Access by Gaza Palestinians to Israeli hospitals:
The facts

Briefing 215 published on 9 July 2008

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1. The context: “ Israel is ruthlessly denying Palestinians access to hospital treatment….”

‘Blockade'. ‘Siege'. ‘Hell'. Just a few of the expressions commonly used by commentators to describe the experience of the Palestinians of the Gaza Strip since Israel 's withdrawal in August 2005.

The image of Gaza as an Israeli ‘prison camp' is increasingly etched on international consciousness. And no issue has done more to reinforce that image than the claim that Israel has been depriving the Palestinians of access to Israeli hospitals to receive treatment, and ruthlessly allowing them to suffer and die.

In this Briefing we summarise some basic facts which dispel the above claim. Far from ‘cutting off' access to Israeli hospitals, the level of access for Gaza Palestinians is extensive, and has been increasing in the last two years.

We refer below to reports on movement in and out of Gaza issued by Israel 's Unit for Coordination of Government Activities in the Territories (‘COGAT').

2. Thousands of Gaza Palestinians given permits to receive treatment in Israeli hospitals

•  In 2007, 7,226 permits were granted to sick Palestinians to travel to Israeli hospitals (COGAT report, 2 April 2008 )

•  This marks a 50% increase in the number of permits granted in 2006, when 4,754 permits were granted (ibid)

•  In the first two months of 2008, 2,317 more Gaza Palestinians were granted permits (COGAT report, 20 February 2008 )

•  All Palestinians who are granted permits are allowed to bring a family member into Israel to accompany them

•  The total number of Gaza Palestinians entering Israel for hospital treatment between June 2008 and the end of February 2008 was in fact 12,400 (a figure which includes patients and a family member)

3. The level of care which Gaza Palestinians receive

Gaza Palestinian patients attend several Israeli hospitals including Soroka in Beersheva, Tel Hashomer in Tel Aviv and Barzilai in Ashkelon .

The following is a quote from Dr Ron Lobel, deputy director of the Barzilai hospital (and is taken from Der Spiegel online, 17 April 2008 ):-

“We treat hundreds of Gazans here each year. Most of them are extremely ill, many of them have bullet wounds. But we never ask them how they were injured or whether they belong to Hamas. Even if they're terrorists, they're treated like any other person. They're treated by Israel for free. We make no distinction between Israelis and Palestinians…..”

(Note: Barzilai hospital has come under Katyusha rocket fire from Palestinian groups in Gaza , as has the town of Ashkelon generally).

Dr Lobel's comments echo those of a Gaza Palestinian doctor, who wrote as follows in an ‘open letter' published in June 2005:

“I have nothing but praise for the doctors, nurses and other medical staff at Soroka hospital. They show compassion, sympathy and kindness….. Soroka is a hospital that has opened its doors to treat Palestinians without discrimination, offering the best care available…”

(For the full text of the ‘open letter', see Beyond Images Briefing 146)

Meanwhile, Dr Dudu Mishali, senior pediatric heart surgeon at Tel Hashomer hospital in Tel Aviv, commented: “Our treatment of Palestinians has not changed…. This cooperation has survived difficult times of terrorism and bombings” (quoted on , 29 May 2007 – see Beyond Images Briefing 197).

4. Save A Child's Heart – free heart surgery to Gaza Palestinian children

The Save A Child's Heart project, based at the Wolfson Medical Centre in Holon , outside Tel Aviv, has provided many Gaza Palestinian children with free heart surgery since the project began in 1994. Save A Child's Heart has continued to provide support to Gaza children despite the second intifada, and the missile and rocket attacks. See

5. Abuse of medical documentation by Palestinians

On several occasions, Gaza Palestinian patients have taken advantage of medical certificates giving them the right to travel to Israeli or West Bank hospitals, to prepare suicide or other attacks. A dossier of these plans has been published on the Israeli Ministry of Foreign Affairs website in a report dated 20 January 2008 , entitled ‘Abuse of Humanitarian Policy for the Purpose of Terrorist Activity'. For instance:-

•  Fatma Zak , a 39 year old Gaza resident and mother of eight children, was apprehended in May 2007 at the Erez crossing point, and confessed that she and her niece were planning to rendezvous with Islamic Jihad members inside Israel, who would supply them with bombs to carry out a double suicide attack, likely to be on a restaurant or a celebration hall in Netanya or Tel Aviv. Zak's niece was supplied with a medical certificate based on false information assembled by Islamic Jihad, and on this basis she and her aunt received permission from Israel to enter the country

•  In June 2005, 21 year old Wafa Al-Biss was arrested at the Erez Crossing point out of Gaza with an explosive belt strapped to her body. She was an outpatient at Israel 's Soroka hospital, whose emergency unit had saved her life some months earlier following serious burns injuries she had suffered in an accident in her kitchen. Al-Biss confessed to planning to bomb the hospital during one of her outpatient appointments – a plan which prompted widespread outrage (see Briefing 146, quoted above)

•  In September 2004 Suhad Aslan, was sent by the Fatah Al Aqsa Martyrs Brigade in the Gaza Strip to carry out a suicide bombing in Israel , after she required medical treatment in the Al-Muqaddas hospital in Jerusalem . The plan had been for her to rendezvous with the bomb planners at the hospital who would instruct her where to go to carry out the attack. Israeli security personnel arrested her before the attack could be carried out

Such incidents compel the Israeli authorities carefully to check the requests of Palestinian patients seeking to enter Israel for hospital treatment. The bureaucracy and delays that regrettably result are entirely the responsibility of those who abuse the medical treatment route into Israel to plan terrorist attacks.

