\u201cAny small, short-term increase Israel cites in evacuation numbers \u2014 even if true \u2014 is a drop in the ocean,\u201d said Shai Greenberg, a spokesperson for the Gisha NGO, which assists Gazans seeking to leave the strip. \u201cBoasting about it is part of Israel\u2019s ongoing effort to mask reality and present a false picture of meeting its obligations.\u201d<\/p>\n
According to Ben-Gurion University Prof. Dorit Nitzan, who has assisted evacuating sick and wounded Gazans in an unofficial capacity since the start of the war, Israel has shown more flexibility in approving evacuations in recent months, leading to the increase.<\/p>\n
\t Palestinian children and their families evacuated from Gaza for medical care arrive at Rome\u2019s Ciampino military airport, Aug. 14, 2025. (AP\/Gregorio Borgia)<\/p>\n \u201cSince March 2025, Israel\u2019s security apparatus \u2014 COGAT, the Shin Bet \u2014 has significantly eased the process for patients to travel for treatment outside Gaza,\u201d said Nitzan.<\/p>\n Nitzan spent 20 years of experience coordinating evacuations from disaster zones worldwide during her work with the WHO before returning to her native Israel, where she is today the head of the School of Public Health at Ben-Gurion University.<\/p>\n Every departure from Gaza requires Israeli security clearance, including checks on the person\u2019s identity and whether they are deemed a security risk. \u201cAt the start of the war, we saw a very low approval rate; today, most names are approved,\u201d Nitzan said. \u201cEvery week there\u2019s at least one evacuation, ranging from dozens to hundreds of people \u2014 depending on the receiving countries\u2019 capacity.\u201d<\/p>\n However, organizations helping Gazans leave say they have not noticed a significant change in recent months.<\/p>\n \t Patients wait to leave the Gaza Strip to Egypt, as wounded and sick Palestinians are allowed to leave the Gaza Strip for medical treatment, in Khan Younis, Feb. 1, 2025. (AP Photo\/Jehad Alshrafi)<\/p>\n Asil Abu Rass, Head of the Occupied Territories Department at Physicians for Human Rights, told The Times of Israel: \u201cFrom what I see, there has been no easing. Two-thirds of the patients evacuated during the entire war in Gaza left through Rafah a year and a half ago and not through Israel.\u201d<\/p>\n Greenberg told the Times of Israel that \u201cIsrael continues to deny medical care to thousands of other injured and sick people, including many children, by blocking their exit from Gaza to places where they could receive proper treatment.\u201d<\/p>\n \u2018These treatments don\u2019t exist in Gaza\u2019<\/p>\n The ability of patients, the wounded and their accompanying relatives to leave Gaza during the war has been complex and has shifted depending on the fighting on the ground.<\/p>\n Both Israel and Egypt shut all crossings in and out of the Strip immediately after Hamas\u2019s October 7, 2023, attack, in which thousands of terrorists stormed into southern Israel, killing 1,200 people and taking 251 hostages back into Gaza.<\/p>\n The closures had far-reaching consequences, cutting off permits for Gazans who previously worked in Israel, but the impact on patients was especially severe.<\/p>\n Even before the war, Gaza\u2019s healthcare system was severely underdeveloped compared to Western standards, with limited treatment options, especially for cancer care. As a result, many Gazans traveled to Israel or the West Bank for medical treatment \u2014 funded by the Palestinian Authority or, more rarely, by humanitarian organizations \u2014 in coordination with Israel through the PA\u2019s Civil Affairs Committee.<\/p>\n This body was responsible for coordinating movement requests between Gaza residents and Israel, and continued operating after Hamas seized control of the Strip in 2007. It has served as the sole intermediary between Gaza\u2019s residents and Israel, which refuses to coordinate with any Hamas-controlled authority in Gaza.