By the waves of crises to befall Gaza since October 2023, one humanitarian effort has remained comparatively regular all through the conflict — the evacuation of the sick and war-wounded out of the Strip for medical care. By ceasefires and durations of intense preventing, Israel has performed a job in facilitating the exit of 1000’s of unwell and injured Gazans to Arab international locations, Europe and elsewhere, together with relations accompanying them.
Israel has been closely concerned in who leaves Gaza since June 2024, when it began utilizing the Kerem Shalom Crossing to evacuate Palestinians by way of its personal territory, following the closure of the Rafah Border Crossing into Egypt a month earlier. For the primary 9 months, some 1,500 Gazans had been allowed to exit the Strip, about 150 per 30 days, in keeping with Israel’s Protection Ministry physique that coordinates with humanitarian operations in Gaza, generally known as COGAT.
That quantity has risen considerably since, with some 2,500 leaving Gaza from mid-March to July, representing between 500 and 600 a month, in keeping with COGAT. The numbers embody each medical evacuations, these escorting sufferers and others given permission to go away for numerous causes, together with overseas citizenship, scholar visas or different ties overseas.
Israel says most who go away achieve this to obtain remedy or accompany somebody sick or wounded, with out specifying a precise breakdown.
World Well being Group figures for a similar interval, nevertheless, put the variety of precise sufferers leaving Gaza over that very same interval at simply 399. The determine represents lower than 3 p.c of the 14,800 sufferers urgently needing to go away Gaza for remedy, in keeping with a July 31 statement from the group.
“Any small, short-term improve Israel cites in evacuation numbers — even when true — is a drop within the ocean,” mentioned Shai Grunberg, a spokesperson for the Gisha NGO, which assists Gazans in search of to go away the strip. “Boasting about it’s a part of Israel’s ongoing effort to masks actuality and current a false image of assembly its obligations.”
In keeping with Ben-Gurion College Prof. Dorit Nitzan, who has assisted evacuating sick and wounded Gazans in an unofficial capability for the reason that begin of the conflict, Israel has proven extra flexibility in approving evacuations in current months, resulting in the rise.
Palestinian youngsters and their households evacuated from Gaza for medical care arrive at Rome’s Ciampino army airport, Aug. 14, 2025. (AP/Gregorio Borgia)
“Since March 2025, Israel’s safety equipment — COGAT, the Shin Wager — has considerably eased the method for sufferers to journey for remedy outdoors Gaza,” mentioned Nitzan.
Nitzan spent 20 years of expertise coordinating evacuations from catastrophe zones worldwide throughout her work with the WHO earlier than returning to her native Israel, the place she is at the moment the pinnacle of the College of Public Well being at Ben-Gurion College.
Each departure from Gaza requires Israeli safety clearance, together with checks on the individual’s id and whether or not they’re deemed a safety threat. “At first of the conflict, we noticed a really low approval charge; at the moment, most names are accepted,” Nitzan mentioned. “Each week there’s not less than one evacuation, starting from dozens to a whole bunch of individuals — relying on the receiving international locations’ capability.”
Nonetheless, organizations serving to Gazans go away say they haven’t seen a big change in current months.
Sufferers wait to go away the Gaza Strip to Egypt, as wounded and sick Palestinians are allowed to go away the Gaza Strip for medical remedy, in Khan Younis, Feb. 1, 2025. (AP Picture/Jehad Alshrafi)
Asil Abu Rass, Head of the Occupied Territories Division at Physicians for Human Rights, instructed The Instances of Israel: “From what I see, there was no easing. Two-thirds of the sufferers evacuated throughout the complete conflict in Gaza left by way of Rafah a yr and a half in the past and never by way of Israel.”
Greenberg instructed the Instances of Israel that “Israel continues to disclaim medical care to 1000’s of different injured and sick individuals, together with many youngsters, by blocking their exit from Gaza to locations the place they may obtain correct remedy.”
‘These remedies don’t exist in Gaza’
The flexibility of sufferers, the wounded and their accompanying family members to go away Gaza throughout the conflict has been advanced and has shifted relying on the preventing on the bottom.
