Mahmoud
in his home in Gaza City

Mahmoud
KhaderGaafar (24) lives with his wife Majd (23) and their one-year-old daughter
Maryam in his parents’ house in Gaza City. On 2 August 2008, Mahmoud was caught
in an internal dispute, during which he sustained severe injuries to his legs.
Due to the severity of the injuries and the lack of appropriate facilities in
Gaza, the Ministry of Health in Gaza requested his referral for medical
treatment in Israel.

The
Israeli authorities rejected this petition on the basis of alleged‘security
concerns,’ and Mahmoud had to undergo emergency surgery in Al Shifa Hospital in
Gaza City, which led to the amputation of his left leg. As his mother, Zeinab
(64), points out: “he could have saved his leg if they had granted him
permission to go to the hospital in Tel Aviv.”

Finally,
following an appeal to the Israeli courts, the Israeli authorities approved the
transfer of Mahmoud to the Ekholov Hospital in Tel Avivon 14 August 2008, mere
days after receiving the emergency treatment in Gaza. He was hospitalised there
in the Intensive Care Unit for 3 months before returning to Gaza. During this
time, he received medical treatment for his amputated left leg and a severe
fracture in his right leg.

On
11 August 2009, Mahmoud was granted permission to travel to a hospital in
Jerusalem, where he could receive further medical treatment for his right leg.
After receiving this treatment, he travelled to the West Bank to arrange for an
orthopaedic left leg, which would make it easier for him to move around, and
significantly improve the quality of his life: “The Ministry of Health usually
covers 80% of the orthopaedic leg’s cost, but after talking to them in Ramallah
they offered me 100% coverage. After solving the financial issue, I travelled
to Bethlehem where a medical association started taking the measurements needed
to build my orthopaedic leg. They said they would have it ready within one
week.”

On
14 December 2009, while Mahmoud was travelling between Ramallah and Bethlehem
for medical treatment, Israeli soldiers stopped and detained himovernight. The
next morning they immediately transferred him to the Gaza Strip, again on the
basis of alleged security concerns, despite the fact that
he had been outside of the Gaza Strip for the past 4 months.He has since been
unable to return to Bethlehem for medical care.

As
he points out: “I was there to receive medical treatment, not for touristic
activities. It is impossible for me to get an orthopaedic leg in Gaza, because
my amputation was performed too close to the hip and this treatment is not
available here. Although orthopaedic services are offered in Egypt, the
orthopaedic legs provided there are too heavy to allow for any movement.” As a
result, he barely leaves his home, and, whenever he does, he moves with the
help of a wheel chair. As Mahmoud says: “With an orthopaedic leg my life would
be totally different.Now, I just spent my time sitting here doing nothing.”

That
was the last time that Mahmoud was permitted to travel to the West Bank:
“Despite the fact that the Ministry of Health in Gaza has on different
occasions requested my medical referral to Bethlehem so that the measurements
needed to build and assemble the orthopaedic leg can be finished, Israel has
systematically refused to authorise the trip.” Mahmoud was turned away at the
Erez crossing, despite having the appropriate permits on 8 March and 8 April
2010.  Since then, all his applications
requesting access to medical facilities in the West Bank have been denied by
Israel, including a request to the Liaison Office on 5 December 2010.

After
this rejection in December 2010, Mahmoud approached PCHR for assistance.  On 19 January 2011, PCHR sent a letter to the
humanitarian center at the Erez crossing requesting that he be allowed to
travel for medical treatment.  This
request was rejected on 17 March 2011.

A
further request was submitted by PCHR to the Israeli Public Prosecution in
Jerusalem on 28 March 2011.  On 13 April
2011, this was also rejected, again on the basis of alleged ‘security
considerations’, therebyeffectively exhausting his legal remedies, despite the
best efforts of PCHR.“Why do they [the Israelis] not allow me to go to the West
Bank? What am I doing to them? I just want to get the treatment I need to have
a life. They have granted me access before, so why are they preventing me from
going back to the West Bank again?”

In
April 2012, Israeli authorities denied a total of 42 patients who required
medical treatment currently unavailable in the Gaza Strip access to hospitals
in the West Bank and Israel. Of these 42 patient applications, 8 were rejected
alleging security concerns, 7 were forced to delay their hospital appointments,
5 patients were requested to change their travelling/care companions and 5 were
prevented from leaving Gaza on arrival at the Erez crossing point, despite
having a valid permit to travel.There are still 17 pending applications.

The
International Covenant of Economic Social and Cultural Rights recognises the
“right of everyone to the enjoyment of the highest attainable standard of
health.” In addition to the obligations contained in the Covenant, Israel, as
an occupying power, also has obligations under international humanitarian law.  Article 56 of the Fourth Geneva Convention
requires Israel to ensure and maintain the health of the occupied population.

By
imposing a closure on the Gaza Strip, Israel is continuing to prevent adequate
medical treatment for patients. The closure constitutes a form of collective
punishment against a civilian population living under occupation, in
contravention of Article 33 ofthe Fourth Geneva Convention.