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Gaza patients in limbo after Palestinian Authority halts coordination with Israel

The impasse over threatened annexation has left Palestinians in the besieged enclave trapped without access to life-saving medical care
Palestinian children suffering from cancer receive treatment at a hospital in Gaza City on 13 February 2018. With the Palestinian territory’s medical sector heavily strained, for many patients, treatment in Israel, East Jerusalem or the West Bank has been a veritable lifeline over the years (AFP)
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Gaza City, Gaza

For the past month, 14-year-old Roaa Hamdan has been waiting to be granted a permit to leave the besieged Gaza Strip and receive treatment at Tel Hashomer hospital in Tel Aviv.

Diagnosed with Hodgkin’s lymphoma, Roaa’s health deteriorates each day as Gaza hospitals remain unable to provide her with the medical treatment she urgently needs.

'I am in constant pain watching my daughter dying in front of my eyes while I cannot do anything to help her'

- Maher Hamdan, father of cancer patient

But since the Palestinian Authority (PA) suspended its coordination with Israel a month ago, the young girl and countless others have been left in limbo.

Following PA President Mahmoud Abbas’s announcement on 19 May to end all agreements and understandings with Israel and the United States as a result of Israel's plans to annex more than 30 percent of the occupied West Bank, the work of the Palestinian Civil Affairs Committee (PCAC) was halted, effectively freezing the process granting exit permits to patients from the Gaza Strip.

“I am in constant pain watching my daughter dying in front of my eyes while I cannot do anything to help her,” Roaa’s father, Maher Hamdan, told Middle East Eye.

Patients, their relatives and humanitarian organisations have urged for a resolution to their plight, as they’ve found themselves victims of a diplomatic standoff that has already had deadly consequences.

‘No patient should experience this’

Hamdan said young Roaa was first diagnosed with cancer two years ago, and had since gone through 24 rounds of chemotherapy.

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“A few months ago, she completed her treatment and the tumours disappeared. She was very happy that she could finally be as healthy as her friends again,” he recalled.

“But not long after that, about two months ago, we learned that the tumour had returned. Her doctor told me that her health situation is critical, and that we might lose her if she does not receive urgent chemotherapy courses that are not available in Gaza hospitals.”

The suspension of exit permits has already been accused of causing the death of eight-month-old Omar Yaghi on Thursday.

According to a statement by Physicians for Human Rights - Israel (PHRI), Omar suffered from a cardiac condition and had initially been scheduled to be operated on at the Sheba Medical Centre in Israel on 24 May.

But his access to medical care was delayed after the Palestinian Civil Affairs Committee refused to transfer the Yaghi family’s permit application to the Israeli District Coordination Office at the Erez Crossing.

Gaza’s healthcare system has long been on the verge of collapse, suffering from shortages of drugs and materiel under 13 years of an Israeli-led blockade, and strained medical facilities following several wars and a violently repressed protest movement.

According to the Euro-Mediterranean Human Rights Monitor (Euro-Med Monitor), cancer drugs are in drastically limited supply, with shortfalls of required supplies soaring from 16 percent in 2005 to 60 percent by the beginning of 2020.

Hamdan, who works as a tailor, is a father of eight children and says that he can barely secure his family’s basic needs. But since his daughter has been unable to undergo a medical examination subsidised by the PA in Israel, he has had to pay 750 Israeli shekels ($216) so that his daughter could have a scan in a Gaza medical centre - a hefty sum in the small Palestinian territory, where the World Bank estimated the monthly income per capita to stand at $152 in 2018.

Hamdan says Roaa still needs to have a positron emission tomography (PET) scan, which is only available in Israel or West Bank hospitals.

“I honestly am hopeless. I feel that I have aged twenty years in the past two years. No cancer patient nor their families should experience this, they are already suffering enough,” he continued. 

No access to West Bank

According to the World Health Organisation (WHO), some 1,750 patients applied for exit permits  - mandatory for any Palestinian attempting to leave Gaza through Israel via the Erez crossing - each month from Gaza. The number has dropped drastically due to the coronavirus pandemic and the subsequent suspension of coordination between the PA and Israel.