Each Israel and Egypt shut all crossings out and in of the Strip instantly after Hamas’s October 7, 2023, assault, during which 1000’s of terrorists stormed into southern Israel, killing 1,200 individuals and taking 251 hostages again into Gaza.
The closures had far-reaching penalties, slicing off permits for Gazans who beforehand labored in Israel, however the impression on sufferers was particularly extreme.
Even earlier than the conflict, Gaza’s healthcare system was severely underdeveloped in comparison with Western requirements, with restricted remedy choices, particularly for most cancers care. Consequently, many Gazans traveled to Israel or the West Financial institution for medical remedy — funded by the Palestinian Authority or, extra not often, by humanitarian organizations — in coordination with Israel by way of the PA’s Civil Affairs Committee.
This physique was accountable for coordinating motion requests between Gaza residents and Israel, and continued working after Hamas seized management of the Strip in 2007. It has served as the only middleman between Gaza’s residents and Israel, which refuses to coordinate with any Hamas-controlled authority in Gaza.
Palestinians wait on the Erez Crossing between Gaza and Israel, July 13, 2014. (Flash90)
Sufferers in search of care outdoors of Gaza would submit requests to the Civil Affairs Committee, together with medical documentation and a allow from Gaza’s well being ministry. The PA would decide whether or not to fund the remedy and go the listing of candidates to Israel, which might carry out safety checks to make sure these requesting to enter the nation had no hyperlinks to armed Palestinian teams.
1000’s had been accepted, however many requests had been turned down by Israel. Of 20,411 purposes submitted for sufferers to go away Gaza for medical care in 2022, some 34% had been denied, in keeping with WHO data. Generally the denials had been express, although a cause was not at all times given, and typically Israel merely failed to supply a solution both means earlier than the scheduled appointment time.
Nitzan mentioned coping with Gazans in search of care in Israel or the West Financial institution was an everyday prevalence up to now.
“Some stayed in Israel for prolonged durations due to lengthy remedy programs – youngsters after organ transplants, most cancers sufferers, each adults and youngsters,” she mentioned. “These remedies merely didn’t exist in Gaza, so the one possibility was to ship them out for care.”
Guests exit the Augusta Victoria Hospital in East Jerusalem. Earlier than the conflict, 30% of its beds had been reserved for Gazan sufferers, July 11, 2022. (AP/Mahmoud Illean)
In keeping with WHO figures offered on August 6, 2025, between 50 and 100 sufferers left Gaza day-after-day for remedy earlier than the conflict. Since October 7, that day by day common has dropped to 11.
Restrictions on items coming into the Strip and heavy preventing have crippled Gaza’s already fragile well being system, leaving it unable to supply providers to Gazans. On the similar time, Israel has stopped admitting Gazans for remedy in Israel or letting them attain hospitals within the West Financial institution or East Jerusalem, complicating their skill to entry remedy.
However many are nonetheless in a position to go away the Strip for neighboring international locations.
For the primary a number of months of the conflict, sufferers turned to Egypt, leaving Gaza by way of the Rafah crossing, which was open from November 2023 till Might 2024, when Israeli troops took management of the crossing and the Philadelphi Route.
Israel continued to vet sufferers leaving by way of Rafah and family members escorting them, whereas the WHO stepped in to coordinate between Gaza’s Well being Ministry and Israel as a substitute of the PA’s Civil Affairs Fee. From Rafah, the overwhelming majority of sufferers would obtain remedy inside Egypt, although some would journey on to 3rd international locations.
In keeping with the WHO, from November 2023 to Might 2024, when Rafah was open, 4,947 sufferers transited by way of Rafah. COGAT put the quantity at 30,000, together with companions and people leaving for causes apart from medical care, and denied Egyptian media stories that the true determine was nearer to 100,000.
Palestinian mother and father say goodbye to their sick son, leaving the Gaza Strip to get remedy overseas by way of the Kerem Shalom crossing, in Khan Younis, southern Gaza Strip, June 27, 2024. (AP/Abdel Kareem Hana)
Following the closure of Rafah, Physicians for Human Rights, Gisha, and HaMoked petitioned Israel’s Excessive Courtroom to permit affected person evacuations by way of Israeli territory as a substitute. The state replied on June 30, 2024, {that a} mechanism was being developed and that particular person approvals had already been granted – together with for 19 sick youngsters and 49 companions – resulting in the petition’s dismissal. The brand new course of concerned bodily transferring sufferers by way of Israel and in search of third international locations keen to host and fund remedy and lodging.