<\/p>\n \t Palestinians wait at the Erez Crossing between Gaza and Israel, July 13, 2014. (Flash90)<\/p>\n Patients seeking care outside of Gaza would submit requests to the Civil Affairs Committee, including medical documentation and a permit from Gaza\u2019s health ministry. The PA would determine whether to fund the treatment and pass the list of applicants to Israel, which would perform security checks to ensure those requesting to enter the country had no links to armed Palestinian groups.<\/p>\n Thousands were approved, but many requests were turned down by Israel. Of 20,411 applications submitted for patients to leave Gaza for medical care in 2022, some 34% were denied, according to WHO data.<\/a> Sometimes the denials were explicit, though a reason was not always given, and sometimes Israel simply failed to provide an answer either way before the scheduled appointment time.<\/p>\n Nitzan said dealing with Gazans seeking care in Israel or the West Bank was a regular occurrence in the past.<\/p>\n \u201cSome stayed in Israel for extended periods because of long treatment courses \u2013 children after organ transplants, cancer patients, both adults and children,\u201d she said. \u201cThese treatments simply didn\u2019t exist in Gaza, so the only option was to send them out for care.\u201d<\/p>\n \t Visitors exit the Augusta Victoria Hospital in East Jerusalem. Before the war, 30% of its beds were reserved for Gazan patients, July 11, 2022. (AP\/Mahmoud Illean)<\/p>\n According to WHO figures<\/a> provided on August 6, 2025, between 50 and 100 patients left Gaza every day for treatment before the war. Since October 7, that daily average has dropped to 11.<\/p>\n Restrictions on goods entering the Strip and heavy fighting have crippled Gaza\u2019s already fragile health system, leaving it unable to provide services to Gazans. At the same time, Israel has stopped admitting Gazans for treatment in Israel or permitting them to reach hospitals in the West Bank or East Jerusalem, complicating their ability to access treatment.<\/p>\n But many are still able to leave the Strip for neighboring countries.<\/p>\n For the first several months of the war, patients turned to Egypt, leaving Gaza through the Rafah crossing, which was open from November 2023 until May 2024, when Israeli troops took control of the crossing and the Philadelphi Route.<\/p>\n Israel continued to vet patients leaving through Rafah and relatives escorting them, while the WHO stepped in to coordinate between Gaza\u2019s Health Ministry and Israel instead of the PA\u2019s Civil Affairs Commission. From Rafah, the vast majority of patients would receive treatment within Egypt, though some would travel on to third countries.<\/p>\n According to the WHO, from November 2023 to May 2024, when Rafah was open, 4,947 patients transited through Rafah. COGAT put the number at 30,000, including companions and those leaving for reasons other than medical care, and denied Egyptian media reports that the true figure was closer to 100,000.<\/p>\n \t Palestinian parents say goodbye to their sick son, leaving the Gaza Strip to get treatment abroad through the Kerem Shalom crossing, in Khan Younis, southern Gaza Strip, June 27, 2024. (AP\/Abdel Kareem Hana)<\/p>\n Following the closure of Rafah, Physicians for Human Rights, Gisha, and HaMoked petitioned Israel\u2019s High Court to allow patient evacuations through Israeli territory instead. The state replied on June 30, 2024, that a mechanism was being developed and that individual approvals had already been granted \u2013 including for 19 sick children and 49 companions \u2013 leading to the petition\u2019s dismissal. The new process involved physically transferring patients through Israel and seeking third countries willing to host and fund treatment and accommodation.<\/p>\n Since then, Israel says it has allowed thousands of patients and those accompanying them to exit via the Kerem Shalom Crossing, traveling to the West Bank\u2019s Allenby Bridge Crossing into Jordan and receiving treatment there or flying to further destinations that agreed to take them in and treat them.<\/p>\n In February 2025, Israel also began allowing them to leave via direct charter flights from Ramon Airport in the Negev.