) consults an infant suffering from a severe form of mpox at the Kavumu hospital, 30 km north of Bukavu in eastern Democratic Republic of Congo, August 24, 2024. (AFP)

Scientists studying the new mpox strain that has spread out of Democratic Republic of Congo say the virus is changing faster than expected, and often in areas where experts lack the funding and equipment to properly track it.

That means there are numerous unknowns about the virus itself, its severity and how it is transmitting, complicating the response, half a dozen scientists in Africa, Europe and the United States told Reuters.

Mpox, formerly known as monkeypox, has been a public health problem in parts of Africa since 1970, but received little global attention until it surged internationally in 2022, prompting the World Health Organization to declare a global health emergency. That declaration ended 10 months later.

A new strain of the virus, known as clade Ib, has the world's attention again after the WHO declared a new health emergency.

The strain is a mutated version of clade I, a form of mpox spread by contact with infected animals that has been endemic in Congo for decades. Mpox typically causes flu-like symptoms and pus-filled lesions and can kill.

Congo has had more than 18,000 suspected clade I and clade Ib mpox cases and 615 deaths this year, according to the WHO. There have also been 222 confirmed clade Ib cases in four African countries in the last month, plus a case each in Sweden and Thailand in people with a travel history in Africa.

"I worry that in Africa, we are working blindly," said Dr. Dimie Ogoina, an infectious diseases expert at Niger Delta University Hospital in Nigeria who chairs the WHO's mpox emergency committee. He first raised the alarm about potential sexual transmission of mpox in 2017, now an accepted route of spread for the virus.

"We don’t understand our outbreak very well, and if we don't understand our outbreak very well, we will have difficulty addressing the problem in terms of transmission dynamics, the severity of the disease, risk factors of the disease," Ogoina said. "And I worry about the fact that the virus seems to be mutating and producing new strains."

He said it took clade IIb in Nigeria five years or more to evolve enough for sustained spread among humans, sparking the 2022 global outbreak. Clade Ib has done the same thing in less than a year.

MUTATING 'MORE RAPIDLY'

Mpox is an orthopoxvirus, from the family that causes smallpox. Population-wide protection from a global smallpox vaccine campaign 50 years ago has waned, as the vaccinating stopped when the disease was eradicated.

Genetic sequencing of clade Ib infections, which the WHO estimates emerged mid-September 2023, show they carry a mutation known as APOBEC3, a signature of adaptation in humans.

The virus that causes mpox has typically been fairly stable and slow to mutate, but APOBEC-driven mutations can accelerate viral evolution, said Dr. Miguel Paredes, who is studying the evolution of mpox and other viruses at Fred Hutchison Cancer Center in Seattle.

"All the human-to-human cases of mpox have this APOBEC signature of mutations, which means that it's mutating a little bit more rapidly than we would expect," he said.

Paredes and other scientists said a response was complicated by several mpox outbreaks happening at once.

In the past, mpox was predominantly acquired through human contact with infected animals. That is still driving a rise in Congo in clade I cases – also known as clade Ia - likely due in part to deforestation and increased consumption of bushmeat, scientists said.

The mutated versions, clade Ib and IIb, can now essentially be considered a sexually transmitted disease, said Dr. Salim Abdool Karim, a South African epidemiologist and chair of the Africa CDC’s mpox advisory committee. Most of the mutated clade Ib cases are among adults, driven at first by an epidemic among female sex workers in South Kivu, Congo.

The virus also can spread through close contact with an infected person, which is likely how clusters of children have been infected with clade Ib, particularly in Burundi and in eastern Congo’s displacement camps, where crowded living conditions may be contributing.

Children, pregnant women and people with weakened immune systems or other illnesses may be at greater risk of serious mpox disease and death, say the WHO and mpox scientists.

Clade I has typically caused more severe disease, with fatality rates of 4%-11%, compared to around 1% for clade II. Ogoina said data from Congo suggests few have died of the new Ib version, but he feared some data is being mixed up.

More research is urgently needed, but three teams tracking mpox outbreaks in Africa say they cannot even access chemicals needed for diagnostic tests. Clade Ib can also be missed by some diagnostic tests.

Planning a response, including vaccination strategies, without this is difficult, the scientists said.

Karim said around half of cases in eastern Congo, where Ib is particularly prevalent, are only being diagnosed by doctors, with no laboratory confirmation.

Getting samples to labs is difficult because the healthcare system is already under pressure, he said. And around 750,000 people have been displaced amid fighting between the M23 rebel group and the government.

Many African laboratories cannot get the supplies they need, said Dr. Emmanuel Nakoune, an mpox expert at the Institut Pasteur in Bangui, Central African Republic, which also has clade Ia cases.

"This is not a luxury," he said, but necessary to track deadly outbreaks.