Since then, Israel says it has allowed 1000’s of sufferers and people accompanying them to exit by way of the Kerem Shalom Crossing, touring to the West Financial institution’s Allenby Bridge Crossing into Jordan and receiving remedy there or flying to additional locations that agreed to take them in and deal with them.
In February 2025, Israel additionally started permitting them to go away by way of direct constitution flights from Ramon Airport within the Negev.
A Palestinian boy injured within the Israeli army’s floor and air offensive on Gaza, seems from an ambulance as the primary group of sick Gaza youngsters arrives in Jordan for medical remedy on the King Hussein Bridge border Crossing on March 4, 2025. (AP /Raad Adayleh)
Nitzan mentioned the swap from Rafah to Kerem Shalom as the principle switch level considerably elevated Israel’s position within the course of.
In keeping with Abu Rass, the transfer meant that far fewer sufferers and their companions got the go-ahead to go away Gaza. From Might to December 2024, many sufferers she tried to help had been denied exit, the Physicians for Human Rights official mentioned.
“If somebody was suspected of being in Hamas — even when the hyperlink was as distant as a relative’s relative — the complete prolonged household may very well be barred from leaving, even when the household tie was as distant as a grandfather’s brother,” she recalled.
Exits appeared to ramp up throughout a two-month ceasefire in January and February 2025, as Rafah was reopened. In keeping with figures offered by COGAT and WHO, 1,673 sufferers and over 2,600 escorting family members exited by way of Rafah throughout the truce, together with some 600 youngsters.
Kids in want of medical remedy and caregivers, in addition to Gazans with twin citizenship, exit Gaza, August 6, 2025. (COGAT)
Nitzan famous that Israel had a novel accountability to make sure Gazans are in a position to obtain medical care regardless of its belligerent relationship.
“If Gaza had been acknowledged as a state and declared an enemy state, we’d don’t have any obligation past the legal guidelines of conflict,” she mentioned, noting that Russia had no half in WHO missions to evacuate the sick and wounded from Ukraine. “Right here it’s completely different. The aspect that was attacked on October 7 and now at conflict with Hamas can also be the one required to hold out the evacuations. We’re a part of this course of — we’re sustaining human dignity.”
In keeping with a February 2025 position paper by Physicians for Human Rights, between October 2023 and February 2025, 15,600 medical evacuation requests had been submitted by way of WHO, however solely 34% — about 5,325 sufferers — resulted in precise transfers.
The low determine displays not solely Israeli approval charges but in addition the problem of discovering international locations keen to simply accept sufferers and their companions in addition to fund remedy.
Leaving, however not for Israel anymore
Nations that conform to obtain sufferers and their companions should cowl hospital prices and, within the case of kids, enroll them within the native schooling system.
“A rustic isn’t simply taking within the affected person – it’s additionally taking in siblings or mother and father, funding their keep, and integrating them into colleges. It’s not easy,” Nitzan mentioned.
With Israel refusing to permit anybody to enter Gaza, together with Palestinians who left the territory for remedy, these stays are at present indefinite, placing many right into a seemingly inexorable limbo. Selections about how lengthy stays are funded or whether or not relations can search employment are topic to particular person international locations’ immigration legal guidelines.
Nitzan recalled the case of a liver transplant recipient who left Gaza throughout the first yr of the conflict. “[She] continues to be within the Rafah space on the Egyptian aspect,” the professor mentioned.
Paramedics and ambulances wait on the Egyptian aspect of the Rafah Border Crossing with the Gaza Strip on January 18, 2025, to enter into Gaza as soon as the ceasefire-hostage launch deal comes into impact. (AFP)
In keeping with WHO, Egypt has acquired essentially the most sufferers so far – 3,995 – adopted by the United Arab Emirates with 1,387, Qatar with 970 and Turkey, which has taken in 437 sufferers.