<\/p>\n \t A Palestinian boy injured in the Israeli military\u2019s ground and air offensive on Gaza, looks from an ambulance as the first group of sick Gaza children arrives in Jordan for medical treatment at the King Hussein Bridge border Crossing on March 4, 2025. (AP \/Raad Adayleh)<\/p>\n Nitzan said the switch from Rafah to Kerem Shalom as the main transfer point significantly increased Israel\u2019s role in the process.<\/p>\n According to Abu Rass, the move meant that far fewer patients and their companions were given the go-ahead to leave Gaza. From May to December 2024, many patients she tried to assist were denied exit, the Physicians for Human Rights official said.<\/p>\n \u201cIf someone was suspected of being in Hamas \u2014 even if the link was as distant as a relative\u2019s relative \u2014 the entire extended family could be barred from leaving, even if the family tie was as remote as a grandfather\u2019s brother,\u201d she recalled.<\/p>\n Exits appeared to ramp up during a two-month ceasefire in January and February 2025, as Rafah was reopened. According to figures provided by COGAT and WHO, 1,673 patients and over 2,600 escorting relatives exited via Rafah during the truce, including some 600 children.<\/p>\n \t Children in need of medical treatment and caregivers, as well as Gazans with dual citizenship, exit Gaza, August 6, 2025. (COGAT)<\/p>\n Nitzan noted that Israel had a unique responsibility to ensure Gazans are able to receive medical care despite its belligerent relationship.<\/p>\n \u201cIf Gaza were recognized as a state and declared an enemy state, we\u2019d have no obligation beyond the laws of war,\u201d she said, noting that Russia had no part in WHO missions to evacuate the sick and wounded from Ukraine. \u201cHere it\u2019s different. The side that was attacked on October 7 and now at war with Hamas is also the one required to carry out the evacuations. We are part of this process \u2014 we are maintaining human dignity.\u201d<\/p>\n According to a February 2025 position paper<\/a> by Physicians for Human Rights, between October 2023 and February 2025, 15,600 medical evacuation requests were submitted via WHO, but only 34% \u2014 about 5,325 patients \u2014 resulted in actual transfers.<\/p>\n The low figure reflects not only Israeli approval rates but also the challenge of finding countries willing to accept patients and their companions as well as fund treatment.<\/p>\n Leaving, but not for Israel anymore<\/p>\n Countries that agree to receive patients and their companions must cover hospital costs and, in the case of children, enroll them in the local education system.<\/p>\n \u201cA country isn\u2019t just taking in the patient \u2013 it\u2019s also taking in siblings or parents, funding their stay, and integrating them into schools. It\u2019s not simple,\u201d Nitzan said.<\/p>\n With Israel refusing to allow anyone to enter Gaza, including Palestinians who left the territory for treatment, those stays are currently indefinite, putting many into a seemingly inexorable limbo. Decisions about how long stays are funded or whether family members can seek employment are subject to individual countries\u2019 immigration laws.<\/p>\n Nitzan recalled the case of a liver transplant recipient who left Gaza during the first year of the war. \u201c[She] is still in the Rafah area on the Egyptian side,\u201d the professor said.<\/p>\n \t Paramedics and ambulances wait on the Egyptian side of the Rafah Border Crossing with the Gaza Strip on January 18, 2025, to enter into Gaza once the ceasefire-hostage release deal comes into effect. (AFP)<\/p>\n According to WHO, Egypt has received the most patients to date \u2013 3,995 \u2013 followed by the United Arab Emirates with 1,387, Qatar with 970 and Turkey, which has taken in 437 patients.<\/p>\n COGAT did not respond to a request for comment on whether diplomatic ties with Israel play a role in where patients who transit through Kerem Shalom are sent.<\/p>\n Other countries that have taken patients include the United States, Jordan, France, Italy, Spain, Germany, Romania, the United Kingdom, the Netherlands and Norway.<\/p>\n Nitzan identified the need to find third countries as a major bottleneck in the process of securing treatment for sick or wounded Gazans.