The Palestinian Centre for Human Rights (PCHR) denounces denial of thousands of sick and wounded Palestinians’ right to travel for treatment outside the Gaza Strip.  PCHR emphasizes that banning critical patients from immediate travel would lead to a slow and painful death given the plight they had to go through in the hallways of the already decimated healthcare facilities due to the ongoing genocidal campaign on the Gaza Strip, as many lives could have been saved if allowed travel and access to timely treatment. 

One year after the aggression on the Gaza Strip, PCHR reiterates its call on the international community to exert real pressure on Israel to open safe corridors to evacuate Gaza Strip’s patients and allow them to travel freely for treatment, including freedom of movement to Palestinian hospitals in the West Bank and occupied Jerusalem.  

PCHR believes that Israel has mercilessly created a catastrophic humanitarian situation and deadly environment for patients in Gaza amid no hospitals equipped to receive them after most had been destroyed and their medical personnel had been killed and ill-treated.  Meanwhile, the remaining operational hospitals were crippled by lack of medicines and medical supplies and equipment due to the restricted flow of aid allowed into the Gaza Strip.  By this and as observed by PCHR, Israel has deliberately prevented the evacuation of patients abroad for treatment, entrenching its policy of collective punishment, which is prohibited under the Fourth Geneva Convention and constitutes a war crime under the Rome Statute of the International Criminal Court.

PCHR emphasizes that all these violations are inseparable from the crime of collective punishment committed by Israel against the population of the Gaza Strip.  According to the World Health Organization (WHO), around 14,000 patients and wounded Palestinians are denied travel for treatment, sentencing them to slow and painful death and deliberately causing bodily and mental harm to them by impeding their access to lifesaving services and depriving them of undergoing qualitative and specialized surgeries not available in the Gaza Strip’s hospitals.

With the beginning of the Israeli military aggression in October 2023, IOF have denied the travel of thousands of patients via Beit Hanoun “Erez” Crossing for treatment in the hospitals in the West Bank, including occupied Jerusalem, contributing to the deterioration of their health conditions. Meanwhile, only limited number of 4895 patients were allowed to travel via Rafah Border Crossing according to an Israeli-restricted mechanism before IOF took over the crossing and shut it down last May. _^[1]

Now, the Israeli occupying authorities impose a futile travel mechanism; by which, over the past five months only 216 patients were allowed to travel with 318 companions from their families to Arab countries like Emirates, Egypt and Jordan._^[2] This is a tiny, limited number compared with the sheer number of patients in need of treatment abroad, meaning that thousands of sick and wounded Palestinians daily lose the chance of their survival while waiting Israel’s slow and very limited approvals.  This mechanism forces patients to go through a prolonged and dangerous journey first within Gaza, then to Israel and finally to a third country and all of this is due to Israel’s refusal to allow patients to receive treatment at the hospitals in the West Bank and occupied Jerusalem.

Dr. Hani Al-Faleet, Head of the Pediatric Department at Al-Aqsa Martyrs Hospital, highlights the urgent need to refer critically sick children, whose treatment^[3] is not available at Gaza Strip hospitals, stating the following:

“In the Pediatric Department, we have cases of sick children in need of advanced medical services unavailable in the Gaza Strip even before the current Israeli aggression. Currently, there is an imminent threat to the children in the department, particularly those born with congenital heart defects. These children were previously referred to hospitals in the West Bank due to the lack of specialized surgeons in the Gaza Strip hospitals. Additionally, children with cancer and rheumatoid arthritis were referred for treatment abroad, as they need chemotherapy and biotherapy that are also unavailable in Gaza. As a result, many children died because their treatment or lifesaving surgeries for their condition were not available due to the lack of specialized doctors and limited resources caused by the collapse of Gaza hospitals’ operations. Thus, we are currently treating critical cases with the available medications until these children can be approved to travel for treatment abroad.”

