'There Are Many Like Me. Too Many': 18,000 Gazans in Need of Treatment Abroad Are Still Stuck in the Strip - Palestinians
Amira Saleh spends most of her days moving between Nasser Hospital's waiting rooms in Khan Yunis. Her 9-year-old son, Yazan, was injured by shrapnel that entered his upper arm and shoulder last summer. The injury damaged nerves and blood vessels, and doctors say he needs specialized surgery that is impossible to do in Gaza, where only half of all hospitals are partially functional.
"He cannot lift his arm," she said. "At first, we thought it was temporary. Now they tell us it will get worse if nothing is done."
Saleh applied for evacuation through Gaza's Ministry of Health in October. She has submitted medical reports and letters from doctors. Each document was carefully folded and placed in a plastic folder she carries everywhere.
The Rafah border crossing – which partially reopened on February 1 after being effectively shut since the Israeli army's controversial Rafah offensive in May 2024 – has become the final step in a long process of referrals, paperwork, waiting lists and uncertainty for patients and their families.
"When Rafah reopened, people congratulated us," she said. "They said, 'Now you will go.' But days passed, and we are still here."
Saleh's young son is one of the more than 18,500 wounded and sick Palestinians who await medical evacuation out of the Gaza Strip. This includes people with complex blast injuries, spinal damage, cancer, kidney failure, heart disease and children requiring reconstructive surgery.
Nawal Kanaan, the mother of a 9-year-old child with leukemiaShe asks me when we will go to the hospital with better medicine. I tell her soon. I do not know what soon means anymore
Aid groups working in Gaza say the number fluctuates as new injuries occur and others die while waiting. Save the Children has warned that at current evacuation rates, it would take more than a year to transfer all urgent cases, even if no new injuries occurred.
"They tell us the process is moving," Saleh says, adding that she stays awake at night as her son complains of pain. "They say names are reviewed, security checks are done, coordination takes time. I understand that. But my child does not understand time like this."
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In November 2023, 70 percent of Gaza's hospitals became non-functional due to Israeli airstrikes. Almost three months after the October cease-fire announcement, the health system remains critically depleted. Medical staff report severe shortages of essential medicines, including anesthesia, antibiotics, IV fluids and surgical supplies.
Hospital administrators and international agencies have warned throughout the war that even basic procedures are being delayed or performed without adequate pain management because of supply gaps. Israeli authorities say restrictions are intended to prevent dual-use materials – including operating tables, scalpels and ultrasound machine components – from reaching militant groups, but doctors inside Gaza argue that the limitations are crippling routine and life-saving care alike.
Since the war began, roughly 1,000 Palestinians have died in Gaza while waiting for medical evacuation, according to the UN's World Health Organization.
The tedious, uncertain evacuation process
The reopening came under strict conditions agreed upon by Israel, Egypt and international mediators, with the involvement of the WHO and the Palestine Red Crescent Society. The crossing now operates under Israeli security oversight and Egyptian control on the other side, with international coordination.
In theory, Rafah is open to medical evacuations. An Israeli official told CNN that 150 patients would be allowed to exit Gaza each day, while Egyptian state media reported that only 50. In practice, only 36 patients (plus 62 companions) evacuated through the border crossing in the first four days it was open, according to WHO. There have also been multiple days since Rafah re-opened in which no patients crossed at all.
The process for medical evacuation is layered and slow. Patients must first be formally referred by Gaza's Ministry of Health or an authorized body, like the Red Crescent. Those referrals are then shared with international organizations, primarily WHO, which coordinates with hospitals abroad willing to receive patients. (Israel's government currently refuses to permit patients in Gaza to receive life-saving medical treatment in the West Bank or East Jerusalem.)
Names are submitted for security screening by Israel's Coordinator of Government Activities in the Territories, and final approval is required before travel. Egypt also conducts its own checks before allowing entry. Only after clearance from all sides can a patient be scheduled to cross. Aid workers say that even minor administrative issues can delay cases indefinitely.
