Child patients from Gaza grievously impacted by Israeli restrictions on access to treatment

10 August, 2020

In the last two months, Physicians for Human Rights Israel (PHRI<https://www.phr.org.il/en>) - an Israeli human rights organization - has assisted over 35 children from Gaza who needed to exit the Strip for medical treatment. Despite the ending of coordination between the Palestinian Authority and Israel, including coordination around medical exit permits, Israel has maintained exit permit restrictions and as a result, already tens of patients from Gaza — including minors and cancer patients — have been prevented from leaving the Strip for critical medical treatment unavailable locally and during this time two babies have died.

Background

After Israel’s announcement of its plans to annex parts of the West Bank, the Palestinian Authority declared that it will end coordination with Israel including coordination around medical exit permits. Without these permits, patients from Gaza cannot exit the Strip for medical treatment in hospitals in the West Bank and East Jerusalem, where e.g. specialist pediatric and oncological treatments exist. Even though cooperation with the Palestinian Authority over medical exit permits has ended, the Israeli authorities — who created the medical exit permit bureaucracy — have continued to prevent free and swift passage for patients and even increased restrictions, with direct impact on patient health. According to the World Health Organization, almost a third of Gazan patients needing medical exit permits are under 18.

PHRI assistance to urgent cases

Following the collapse of the coordination mechanism, in the dearth of other options available to patients requiring urgent care, PHRI has assisted five times as many patients as prior to the coronavirus outbreak. This assistance — unlike prior to the collapse, where PHRI intervened only in cases of rejected or unanswered medical exit permits — now includes the initial application to the Israeli authorities to even request a permit.

As documented by PHRI, and based on direct assistance to almost 200 critical patients <https://www.phr.org.il/wp-content/uploads/2020/08/patient-exit-gaza-july... in the last two months, Israel has consistently limited medical exit permits to only urgent cases. This restriction — which denies access to medical care for non-urgent cases — was initially imposed in March, as a result of COVID-19 outbreak. Since then, however, movement restrictions in Israel and the West Bank have been lifted and it is unclear why Israel has not taken the same steps in Gaza.

Moreover, at least 50% of PHRI’s patients were denied access, including in cases where Israel refused to respond to requests in time for the hospital appointment, requiring patients to re-apply for a permit. Patients were also delayed at the Erez Crossing into Israel, even when they had a medical permit, and therefore missed their hospital appointment. Meanwhile, patients were suddenly required to send in certain medical test results as a condition for a permit, rendering the application even more complicated, despite army claims to PHRI that permits depend only on security screenings and that the medical need is not disputed.

Patients who tried to apply online, via a system created by the Coordinator of Government Activities in the Territories (COGAT) that was only made available for direct patients use following interventions by PHRI, experienced lack of transparency, as they could not follow up on their applications. COGAT, moreover, claimed that certain treatments are available in the Gaza Strip, and as a result refused to give permits, including to cancer patients. Even if these treatments are theoretically available, as a result of shortages of equipment and medications, they are not practically offered.

Legal and medical ethics background.

Israel’s current policy and restrictions on the movement of patients is in violation of the right to health, standing contrary to the Convention of Economic, Social and Cultural Rights as well as various WMA declarations, such as the WMA Statement on Access of Women and Children to Health Care. Even prior to the suspension of coordination, Israel’s medical exit permit system was violating patients’ health, and the Committee on Economic, Social and Cultural Rights has already called on Israel to “review the medical exit-permit system with a view to making it easier for residents of Gaza to access, in a timely manner, all medically recommended health-care services.”

Israel must lift the blockade and enable free and safe passage for these patients. In the short term, it must lift the requirement for urgency as part of the medical exit permit criteria and allow patients, including those whose medical care is not defined as “urgent” to access treatment. Israel must also provide medical exit permits within a reasonable time-frame that corresponds to the urgency of the patients’ medical condition, improve the application form and allow patients to view the status of the request.

For further information, please contact dana@phr.org.il

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דנה מוס | دانا موس | Dana Moss

International Advocacy Coordinator

רכזת סנגור בינלאומי

منسقة المرافعة الدولية

03-5133105 03-6873029 054-5753426

דרור 9 תל אביב יפו | شارع درور رقم 9 يافا |

9 Dror st. Jaffa Tel Aviv

www.phr.org.il<http://www.phr.org.il/>

CHIFA profile: Dana Moss is International Advocacy Coordinator at Physicians for Human Rights Israel. Professional interests: vulnerable communities. Email address: dana AT phr.org.il