Patients with Borders, Case Study 3

[Editor’s Note: This is the third post in a series of case studies describing the bureaucratic and political barriers to medical access outside of Gaza and the stories of three individual Gazan patients. The first post can be found here, and the second can be found here.]

Below is one PHR-Israel case study representing a current trend in the provision of exit permits to Gazans for medical reasons. Case studies such as this one have been provided by PHR-Israel to raise awareness about border restrictions in Gaza that prevent Gazan patients from receiving critical health care. Full names are withheld for reasons of medical confidentiality and can only be released for purposes of access to medical care.

Case Study 3

(Provided by PHR-Israel)

August: Diplomatic pressure fails to reverse a prohibition on medical access from Gaza
Yousef I.A.L, male, 41, is a father to six children from the Jabalia refugee camp in the Gaza Strip. In 2005, Yousef underwent surgery replacing a mitral valve and also removing a cancerous tumor from his heart. He currently suffers from chronic renal failure and is awaiting a kidney transplant. He also suffers from recurrent venous and arterial thrombosis, including pulmonary embolism and critical ischemia in the legs and hip, from diabetes, high blood pressure, and nerve atrophy which began in childhood. Over the past three months, Yousef has lost over 30kg of his body weight and together with the overall deterioration in his physical condition there is a concern for the recurrence of cancer in his body.

On May 13, 2009, Yousef was referred by the Palestinian Health Ministry for treatment at Al Makassed Hospital in East Jerusalem after the hospitals in Gaza could not provide him with the required care. The patient was since invited five times by Al Makassed Hospital, three times by the Department of Cardiology (June 21, July 1, and July 19) and the other two by the Department of General & Vascular Surgery (June 3 and June 18). Yet Yousef was not able to attend any of these appointments. The Israeli secret police (ISA/GSS/Shin Bet) rejected three applications that Yousef had submitted to the Israeli authorities at Erez, based on a “security prohibition” against him. In addition, an application to exit Gaza submitted by the Palestinian coordinating mechanism in May 2009 did not receive any response from the Israeli army. Only after PHR-Israel contacted the army in July 2009 it was told that the application had been denied by the secret police. Applications submitted by PHR-Israel on behalf of the patient on July 21 and August 12 were also denied on the same grounds.

To assess the patient’s medical condition, PHR-Israel consulted with two of its volunteer Israeli medical doctors who are experts in the fields of Yousef’s condition. These physicians were provided with his medical files. Professor Raphael Walden, an expert on vascular medicine and Deputy Director at Sheba Medical Center in Tel Hashomer, wrote that “treating the patient in Gaza is impossible and his life is in danger….” Prof. Dina Ben Yehuda, Head of the Hematological Department at the Hadassah Medical Center in Jerusalem, wrote that “the patient requires evaluation in a tertiary hospital to find the reason for his thrombosis as well as for the possibility of performing surgery on his ischemia.” Despite the fact that this information was brought to the attention of the Israeli military authorities and secret police, Yousef’s applications were denied. It is worth mentioning that Yousef entered Israel and East Jerusalem at least seven times in the past to receive treatment. On August 19 PHR-Israel applied to the embassy of the EU presidency (Sweden) in Tel Aviv as well as the Norwegian embassy, to members of Knesset and to well known public personages in Israel to apply pressure on the Israeli authorities to enable access to lifesaving care to this patient. One week later, the Israeli coordinator of operations in the OPT (COGAT), Mr. Uri Singer, informed the embassy representatives by telephone that their response to this request was negative. The patient remains in Gaza in imminent danger of his life.