The Palestinian Centre for Human Rights (PCHR) warns of the catastrophic consequences amid the ongoing closure of Gaza Strip crossings that has prevented the travel of urgent and lifesaving cases of patients and persons wounded during Israeli Occupying Forces' (IOF) escalating war across the Gaza Strip. IOF control and closure of Rafah crossing, the only outlet for the sick and wounded from the Strip, constitutes the latest episode in Israel's series of blatant violations that crystalizes Israel's persistent commission of genocide against the people of the Gaza Strip. Those who have not been killed by the Israel’s war machine are not spared by the complete Israeli siege and closure on Gaza, leaving thousands of wounded and sick doomed to certain death, especially after the deliberate destruction and collapse of the healthcare system and the weakening of its remaining lifesaving resources.
PCHR believes that Israel has created catastrophic conditions on the ground and an inhumane and deadly environment for Gaza's patients. There are no equipped hospitals left to receive them after most have been destroyed, and the remaining ones lack medicines, and medical supplies and equipment due to their restricted entry into the Strip. Additionally, starvation is used as a weapon of war to gain military advantage, including depriving Gaza population of healthy types of food and restricting the entry of hygiene and disinfecting supplies throughout the entire Strip, particularly Gaza City and North Gaza. As a result, the people and patients of the Gaza Strip live in a contaminated environment that has become a looming threat to their lives, with fears of a polio outbreak in Gaza.
Through their control of the Rafah crossing, the IOF persist in their atrocious violations and genocidal acts by deliberately inflicting severe bodily harm and material damage on Gaza's patients. Despite the staggering toll of civilian casualties, with around 39,000 reportedly killed and about 90,000 wounded, and the devastating collapse and failure of the healthcare system to provide health services, Israel:
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Insists on denying around 14,000 sick and injured as a result of the war, whose conditions are deemed extremely critical and for whom no treatment is available inside Gaza, according to the Health Cluster in Palestine. The number of cases with referrals for treatment abroad stands at 5867, while 8,010 cases are still waiting for referrals for treatment outside the Strip; 57% are females and 43% are males, with children and the elderly making up about 43% of the total cases. Among these are 4,454 critically ill patients suffering from heart diseases, eye conditions and diseases, and gastrointestinal diseases; around 4,500 wounded from the war; 4,380 cancer patients; and 620 patients with kidney failure.
Abdullah Mo’een ‘Ata Al-Ghandour's father, stated to PCHR’s researchers that his son is in critical condition after his left leg had been amputated, but his condition worsened after Israeli soldiers attacked him while he was at Al-Shifa Hospital in March 2024 and again during a second invasion on Al-Maamadani Hospital, smashing his right foot bones. He added:
“My 28-year-old son Abdullah, married with a daughter, sustained an injury at the end of February 2024 in an Israeli airstrike and was taken to Al-Shifa Hospital for treatment where the doctors amputated his left leg and had a platinum implant in his right leg due to severe bone laceration. During his treatment and stay at the hospital, IOF stormed the hospital in March 2024, assaulted him, stomped on his right foot, and shot it at close range, leaving him to bleed until they withdrew from the hospital. His family transferred him to Al-Maamadani Hospital in central Gaza to stop the bleeding. While there, the Israeli army stormed the hospital, forcibly patients, including my son, out after assaulting him once more. Currently, my son is in the Al-Zaytoun neighborhood in eastern Gaza, and we have been unable to evacuate him abroad because he is awaiting approval for a referral for treatment abroad to have a joint replacement in his right foot. However, the closure of the crossings deprives him of his right to travel abroad for treatment, effectively sentencing him to death in besieged areas without any medical treatment for the wounded."
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As of the first week of July 2024, it was reported that 436 cancer patients had died after being denied treatment abroad[1] because hospitals failed to provide them even the minimum healthcare services. Meanwhile, it is believed that hundreds of patients suffering from various diseases have died silently, with no statistics available in this regard due to disruptions in official medical monitoring and documentation systems. These patients could not access healthcare facilities and hospitals, especially in the besieged areas of Gaza City and north Gaza.
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Due to the Israeli ongoing genocide and systematic targeting of health facilities and medical personnel, in violation of the International Humanitarian Law (IHL) which ensures respect and protection of the medical personnel assigned to medical duties in all circumstances, many doctors had to evacuate the Gaza Strip due to the attacks on healthcare system and health professionals. At least 50 specialist doctors have been killed since Israel launched its offensive on the Gaza Strip in October 2023, among those doctors were 2 out of five pathologists in Gaza, noting that this specialty is crucial for the diagnosis and treatment of cancer patients. All of this has contributed to a much lower chance of survival for hundreds of patients and the wounded because of the killing and forced displacement of health professionals, who could have been performing surgeries now to save the lives of hundreds of patients and the wounded.
