Most patients with serious cases eventually do get to cross into Israel, according to World Health Organization statistics. But thousands each year face unpredictable Israeli delays and denials that a 2021 WHO study has shown to be deadly.
Yousef Al-Kurd, 70, a resident of Gaza with heart disease, waits to be seen by Dr. Saher Abu Ghali at Shifa Hospital. Al-Kurd is one of many Gazans who struggle to get permission to leave Gaza for medical treatment.
No place on Earth has been spared a health crisis, as the last few years have shown. Yet Gaza's protracted emergency is driven not only by a pandemic but by people — enemies locked in a 15-year standoff with no end in sight. The victims of Gaza's deadly military conflicts capture headlines, but a frequent contributing factor to illness and death in Gaza are the barriers to health care.
He studied engineering in Germany before returning home to a 30-year career in Gaza fixing loudspeakers for mosques, schools and pushcart vendors.Yousef Al-Kurd waits with his son Ibrahim to be seen by a doctor in Gaza. After a sudden heart attack on April 1, 2020, Al-Kurd needed open heart surgery. "From four, we became three and now we became two," Abu Ghali said from his small office in the hospital.Dr. Saher Abu Ghali is the head of cardiac surgery at Shifa Hospital. He is one of only two heart surgeons for the two million residents of Gaza."This is not the only problem," he said."You don't have all the instrumentation. You don't have all the resources.
Israel doesn't let Palestinian doctors out of Gaza very often to update their skills with training abroad. To compensate for the gaps in care, Israel does allow delegations of surgeons, Palestinian citizens of Israel, to enter Gaza to conduct surgeries a few days a month. Other foreign surgeons visit, too. But it's not enough to meet the demands.
Most people seeking medical care outside Gaza are cancer patients; there's very little chemotherapy in Gaza and no radiation therapy. The second most common patients requesting treatment abroad are heart patients like Al-Kurd.Take this case: on day in early December, at the Palestinian health ministry's headquarters in the West Bank, a health official rushed into the office of Dr. Haitham Al-Hidri, who at the time oversaw financial coverage for Palestinian medical referrals.
Dr. Al-Hidri said he cleaned house when he entered the job in 2019: he fired clerks who took bribes and blocked unnecessary medical referrals, saving the cash-strapped Palestinian Authority tens of millions of dollars.Dr. Haitham Al-Hidri oversaw financial coverage for Palestinian medical referrals when Yousef Al-Kurd was seeking coronary artery bypass surgery outside of Gaza.
The health minister acknowledged she has approved private medical care for Palestinians, but denied the approvals were political favors. She said public hospitals are overburdened and her approach is"humanitarian," referring the"the poorest of the poor" to private hospitals when"prominent people in the country" lobbied on their behalf.
There have been isolated cases where Israel has accused patients of smuggling explosives or spying for Hamas. Some patients have been given Israeli permission to leave for medical treatment and then never returned, going on the lam in the West Bank for better economic conditions or to escape family vendettas and personal troubles in Gaza.
Israel does eventually grant most permits, but about a third of applications was delayed or denied in 2021, the World Health Organization said. WHO estimates thousands of people have had to reschedule surgery or chemotherapy as they await Israeli security clearance to travel. In the meantime, WHO said, these patients often grow more ill.
Pleading is part of the job in trying to get Israeli permits. One Palestinian official, who asked not to be named fearing repercussions to his job, told NPR he takes pictures of patients with their bulging neck tumor or their sick baby, which he said tends to win Israeli officers' sympathy.barriers to accessing health care for Palestinians.
Then they reached Israel's sole civilian border crossing with Gaza: the Erez crossing, one of the world's most heavily fortified border crossings.Hamas, committed to armed conflict with Israel, is contained on the other side. So are 2 million Palestinian civilians. Israel's stated policy since Hamas' takeover is"separation": sealing Gaza off from the West Bank and limiting passage between the two main Palestinian territories.
The driver put the destination in his navigation app: an Israeli security checkpoint in the Israeli-occupied West Bank, a bit more than an hour away.Arnon Avni, 69, an Israeli graphic designer and political cartoonist, volunteers with Road to Recovery, a group of Israelis who drive Palestinian patients to their medical appointments. Avni gave a ride to Yousef Al-Kurd, the Gaza resident seeking heart bypass surgery at a hospital in the West Bank.
"I see the eyes of all of my passengers on my travels," Avni said from the driver's seat."All of them feel the same...the roads, the cars, the new cars. It's something else. It's like for me to travel to New York, or something like that."
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