Challenges of the Gaza Humanitarian Aid Pier Offer Lessons for the US Army

A truck carries humanitarian aid across Trident Pier, a temporary pier to deliver aid, off the Gaza Strip, amid the ongoing conflict between Israel and the Palestinian group Hamas, near the Gaza coast, May 19, 2024. US Army Central/Handout via REUTERS
A truck carries humanitarian aid across Trident Pier, a temporary pier to deliver aid, off the Gaza Strip, amid the ongoing conflict between Israel and the Palestinian group Hamas, near the Gaza coast, May 19, 2024. US Army Central/Handout via REUTERS
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Challenges of the Gaza Humanitarian Aid Pier Offer Lessons for the US Army

A truck carries humanitarian aid across Trident Pier, a temporary pier to deliver aid, off the Gaza Strip, amid the ongoing conflict between Israel and the Palestinian group Hamas, near the Gaza coast, May 19, 2024. US Army Central/Handout via REUTERS
A truck carries humanitarian aid across Trident Pier, a temporary pier to deliver aid, off the Gaza Strip, amid the ongoing conflict between Israel and the Palestinian group Hamas, near the Gaza coast, May 19, 2024. US Army Central/Handout via REUTERS

It was their most challenging mission.
US Army soldiers in the 7th Transportation Brigade had previously set up a pier during training and in exercises overseas but never had dealt with the wild combination of turbulent weather, security threats and sweeping personnel restrictions that surrounded the Gaza humanitarian aid project.
Designed as a temporary solution to get badly needed food and supplies to desperate Palestinians, the so-called Joint Logistics Over-the-Shore system, or JLOTS, faced a series of setbacks over the spring and summer. It managed to send more than 20 million tons of aid ashore for people in Gaza facing famine during the Israel-Hamas war.
Service members struggled with what Col. Sam Miller, who was commander during the project, called the biggest “organizational leadership challenge” he had ever experienced.
Speaking to The Associated Press after much of the unit returned home, Miller said the Army learned a number of lessons during the four-month mission. It began when President Joe Biden announced in his State of the Union speech in March that the pier would be built and lasted through July 17, when the Pentagon formally declared that the mission was over and the pier was being permanently dismantled.
The Army is reviewing the $230 million pier operation and what it learned from the experience. One of the takeaways, according to a senior Army official, is that the unit needs to train under more challenging conditions to be better prepared for bad weather and other security issues it faced. The official spoke on condition of anonymity because assessments of the pier project have not been publicly released.
In a report released this week, the inspector general for the US Agency for International Development said Biden ordered the pier's construction even as USAID staffers expressed concerns that it would be difficult and undercut a push to persuade Israel to open “more efficient” land crossings to get food into Gaza.
The Defense Department said the pier “achieved its goal of providing an additive means of delivering high volumes of humanitarian aid to the people of Gaza to help address the acute humanitarian crisis.” The US military knew from the outset “there would be challenges as part of this in this complex emergency,” the statement added.
The Biden administration had set a goal of the US sea route and pier providing food to feed 1.5 million people for 90 days. It fell short, bringing in enough to feed about 450,000 people for a month before shutting down, the USAID inspector general's report said.
The Defense Department’s watchdog also is doing an evaluation of the project.
Beefing up training Army soldiers often must conduct their exercises under difficult conditions designed to replicate war. Learning from the Gaza project — which was the first time the Army set up a pier in actual combat conditions — leaders say they need to find ways to make the training even more challenging.
One of the biggest difficulties of the Gaza pier mission was that no US troops could step ashore — a requirement set by Biden. Instead, US service members were scattered across a floating city of more than 20 ships and platforms miles offshore that had to have food, water, beds, medical care and communications.
Every day, said Miller, there were as many as 1,000 trips that troops and other personnel made from ship to boat to pier to port and back.
“We were moving personnel around the sea and up to the Trident pier on a constant basis,” Miller said. “And every day, there was probably about a thousand movements taking place, which is quite challenging, especially when you have sea conditions that you have to manage.”
Military leaders, he said, had to plan three or four days ahead to ensure they had everything they needed because the trip from the pier to their “safe haven” at Israel's port of Ashdod was about 30 nautical miles.
The trip over and back could take up to 12 hours, in part because the Army had to sail about 5 miles out to sea between Ashdod and the pier to stay a safe distance from shore as they passed Gaza City, Miller said.
Normally, Miller said, when the Army establishes a pier, the unit sets up a command onshore, making it much easier to store and access supplies and equipment or gather troops to lay out orders for the day.
Communication difficulties While his command headquarters was on the US military ship Roy P. Benavidez, Miller said he was constantly moving with his key aides to the various ships and the pier.
“I slept and ate on every platform out there,” he said.
The US Army official concurred that a lot of unexpected logistical issues came up that a pier operation may not usually include.
Because the ships had to use the Ashdod port and a number of civilian workers under terms of the mission, contracts had to be negotiated and written. Agreements had to be worked out so vessels could dock, and workers needed to be hired for tasks that troops couldn't do, including moving aid onto the shore.
Communications were a struggle.
“Some of our systems on the watercraft can be somewhat slower with bandwidth, and you’re not able to get up to the classified level,” Miller said.
He said he used a huge spreadsheet to keep track of all the ships and floating platforms, hundreds of personnel and the movement of millions of tons of aid from Cyprus to the Gaza shore.
When bad weather broke the pier apart, they had to set up ways to get the pieces moved to Ashdod and repaired. Over time, he said, they were able to hire more tugs to help move sections of the pier more quickly.
Some of the pier's biggest problems — including the initial reluctance of aid agencies to distribute supplies throughout Gaza and later safety concerns from the violence — may not apply in other operations where troops may be quickly setting up a pier to get military forces ashore for an assault or disaster response.
“There’s tons of training value and experience that every one of the soldiers, sailors and others got out of this,” Miller said. "There’s going to be other places in the world that may have similar things, but they won’t be as tough as the things that we just went through.”
When the time comes, he said, “we’re going to be much better at doing this type of thing.”
One bit of information could have given the military a better heads-up about the heavy seas that would routinely hammer the pier. Turns out, said the Army official, there was a Gaza surf club, and its headquarters was near where they built the pier.
That "may be an indicator that the waves there were big,” the official said.