<\/p>\n Advocates say the best course of action would be to reinstate access to hospitals in the West Bank or East Jerusalem.<\/p>\n \u201cThere are Palestinian hospitals ready to receive them \u2014 like Augusta Victoria in East Jerusalem, which before the war reserved 30% of its beds for Gazan patients and works closely with hospitals in Gaza. Hospitals in Nablus and Jenin are also ready,\u201d Abu Rass said.<\/p>\n \t Sick and injured Palestinians being transferred from the Gaza Strip to Egypt, at Kerem Shalom Border Crossing, June 27, 2024. (COGAT)<\/p>\n \u201cIsrael\u2019s insistence on sending patients abroad instead is stalling the process. West Bank and East Jerusalem hospitals could also stabilize more severe cases before transferring them abroad,\u201d she added.<\/p>\n Greenberg, from Gisha, called on Israel to \u201callow permanent, transparent, consistent, swift, and efficient evacuations, including to West Bank and East Jerusalem hospitals, without separating children from their parents and guarantee their right to return.\u201d<\/p>\n Gaza health ministry remains the gatekeeper<\/p>\n The process of securing medical evacuations from Gaza during the war has become even more complex than it was before October 7, though it was never quite simple.<\/p>\n \u201cYou need a doctor\u2019s referral stating you require treatment outside Gaza \u2014 and that\u2019s not always available in Gaza,\u201d Abu Rass said. \u201cThe patient submits this documentation through\u2026 a local hospital to a committee in the Gaza health ministry. It\u2019s not enough for a doctor to give an opinion; the committee reviews and prioritizes who most urgently needs to leave. That committee has been operating throughout the war, just as it did before, but now the list goes to WHO instead of the Civil Affairs Committee.\u201d<\/p>\n \t A woman carries a child off an Italian military plane arriving from Israel as medics and health personnel welcome Palestinian children from Gaza seeking medical care and their families, on August 14, 2025 at Rome\u2019s Ciampino airport. (Andreas SOLARO \/ AFP)<\/p>\n In response to The Times of Israel, WHO said it \u201cworks with the Israeli authorities to secure approvals for evacuees and their companions once the final approved lists from the Gaza health ministry are received.\u201d<\/p>\n Nitzan noted that for some patients, reaching a doctor to obtain the referral is itself a challenge: \u201cIf there\u2019s a very sick child whose parents are constantly moving due to the fighting, I don\u2019t know if everyone knows how to get onto the list \u2014 you need to know whom to approach. With limited access to international organizations and few personnel on the ground, getting the right person onto the list is a challenge.\u201d<\/p>\n This is not unique to Gaza, she added: \u201cIn every emergency zone, the challenge is how to get the person at the far end onto the list.\u201d<\/p>\n Once WHO receives the lists, they are passed to Israel for a security screening and a search begins for a potential host country. This outreach is conducted by multiple actors \u2014 WHO, Israel and humanitarian groups \u2014 each using their own networks to secure treatment offers abroad. As a result, the process does not always follow a neat, step-by-step sequence.<\/p>\n \t Prof. Dorit Nitzan (Hilel Bider)<\/p>\n Abu Rass said that sometimes WHO first secures an agreement from a receiving country before sending names for Israeli security checks: \u201cWith so many requests and people needing to leave, they only send for approval those who have a realistic chance of exiting,\u201d she said.<\/p>\n Alongside the patient\u2019s name, the list also includes companions essential for support, especially for small children.<\/p>\n Some countries only accept certain types of patients, Abu Rass noted.<\/p>\n \u201cMany refuse to take adults and accept only children \u2014 Italy, for example,\u201d she said. \u201cThe UAE has declined to receive war-wounded, accepting only the sick. Jordan agreed to take only children with cancer. Each country has its own criteria.\u201d<\/p>\n While most patients go through the Gaza health ministry, WHO and some host countries have at times also submitted names independently, bypassing the Hamas-controlled authority.