Correction – Munir waited six months for chemotherapy

Munir has thyroid cancer which has spread to other parts of his body. He lives in Gaza with his wife and six sons but must travel frequently for critical medical treatment which is unavailable in the Gaza Strip, for which he requires a permit from the Israeli authorities.

Munir featured in last week’s interagency report on the humanitarian crisis in Gaza. Thanks to high-level Jordanian intervention he reached Jordan for the treatment he desperately needs. This came to light after the report had been finalised and circulated and a matter of hours before its publishing time of 00:01 on Thursday 6th March.

Yet the fact remains that Munir’s crucial cancer treatment was delayed for six months, during which time his cancer spread from his thyroid to other parts of his body, and his mental and physical health deteriorated. We remain convinced that Munir’s story is a good example of how lack of access to vital medical treatment is affecting ordinary people’s lives.

Munir’s son Hamed also featured in the report. He suffers from haemophilia which requires blood transfusions at least three times a week. Since last November, Hamed’s medicines have been unavailable in Gaza, and he has still not been granted permission to travel for treatment. 

Munir has now returned to Gaza, and he and Hamed are both hoping for a permit to travel for treatment in April, with the support from the Palestinian Centre for Human Rights¹.

Munir and Hamed are two of the 1,627 patients denied permits for health treatment in 2007. Overall, 18.5% of applicants were denied permits in 2007. The monthly figures paint a dramatic picture of a sharp decline in patients receiving permits throughout the year. In January 2007 89.3% of patients were granted permits but by December this figure had declined to 64.3%².

What these statistics fail to show are those who were granted a permit but were turned back at the border, and those whose permits have not been refused but ‘delayed’ – sometimes for months while serious medical conditions deteriorate.  

Deaths due to refused permits

Miri Weingarten of the Physicians for Human Rights - Israel explains that although access related deaths are hard to estimate statistically given the many factors involved, every delay lessens the chances of recovery and denies the patient the right to the best available care. PHRI estimate that at least four patients died due to deterioration in medical conditions after their travel permits were delayed or denied since the beginning of this year³.

These included one-year-old Bayyan Abu Hilu, who suffered from a genetic liver condition, but whose parents were refused permission to take her to hospital in Israel for ‘security reasons’. Bayyan died on the 2nd March 2008.

45- year old mother of ten Fatmeh Al-Ladawi , and 77-year old Fatmeh Mahdi both died of cancer due to being unable to access treatment outside Gaza.

In December 2007 65-year old Khadija Al Aqed was referred urgently to a hospital in Jordan for surgery when her pacemaker stopped working. Mrs Al Aqed was refused access for ‘security reasons’ and on February 10th she died of cardiac arrest⁴.

Lack of a coordinated system

There is no coherent coordinating mechanism to ensure that Gazans who need medical treatment unavailable in the Gaza Strip are able to access it.

The current mechanism between the Palestinian Authority and the Israeli authorities at Erez Crossing – including a recent development whereby patients have been sent by shuttle bus to Jordan or Egypt – functions only partially with long delays, problems of transparency with procedures and no right of appeal.

Hamas and Egypt have recently set up a temporary agreement regarding access to medical treatment.  A number of cases are now receiving treatment in Egypt and Jordan under this agreement. However, this system is neither comprehensive nor permanent. It does not serve all residents of Gaza and does not allow people to access treatment in Israel, Jordan or the West Bank.

Ms Weingarten said : ‘The current system is opaque and obstructive to patients needing medical care. The Government of Israel, which still controls all the sources of sustenance of the Gaza Strip, must establish a transparent and fair system to ensure access of patients to medical centres outside Gaza whenever necessary. Such a system is urgently needed in order to save lives’.

Read the full report here.