Experts: Baby in Gaza Has Strain of Polio Linked to Mistakes in Eradication Campaign

The mother of Palestinian boy Abdul Rahman Abu Al-Jidyan, who is the first person to contract polio in Gaza in 25 years, gestures as she looks after him in their tent, in Deir Al-Balah, in the central Gaza Strip August 28, 2024. REUTERS/Ramadan Abed
The mother of Palestinian boy Abdul Rahman Abu Al-Jidyan, who is the first person to contract polio in Gaza in 25 years, gestures as she looks after him in their tent, in Deir Al-Balah, in the central Gaza Strip August 28, 2024. REUTERS/Ramadan Abed
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Experts: Baby in Gaza Has Strain of Polio Linked to Mistakes in Eradication Campaign

The mother of Palestinian boy Abdul Rahman Abu Al-Jidyan, who is the first person to contract polio in Gaza in 25 years, gestures as she looks after him in their tent, in Deir Al-Balah, in the central Gaza Strip August 28, 2024. REUTERS/Ramadan Abed
The mother of Palestinian boy Abdul Rahman Abu Al-Jidyan, who is the first person to contract polio in Gaza in 25 years, gestures as she looks after him in their tent, in Deir Al-Balah, in the central Gaza Strip August 28, 2024. REUTERS/Ramadan Abed

