Referral Abroad of Patients From the Gaza Strip – WHO Monthly Report (May 2010)

Summary

Referral Abroad Department

Between 1 and 31 May 2010, the Referral Abroad Department (RAD) approved and issued 1213 referral documents, compared with 1149 in April and 1197 in March 2010.

Referrals by destination were as follows: 19% to Israeli hospitals, 43% to the West Bank and East Jerusalem, 17% to Egypt, 1% to Jordan, and the remainder to NGO hospitals within Gaza. Referrals this month increased by 3% to Israeli hospitals and by 8% to hospitals in the West Bank and East Jerusalem.

The breakdown of referrals by main disease or health condition is as follows: 15% – cardiovascular disease, 10% – oncology, 12% – ophthalmology, 7.5% – orthopedics, and 6% – neurosurgery. These health conditions accounted for 50.5% of referrals.

The District Liaison Office for Erez crossing processed 1225 applications for permits for patients to cross Erez for hospital appointments during May, compared to 1047 in April and 1029 in March. Of the 1225 applications processed in May, 73% were approved, 13% (155 cases) were denied and 14% (176 cases) delayed. 15% of delayed applications (26 cases) were for children. The proportion of patients denied permits increased from 4% in April to 13% in May.

Of the 176 patients whose applications were delayed by the Israeli authorities, 52 were called for interview with the Israeli Intelligence Services, known as General Security Services (GSS). Thirty-seven of those referred to the GSS did not attend the interview; ten were asked to submit new applications; four were given permission to cross after the interview; and one was denied permission.

The majority of the 176 patients whose applications were delayed faced delays of more than eight days (61%). 94% of applications were processed within 30 days. The delayed patients missed their appointments. As a result, they have to obtain new hospital appointments and submit new applications for permits to cross Erez. Delays in processing applications can be critical for patients who are waiting for urgent medical treatment. Some may die while waiting for permission to access the medical facility they have been referred to. There have been 31 deaths of patients awaiting referral since the beginning of 2009 to date.

The continuing closure of the Gaza strip has led to a further deterioration in medical services. Shortages of medical equipment and spare parts are common. Clinical staff are unable to leave Gaza to upgrade their knowledge and skills. This increases the need to refer patients for treatment outside Gaza. The process of obtaining a referral document is not easy, and when a patient manages to obtain it, he or she then has to wait for a hospital appointment to come through, before applying to the Israeli authorities for permission to leave Gaza.

According to the Liaison Officer at Erez, 836 patients crossed Erez in May, including 31 patients who crossed via back to back ambulances. This compares to 711, including 44 via back to back ambulances last month.

Rafah border was opened for five days from 15 to 19 May 2010. During this time, 1490 patients crossed the border to access the Egyptian hospitals they had been referred to.