The doctor’s words are explicitly reflected in the case of infant Mohammed Tayseer Diyab Na’eem. Mohammed was born with a congenital heart defect and is in an urgent need of treatment abroad and a surgery that cannot be performed at Gaza hospitals. Mohammed’s father talked about his son’s suffering to PCHR’s researcher^[4]:

“My 5-month-old son Mohammed was born with a hole in his heart (ventricular septal defect) and another hole in his lungs. He is in urgent need of travel to undergo several lifesaving surgeries. We have already obtained the medical referral, but we are still waiting for the Israeli authorities to approve his travel. My son’s health is deteriorating, and I always fear losing him before he is allowed to travel.”

Among these patients, there are about 10,000 cancer patients in need of medical evacuation outside the Gaza Strip, including 4,200 women and 750 children with cancer and other chronic diseases, with at least 200 cancer diagnoses surfacing monthly.^[5] As of the end of July 2024, 436 cancer patients were reportedly dead,^[6] while about 650 kidney patients out of 1,400 died after being unable to undergo dialysis or receive treatment abroad. Also, many patients have died silently, with no statistics available in this regard.^[7] Further, at least 2,000 patients with other diseases are awaiting their names to appear on patients’ lists to travel, in addition to thousands of others injured during the ongoing military aggression, including 5,000 in need of upper or lower limb prosthetics.^[8]“

Furthermore, the injured Sameh Saleh Sa’d (41), from al-Tuffah neighborhood in eastern Gaza City, said to PCHR’s researcher: ^[9]

“On 03 January 2024, I was injured with tank shell shrapnel when I was in my house in al-Sha’af area. I was then taken for treatment at al-Shifa Medical Complex, where doctors informed me that I needed surgeries on my left leg, which was hit by shrapnel and caused me bone laceration.  As a result, my left leg has become 15 centimeters shorter than my right leg. The doctors at the al-Shifa Medical Complex were unable to perform the surgery amid lack of resources, and I was then referred to several hospitals due to invasion threats and evacuation orders. I am still waiting for the approval on my travel for treatment abroad for bone grafting in my left leg.”

It is should be noted that IOF have conducted about 1000 military attacks on healthcare facilities across the Gaza Strip,^[10] forcing the remaining facilities to endure dire conditions, including power outage, an acute shortage of fuel needed for the operation of generators at hospitals, as well as lack of medicines, specialized medical and therapeutic equipment, and surgical instruments. Currently, only 17 out of 35 pre-war functional hospitals are partially operating, with bed occupancy averaging 439%.^[11] Additionally, IOF’s attacks have killed about 986 of the medical personnel, including 146 doctors and 260 nurses.^[12] Among the doctors killed were two out of five pathologists, whose specialization is essential for the diagnosis and treatment of cancer patients, in addition to 39 physiotherapists.^[13] Also, IOF arrested and tortured 310 healthcare workers in harsh conditions.^[14] 

After a year of the ongoing aggression and amid no real deterrent restraints, Israel continues to disregard the ruling of the International Court of Justice issued on 28 January 2024 ordering Israel to take all reasonable measures within its power to prevent the commission of all genocidal acts, PCHR stresses that time is decisive and essential to the evacuation and survival of patients; thus, given the current situation, it warns of the serious consequences on the realization of the right to health for the patients in the Gaza Strip in accordance with the principles of the international humanitarian law. 

In light of the above, PCHR:

• Calls for exerting pressure on Israel to reactivate the patients’ referral mechanism for treatment in the West Bank and occupied Jerusalem’s hospitals and allow them to travel freely via Beit Hanoun “Erez” crossing given their serious health conditions.
• Welcomes any further effort to enable patients to travel for treatment outside the Gaza Strip, but at the same time warns of Israel’s adopting the current slow mechanism; according to which, only limited number of patients and wounded persons are allowed to travel while a significantly higher number are denied.  This mechanism is part of Israel’s entrenched collective punishment policy that had been adopted against the Gaza Strip before the war through imposing unjust criteria, in violation of the Fourth Geneva Convention and depriving patients of their right to movement and travel to receive medical treatment and save their lives.
• reiterates its call upon the Special Rapporteur on the right to health and all international organizations, particularly WHO, to spare no efforts aiming at the end of suffering of thousands of Palestinian patients and wounded in a way that ensures their safe evacuation to receive immediate and urgent treatment.