According to the World Health Organization (WHO) estimates, 10,000 patients need medical evacuation outside the Gaza Strip for specialized care, including 750 children with cancer and other serious diseases and around 2000 female patients with different diseases in dire need of immediate evacuation abroad for their treatment in addition to thousands of persons injured by the ongoing Israeli aggression. These patients wait impatiently for their names to appear on the med-evacuation lists; however, the ongoing closure of the crossing has dashed their hopes of receiving their lifesaving treatment
According to a report previously published by PCHR, only 4,895 patients were able to travel abroad for treatment before IOF's control over Rafah Crossing on 07 May 2024, while the total number of patients who applied to travel for treatment and in need of urgent surgeries unavailable at Gaza Strip's hospitals is 25,000. Before Israel's invasion into Rafah, 40 patients daily traveled, constituting only 3% of the total number of patients allowed to travel. The Israeli occupation authorities imposed abusive criteria for patients' travel requests; for example, they reject the requests for male patients at younger ages. It should be mentioned that also before Israel's taking over Rafah Crossing, the wounded and sick and other categories are allowed to travel only upon the Israeli authorities' approval.
PCHR's field researcher met with M. L., a 30-year-old patient, who has been displaced several times within the southern Gaza Strip, noting he is originally from Naser neighborhood in Gaza City. M. L. said that his health condition is rapidly deteriorating after several failed checks on his name on the travel lists despite obtaining a medical referral before the crossing was closed. He had been rejected several times for being at a young age. He added, "since last year, I have suffered from thyroid lymphoma and I underwent surgery to remove 10 lymph nodes, where cancer spread. At the time, doctors had to leave some of the lymph nodes near the brain due to their serious location. According to the doctors, I should have tests and checkup after 4 months, i.e. in October 2023. However, I could not do so because the war broke out and is still ongoing up to this moment. My checkup was delayed, and my health condition deteriorated; the left side of my neck got swollen again and I cannot move it out of severe pain. I have not received any medical treatment since IOF launched its aggression on Gaza, and I feel it has become too late to save my life from the cancer spread. I did all the procedures needed to obtain a medical referral, which was issued on 30 December 2023. However, so far I have not been able to travel."
Israel continues its aggression on the Gaza Strip for the 10th month consecutively amid failed efforts to forge a ceasefire in light of no pressure and restraints imposed on Israel that has always enjoyed a long history of impunity, rendering it a state above the international law. Israel's disregard for international law materializes through its explicit defiance of ICJ's ruling issued on 28 January that order Israel to take all reasonable measures within its power to prevent the commission of all genocidal acts as well as Israel's ability to ignore ICJ's latest advisory opinion affirming that Israel is not entitled to sovereignty over any part of the Occupied Palestinian Territory on account of its security concerns; however, Israel violates this advisory opinion daily by their persistent control and closure of Rafah Crossing.
Thus, PCHR calls upon the international community, especially the members of the United Nations (UN) Security Council, to take immediate and concrete steps to exert pressure on Israel through issuing an abiding decision according to Chapter VII of the UN Charter to open safe corridors for the medical evacuation of the sick and wounded during the war so they can access their lifesaving treatment, particularly the sick and wounded trapped in the remaining hospitals in Gaza City and north Gaza.
PCHR welcomes any efforts exerted towards the evacuation of patients like the medical evacuation of sick children last June for treatment in other countries. Meanwhile, PCHR warns against any partial steps taken to allow only limited categories of the sick and wounded to travel and deprive most categories. This collective punishment policy had been adopted by Israel against the population of the Gaza Strip through imposing unjust criteria that violate the Fourth Geneva Convention and deprive patients of their right to movement and travel to receive medical treatment and save their lives as well as depriving the Gaza Strip population of their right to freedom of movement guaranteed by all international laws.
PCHR 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. PCHR also calls on the High Contracting Parties to exert pressure on Israel and ensure its compliance with all international conventions and norms, particularly the four Geneva conventions, ICJ's three provisional measures orders, and UN Security Council Resolutions demanding an immediate ceasefire and protection of civilians, including the sick and wounded.
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[1] Information obtained by PCHR’s researchers from Dr. Subhi Sakik, General Director of the Turkish-Palestinian Friendship Hospital for Cancer.