Reportage. WHO reports that between 2008 and 2022, approximately 30% of patient leave requests were denied or delayed, and applicants did not receive the final response by the date they were summoned to the hospital. Of these, 24% were cancer patients and 31% were children.

Farouq died waiting for an Israeli medical permit that never arrived

A few years ago, the Salah Edin Road that crosses the Gaza Strip from north to south was turned into a wide expressway in the stretch from the capital, Gaza City, to Khan Yunis. Here motorists drive at high speeds, and cab drivers perform sudden braking maneuvers to pick up potential customers waiting along the road. The Salad Edin is the pride of Qatar, whose generous donations serve as a breath of oxygen for this little piece of Palestinian territory.

But on the narrow street of the Maan neighborhood in Khan Yunis, where Ashraf and Khulud Abu Naja live, there is not even asphalt, just dirt and sand. This is one of the poorest areas in the city.

“Here, outside the house, my Farouq used to play,” Khulud Abu Naja tells us, recounting the beginning of his son’s illness. “Until he was 3 years old he was a healthy child, then one day he started complaining, he had pain in his right leg. From then on it was hell, his growth stalled and he got worse month after month. I watched him slowly fade away.”

Farouq Abu Naja, aged 6, died on August 25. For months he had been waiting for permission from the Israeli authorities to go through the Erez Crossing and go to Hadassah Ein Kerem Hospital in Jerusalem, where he was supposed to receive the proper treatment for his illness, unavailable in Gaza, where the healthcare system, between Israeli military offensives (the last one was a month ago and left 49 dead, including several children) and a lack of resources, is close to collapse.

Khulud, 29, wears the niqab. The long black veil leaves only her eyes uncovered. Her bowed head still manages to convey her emotions and the pain of a mother who recently lost her child. Her husband Ashraf is silent, his gaze sometimes lost in the distance. Their remaining consolation is their daughter, Farouq’s little sister, who is playing on the steps of the house.

“Luckily, she is healthy, she has no problems,” Khulud says, who then falls silent for a few seconds to listen to her daughter’s voice. The couple is unable to tell us the precise diagnosis made by the doctors and the name of the disease that killed their child. Ashraf shows us the medical records issued by the Khan Yunis European Hospital, where they speak generically of “developmental regression” and a “severe neuromuscular disorder.” Silence descends in the room. “We want more children, but we fear there is something genetic behind Farouq’s death. My wife and I are first cousins,” Ashraf adds. “If one day I will have the means, I will go to Egypt, to do extensive testing,” he says.

The Abu Naja family went to great lengths to treat their child, despite lacking the resources. Farouq could have been cured, they say, but he needed expensive and advanced specialized care. And the doctors at the Israeli Hadassah Hospital had said they were willing to provide it. The Palestinian National Authority’s Ministry of Health would have covered the costs. However, the child never made it to Hadassah, as he never got permission from the Israeli authorities to leave the Gaza Strip.

His death has once again brought into the spotlight the cases of Palestinians who are seriously ill, including children, who are stranded, sometimes for months, before they can leave the Strip or who never get permission at all. In Gaza, where more than 2.2 million Palestinians live, chemotherapy, radiation therapy and CT/CAT scans are not available. This leaves patients who need life-saving treatments with no choice but to seek them abroad, most often in Jordan.

The WHO reports that between 2008 and 2022, about 30% of permits for patients were denied or delayed, and applicants did not receive a final response by the date of their hospital appointment. Of these cases, 24% were cancer patients and 31% were children. The WHO also records 839 patient deaths while waiting for a permit approval from Israel between 2008 and 2021. And it is equally striking that during the same period, 43% of sick children left Gaza without their parents, who were blocked by Israeli authorities.

Israel categorically denies that it is denying the Palestinians in Gaza their right to health. It points out that it is often Israeli hospitals that take in Palestinian children and adults in need of highly specialized medical care.

“The reality of the permits, however, is obvious to everyone,” observes Farouq’s legal representative, who works for Al Mezan, the Gaza-based human rights NGO. In recent days, she has been denouncing what happened to the child in Khan Yunis: “The patients’ exit permit applications, submitted to the Israeli authorities on January 12, 2022, and August 10, 2022, have remained in the review phase. This delay led to a serious deterioration of Farouq’s condition, who passed away on Thursday, August 25.”

Al Mezan also reports that since the beginning of 2022, four Palestinian patients, including three children, have died as a result of being refused exit permits or having them delayed: “Farouq’s case is another example of Israel’s violation of international humanitarian and human rights law and its obligations as an occupying power, particularly that of respecting and guaranteeing freedom of movement in the Occupied Territories and ensuring the right to health of the occupied population. […] Delaying access to necessary medical treatment for a child for more than five months is unjustified and a grave matter,” the complaint reads.

Al Mezan points out that obtaining the permit doesn’t even guarantee that patients won’t be mistreated at the Erez crossing. Even at that point, some are still sent back for “security reasons.”

Khulud Abu Naja can’t make any sense of it. “Why didn’t they let my son through, what harm could a 6-year-old have done,” she says with a faint voice, spreading her arms wide.

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