Critically ill child dies in Gaza waiting for referral and permit
Razan Salah, 11 years old, from Rafah, was admitted to European Gaza hospital on November 5 with sudden bleeding into the skin. After tests she was diagnosed with aplastic anemia (bone marrow failure) and referred on November 11 for urgent bone marrow transplantation available only in Israeli hospitals. However, new procedures within the Referral Abroad Department in Gaza and in Ramallah caused her referral to be delayed several days, misdirected to a hospital that lacks the capacity to treat the condition, then refused for financial coverage for a bone marrow transplant, which the receiving Israeli hospital had requested. Razan was approved only for an outpatient appointment. The family applied for an urgent permit from Israeli authorities to exit Erez, without an immediate response. On the evening of November 20, Razan’s condition deteriorated and she was transferred to the pediatric ICU, where she died 5 days later.
Summary: November 2014
Access restrictions tighten
Rafah border: Gaza’s access to Egypt through Rafah has been completely closed since October 25 following an attack in north Sinai which killed 30 Egyptian soldiers. So far in 2014, the terminal has been closed on 216 days (65% of days).
Access through Erez: only 78.97% of 1,636 patients who applied for Israeli permits to exit Gaza via Erez for medical treatment in November were approved. 44 patients (19 females and 25 males, including 15 children and 4 elderly) were denied permits. 300 patients (111 females and 189 males, including 82 children and 21 elderly people over 60) received no response to their applications, and missed their medical treatment appointments.
Interrogations: 17 patients (including 1 female) were requested to attend Israeli security interviews after applying for a permit to cross Erez.
Casualty patients
29 patients (including 11 children) with war-related injuries applied to exit Gaza via Erez checkpoint. 23 were approved to exit for travel to Jordan, and 6 were delayed. The patients had been referred by the Ministry of Health during November with the cost to be covered by the receiving hospitals.
Patient detained at Erez
A patient remains in Israeli detention for 26 days after being arrested in Erez checkpoint enroute to his hospital treatment (page 6).
Low referrals reflect new policy guidelines
Child dies while waiting for referral/permit approval: see photo story above.
Regular referrals declined 22%: the Ministry of Health Referral Abroad Department (RAD) in Gaza referred 1,448 patients in November to hospitals outside of (MoH) facilities, 22% less than the monthly average for the first half of 2014.
Gender gap: the gender gap in referrals widened: 58.43% male patients versus 41.57% female patients. 25.07% of all referrals were for children aged 0-17 years and 19.54% were for patients aged over 60 years.
Estimated cost of referrals for October: NIS 6,144,932.