A patient in Gaza is different from any patient elsewhere in the world.
Since a ceasefire halted the fighting in Gaza last October, a quieter dying has continued — not from bombs, but from waiting. Approximately three hundred Palestinians have perished in the months since, their approved medical evacuations tangled in layers of security clearance, bureaucratic sequencing, and restricted border access that move far slower than disease. With fifteen thousand still on waiting lists and fewer than two thousand evacuated in eight months, the gap between what was promised and what is possible has become, for many families, the measure of a life lost.
- Patients with cancer, spinal injuries, and necrotising infections are dying before paperwork clears — one mother received her travel approval two weeks after her funeral.
- Only 1,977 people have been evacuated in over eight months, while 15,000 remain on waiting lists, creating a backlog that experts say could take years to clear at the current pace.
- Medical crossings operate just one to three days per week, and each patient must survive multiple rounds of security screening by Israel, receiving countries, and transit nations before a single step is taken.
- Gaza's hospitals, unable to fill the gap, are rationing chemotherapy and dialysis, loaning medicines between wards, and cancelling surgeries — while Israel and humanitarian agencies dispute whether aid flows are adequate.
- Desperation has opened the door to fraud: families are paying self-declared agents thousands of pounds for promises no one can keep, prompting the WHO to issue urgent public warnings.
Amina Abu al-Kas had a necrotising infection consuming her skull. When Gaza's medical board approved her for treatment abroad, her son Saber said it brought life back into her — she knew there was nothing left for her at home. What followed was months of waiting: security clearances from Israel, acceptance letters from foreign hospitals, visas, transit approvals. No call came. Amina died on May 29th. Two weeks after her funeral, the hospital rang to say her paperwork was ready.
Amina is one of roughly three hundred Palestinians who have died waiting for medical evacuation since the ceasefire between Israel and Hamas began last October. Fifteen thousand more remain on waiting lists. The World Health Organization, which coordinates these transfers, has evacuated just 1,977 people in over eight months — a pace that would take years to clear the backlog.
The obstruction is structural. Patients must pass security screening by Israel, by the receiving country, and by Egypt or Jordan if they transit there. Many host nations accept only narrow categories of cases. The crossings themselves are throttled to a few days per week. Outside the ruins of al-Shifa hospital, families gathered to protest: a father wailing for his son who needed a corneal transplant; a woman who had lost her breasts, ovaries, and uterus to cancer, asking what painkillers could possibly do for her; a fourteen-year-old boy on crutches, waiting for evacuation both for his amputated leg and for the spinal cancer he had fought since infancy, four loose screws now pressing against his lungs.
The evacuations would be less urgent if Gaza's healthcare system had recovered. Eight months after the ceasefire promised full aid access, doctors are rationing life-saving drugs, turning away dialysis and chemotherapy patients, and borrowing medicines between wards. The ICRC documented shortages of everything from gauze to advanced equipment. Israeli authorities cited seventeen thousand tons of medical aid delivered since the ceasefire; humanitarian officials said those figures masked systematic gaps. The WHO's representative offered the clearest measure: if supply were truly unrestricted, the debate over what is given versus what is needed would not exist.
Desperation has created a secondary market. Some families have paid self-declared agents thousands of pounds hoping to accelerate their cases. The WHO issued a public fraud warning. No one, it noted, can move the queue. Saber, reflecting on his mother's death, recalled what mourners kept saying at her funeral: at least she is at peace now. "That sentence," he said, "sums up everything. Because a patient in Gaza is different from any patient elsewhere in the world."
Amina Abu al-Kas was dying of a necrotising infection that had eaten into her skull. The pain kept her awake through entire nights, and the only medicines that might have dulled it made her stomach bleed. When Gaza's medical board approved her for treatment abroad, her son Saber felt something shift. "It brought life back into her," he said. "She knew there was no treatment in Gaza, so she was happy and excited."
Then came the waiting. After the approval, the family needed security clearances from Israel, acceptance from a foreign hospital, visas, more clearances from transit countries. Days turned into weeks. Saber and his mother existed in a strange limbo—knowing that at any moment a call might come saying pack your bags, or knowing that at any moment she might simply die. "We waited a long time, but no response came," Saber told the BBC. Amina died on May 29th. Two weeks after her funeral, the hospital called. Her paperwork was ready.
Amina is one of three hundred Palestinians who have died waiting for medical evacuation since the ceasefire between Israel and Hamas began last October. Another fifteen thousand remain on waiting lists, some with war injuries, others with cancers and conditions that Gaza's shattered healthcare system cannot treat. The World Health Organization, which coordinates these transfers, has managed to evacuate just 1,977 people in over eight months. At that pace, clearing the backlog could take years.
