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DEIR AL-BALAH, Gaza Strip (AP) — A 12-year-old Palestinian boy, suffering from leukemia and severe malnutrition, was lying in a hospital bed in central Gaza in late October when Rosalia Bollen, a UNICEF official, saw him. Despite his family’s repeated requests to Israeli authorities for permission to leave Gaza for a life-saving stem cell transplant, their pleas had been denied six times over the past few months, citing unexplained security reasons. Three days after Bollen’s visit, Islam al-Rayahen passed away.
Thousands of patients in Gaza, including at least 2,500 children, are awaiting Israeli approval for medical evacuation due to war injuries or chronic illnesses. Many of these children are in urgent need of care that is unavailable in Gaza, whose health infrastructure has been decimated by Israel’s 15-month military campaign.
“They cannot wait. These children are dying as they wait,” said Bollen, emphasizing the urgency of the situation.
The Israeli military’s response to medical evacuation requests has been slow, with many applications delayed for months. In some cases, requests for evacuations are rejected, often without clear explanations.
Moeen Mahmood, the Jordan country director for Doctors Without Borders, criticized Israel’s arbitrary decisions, claiming they lack clear criteria.
In a statement, COGAT, the Israeli military agency handling humanitarian issues for Palestinians, said it works to approve evacuations for children and their families after security checks. However, they did not comment on Islam’s case. An Israeli military official explained that Israel’s internal intelligence service reviews whether the patient or their caregiver is connected to terrorism, and if such a link is found, the request is rejected.
Osaid Shaheen, a nearly 2-year-old boy diagnosed with cancer in his retinas, now faces the prospect of losing his eyes after his evacuation request was denied on security grounds. His mother, Sondos Abu Libda, was devastated by the rejection.
“We never imagined a child could be denied for security reasons,” Abu Libda said. Despite receiving three chemotherapy treatments, Osaid’s cancer has spread, and without further treatment, his only option is to have his eyes removed.
WHO estimates that 14,000 patients, including those with severe conditions, urgently need to be evacuated from Gaza, a number the Gaza Health Ministry places at 22,000. Since the war began on October 7, 2023, only 5,230 patients have been evacuated, with just 342 evacuated since May due to the closure of the Rafah crossing.
Before the war, around 100 patients a day were transferred out of Gaza.
More than 44,500 Palestinians have been killed, and over 105,000 have been wounded by Israeli bombardment and ground offensives in retaliation for Hamas’ October 7 attack on southern Israel. Gaza’s health system has been overwhelmed by war casualties and the destruction of critical infrastructure, including its cancer hospital, which was seized by Israeli troops.
In some instances, aid groups like Doctors Without Borders have had to resubmit evacuation requests for children, but Israeli authorities often block the caregivers accompanying them on security grounds, without providing detailed explanations.
For families like those of Qusay and Al-Hassan, the wait for medical evacuation is a matter of life and death. Qusay, a 4-year-old with a heart defect, risks paralysis without surgery. His mother, Nima al-Askari, is desperate: “Should I wait until my son becomes paralyzed?” she asked. Similarly, Asma Saed is anxiously awaiting approval for her 2-year-old son, Al-Hassan, to travel for kidney failure treatment.
Amid the desperate pleas and escalating health crisis, the children of Gaza continue to wait for the treatment they need—while time slips away.
