One in five faces access constraints
In recent years, access to health care has become more restricted for Gaza patients. The Palestinian Ministry of Health (MoH) relies on the procurement of specialized medical treatment from external health providers to fill gaps in its own health care system. Gaps are acute in Gaza due to the serious shortages in medicines, medical supplies, equipment and trained personnel.
Thousands of patients previously relied on Egypt as an accessible and affordable destination for medical services. However, Egypt’s partial closure of the Rafah border with Gaza since mid-2013 has virtually severed access for private patients and significantly reduced MoH referrals. This loss has been buffered in part by an increase in the number of MoH referrals of Gaza patients to the West Bank, including East Jerusalem, and to Israeli hospitals. The closure of Rafah has reduced the options open to private patients from Gaza for specialized health care.
To access West Bank and Israeli hospitals, patients and their companions require permits from the Israeli authorities to leave Gaza through the Erez checkpoint. In January and February 2015, 2,350 patients, or 80.5 per cent of all applicants, had their permit applications approved, averaging about 47 patients per day, slightly below the 81.7 per cent approval rate for 2014. The remaining 568 applications (19.5 per cent) were denied or delayed, resulting in patients missing their appointments and having to re-apply. Since the beginning of 2015, 32 patients were summoned for security interviews with Israeli officials, with some interviews lasting all day, as a precondition for their application to be processed.
Despite rapid population growth and the increasing level of need, annual referrals of Gaza patients between 2010 and 2014 has risen by only 1.3 per cent, although the destination of referrals has changed significantly. Overall, during the past four years, the number of Gaza patients referred outside of the oPt, particularly to Egypt, fell by 25 per cent, while referrals to Palestinian hospitals in East Jerusalem and elsewhere in the West Bank have increased markedly since 2012.
Alongside the increase in the absolute number of patients who have obtained permits to leave Gaza through the Erez crossing in the past four years, the percentage of applications rejected or delayed has also increased.