Patients dying in Gaza amid evacuation delays, MSF warns
In May, the World Health Organisation (WHO) warned that Gaza's health systems were stretched beyond breaking point as a result of continued ground offensives and evacuation orders.
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The number of patients requiring medical evacuations is between 12,000 and 15,000, according to the United Nations (UN) and Red Cross, though a study in the BMJ released last week shows only 5383 have occurred.
Doctor Hani Isleem, MSF project coordinator for medical evacuations from Gaza, has urged Israeli authorities to allow for more evacuations and called for support from other nations to assist Gazan patients.
In a statement, Dr Isleem said: "We are looking for countries, we really want them to open their doors, to accept more and more cases because those patients are dying inside Gaza.
'According to the WHO, at least 12,000 patients need to be evacuated outside Gaza to access vital medical care. The medical evacuation process is very complex and it is changing according to the [military] stages in Gaza. We can divide the phases into four.
'Before the closure of the Rafah border on May 7 [2024], it was directly from Gaza to Egypt and from Egypt to a third country.
'Then during the closure of the Rafah border, it was happening through Kerem Shalom [crossing point] directly from Gaza to Israel and from Israel with two options, either to EU countries or to Jordan, and then transiting to other countries.
'During the ceasefire, those stages changed again and [medical evacuations] went through the Rafah border. And after the collapse of the ceasefire, it went again through Kerem Shalom with very limited options.'
Medical evacuation requires clearance from COGAT – the Coordinator of Government Activities in the Territories – a coordination body in Israel that manages governmental activities in occupied Palestinian territory.
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Dr Isleem said decisions made by the body are 'often arbitrary and opaque', with many cases denied or delayed regardless of severity.
Palestinians suffering from chronic illnesses and diseases like cancer and cardiovascular issues are amongst those requiring urgent evacuations, alongside those injured in Israeli strikes.
According to MSF, medical evacuations from Gaza remain severely limited due to overwhelming health needs, administrative barriers, and a lack of willing host countries.
Even when patients are approved to leave, accompanying family members are often denied, resulting in painful separations, Dr Isleem said in his statement, noting that these restrictions have discouraged countries that initially tried to help, with many eventually abandoning their efforts.
He continued to say that Gaza's healthcare system is overstretched, and medical evacuations are subject to strict medical and administrative criteria imposed by receiving countries. Only a few nations accept patients, and some fear being seen as supporting forced migration or taking on long-term care responsibilities.
MSF managed to evacuate just 22 patients to countries like the UAE, France, and Canada – far fewer than the thousands initially identified by the organisation.
'A clear and predictable medical evacuation system, with safe corridors and without family separations, must be urgently established while ensuring Palestinians' right to return to the Gaza Strip after treatment', Dr Isleem continued.
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'We are calling on the Israeli authorities to allow patients to leave Gaza and to be more flexible in the approval of [medical] cases.
'We are asking all the countries to be on the side of the Gazan people by allowing more and more cases to have access to their health care systems, participating in the medical evacuations and saving the lives of people."
Dr Mohammed (Abu Abed) Abu Mughaisib – the deputy medical coordinator for MSF's operations in Palestine – told The National that evacuations are moving "very slowly".
"Once every two weeks you have a medical evacuation", he said.
"Since the ceasefire was broken in March, it's been moving very slowly. The waiting list [has] thousands of people waiting to be medically evacuated."
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