Israel's deadly restrictions on Palestinian patients

Awatef Abu Daher and her son Naim, who was born with congenital defects in the heart and other organs that cannot be treated in Gaza.
Khaled Azayzeh B’Tselem

Israel’s robust hasbara – or propaganda – effort devotes no small amount of energy to presenting its army as dedicated to the health and well-being of Palestinians – whether in the occupied West Bank, including East Jerusalem, or the blockaded Gaza Strip.

For example, last year the Israeli army proudly announced that it had created a new unit whose sole focus would be the provision of medical care and humanitarian assistance to the Palestinian population in “emergency” situations.

“When people are in need of care, we can’t afford to be indifferent,” Dr. Yishai Lev, a deputy commander in the new unit, explained.

“Indifferent” the army certainly is not. Quite the contrary: Israeli policy practically dictates the health of the people it occupies.

In the first 10 months of 2015, Israel’s military occupation administration, which it calls COGAT – Coordination of Government Activities in the Territories – denied 1,035 Palestinians in Gaza exit permits to receive necessary treatment in the occupied West Bank, Israel or Jordan.

This represents almost twice as many denials as were issued the entire previous year.

As a policy, Israel issues permits only – but not always – for life-threatening conditions, allowing countless critical ailments and illnesses to go untreated.

But Gaza’s health care system, battered by repeated military assaults and a nearly nine-year siege, is “severely lacking,” according to B’Tselem.

The Israeli human rights group recently reported that Gaza’s health infrastructure simply cannot “provide for the needs of the local population.”

Battered health care system

B’Tselem notes that four decades of direct Israeli occupation followed by years of near-total blockade have made it impossible for Gaza’s hospitals and doctors to adequately treat their patients.

Hospitals lack equipment and supplies and doctors, unable to access the world outside Gaza, lack continued training and skill development.

Israel’s policy of preventing people from obtaining exit permits for medical treatment unless or until their condition becomes “life threatening” can lead to premature death, according to Physicians for Human Rights-Israel.

Some of the hundreds of people in dire need of medical attention that Israel won’t allow to leave Gaza for treatment include 46-year-old Ali Khader Muhammad Bashir – one of the individuals profiled in B’Tselem’s report.

Bashir, a father of eight children, suffers from an apparent neurological impairment that causes debilitating vertigo. These severe spells causes major impairment to his daily life.

Without access to the required diagnostic and imaging equipment, doctors in Gaza are unable to determine the cause of his condition.

Over the last three years, Bashir has been referred to hospitals in Nablus, in the occupied West Bank, and in Cairo, but has been denied permits to cross through Israel. He could not get to Cairo because of Egypt’s constant closure of the Rafah crossing.

No exit

Palestinians were once able to use Rafah on a reasonably regular basis. However, since Abdulfattah al-Sisi and the Egyptian military seized power from President Mohammed Morsi in 2013, the exit from Gaza to Egypt has been almost entirely sealed.

That amounts to a dramatic change in reality for Palestinians living in Gaza: in the first half of 2013, before Sisi’s coup, an average of more than 20,000 people exited Gaza via Rafah every month and a similar number entered.

In 2014, the number of exits and entries fell by more than half to an average of about 8,000 per month, according to Gisha, an Israeli human rights group that monitors Israel’s blockade of Gaza.

This is less than a quarter of the number who moved through the crossing in the years before Israel began to impose the blockade.

In 2015, the Rafah crossing was open for just 19 days. The average monthly exits and entrances plummeted to just 2,500, but in four months of the year the actual number was zero.

New demands

Children who are given medical exit permits must be accompanied by an adult caregiver who must also undergo a security check.

At the end of 2015, Israel raised the required age of the caregiver from 35 to 55, adding a significant burden for families trying to obtain treatment for their sick or injured children.

B’Tselem notes, moreover, that the “security checks” are lengthy and rarely successful.

This new age-restriction worries people like 41-year-old Awatef Abu Daher, a Red Crescent nurse and mother of four who lives in Deir al-Balah.

She was widowed when an Israeli airstrike killed her husband during Israel’s summer 2014 assault on Gaza. She was pregnant at the time.

Their son, Naim, who was diagnosed with numerous congenital defects of the heart, stomach and intestines while still in the womb, was born in an Israeli hospital. The infant spent the first year of his life in and out of Israeli hospitals. But now his mother has been unable to obtain permission for him to leave for another operation doctors say is necessary.

Having been summoned for questioning by the Israel Security Agency, also known as Shin Bet, Abu Daher is worried she won’t be allowed to travel with her baby boy.

Across the occupied West Bank and Gaza, Physicians for Human Rights-Israel estimates that Israel rejects about 20 percent of applicants for a medical exit permit.

But even according to Israel’s stringent – if entirely vague – criteria, occupation authorities could approve more applicants.

Physicians for Human Rights-Israel says that in almost half of the cases in which the organization intervenes, Israel overturns its original rejection.

However, only a fraction of those rejected by Israel seek help from the group.

“A semblance of ‘calm’ prevails ordinarily, but it is only illusory,” Physicians for Human Rights-Israel says of Israel’s stranglehold on Palestinian health. “In reality, Israeli control over the Palestinians only takes on a different form, one that is daily and even transparent, yet no less painful and deadly.”