On 9 January 2022, around 1 pm, medical sources at Palestine Medical Complex in Ramallah announced the death of Gaza resident Salim Mohammed al-Nawati, 16, from leukemia. Al-Nawati was diagnosed at Al-Rantisi Specialized Hospital in Gaza and because of lack of available treatment in the Strip, received a medical referral from the Ministry of Health to Al-Najah National University Hospital in Nablus. Al-Nawati scheduled an appointment for 24 November 2021, however, he was prevented from leaving Gaza by the Israeli authorities. His family booked another appointment and re-submitted the application for the travel permit, which is an obligatory, discriminatory measure imposed by the Israeli authorities on all Palestinian patients needing to leave Gaza for treatment. The patient missed three hospital appointments due to Israel’s delayed responses to his requests, and was finally granted an exit permit on 26 December 2021.

Israel’s practice of delaying the issuance of exit permits until the hospital appointment has passed is a regular occurrence for Gaza patients, who consequently complain of their health conditions worsening and their chances for recovery diminishing. Al Mezan’s documentation shows that between 2017 and 2021, 63 patients—including eight children and 22 women—died after the Israeli authorities denied them access to hospitals and medical care outside the Gaza Strip.

Despite the significant role played by the Ministry of Health’s Referral Abroad Department, many patients in the Gaza Strip complain of delays in obtaining medical referrals and financial coverage. Patients who are in their last stages of treatment and have been receiving referrals for years also report delays in renewing their referrals, and they fear that their recovery will be impacted.

Al Mezan mourns, with the Al-Nawati family, the death of their child, and calls on the international community to urge Israel to stop obstructing patient access to hospitals in the West Bank, including East Jerusalem, and within the Green Line. Israel must also fully and unconditionally lift its unlawful closure and blockade, which, among its restrictions, prevents the entry of diagnostic and therapeutic devices needed in Gaza and patients’ freedom of movement.

The authorities must investigate the death of Al-Nawati, particularly the procedures followed by the Referral Abroad Department, as Al Mezan was informed that the child was being referred to hospitals that the Ministry of Health is aware do not receive such cases—either because of the accumulated debts on the Ministry itself or because they are unspecialized hospitals. Al-Najah Hospital and the Palestine Medical Complex both refused to admit the child, which is unwarranted. The process that the patient went through on the Palestinian side requires investigation.   

Al Mezan reiterates the need to localize healthcare services and invest in capacity building of public and private hospitals in the Gaza Strip in order to prevent the further suffering of patients, while also cost-saving. Al Mezan calls on the international community, the World Health Organization, and other healthcare and medical organizations to work towards upgrading Gaza’s hospitals and equipping them with the necessary devices to enable them to provide medical care for cancer patients and other patients with serious diseases.

In the end, the occupying power is responsible for ensuring the right to health. It’s numerous barriers and the complex permit regime must be dismantled.