“I can’t run, play, or get treatment” - 16-year blockade leaves two children a day in Gaza unable to access medical treatment

Nearly 100 children's applications to Israeli authorities were denied or left unanswered in the month of May alone, when hostilities escalated between Israel and armed groups in Gaza, leaving 33 Palestinians, including at least seven children, and two people in Israel dead.

According to the Ministry of Health in Gaza, during the escalation of hostilities between 9 and 13 May 2023, hundreds of patients and their caregivers were unable to reach vital medical care in the West Bank, including East Jerusalem, or in Israel.

Last year, three children died while their applications for Gaza exit-permits were either denied or remained under review, including a 19-month-old child with a congenital heart defect and a 16-year-old child with leukaemia. 

Neither chemotherapy nor radiology treatments are available due to Israeli Government restrictions on medical equipment and medication entering Gaza.

Zeinab,^* nine years old, underwent surgery three times in Gaza between the age of one and three to treat nerve damage in her leg, a condition she has from birth. All three surgeries were unsuccessful, and her family has tried for over a year to get a permit for her and a caregiver to travel for treatment outside Gaza.

“I felt very bad when my application was denied. It was during Eid, I really wanted to go and play with my friends. I wish I could run and wear trousers,’ she said. ‘The device they fit on my leg hurts when I walk, when I go to school. I hope I can have it removed. I am a child, and I wish to be treated like other children.”

Her grandmother Maryam^* said: “I often find Zeinab crying, she tells me she’s in pain, that she wishes she could have this device removed and play and dress up. Why doesn’t she have a right to medical treatment like any other girl?”

According to the World Health Organization (WHO), treatment and diagnostic services for cancer comprised the single largest reason for patient permit requests to exit the Gaza Strip for 2019 to 2021.

During the same period, 32% of children with approved permits to travel for health care from the Gaza Strip did not have a parent approved to accompany them, resulting in them traveling with a different relative or not travelling at all.

Gaza’s health system remains on the brink of collapse after 16 years of blockade. Along with recurrent escalations of violence, this poses a constant threat to children’s lives in Gaza; the restrictions imposed under the blockade contribute to increasing poverty rates and health supplement shortages in the local markets.

According to a recent Save the Children survey, malnutrition is dominant among families living in ‘access restricted areas’ that are close to the Israeli fence and witness frequent attacks, lack access to basic needs, suffer from poor public infrastructure and a history of waterborne diseases and solid waste pollution. 10% of families surveyed by Save the Children reported losing a child due to a preventable cause before the age of 5.

The May 2023 escalation highlighted the urgent need for humanitarian assistance in the occupied Palestinian territory (oPt). Two thirds of the way through the year, only a third of the $502 million required in the 2023 Humanitarian Response Plan has been funded.

Jason Lee, Save the Children’s Country Director in the occupied Palestinian territory said:

“Despite approval rates for medical permits increasing this year, there is still an average of 60 children every month who need medical treatment outside Gaza and whose applications are rejected or left unanswered. Some are desperately sick children who have no options other than leaving Gaza to survive. 

Denying children healthcare is inhumane and an infringement of their rights,^[1] and separating children from their parents during treatment can make it even harder for those children to cope.

The 16-year blockade is impacting every aspect of children’s lives, including their physical and mental health. Our research in 2022 showed that four out of five children in the Gaza Strip live with depression, grief and fear. Their reality is so far removed from the things we associate with childhood. This systemic violence and deprivation have to stop.”

Save the Children is calling on the Government of Israel to end the blockade of Gaza as it is the root cause of ongoing violations of the most fundamental rights of children.

As per the legal obligations of an occupying power,^[2] the Government of Israel should take every step possible to protect Gaza patients, promote unhindered access to essential healthcare, and uphold the right to health and healthcare for Gaza’s children and their families. 

• According to WHO data, between January-June 2023, 1,746 patients of which 373 children had their applications rejected or delayed. Out of 2,789 applications for children, 2,416 were approved and 373 were rejected or delayed. An average of 60 children’s applications were unsuccessful each month.
• In July 2023, Save the Children conducted a study on nutrition in Gaza, using qualitative and quantitative tools: 322 mothers from five geographic locations in Gaza Strip were surveyed, and two focus group discussions were held with 63 parents of children who were diagnosed with malnutrition. All respondents lived in areas that are classified as Access Restricted Areas (ARA) which lack basic infrastructure services due to their closeness to the Israeli fence. Residents of these areas lack access to basic services including health and nutrition. 73% of responding families reported that the main barrier for them to reach a health centre is the long distance. 
• Save the Children works with Al Mezan, an independent, non-governmental human rights organization based in the Gaza Strip since 2014. Save the Children provides support and legal aid to child medical patients to overturn denial or delay of exit permit application to access medical treatment outside the Gaza Strip.