The Impact of the Conflict on Daily Life

Medical Treatment Abroad for Gaza Residents: Closures and Access

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World Health Organization
January 31, 2005

The Palestinian Authority purchases services from foreign institutions for the residents of Gaza Strip. Some services do not exist at all in the Gaza Strip, including: catheterization and cardiac surgery, burn treatments, paediatric cardiology, neurosurgery, orthodontic surgery, radiotherapy, all types of transplants, eye operations and various tests (such as MRI, bone and bone marrow tests, metabolical tests, etc.). In addition, there are many fields where although services exist in the Gaza Strip, they are performing at a level of specialization that is insufficient for managing the most complicated cases. There are virtually no subspecializations in the Gaza Strip in the fields of surgery, oncology, urology.

These services are purchased by the Palestinian Authority at full cost mainly from Egypt, Israel and Jordan. In 2003, the Palestinian Authority issued 7,805 certificates for referral to medical treatment outside the Gaza Strip in order to meet local medical needs.

Since 13th of December 2004, restriction of passage through Rafah and Erez crossing in Gaza strip has prevented most patients to reach health care facilities abroad, in order to receive specialized care not locally available.

Up to day, January 31st, the two borders are still closed. However, according to the Israeli authority (Directorate of Civil Liaison in Erez) and to the MoH liaison person with Israel, Rafah terminal will open tomorrow for Palestinians, with precedence given to patients.

Between 13th December 2004 and 30th January 2005, the number of patients that the MoH certified as in need of being referred to neighbouring countries for specialized care is 582. The destination of these patients, is as follows: 235 to Israel, 174 to East Jerusalem and West Bank (through Erez crossing); 318 to Egypt and 27 to Jordan (through Rafah crossing).

The type of health care needed by these patients is the following

• Cardiac surgery (134 patients)
• Radiotherapy for cancer (72 patients)
• Internal medicine diagnostic procedure (22 patients)
• Pediatric surgery for newborns with congenital malformation (78)
• Urological and nephrology specialized medical treatment, including treatment for renal failure (52 patients)
• Intensive care and burn units (21 patients)
• Neurosurgery (53)
• Ophthalmology diagnostic and treatment (70)
• Others (80)

Among these patients, 6 have been permitted to leave through Rafah crossing – on January 26 – as a result of an appeal to the Israeli High Court of Justice launched by the Israeli human right organization “Physicians for Human Rights”.

Further 45 patients were permitted to leave Gaza through Erez check point between December 13th and January 13th , all of them seeking radiotherapy treatment for cancer.

Since January14th, following extended closures in the Gaza Strip, the transit of patients through Erez check point has virtually stopped. During this period, the MoH has beennegotiating with the Israeli authority for the crossing of the patients in need, but so far only 10 patients have been allowed to pass.

As an effect of the closures, many Gaza residents have been trapped outside Gaza on their way back home. Among them, 877 patients who had previously left to be treated in Egypt and Jordan. Among these, 42 were children under 5 and 454 were women. The main reasons for their referral abroad had been cardiovascular surgery and radiotherapy for cancer. During the waiting period, 7 of these patients died and were buried in Alarish, at the Egyptian border, as the Israeli authority did not allow the transfer of the bodies in Gaza. After 40 days of waiting, the remaining patients have been allowed to enter Rafah crossing, that has opened, only in one direction, from January 21st.