Concerns Raised Over Entry Restrictions On Gaza Palestinians Seeking Medical Care In Israel

GAZA CITY, Gaza Strip — Fifty-one Palestinians from the Gaza Strip have died over the past 11 months while waiting for permits to enter Israel for medical treatment or after having been denied permission to enter, according to the World Health Organization.

The Palestinian Health Ministry in Gaza, which compiles such figures separately, says 245 people have died since June last year from factors relating to the partial closure of Gaza's only two access points to the outside world, land crossings into Israel and Egypt.

Since Israel signed a truce in June with Hamas, the militant group that rules Gaza, it has lessened restrictions on the transfer of goods into Gaza, at the same time allowing fewer patients, some facing life-threatening illnesses, to cross into Israel for treatment.

It is impossible to know how many of those might have been successfully treated and how many might have died regardless of access to better health care, said Tony Laurance(cq), acting head of the World Health Organization offices in the Gaza Strip and West Bank.

He called rising numbers of Palestinians denied access to proper medical care "a grave concern."

"Human rights seem to get lost in the decision making on individual cases," said Mike Bailey, spokesman for the aid group, Oxfam International, which has also raised alarm about the issue.

A spokesman for the Israeli Defense Ministry said all Palestinians seeking permits to enter Israel for any reason are approved or denied based on security checks.

"In our mind, we're facilitating 100 percent solutions for all the medical needs," said Maj. Peter Lerner, of the ministry's office of coordination of government activities in the Palestinian territories.

In the first six months of this year, 3,520 Palestinians were granted permission to enter Israel for medical treatment, or nearly 57 percent of those who applied. Before Hamas seized control of Gaza in June last year, that figure was near 90 percent, according to the World Health Organization.

"The security threat and the assessment of the security problems from Gaza, they dictate exactly who can come and go. And the threat is serious and tangible. It's not in theory," Lerner said.

Last year, two Palestinian women who requested entry with forged medical documents told Israeli interrogators that they planned to blow themselves up at hospitals in Tel Aviv and Netanya, according to Lerner.

"If this channel is taken advantage of by terrorist factions, then that's something we have to take into consideration," Lerner said.

There are currently about 800 Palestinians with a variety of illnesses and diseases — including cancer, heart disease and complications from gunshot wounds and other trauma that cannot be properly treated in the Gaza Strip — who have been referred to hospitals in Israel, Jordan or the West Bank, but who have not been able to reach them, according to Palestinian health officials and outside aid groups. Some have been waiting for more than a year.

Jamal Doghmosh, 54, who suffers from heart disease, was allowed to exit Gaza in August last year to be treated in Tel Aviv for an irregular heartbeat. Upon being discharged from the hospital, doctors recommended further treatment, but Israeli authorities have repeatedly rejected his requests to reenter Israel. Most recently, last Monday (EDS: (9/1), Israel rejected his second request to travel to Jordan for treatment.

Lerner said he wasn't familiar with Doghmosh's case.

Doghmosh is awaiting surgery to place a new pacemaker that cannot be performed in Gaza. He complains of shortness of breath and says he has trouble walking up and down the stairs at his home.

Yaakov Henkin, a senior cardiologist at Soroka Hospital in Beersheva, Israel, wrote in an assessment included in Doghmosh's requests to enter Israel that "denial of this treatment may endanger his life."

In a security interview at the Erez crossing terminal, Doghmosh's interrogators asked him to explain the fact that his son works in the Hamas-run police force in Gaza City, he said. He said his son was not a member of Hamas, but merely an employee. "What else can anybody do?" he said, referring to the scant job opportunities in the impoverished territory.

His son started working as a police officer two years ago, before Doghmosh was approved for entry into Israel in August last year.

The interrogators further asked Doghmosh to provide information on Hamas operatives plotting attacks on Israel, he said. He denied having any connection to militants and refused to cooperate.

"I told them I am a sick man," he said. "I will be suspected, someone my age collecting information. . .You are asking me to commit suicide."

In a report, "Holding Health to Ransom," issued last month, Physicians for Human Rights-Israel found more than 30 cases of Israeli security agents attempting to coerce Palestinians into working as collaborators as a condition for permission to exit Gaza for medical treatment.

"If you already get asked to collaborate in any way and you say, 'no,' you don't have much chance of getting out again," said Miri Weingarten, director of the occupied territories department of Physicians for Human Rights-Israel, which provides health care for Palestinians and advocates on their behalf.

Mark Regev, a spokesman for Prime Minister Ehud Olmert, who also speaks for the Israel Security Agency, called the report's conclusions "false."

"In no way whatsoever is working for Israeli intelligence a prerequisite for being allowed to come into Israel for medical treatment," Regev said.

But when asked directly, he did not confirm or deny that officials ask patients to provide information unrelated to their own security background check.

Exploiting the medical needs of patients for the purposes of intelligence gathering would be a violation of international humanitarian law and the Fourth Geneva Convention, according to Physicians for Human Rights-Israel.

Palestinian doctors and outside observers say that Israel's restrictions on the transfer of goods into the Gaza Strip, including some medical supplies, has strained the ability of Gaza hospitals to care for the sick and injured, which has contributed to greater numbers seeking health care outside Gaza.

"It is cumulative. The number of patients are ever-increasing and the percentage that are allowed to go (to Israel) is very small," said Hassan Khalaf, director general of Shifa Hospital, Gaza's largest. "We feel deficient. We feel very, very sorry. Very sad. I know the treatment but because of a lack of facilities we cannot do it."

Egypt, which has also generally kept its border with Gaza closed since Hamas rose to power, opened the crossing last weekend to 400 Palestinians who had been referred for treatment at hospitals in Cairo. Egypt is generally considered a last resort for Gaza patients as Cairo is much farther than Tel Aviv and Egyptian health care is not as advanced as in Israel.

Physicians for Human Rights-Israel had in the past appealed urgent cases of Palestinian patients barred from entering Israel to the Israeli High Court of Justice, which overturned some prohibitions.

But the court ruled in May in an opinion that was made final on Thursday (EDS: 9/4) that it would no longer intervene in such cases because Israel does not bear responsibilities of an occupying power in Gaza.

"It was a turning point," Weingarten, of Physicians for Human Rights-Israel, said. "Whether Israel is an occupying power or not, it remains responsible for access to medical centers. . .For human rights organizations, it's very problematic because we no longer have means of local legal redress regarding Gaza."

Doghmosh, a father of 13 who worked for 10 years as a laborer for a cement company in Israel and later opened a carpentry business in Gaza, closed his shop because he says he is too weak to work.

"I am ready to sell my house if they give me a chance to leave," he said of paying for medical bills. "I still have babies at home. They need me."

"I blame Fatah and Hamas and Israel," Dohhmosh said, referring to the rival Palestinian factions. "All of them bring a burden to us."

Then he added: "Hamas is responsible here. They should improve my life."