<\/p>\n \u201cStates like the UAE can identify patients they wish to receive, add their names to the list and send them to Israel for approval,\u201d Nitzan said.<\/p>\n \t People check the damage outside the Kamal Adwan hospital in Beit Lahia in the northern Gaza Strip, following a reported Israeli strike that hit the medical complex on December 6, 2024. (AFP)<\/p>\n Abu Rass told The Times of Israel that the UAE has, at times, sent lists of patients\u2019 names directly to Israel without WHO involvement, requiring only security clearance.<\/p>\n Once a case has been cleared medically, approved by Israel\u2019s security authorities, and accepted by a receiving country, WHO representatives in Gaza contact the family and organize the evacuation.<\/p>\n Most evacuees are women and children. According to COGAT, about 80% of those evacuated during the war have been children.<\/p>\n Nitzan said this reflects not only the preferences of receiving countries, but also the reality of Israeli security vetting.<\/p>\n \t Egyptian ambulances cross the Rafah Border Crossing towards Gaza on February 1, 2025, to transport Palestinian patients out of the Strip.(Kerolos Salah\/AFP)<\/p>\n \u201cAnyone linked to fighters or armed factions in Gaza will not pass,\u201d she said. \u201cWomen and children are easier to approve, and humanitarian organizations always prioritize them as a population to be removed from conflict zones.\u201d<\/p>\n The process can take considerable time. Nitzan said though Israel had eased its own approval process, there was still a serious bottleneck in finding countries willing to host patients or fund treatment.<\/p>\n WHO told The Times of Israel that some patients in Gaza have been waiting more than 18 months for evacuation. The organization did not specify whether the delays were due to logistical challenges, Israeli refusals, or the lack of a willing host country.<\/p>\n Escape to Norway<\/p>\n Today, Aisha is in Norway, but getting there from Gaza took some 20 months of red tape and waiting for various approvals, her sister-in-law Najm told the Times of Israel.<\/p>\n The 35-year-old from Beit Lahiya in northern Gaza has suffered from a severe degenerative disease from an early age, leaving her in constant pain and struggling to walk. For the last 15 years, she has relied on Najm as her primary caregiver, bringing her with her to Scandinavia when she was finally able to leave the Strip late last month.<\/p>\n \t An aerial photograph taken by a drone shows tents amidst the destruction from war in Beit Lahiya, northern Gaza Strip, on February 17, 2025. (Mohammad Abu Samra\/AP)<\/p>\n \u201cShe has been sick for 30 years, and the treatment for her disease doesn\u2019t exist in Gaza. From the day I got married, I\u2019ve been helping her \u2014 dressing her, caring for her,\u201d said Najm, also 35, who spoke for Aisha due to difficulties speaking stemming from her condition.<\/p>\n Both women asked to remain anonymous for privacy reasons. (Aisha and Najm are pseudonyms).<\/p>\n Najm said that Aisha used to travel to Tel Hashomer hospital near Tel Aviv for treatment, but later started going to Palestinian hospitals instead.\u00a0 The last time Aisha left Gaza for medical care was eight years ago, when she was treated at Al-Makassed Hospital in East Jerusalem.<\/p>\n The family applied for Aisha\u2019s evacuation in November 2023, just weeks after the war began, as conditions became extremely difficult. Less than a week after October 7, the family fled their home near Gaza\u2019s border with Israel, which was later blown up in an Israeli strike.<\/p>\n \u201cFrom that day until we left Gaza, we kept moving from place to place. We were displaced,\u201d Najm recalled.<\/p>\n To get approval to leave, they submitted a form to the Gaza health ministry, which was approved and sent to the WHO. But it was still a year and eight months before they were able to leave.<\/p>\n \u201cThe process took a very long time,\u201d Najm said.<\/p>\n![\"\"](\"https:\/\/www.europesays.com\/uk\/wp-content\/uploads\/2025\/08\/AP25225804064534-640x400.jpg\")
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