physicians for human rights-israel: the beaten track - obstacles facing gaza patients in need of...

8/8/2019 Physicians for Human Rights-Israel: The Beaten Track - Obstacles Facing Gaza Patients in Need of Medical Care, 2010

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Obstacles Facing Gaza Patients in Need of Medical Care


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Illustration: Moran Barak

Design: David Moscovitz | Studio David & Yose


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A full hour passed until he found himself up at the desk,

opposite a police woman eying him suspiciously.

He handed her two tickets and said, "I would like to know

if my permits have arrived."

She pushed the familiar papers toward him.

"Fill out these forms and take them to E-5, Have your

tickets and reservation slips with you."

She glanced over K's shoulder resting her eyes on the

man behind him. "Yes?""No!" Shot back K, struggling to regain her attention.

"I already applied for the permit. All I want to know is

has it arrived."

"Before you can get a permit you must have a reservation.

Do you have a reservation? When is it for?"

"August 18th. But my mother-"

"August 18th is a month away! If you applied for a permit

and the request was granted, the permit will be sent to

your house! Next!"

"But that is what I want to know. Because if the permit

wont come, I must make other plans. My mother is sick-"

The policewoman pounded her fist on counter as if

to silence him and shouted, "Don't waste my time! I'm

telling you for the last time, if the permit is granted the

permit will come!

J.M. Coetzee, The Life & Times of Michael K.


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Schedule an appointment. See a doctor.

Get treated. This is how it works in Israeland probably where you're from as

well. For Palestinians in the Gaza Strip,

receiving medical treatment is highly

problematic and involves numerous

obstacles. Sometimes patients areforced to opt out of treatment altogether.

Physicians for Human Rights Israel

assists approximately 100 patients

per month access medical treatment

unavailable in Gaza. This is the storyof the exhausting journey they must go

through in order to see a doctor. This is

a story about individuals whose right to

health is being undermined every day by

the bureaucracy of Israeli Occupation.


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Referral for Treatment Abroad A physician working in one oGazas hospitals determines that his or her patient requires treatment unavailable

in the Gaza Strip and issues them a reerral or treatment abroad. The reerralmust then be authorized by both the Head o the Medical Unit and the Hospital

Director. Oncology, Cardiology, Orthopedics, and Ophthalmology comprise the

main medical elds in which sucient medical treatment is simply unavailable.


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Palestinian Bureaucracy as Required by IsraelA Medical Committee in Gaza is required to approve all reerrals or

treatments abroad. I approved, the reerral is sent along with an ocial

request to the Palestinian Ministry o Health in Ramallah to obtain nancial

coverage or the treatment and exam. The patient is then required tosubmit these papers to the Palestinian Ministry o Health in Gaza which

then schedules an appointment or the patient in an Israeli or Palestinian

Hospital. These steps, which together yield the documents required by Israel

in order to process the request, take on average 7-10 days to complete.


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Submitting an Entry Permit Application Patientssubmit their entry requests (comprised o authorized reerral, nancial

undertaking, and exam date) to the Palestinian Civil Aairs Committee. In

practice, this Committee is made up o one person - the Palestinian Health

Coordinator, appointed by the Palestinian Authority in Ramallah. He is the

only person with whom Israel is willing to cooperate to coordinate patientsexit. The Palestinian Coordinator is thus exclusively in charge o handling

all applications submitted by Gaza patients and their amily members. In his

absence, patients encounter great diculties, oten missing appointments

and access to timely medical treatment.


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Israel Decides Who Will Exit and Who Will NotThe Palestinian Health Coordinator submits patients entry permit applications

to the District Coordination Oce (DCO), a division o the Israeli military.

The DCO reviews each application, one by one, and transers them to the

Israeli General Security Service (GSS or Shabac) or security clearance. Whilemany patients receive an entry permit at the end o this process, hundreds

are not contacted in time. In many cases, patients applications are fat-out

rejected, preventing their exit entirely. The number o approvals is requently

aected by the political situation.


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Between a Rock and a Hard Place Hundreds o Gazaresidents who submit applications or entry into Israel or medical treatment

are summoned every year or Shabac questioning at Erez Crossing. In 2009,

or example, over 600 patients were summoned or an interrogation at the

hands o the Shabac. Not only is this a highly unavorable situation or

a Gaza resident (to say the least), in addition, a Hamas checkpoint has

been erected on the way to the Crossing intended to deter patients romproceeding to their interview. These actors cause some patients not to show

up or their interrogation altogether. By so doing, patients also give up on

their chances o receiving medical treatment.


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Arriving at Shabac Interrogation The GSS regularly summons

patients or an interrogation ater their medical appointment date has alreadypassed. Upon arrival at Erez Crossing on the day o the interrogation, many

patients must wait several hours beore being called in or questioning.


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Threats and Extortion of Patients During the interrogation,Shabac interrogators oten threaten and extort patients as a prerequisite or

obtaining an entry permit into Israel. Although this practice is usually a trick

and patients may receive an entry permit even i they reuse to cooperate, as

ar as many patients are concerned, the threat is very real. Patients become

stuck between two options: collaborating and risking their lives once they

return home, or risking their health and well being by reusing to provide

inormation and thus not being approved exit in time.


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Resubmitting Applications More Waiting. When Shabacinterrogations are scheduled ater a persons appointment date, patients

return home rom an interoggation, only to start the process over again.

Contacting the Ministry o Health and resubmitting their requests to the

Palestinian Civil Committee subjects them to wait times upwards o severalweeks beore hearing back once again rom Israeli authorities.


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Security Examination at the Erez Crossing Patientswhose requests have been approved are assigned an exit date and are called

to Erez Crossing on that day. Patients - even those who are weak or in

advanced stages o illness - are expected to walk a distance o approximatelyone kilometer on their own inside the Erez Crossing, and then must pass

through an additional security examination.


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Almost There Ater undergoing a security check, patients mustwait to receive a nal approval. This again can take several hours.Even critically ill patients must wait.


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Exiting Gaza for Medical Treatment In 2009, 7,534patients applied or a permit to cross Erez. 5,211 applications (69%) were

approved. The applications o over 2,300 patients (31%) were denied or

delayed causing them to miss scheduled medical appointments. Between

January-March 2010, 3,089 patients applied or entry permits. Theapplications o 2,392 patients (77%) have been approved during this period,

while those o 697 patients (23%) have been denied or delayed.


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PHR-ILs contact information:

Dror St., Tel Aviv-Jaffa 68135, Israel | Tel: 972-3-6873718 | Fax: 972-3-6873029mail@phr org il | www phr org il

Physicians for Human Rights-Israel (PHR-Israel) believes

that every person has the right to health in its widest

possible sense, as defined by the principles of human

rights, social justice and medical ethics. It is the

responsibility of the State of Israel to ensure the fulfillment

of this right in an egalitarian manner for all populations

under its legal or effective control: residents of Israel

who are eligible for National Health Insurance, Bedouin

residents of unrecognized villages in the Negev desert,

prisoners and detainees, migrant workers, refugees and

asylum seekers, and Palestinian residents of the occupied

Palestinian territory.

PHR-Israel comprises some 1,500 members & volunteers,

including senior medical professionals in the Israeli

health system

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