A staggering average of 60 young patients were not allowed to leave for the occupied West Bank to receive urgent medical attention each month, equivalent to over two children per day.
These denials have left children without access to critical surgeries and urgent medication, which are unavailable in the blockaded enclave.
“Some are desperately sick children who have no options other than leaving Gaza to survive,” said Jason Lee, Save the Children’s director in the occupied Palestinian territory, in a statement.
“Denying children healthcare is inhumane and an infringement of their rights.”
The London-based organisation said that in May alone, Israeli authorities denied or left unanswered 100 children’s applications to request permits to exit through the Beit Hanoun (Erez) crossing, which Israel controls, in the north of the Gaza Strip.
During the same month, at least seven children were among 33 Palestinians killed in Israel’s attack on Gaza between 9 and 13 May 2023.
Left to die
Because of the severe lack of medical equipment and personnel, a significant portion of patients in Gaza, notably those suffering from conditions such as cancer and chronic diseases, must obtain medical referrals covered by the Palestinian Authority (PA) to enable them to seek treatment in the occupied West Bank or Israel.
After they receive approvals and financial coverage for their medical treatment, patients are then required to apply for Israeli exit permits to be allowed to leave the strip through the Beit Hanoun, the only land crossing for Palestinians who want to move between Gaza and the rest of the occupied Palestinian territory.
One in 10 patients who seek exit permits from Gaza die within six months after their first application.
Yet, they endure a waiting period of almost five weeks for each application to undergo processing by Israeli authorities.
In 2022, three Palestinian children died after months of waiting for Israeli exit permits that would have enabled them to cross the border and access life-saving medical treatment in the occupied West Bank. Among them were 16-year-old leukaemia patient Salim al-Nawati and 19-month-old Fatima al-Masri.
Masri, who suffered an atrial septal defect (hole in the heart), was born after eight years of marriage and died after Israeli authorities left unanswered five applications her parents submitted to get her an exit permit.
“I submitted the first application at the end of  and got an appointment on 26 December, but shortly before that date, I received a text message saying that her application was pending under review,” Masri’s father, Jalal, previously told MEE.
“I went through the same prolonged procedures again to submit another application and got another appointment on 13 February. Three days before the appointment, I received the same message again. So I submitted a third application to get another appointment on 6 March, which was delayed until 27 March and then 5 April. Fatima died 11 days before that date.”
Complex restrictions on healthcare
Devastated by 16 years of an Israeli-led blockade and recurrent military attacks, Gaza’s healthcare system faces immense challenges, with the entry of vital medical supplies, equipment and medications severely restricted by Israel.
According to the Palestinian Ministry of Health in Gaza, around 224 drug items (43 percent of the essential medicine list) and 213 medical disposables (25 percent of the essential list) were at zero stock in May.
While tens of thousands of patients are granted medical referrals outside of Gaza by the PA each year, almost a third of them are denied exit permits by Israel.
‘Denying children healthcare is inhumane and an infringement of their rights’
– Jason Lee, Save the Children
In 2022, around 33 percent of the 20,295 patient permit applications submitted to Israeli authorities were denied or delayed. This includes a minimum of 29 percent of applications filed on behalf of child patients, according to the World Health Organisation (WHO).
However, permit denials are not the only challenge Gaza patients face throughout the prolonged process of getting proper medical treatment outside of the strip.
In the majority of cases, approximately 62 percent of the time, Israeli authorities denied or delayed permit applications for caregivers and companions who are meant to accompany patients during their medical journeys.
Moreover, 225 patients underwent security interrogations by Israel, of whom only 24 were granted exit permits.
The coastal enclave, home to more than two million residents, has 36 hospitals providing an average of 1.26 hospital beds for every 1,000 people, according to the Palestinian Ministry of Health.