"We are facilitating, not deciding," the official said. "We transport patients when lists are approved. The challenge is that approvals are very limited."
Mahmoud al-Hassan, 41, has been waiting since last summer. He was injured when an airstrike hit a nearby building in eastern Khan Yunis, sending debris through the street where he was standing. His left leg was shattered below the knee.
"I was taken to three different hospitals," he said, sitting outside a clinic in Khan Yunis where he comes twice a week for wound care. "They stabilized me, they cleaned the injury, they tried to save the bone. But after a while they told me clearly: This needs advanced surgery. This is not something they can do here."
Hassan received a referral for treatment abroad in August 2025. His name was submitted to the Ministry of Health, then passed to international coordinators. Since then, he has heard nothing definitive.
"Every few weeks, someone tells me there is movement at Rafah," he said. "I ask the same questions: How many crossed today? Are they calling people with leg injuries? Do they take adults or only children? No one has answers."
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He lives with his wife and two daughters in a damaged apartment. The stairs are difficult for him, and he rarely leaves the house except for medical appointments.
"I am not asking to travel," he said. "I am asking to walk again. Or at least to stand without pain."
Deteriorating health over a multi-year wait
Yousef Abu Nasser, 46, has chronic kidney failure. He requires regular dialysis, but the machines in his area are overstretched and often malfunction due to power cuts and lack of spare parts.
"Sometimes my session is shortened because another patient is waiting," he said. "Sometimes the electricity goes out in the middle."
Yousef was advised to seek treatment abroad more than a year ago. His condition has since deteriorated. "I am not critical yet," he said. "But I am getting closer. Doctors tell me this quietly, not to scare me."
He visits a local hospital three times a week and spends the rest of his time at home, conserving energy. "When Rafah opened, I went to the hospital to ask if my name was on the list," he said. "They told me there are many like me. Too many."
International organizations – many of whom are fighting new Israeli regulations to continue providing medical aid in the Strip – have repeatedly warned that Gaza's health system cannot recover without sustained access to external treatment pathways. WHO officials said earlier this month that the number of patients awaiting evacuation remains dangerously high, and that delays are costing lives.
Meanwhile, Israeli authorities have said that security screening is necessary and that the reopening of Rafah represents significant progress. Egyptian officials have emphasized that border controls are required to prevent permanent displacement.
Also blockaded: Essential medicines and supplies
For families waiting near Rafah, these explanations feel insufficient. Nawal Kanaan, 52, arrived in Rafah from Gaza City with her 9-year-old daughter Layla, who has leukemia. They live in a small rented room near the crossing, waiting for a call.
"We came because we thought being close would help," Kanaan said. "They told us sometimes you must be ready on short notice."
Layla's chemotherapy was interrupted months ago due to medication shortages that are affecting medical conditions as complex as cancer and as common as colds.
Last week, Gaza's Health Ministry reported the complete depletion of 84 percent of lab and blood bank supplies, 46 percent of essential medicines and two-thirds of essential products like PPE, syringes, needles and catheters. Hospital officials told Haaretz last month that influenza vaccines and antiviral medications were completely unavailable amid a sharp rise in cold-related illnesses.
"She asks me when we will go to the hospital with better medicine," Kanaan said. "I tell her soon. I do not know what soon means anymore."
Every morning, Kanaan checks her phone for messages from hospital administrators or aid workers. "Some days, no one crosses," she said. "Those are the hardest days."
Nearby, Khaled Darwish waits with his infant son, who suffers from respiratory problems worsened by dust and cold. Khaled said doctors recommended treatment abroad after repeated infections.
"I don't want my son to grow up in hospitals," he said. "I want him to grow up breathing properly."
Darwish said he does not blame doctors or aid workers. "They are also trapped," he said. "The system is bigger than all of us."