‘Two weeks after her death I got a call’: Gaza patients face agonising delays for evacuation

Two weeks after her death I got – Since the implementation of the US-brokered ceasefire between Israel and Hamas in October 2023, thousands of Palestinians have been waiting for medical evacuations from the Gaza Strip. For many, the process feels like a race against time, with conditions worsening while delays mount. One family’s story, however, highlights the emotional toll of this prolonged uncertainty. Saber Abu al-Kas, whose mother Amina died in May after months of waiting, described the experience as both heartbreaking and surreal. “It brought life back into her. She knew there was no treatment in Gaza, so she was happy and excited,” Saber told the BBC. Yet, despite this hope, Amina’s fate was sealed when she succumbed to a severe infection that spread to her skull.

“My mother couldn’t sleep day or night; she stayed awake, crying out from the pain. Painkillers caused stomach ulcers and inflammation, and the doctors banned her from taking them,” Saber added. The agony of waiting for clearance to leave Gaza became a defining moment for the family, as they anticipated a potential miracle. “We knew that at any moment God might take her. And we also knew that at any moment a miracle might happen, that we might get a call saying, ‘Get your bags ready and prepare to travel through the crossing,'” he recounted. But two weeks after Amina’s death, Saber finally received the news that her paperwork was complete. “We waited a long time, but no response came,” he said. “My mother died on 29 May, and only then did we get confirmation that she was ready to go.”

Amina’s case is not unique. According to Gaza’s Hamas-run health ministry, over 300 Palestinians have died while waiting for medical evacuation since the ceasefire began. These numbers are corroborated by the World Health Organization (WHO), which also tracks the process and assists with patient transfers. The WHO reports that 1,977 people have left Gaza for treatment abroad since the ceasefire started eight months ago. However, the wait for those still in the queue remains agonising. The health ministry estimates that 15,000 patients are currently awaiting evacuation, with some suffering from war-related injuries and others from chronic conditions like cancer.

The Evacuation Process: A Delicate Dance

The journey to secure medical evacuation involves multiple steps, each fraught with challenges. Patients first need approval from Gaza’s medical referral board, which assesses their criticality for treatment abroad. Once approved, they must pass rigorous security checks conducted by Israel, as well as transit countries such as Egypt and Jordan. Additionally, the host nation must accept the patient, a process that can be influenced by political considerations. Dr. Reinhilde Van de Weerdt, WHO Representative for the occupied Palestinian territory, noted that recipient countries often have specific criteria. “Many host nations are quite selective about the type of patients they can support—for example, some only want children, while others prefer patients requiring shorter stays,” she explained. This selectivity, combined with the need for visas and clearance from multiple authorities, creates a bottleneck that keeps many patients stranded.

“Then patients and their companions need visas for the host country, and to pass security checks by Israel, Egypt/Jordan and the host nation,” Dr. Van de Weerdt said. The complexity of these requirements means that even those who are medically urgent may face significant hurdles before they can leave. For Saber, the process was a constant waiting game, with his family hoping for a breakthrough that never materialised. “We are talking about something that feels like a miracle,” he remarked. “If a patient’s name is selected and they are granted permission to travel for treatment abroad, it is almost a miracle.”

Delays are exacerbated by the limited number of departure days through Gaza’s border crossings. The Israeli defence ministry’s Cogat, which oversees civil affairs in the Strip, stated that evacuations are scheduled based on the availability of host countries and the completion of security screenings. As of early June, medical evacuations through the Kerem Shalom crossing with Israel occurred only one day a week, while the Rafah crossing with Egypt allowed departures three days a week. This restriction means that patients must wait for their turn, often in a system that is slow to respond.

A System Under Strain

The evacuation process has become a symbol of the broader struggles within Gaza’s healthcare system. With limited resources and overcrowded facilities, many patients receive care that is inadequate for their condition. For Amina, this meant a necrotising infection that doctors in Gaza could not treat. “Doctors told us they did not have the medicines or therapies to fight the infection,” Saber said. “It was a daily battle, but we never thought she would die before getting help.”

“The wait stretched on, yet no confirmation arrived. My mother died on 29 May, and only then did we get the news that her paperwork was ready,” Saber recalled. His words reflect the frustration of families who have been forced to endure months of uncertainty. The WHO, which facilitates evacuations through Gaza’s Israeli-controlled crossings, has acknowledged the backlog. “The process is constantly fluctuating because patients’ conditions and decisions change,” a WHO official noted. “This means not all deaths may be recorded, but the numbers are still alarming.”

Thousands of others are in the same boat, with some waiting for years for their chance to leave. The health ministry’s acting undersecretary, Maher Shamia, cited the security screening process as the primary cause of delays. “The main issue is the lengthy checks and the limitations on the number of departures,” he explained. The system’s fragility is evident in the frequent disruptions, whether due to political tensions or logistical challenges. “We are trying to make the process as efficient as possible, but it’s a constant struggle,” Shamia said.

Protests and Human Cost

In the heart of Gaza City’s al-Shifa hospital, the situation has sparked protests. Families of patients gather daily to voice their concerns about the slow pace of evacuations. Nidal al-Arir, a local resident, described the frustration of watching loved ones suffer. “We see people crying, exhausted from waiting. It’s like they’re being forgotten,” he said. These protests highlight the growing despair among those who feel the system is failing them. For Saber, the emotional weight of his mother’s death has left a lasting impact. “Every day was a test of patience, and we lost her before we even got to see the outcome,” he said.

The WHO continues to advocate for a faster evacuation process, but progress has been slow. With over 15,000 patients waiting, the organisation warns that the delays could stretch for years. “Unless the process speeds up, we might see thousands more die before they can reach treatment,” a WHO spokesperson said. The situation has also strained the relationship between Gaza and the international community, as the lack of independent reporting has forced the BBC to rely on trusted freelance journalists to document the challenges on the ground. “Israel has not allowed international news organisations into Gaza since the start of the war, so we depend on local reporters to provide accurate updates,” the BBC stated.

As the months pass, the stories of those waiting for evacuation grow more urgent. Amina’s death serves as a stark reminder of the stakes involved. Her family’s experience underscores the human cost of the delays, a cost that extends far beyond individual suffering. The broader implications for Gaza’s healthcare system and the population’s morale are profound. “It’s not just about one patient—it’s about the whole community,” Saber said. “We’re all waiting, hoping for a chance to start over. But for now, we’re just holding on.”