The baby in Gaza who was recently paralyzed by polio was infected with a mutated strain of the virus that vaccinated people shed in their waste, according to scientists who say the case is the result of “an unqualified failure” of public health policy.
The infection, which marked the first detection of polio in the war-torn Palestinian territory in more than 25 years, paralyzed the lower part of one leg in the unvaccinated 10-month-old child. The baby boy was one of hundreds of thousands of children who missed vaccinations because of the fighting between Israel and Hamas.
Scientists who have been monitoring polio outbreaks said the baby's illness showed the failures of a global effort by the World Health Organization and its partners to fix serious problems in their otherwise largely successful eradication campaign, which has nearly wiped out the highly infectious disease. Separately, a draft report by experts deemed the WHO effort a failure and “a severe setback.”
The polio strain in question evolved from a weakened virus that was originally part of an oral vaccine credited with preventing millions of children worldwide from being paralyzed. But that virus was removed from the vaccine in 2016 in hopes of preventing vaccine-derived outbreaks.
Public health authorities knew that decision would leave people unprotected against that particular strain, but they thought they had a plan to ward off and quickly contain any outbreaks. Instead, the move resulted in a surge of thousands of cases, The Associated Press reported.
“It was a really horrible strategy,” said Columbia University virologist Vincent Racaniello, who was not involved with the report or the WHO. “The decision to switch vaccines was based on an incorrect assumption, and the result is now we have more polio and more paralyzed children.”
A draft copy of the report commissioned by the WHO and independent experts said the plan underestimated the amount of the strain in the environment and overestimated how well officials would be able to squash outbreaks.
The plan led to vaccine-linked polio outbreaks in 43 countries that paralyzed more than 3,300 children, the report concluded.
Even before the Gaza case was detected, officials reviewing the initiative to tinker with the vaccine concluded that “the worst-case scenario has materialized,” the report said.
The report has not yet been published, and some changes will likely be made before the final version is released next month, the WHO said.
The strain that infected the baby in Gaza had lingered in the environment and mutated into a version capable of starting outbreaks. It was traced to polio viruses spreading last year in Egypt, according to genetic sequencing, the WHO said.
In 2022, vaccine-linked polio viruses were found to be spreading in Britain, Israel and the US, where an unvaccinated man was paralyzed in upstate New York.
Scientists now worry that the emergence of polio in a war zone with an under-immunized population could fuel further spread.
Racaniello said the failure to track polio carefully and to sufficiently protect children against the strain removed from the vaccine has had devastating consequences.
“Only about 1% of polio cases are symptomatic, so 99% of infections are silently spreading the disease,” he said.
The oral polio vaccine, which contains a weakened live virus, was withdrawn in the US in 2000. Doctors continued to vaccinate children and eventually moved to an injected vaccine, which uses a dead virus and does not come with the risk that polio will be present in human waste. Such waste-borne virus could mutate into a form that triggers outbreaks in unvaccinated people.
The report's authors faulted leaders at the WHO and its partners, saying they were unable or unwilling “to recognize the seriousness of the evolving problem and take corrective action.”
WHO spokesman Oliver Rosenbauer acknowledged that the vaccine strategy “exacerbated” the risk of epidemics linked to the vaccine.
He said in an email that immunization “was not implemented in such a way to rapidly stop outbreaks or to prevent new strains from emerging.” Rosenbauer said not hitting vaccination targets was the biggest risk for allowing vaccine-linked viruses to emerge.
“You need to reach the children with the vaccines ... regardless of which vaccines are used,” he said.
The WHO estimates that 95% of the population needs to be immunized against polio to stop outbreaks. The UN health agency said only about 90% of Gaza’s population was vaccinated earlier this year.
To try to stop polio in Gaza and the wider region, the WHO and its partners plan two rounds of vaccination campaigns later this week and next month, aiming to cover 640,000 children. Authorities will use a newer version of the oral polio vaccine that targets the problematic strain. The weakened live virus in the new vaccine is less likely to cause vaccine-derived outbreaks, but they are still possible.
Racaniello said it was “unethical” that the WHO and its partners were using a vaccine that is unlicensed in rich countries precisely because it can increase the risk of polio in unvaccinated children.
The oral polio vaccine, which has reduced infections globally by more than 99%, is easy to make and distribute. Children require just two drops per dose that can be administered by volunteers. The oral vaccine is better at stopping transmission than the injected version, and it is cheaper and easier to administer.
But as the number of polio cases caused by the wild virus have plummeted in recent years, health officials have been struggling to contain the increasing spread of vaccine-linked cases, which now comprise the majority of polio infections in more than a dozen countries, in addition to Afghanistan and Pakistan, where transmission of the wild virus has never been stopped.
“This is the result of the Faustian bargain we made when we decided to use" the oral polio vaccine, said Dr. Paul Offit, director of the Vaccine Education Center at the University of Philadelphia. “If we really want to eradicate polio, then we need to stop using the vaccine with live (weakened) virus.”