Mahmoud al-Kurd, 45, from Deir al-Balah in the central Gaza Strip, died on 16 December, two days after he was granted an exit permit by the Israeli military to leave Gaza for treatment in the West Bank.

A father of six – one girl and five boys – Mahmoud underwent months of fear and pain.

“We submitted five applications to the Israeli authorities to transfer Mahmoud to a hospital in Jerusalem. For six months, we kept receiving ‘request under review’ replies,” his wife Amatulrahman al-Kurd, 40, said.

In November 2020, al-Kurd had been diagnosed with lung cancer. He underwent seven chemotherapy sessions in Gaza but his health continued to deteriorate.

In 2021, he was transferred to Egypt for treatment, where he stayed three months but showed no improvement.

In September 2021, he was referred by the ministry of health to Augusta Victoria Hospital in Jerusalem for urgent medical treatment.

But he needed a permit from Israel’s Gaza Coordination and Liaison Administration (CLA) – a branch of the Israeli military – to allow him to exit Gaza through the Erez checkpoint.

He had already been assured of financial coverage from the Palestinian Authority.

“My husband lost 60 kilos. I was totally helpless, just waiting for their approval [for travel permit]. Seeing him like this will forever be the hardest thing I went through,” Amatulrahman told The Electronic Intifada.

On 25 November, Mahmoud’s health deteriorated dramatically. He lost consciousness and suffered convulsions and was hospitalized for three days.

Doctors said the cancer had spread to the rest of his body.

At the same time, his family was repeatedly completing procedures to secure his travel permit.

“From July to December, we submitted five applications,” Amatulrahman said. “All were delayed or we didn’t get any replies.”

Too late

Frustrated, the family turned to the Gaza-based rights group Al Mezan and Physicians for Human Rights in Haifa to try to expedite the process.

The two organizations tried to persuade the Israeli military authorities to grant him a permit to receive treatment in the King Hussein Medical Center in Amman, Jordan, which meant more delays.

“We had no choice but to start new procedures to transfer him for treatment in Amman, even though we realized that we were clinging to the tiniest shards of hope,” his wife said.

The permit never came and at this point, she said, Mahmoud was getting progressively worse. With the cancer spreading to his brain, he had first lost the ability to walk, then to move, then to talk and eat.

Finally, he had to be put on a ventilator.

During this time, the two rights organizations eventually prevailed upon the Israeli authorities to issue an exit permit for treatment in Jerusalem.

On 14 December, an ambulance transported Mahmoud from the Gaza Strip to Jerusalem.

It was too late.

“At 10 pm on Friday, Mahmoud died before my eyes. I don’t know what sin he committed to deserve all this torment. I hope that no one else will suffer the same fate as Mahmoud, although I know there are dozens of similar cases.”

According to the World Health Organization, since 2007 and the tightening of Israel’s blockade of Gaza, about a third of Gaza’s patients’ exit permit applications have been either denied or delayed.

According to Al Mezan, nine patients, including three children, died in Gaza after being denied exit permits in 2022.

“The lives of dozens of patients with critical conditions in Gaza are at risk because they need urgent medical treatment in West Bank hospitals,” said Ashraf al-Qedra, a health ministry spokesperson.

“But they are still waiting for exit permits. A number of them have applied several times.”

A wedding with no relatives

A wedding with no family, a bride without bridesmaids and a special day that caused only painful memories.

This is how Oruba Othman, 32, described her September wedding in the West Bank.

Othman is from Gaza but is teaching at Bethlehem University’s department of social sciences. She is also a PhD student at Birzeit University.

She married a lawyer from Bethlehem, but her wedding turned into a somber occassion without family and friends, who were denied exit permits from Gaza to attend.

“Two months before the wedding, I submitted an application for my father to attend, but I kept receiving ‘request under review’ replies. Not one of my family or friends was able to attend my wedding and this will be one of my saddest moments.”

They supported her as best they could, she told The Electronic Intifada. Her friends and relatives attended via video conference.

It was scant consolation.

Indeed, Othman has not seen her family since 2015, because of Israeli travel restrictions that were always onerous but became almost impossible to navigate after the siege was tightened in 2007.

“I moved to live in the West Bank because I got a scholarship from Birzeit University [in the West Bank] seven years ago,” Othman said, describing her obtaining an exit permit as “miraculous” for a young person.

She had to wait a year.

“Fortunately, I was invited to an event organized by a German Palestinian Academy to collect stories about the suffering of Palestinian journalists, so I took advantage of this opportunity and presented my problem to this academy. They helped me secure the exit permit.”

The Gaza Strip should be less than an hour’s drive from the West Bank. Yet with travel restrictions and checkpoints, the journey can take months or years.

It also confronted Othman with her first direct meeting with an Israeli soldier.

“When the Israeli soldiers searched me at the checkpoint, my emotions were disturbed. I felt so offended: this is my land, yet this soldier controls my freedom.”

She persevered, however, in her excitement to see the West Bank for the first time in her life.

“I was enthusiastic to enter the West Bank, which the Israeli occupation tries to split from the Gaza Strip.”

Palestinians in Gaza who succeed in entering the West Bank then encounter further obstacles. They are not allowed to move between the cities of the West Bank.

The Israeli military checks IDs at the some 100 military checkpoints dotted around the West Bank, and a Gaza ID holder risks imprisonment or forced return to Gaza if stopped in the “wrong” area.

“In brief, being a Palestinian means that you do not have the luxury to enjoy your simplest rights,” Othman said, recalling her student days in the West Bank city of Ramallah, when she was not allowed to go anywhere else.

“Being Gazan and living in the West Bank means that I can barely see my family and friends in Gaza. In other words, I will spend my happy and sad moments alone.”

Not only that, even though she has a permit to work, she lives in constant fear that her marriage, her job, and West Bank life could be ruined at any moment.

“I am always terrified that I may lose my husband, my job and my studies. All it takes is a colonial soldier in a bad mood who discovers that I am from Gaza.”

Her precarious situation has also affected her professionally.

“I am not just prevented from moving through the West Bank, I am also deprived from traveling abroad. Unfortunately, I missed a lot of opportunities to attend international conferences and research fellowships abroad.”

Aseel Mousa is a journalist based in Gaza.