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A Ramallah-based employee of the PA Ministry of Health, who requested anonymity, told MEE that the PA only halted financial subsidies for Palestinian patients receiving treatment in Israeli hospitals, but was still covering medical expenses for Gaza and West Bank patients receiving treatment in Palestinian hospitals in the West Bank.

The suspension of exit permits, however, has also jeopardised Gaza patients’ access to West Bank medical facilities, as they must travel through Israel to access the rest of the occupied territories.

“The suspension of coordination has not only affected those receiving medical treatment in Israeli hospitals, but even put Gaza patients who receive treatment in Palestinian hospitals in the West Bank in a dilemma,” he said.

“There are patients from Gaza who are currently stuck in the West Bank as Israeli authorities refuse to allow them into Gaza after their treatment because PA authorities have not coordinated for their return.”

Palestinian news outlets have reported that Israeli hospitals have also been refusing to provide further treatment to patients from the West Bank, occupied East Jerusalem and the Gaza Strip since the PA has stopped paying for such procedures and filing requests of medical treatment.

“We are on the brink of medical chaos,” PHRI warned in a press release on 10 June. “Right now, hundreds are affected. Thousands will be affected soon.”

The Jaffa-based organisation said it had set up an “alternative coordination mechanism” for humanitarian and medical travel permits since late May, but maintained that it held “the Israeli occupation fully responsible for the lives of Palestinian patients in the Gaza Strip who are in dire need for medical treatment abroad”.

PHRI had been coordinating the exit permit for young Omar Yaghi, successfully obtaining permits for him to be operated on 21 June. The infant died only three days before the scheduled operation.

“As an occupying power, Israel is responsible for the wellbeing of the civilian population of the Gaza Strip and the occupied territories under international law,” Muhammed Emad, a legal adviser for Euro-Med Monitor, told MEE.

“No matter what the circumstances are, Israeli authorities must at least find an alternative to allow patients in the blockaded Gaza Strip to receive medical treatment in the Palestinian hospitals in the West Bank.”

Fearing death

With no solution in sight, patients from Gaza have been fearing the worst.

Um Mohammed Youssef, a 67-year-old cancer survivor, says that she is afraid that her tumour will return while she is unable to undergo her regular medical examination at the Augusta Victoria Hospital in East Jerusalem.

“Since I was first diagnosed with cancer over 16 months ago, I have been through many difficulties where Israeli authorities made things even harder on me,” she told MEE. “For example, they have denied all my children permits to accompany me during my previous visits, which resulted in many delays for appointments.

“But now, I am afraid that I will not even be able to obtain my own exit permit, and that might lead to many bad consequences on my health.”

Roaa, 14, has been battling Hodgkin’s lymphoma for the past two years, but is now unable to receive further treatment (Supplied)
Roaa, 14, has been battling Hodgkin’s lymphoma for the past two years, but is now unable to receive further treatment (Supplied)

The suspension of Israeli-issued exit permits has only worsened his daughter’s psychological state, Hamdan added.

“Roaa already feels very stressed out about chemotherapy, she regularly needs psychological support, and the current situation is even adding more pressure on her.”

The Palestinian father denounced how patients were being held hostage by the political situation.

“They should not be party to political disputes. This is a humanitarian cause, Israel must at least grant patients exit permits as soon as possible to allow them to receive medical treatment in the West Bank,” he said.

“Roaa stopped attending school two years ago due to her severe illness and constant pain,” Hamdan added. “We were hoping that she would be able to go back to school next year, but as long as the situation remains the same, I am not even sure that she will be alive then.”

Youssef said that the worst part of the current crisis was the separation of patients, now stuck alone in Israel or in the occupied territories, from their families in the Gaza Strip.

“A relative of mine with leukaemia has reached a point where her body no longer responds to treatment. She is currently in a West Bank hospital and cannot come back to Gaza due to the lack of coordination,” she said.

“I call her every couple of days, and every time I speak to her she cries and tells me that she just wishes to come back home so that she would die among her family.”