Cancer patients, other ill Gazans await Israels permission to leave for treatments

Physicians, families and advocates urged that border crossings be reopened for medical cases before the most vulnerable patients become critically ill or die.

Late Monday, the Israeli military said that patients with permits for medical treatments would be allowed to cross into Israel beginning Tuesday morning as part of the resumption of normal border operations, including the passage of humanitarian teams, medical equipment, food and fuel.

On the fourth day after a cease-fire ended the near-constant rocket launches into Israel and Israel's retaliatory bombardment, more supplies of fuel and medical equipment entered Gaza through checkpoints in Israel and Egypt.

At least seven workers from humanitarian and aid groups, who had been blocked from entering, also arrived in Gaza on Sunday, according to the Association of International Development Agencies, an umbrella group of agencies in Jerusalem. But many of the groups are waiting for border openings to become more predictable before sending larger teams or specialists, the group said, to prevent their staff from being stranded inside the enclave.

No medical patients have been allowed to leave through the Erez Crossing into Israel during the limited hours that Israeli officials have opened to checkpoint to journalists or diplomats. That means many patients who missed critical appointments over the last two weeks still do not know when they will be able to reach their doctors.

The Gaza Health Ministry office that facilitates outside medical care was crowded Sunday with patients and families trying book new appointments and secure their exit permits.

Hussein Najjar, a fisherman from southern Gaza, said his 61-year-old mother has grown weak and depressed since missing her regular chemotherapy treatment in East Jerusalem's Augusta Victoria Hospital for colorectal and lung cancer.

"Even if we get an appointment today, we don't know when the crossing will be open and she will be able to go," Najjar said. "She's looking for a way to survive, and we can't find it."

The family situation was made even more difficult when Najjar's boat was destroyed along with several others when an Israeli missile struck a harbor during the bombardment, he said. His family of seven, including his father and ailing mother, are surviving on a monthly donation of about $50 a month from Oxfam International, he said.

Gaza's impoverished health system cannot provide many of the treatments needed by the most serious medical cases. There are no radiation treatment facilities in Gaza, for example, leaving cancer patients to seek that and other basic therapies in hospitals outside the enclave.

The Health Ministry said it makes appointments and processes exit permits for about 100 patients a day, 90% f them for hospitals in the West Bank and the rest for facilities in Israel, Jordan and Egypt.

They system is cumbersome at best, according to Mazin Hindi, the physician who runs the outside referral program. When there is a military escalation, it fails entirely, he said. Patients who need lifesaving treatments or surgeries can wait weeks for Israeli authorities to give the green light, sometimes not before it is too late.

"It's very difficult on a human level," Hindi said. "I feel like the patient in front of me is like my own mother, my own wife, my own child, and there is nothing I can do. I am helpless at times like this."

The latest disruption is only the latest in an inefficient treatment network that often fails patients, according to Eman Shanan, an advocate for women cancer patients. Between Israeli restrictions, the lack of financial support from Hamas and the Palestinian Authority and the personal cost of transportation, many patients face hurdles to treatment that are sometimes insurmountable.

Covid-19 only made the situation worse, Shanan said. Cancer patients, who are often immune-compromised, were scared to travel for months. Seventeen thyroid patients she works with have not had treatment in more than a year because quarantine requirements in Egypt and Jordan meant they would be potentially apart from their young children for weeks.

"The war just made it worse," said Shanan, head of the Gaza-based Aid and Hope Program for Cancer Patient Care. "Nobody is caring about cancer patients."