WHO EMRO | Patients in the unable to obtain Israeli-issued permits to access the healthcare

Following suspension of permit processing and coordination, Palestinian patients face additional difficulties to accessing healthcare. Before March, there were more than 1,750 permit applications each month for Gaza patients and more than 7,000 permit applications each month for patients, though this number reduced drastically during the COVID-19 outbreak. Patients need permits to reach health services in different parts of the occupied Palestinian territory, with the majority needing access to . Almost a third of applications are for cancer patients; others require specialized surgeries, diagnostic imaging, cardiology, or other services otherwise unavailable. Overall, this group of patients is very sick, with their probability of survival at six months from first permit application less than 90%.

Waseem is 25 years old and has a congenital heart problem. He is from Beit Lahia in the north of Gaza Strip.

21 June 2020

1 / 7 WHO EMRO | Patients in the Gaza Strip unable to obtain Israeli-issued permits to access the healthcare

Waseem was born with a congenital heart problem that involved the narrowing of one of his heart valves. When he was a child, he underwent treatments including a procedure to dilate the valve and open-heart surgery. The surgery was effective at that time, and Waseem finished school and went onto graduate from Al-Azhar University in business administration in 2018.

In March 2018, however, Waseem noticed general tiredness and had difficulty breathing. Investigations at Shifa revealed that the same heart valve was not working properly. He was referred to Makassed Hospital in East Jerusalem and had further surgery there in April 2018. After he returned to Gaza, he suffered complications of his surgery with an infection in the heart. He was treated in the intensive care unit at Shifa Hospital in Gaza City where he stayed for approximately six weeks, until his condition stabilized. Waseem attended several follow up assessments at Makassed Hospital after his health had improved, the last of which was on 3 February 2020.

On 14 April 2020, Waseem was admitted again to Shifa Hospital with infection in his heart and

2 / 7 WHO EMRO | Patients in the Gaza Strip unable to obtain Israeli-issued permits to access the healthcare

stayed as an inpatient again for almost two months.

Now he has been referred urgently to Makassed Hospital for further surgery that is unavailable in Gaza. He had an appointment on 15 June 2020, but since the suspension of permit processing and coordination between Palestinian and Israeli authorities he has been unable to obtain a permit to exit.

Frustrated, Waseem discharged himself from Shifa Hospital. He said, “I’m tired of . I need to be in a calm environment and the doctors have agreed that I can receive antibiotics at home for now.”

Waseem and patients like him currently have no means to exit the Gaza Strip to access essential health services. An urgent solution is needed to protect the fundamental right to the highest attainable standard of health for Palestinian patients.

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Azmi is a 52-year-old man from Deir Al-Balah in the Gaza Strip, who was recently diagnosed with a cancer called a cholangiocarcinoma.

21 June 2020

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