6. Israeli shuttle service to Jordan or Egypt for Palestinians denied entry

As a result of the security vetting procedures which Israel has no choice but to apply, 10%of Gaza Palestinians applying for permits to enter Israel have been refused entry (statement of Colonel Nir Press, head of COGAT, reported in Jerusalem Post, 1 April 2008 ).

Colonel Press also confirmed that all Palestinians who are denied entry into Israel are given the opportunity to take an Israeli shuttle to the Allenby Bridge and cross into Jordan , or else go down to the crossing with Egypt .

7. World Health Organisation accusations, and Israel 's refutation

In March 2008, the World Health Organisation (WHO) issued a report which accused Israel of being “inhumane” in its dealings with Gaza Palestinians who wish to enter Israel for medical treatment.

The WHO report was launched by the head of WHO in Gaza who relied upon five case studies of Palestinians allegedly allowed to die by Israel as a result of them being denied access to the country.

Colonel Press, head of COGAT, responded the next day by holding a press conference (which was reported in the Jerusalem Post on 1 April 2008) where he demonstrated that all five of the Palestinians allegedly allowed to die had in fact received permits to enter Israel for medical treatment.

Press explained that two of the Palestinians cited by WHO had been treated in Israeli hospitals. The other three never used their permits due to what Press described as “internal Palestinian considerations”.

8. 19 major Palestinian attacks on crossing points into and out of Gaza

Another obstacle to hospital treatment for Palestinians in Israel is the sequence of violent attacks by Palestinians on the crossing points into Israel .

There are several heavily guarded crossing points into and out of Gaza . These are used by the thousands of Palestinians who enter into Israel for hospital treatment (as well as serving as entry points for thousands of tonnes of humanitarian aid being brought into Gaza from Israel ). Among the crossing points are Erez, Karni, and Kerem Shalom.

•  These crossing points have come under repeated armed attack by Palestinian groups – including bombings, rocket attacks and other attacks

•  There have been 19 major armed attacks on the Gaza crossing points since November 2000, and dozens of smaller attacks (figure taken from a report called ‘Main terrorist attacks carried out at Gaza Strip crossings' on Israel 's Ministry of Foreign Affairs website, dated 6 May 2008 )

•  In one of the most recent attacks, Palestinians drove three explosives-laden vehicles into the Keren Shalom crossing point, killing the drivers, wounding many Israeli soldiers and guards, and causing its temporary closure (New York Times, 20 April 2008 )

•  Such attacks obviously delay Palestinians who wish to cross into Israel for medical treatment, and therefore harm their welfare

Far from Israel denying the Palestinians hospital treatment, the Israelis are making such opportunities available, but they are being sabotaged by the Palestinian violence.

For further illustrations of how attacks on the crossing points have harmed the Palestinians see Beyond Images Briefing 126 – ‘Sabotaging Recovery: Attacks on Palestinian Industrial Zones and Crossing Points' (January 2005).

9. Israeli medics coming under fire while collecting a sick Palestinian baby

On 27 May 2007 , an Israeli ambulance team came under shellfire at a crossing point while picking up a Palestinian baby for treatment inside Israel . The Israeli team completed their mission, and the baby was treated inside Israel (see Beyond Images Briefing 197). The position was summed up as follows by Colonel Press:-

“Despite the rocket fire, Israel is doing all it can when it comes to allowing sick Palestinians into Israel from Gaza and the West Bank …. The reality is the outcome of the terror that does not stop against Israel and which targets the crossings that are used to take people out of Israel for medical treatment….”

(quoted in Jerusalem Post, 1 April 2008 )

10. Hamas accused by the Palestinian health ministry of seizing fuel destined for Gaza hospitals

Palestinian policies not only make it harder for Palestinians to access Israeli hospitals, but they even harm Palestinian hospitals. Hamas was recently accused of diverting fuel destined to be delivered to Gaza hospitals. The condemnation was issued not by Israel , but by the Palestinian health ministry :

“Members of Hamas in the Gaza Strip opened fire on Sunday 29 April on fuel trucks that were full of fuel destined for hospitals in the territory….”

(Press release by the Palestinian Health Ministry, and reported by AFP (Agence France Presse), 29 April 2008 )

11. EU condemnation of Hamas for aggravating the humanitarian situation

The EU recently issued a statement (reported in the Jerusalem Post, 28 April 2008 ) condemning Hamas for its role in worsening the humanitarian situation of the Palestinians in Gaza :-

“Hamas and other militant groups in Gaza have their share in aggravating the humanitarian situation, including through carrying out attacks on the crossing points… the EU president condemns such actions, which only lead to further suffering of the population…”

12. Other Palestinian actions which damage the Palestinians in Gaza

Many other Palestinian actions harm the Palestinians of Gaza, including the cutting off or diversion of fuel supplies from Israel; the smuggling into Gaza of explosives under cover of EU humanitarian relief; and the use of hospitals and school premises in Gazan towns to assemble weapons, and launch missile and other attacks. These topics are beyond the scope of this Briefing.

13. Israeli medical support for Palestinians, while under rocket attack

Since 2001, over 7000 missiles, rockets and mortars have been fired indiscriminately into Israel from Gaza . (See Gaza and Disengagement on the Beyond Images website). Many governments in the situation of Israel 's Government might cut links with Gaza completely, in response to this assault.

Israel has not done so. Even in the face of the Qassams and Katyushas, the attacks on crossing points, and the Palestinian attempts to abuse medical permits, Israel has provided Gaza Palestinians with extensive access to its hospitals, and that access is increasing (including during periods of fragile ‘truce'). Yet Israel is demonised for its Gaza policies, and the facts in this Briefing are virtually unknown around the world.