For Children of Gaza, War Means No School, No Indication When Formal Learning Might Return 

A Palestinian child plays next to empty ammunition containers in Khan Younis in the southern Gaza Strip on May 16, 2024, amid the ongoing conflict between Israel and Hamas. (AFP)
A Palestinian child plays next to empty ammunition containers in Khan Younis in the southern Gaza Strip on May 16, 2024, amid the ongoing conflict between Israel and Hamas. (AFP)
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For Children of Gaza, War Means No School, No Indication When Formal Learning Might Return 

A Palestinian child plays next to empty ammunition containers in Khan Younis in the southern Gaza Strip on May 16, 2024, amid the ongoing conflict between Israel and Hamas. (AFP)
A Palestinian child plays next to empty ammunition containers in Khan Younis in the southern Gaza Strip on May 16, 2024, amid the ongoing conflict between Israel and Hamas. (AFP)

Atef Al-Buhaisi, 6, once dreamed of a career building houses. Now, all he craves is to return to school.

In Israel's war with Hamas, Atef's home has been bombed, his teacher killed and his school in Nuseirat turned into a refuge for displaced people. He lives in a cramped tent with his family in Deir al-Balah in central Gaza, where he sleeps clinging to his grandmother and fears walking alone even during the day.

Since the war erupted Oct. 7, all of Gaza's schools have closed — leaving hundreds of thousands of students like Atef without formal schooling or a safe place to spend their days. Aid groups are scrambling to keep children off the streets and their minds focused on something other than the war, as heavy fighting continues across the enclave and has expanded into the southern city of Rafah and intensified in the north.

"What we’ve lost most is the future of our children and their education," said Irada Ismael, Atef’s grandmother. "Houses and walls are rebuilt, money can be earned again ... but how do I compensate for (his) education?"

Gaza faces a humanitarian crisis, with the head of the UN's World Food Program determining a "full-blown famine" is already underway in the north.

More than 35,000 Palestinians have been killed in the war, according to the Gaza Health Ministry, which does not distinguish between civilians and combatants in its figures. About 80% of Gaza’s population has been driven from homes. Much of Gaza is damaged or destroyed, including nearly 90% of school buildings, according to aid group estimates.

Children are among the most severely affected, with the UN estimating some 19,000 children have been orphaned and nearly a third under the age of 2 face acute malnutrition. In emergencies, education takes a back seat to safety, health and sanitation, say education experts, but the consequences are lasting.

"The immediate focus during conflict isn’t on education, but the disruption has an incredibly long-term effect," said Sonia Ben Jaafar, of the Abdulla Al Ghurair Foundation, a philanthropic organization focused on education in the Arab world. "The cost at this point is immeasurable."

Before the war, Gaza was home to more than 625,000 students and some 20,000 teachers in its highly literate population, according to the UN In other conflicts, aid groups can create safe spaces for children in neighboring countries — for example, Poland for shelter and schooling during the war in Ukraine.

That's not possible in Gaza, a densely populated enclave locked between the sea, Israel and Egypt. Since Oct 7, Palestinians from Gaza haven't been allowed to cross into Israel. Egypt has let a small number of Palestinians leave.

"They’re unable to flee, and they remain in an area that continues to be battered," said Tess Ingram, of UNICEF. "It’s very hard to provide them with certain services, such as mental health and psychosocial support or consistent education and learning."

Aid groups hope classes will resume by September. But even if a cease-fire is brokered, much of Gaza must be cleared of mines, and rebuilding schools could take years.

In the interim, aid groups are providing recreational activities — games, drawing, drama, art — not for a curriculum-based education but to keep children engaged and in a routine, in an effort for normalcy. Even then, advocates say, attention often turns to the war — Atef's grandmother sees him draw pictures only of tents, planes and missiles.

Finding free space is among the biggest challenges. Some volunteers use the outdoors, make do inside tents where people live, or find a room in homes still standing.

It took volunteer teachers more than two months to clear one room in a school in Deir al-Balah to give ad hoc classes to children. Getting simple supplies such as soccer balls and stationery into Gaza can also take months, groups report.

"Having safe spaces for children to gather to play and learn is an important step," Ingram said, but "ultimately the children of Gaza must be able to return to learning curriculum from teachers in classrooms, with education materials and all the other support schooling provides."

This month, UNICEF had planned to erect at least 50 tents for some 6,000 children from preschool to grade 12 for play-based numbers and literacy learning in Rafah. But UNICEF says those plans could be disrupted by Israel's operation there.

Lack of schooling can take a psychological toll — it disrupts daily life and, compounded with conflict, makes children more prone to anxiety and nervousness, said Jesus Miguel Perez Cazorla, a mental health expert with the International Committee of the Red Cross.

Children in conflicts are also at increased risk of forced labor, sexual violence, trafficking and recruitment by gangs and armed groups, experts warn.

"Not only are children vulnerable to recruitment by Hamas and other militant groups, but living amid ongoing violence and constantly losing family members makes children psychologically primed to want to take action against the groups they consider responsible," said Samantha Nutt of War Child USA, which supports children and families in war zones.

Palestinians say they've seen more children take to Gaza's streets since the war, trying to earn money for their families.

"The streets are full of children selling very simple things, such as chocolate, canned goods," said Lama Nidal Alzaanin, 18, who was in her last year of high school and looking forward to university when the war broke out. "There is nothing for them to do."

Some parents try to find small ways to teach their children, scrounging for notebooks and pens and insisting they learn something as small as a new word each day. But many find the kids are too distracted, with the world around them at war.

Sabreen al-Khatib, a mother whose family was displaced to Deir al-Balah from Gaza City, said it's particularly hard for the many who've seen relatives die.

"When you speak in front of children," al-Khatib said, "what do you think he is thinking? Will he think about education? Or about himself, how will he die?"

On Oct. 7, 14-year-old Layan Nidal Alzaanin — Lama's younger sister — was on her way to her middle school in Beit Hanoun when missiles flew overhead, she said. She fled with her family to Rafah, where they lived crowded in a tent. Since Israel ordered evacuations there, she fled to Deir al-Balah.

"It is a disaster," she said. "My dreams have been shattered. There is no future for me without school."



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.