The bottleneck is bureaucratic and structural. Patients must clear security screening by Israel, by the receiving country, by Egypt or Jordan if they transit there. Many host nations accept only certain types of patients—children, or cases requiring short-term treatment. The crossings themselves are throttled: medical evacuations through the Kerem Shalom crossing with Israel happen one day a week. Through Rafah into Egypt, three days a week. In early June, Gaza's acting health undersecretary Maher Shamia identified the core problem: the security screening process itself, and the limits Israel imposed on departures. Israeli authorities said they had approved the vast majority of requests since the start of 2025, but the numbers tell a different story.
Outside the bombed-out shell of al-Shifa hospital in Gaza City, patients and families gathered to protest. Nidal al-Arir wailed on the ground, pleading for his son, who needed a corneal transplant. Raeda Nuaizi, who had lost her breasts, ovaries, uterus, and pelvic bone to cancer before the war, cried out: "What is my treatment? Painkillers! But what can painkillers do for a cancer patient?" Fourteen-year-old Muath al-Dini stood on crutches, waiting for two separate medical evacuations—one for the leg he lost in an airstrike that killed his sibling, another for the spinal cancer he had battled since infancy. Before the war, he had received treatment in Jerusalem. That route is now almost entirely closed. His mother, Umm Samir al-Dini, said four of the screws holding his spine in place had come loose and were affecting his breathing. Doctors recommended further amputation. After receiving security clearance in May, the family heard nothing more.
The deeper crisis is that these evacuations would not be necessary if Gaza's healthcare system functioned. Eight months after the ceasefire agreement promised "full aid" into the Strip, doctors are rationing life-saving drugs, loaning essential medicines to each other, turning patients away from chemotherapy and dialysis. The International Committee of the Red Cross documented shortages of everything from gauze dressings and painkillers to advanced equipment. Pat Griffiths, the ICRC's spokesman in Jerusalem, said plainly: "There is no doubt in my mind that people in Gaza are dying because they can't receive the care they need—and that there are preventable deaths happening because of the limits on what can be brought in." Israel's Cogat authority countered that seventeen thousand tons of medical aid had entered since the ceasefire, including cancer medications, dialysis machines, and CT scanners. But a humanitarian official, speaking anonymously, said Israeli authorities used anecdotal examples to mask systematic shortages. The WHO's Reinhilde Van de Weerdt put it differently: "If medical supply is unrestricted, you don't have these discussions about what is given versus what is needed."
The desperation has spawned a secondary crisis. Some patients have begun paying self-declared agents thousands of pounds, hoping to move their cases forward in the queue. The WHO posted a warning in large red letters: "Beware of fraud." No one can speed up the process. Saber, Amina's son, reflected on what her death meant. "Most of those who came to offer condolences said, 'At least she is at peace now.' That sentence sums up everything. Because a patient in Gaza is different from any patient elsewhere in the world."
Citas Notables
It brought life back into her. She knew there was no treatment in Gaza, so she was happy and excited.— Saber Abu al-Kas, son of Amina Abu al-Kas, on his mother's reaction to medical evacuation approval
There is no doubt in my mind that people in Gaza are dying because they can't receive the care they need—and that there are preventable deaths happening because of the limits on what can be brought in.— Pat Griffiths, International Committee of the Red Cross spokesman in Jerusalem
La Conversación del Hearth Otra perspectiva de la historia
Why does the evacuation process take so long? Surely if someone is dying, that should move faster.
It should. But there are layers. First, Gaza's medical board has to approve you. Then Israel screens you for security. Then the receiving country has to accept you and issue a visa. Then Egypt or Jordan screens you if you're transiting through. And the crossings themselves only operate certain days.
So it's not one bottleneck—it's many in sequence.
Exactly. And if any one of them stalls, you're stuck. Amina got approval in May. She died before she could leave. Her paperwork cleared two weeks after her funeral.
But couldn't countries prioritize medical cases? Make exceptions for people who are actively dying?
In theory, yes. But some host countries are very specific about what they'll accept. Some only take children. Some only take cases they can finish quickly. And the security screening—that's not something anyone wants to rush, from any side.
So the system is designed to be slow.
It's designed to be cautious. But caution has a cost when people are in pain and running out of time.
What happens to the people still waiting?
They stay in a healthcare system that's barely functioning. Doctors ration painkillers. Surgeries get cancelled because the generators don't provide enough power. Some patients are so desperate they pay fraudsters thousands of pounds, hoping someone can move them up the list.