Referral of Patients from the Gaza Strip – WHO monthly report (December 2014)

Access restrictions tighten

• Rafah border: Gaza’s access to Egypt through Rafah border was closed for 27 days in December. 28 patients travelled to Egypt on the 3 open days. Access has been restricted since July 2013 bus was halted following the October 25 attack in north Sinai which killed 30 Egyptian soldiers. In 2014, the terminal was closed on 241 days (66% of days).

• Access through Erez: only 81.89% of 1,684 patients who applied for Israeli permits to exit Gaza via Erez for medical treatment in December were approved. 56 patients (20 females and 36 males, including 3 children and 1 elderly) were denied permits. 249 patients (89 females and 160 males, including 61 children and 22 elderly people over 60) received no response to their applications, and missed their medical treatment appointments.

• Interrogations: 20 patients (including 1 female) were requested to attend Israeli security interviews after applying for a permit to cross Erez. 1 patient was later approved.

Casualty patients Of the 8 patients (including 2 children) with war-related injuries who applied to exit Gaza via Erez checkpoint, 6 were approved to exit for travel to Jordan, and 2 were delayed. The patients had been referred by the Ministry of Health during December with the cost to be covered by the receiving hospitals.

Low referrals reflect new policy guidelines

• Referrals declined 20.5%: the Ministry of Health Referral Abroad Department (RAD) in Gaza referred 1,489 patients in December to hospitals outside of (MoH) facilities, 20.5% less than the monthly average for the first half of 2014.

• Gender gap: the gender gap in referrals widened: 56.35% male patients versus 43.65% female patients. 24.91% of all referrals were for children aged 0-17 years and 18.54% were for patients aged over 60 years.

• Estimated cost of referrals for December: NIS 8,601,579.

In 2014: The average monthly referrals in the second half of 2014 (1,172) is 37% lower than in the first half in 2014 (1,849). The volume of permit applications in 2014 was 32.6% higher, while the approval rate was 6.29% lower than in 2013. A total of 528 patients were denied access in 2014 compared to only 40 patients denied in 2013, indicating more severe restrictions on health access.