COGAT didn’t reply to a request for touch upon whether or not diplomatic ties with Israel play a job in the place sufferers who transit by way of Kerem Shalom are despatched.
Different international locations which have taken sufferers embody the US, Jordan, France, Italy, Spain, Germany, Romania, the UK, the Netherlands and Norway.
Nitzan recognized the necessity to discover third international locations as a significant bottleneck within the technique of securing remedy for sick or wounded Gazans.
Advocates say the most effective plan of action can be to reinstate entry to hospitals within the West Financial institution or East Jerusalem.
“There are Palestinian hospitals able to obtain them — like Augusta Victoria in East Jerusalem, which earlier than the conflict reserved 30% of its beds for Gazan sufferers and works intently with hospitals in Gaza. Hospitals in Nablus and Jenin are additionally prepared,” Abu Rass mentioned.
Sick and injured Palestinians being transferred from the Gaza Strip to Egypt, at Kerem Shalom Border Crossing, June 27, 2024. (COGAT)
“Israel’s insistence on sending sufferers overseas as a substitute is stalling the method. West Financial institution and East Jerusalem hospitals might additionally stabilize extra extreme circumstances earlier than transferring them overseas,” she added.
Grunberg, from Gisha, known as on Israel to “enable everlasting, clear, constant, swift, and environment friendly evacuations, together with to West Financial institution and East Jerusalem hospitals, with out separating youngsters from their mother and father and assure their proper to return.”
Gaza well being ministry stays the gatekeeper
The method of securing medical evacuations from Gaza throughout the conflict has turn into much more advanced than it was earlier than October 7, although it was by no means fairly easy.
“You want a physician’s referral stating you require remedy outdoors Gaza — and that’s not at all times accessible in Gaza,” Abu Rass mentioned. “The affected person submits this documentation by way of… a neighborhood hospital to a committee within the Gaza well being ministry. It’s not sufficient for a physician to present an opinion; the committee evaluations and prioritizes who most urgently wants to go away. That committee has been working all through the conflict, simply because it did earlier than, however now the listing goes to WHO as a substitute of the Civil Affairs Committee.”
A girl carries a baby off an Italian army airplane arriving from Israel as medics and well being personnel welcome Palestinian youngsters from Gaza in search of medical care and their households, on August 14, 2025 at Rome’s Ciampino airport. (Andreas SOLARO / AFP)
In response to The Instances of Israel, WHO mentioned it “works with the Israeli authorities to safe approvals for evacuees and their companions as soon as the ultimate accepted lists from the Gaza well being ministry are acquired.”
Nitzan famous that for some sufferers, reaching a physician to acquire the referral is itself a problem: “If there’s a really sick little one whose mother and father are always shifting as a result of preventing, I don’t know if everybody is aware of easy methods to get onto the listing — you could know whom to strategy. With restricted entry to worldwide organizations and few personnel on the bottom, getting the proper individual onto the listing is a problem.”
This isn’t distinctive to Gaza, she added: “In each emergency zone, the problem is easy methods to get the individual on the far finish onto the listing.”
As soon as WHO receives the lists, they’re handed to Israel for a safety screening and a search begins for a possible host nation. This outreach is carried out by a number of actors — WHO, Israel and humanitarian teams — every utilizing their very own networks to safe remedy presents overseas. Consequently, the method doesn’t at all times comply with a neat, step-by-step sequence.
Prof. Dorit Nitzan (Hilel Bider)
Abu Rass mentioned that typically WHO first secures an settlement from a receiving nation earlier than sending names for Israeli safety checks: “With so many requests and other people needing to go away, they solely ship for approval those that have a sensible probability of exiting,” she mentioned.
Alongside the affected person’s title, the listing additionally contains companions important for assist, particularly for babies.
Some international locations solely settle for sure kinds of sufferers, Abu Rass famous.
“Many refuse to take adults and settle for solely youngsters — Italy, for instance,” she mentioned. “The UAE has declined to obtain war-wounded, accepting solely the sick. Jordan agreed to take solely youngsters with most cancers. Every nation has its personal standards.”
Whereas most sufferers undergo the Gaza well being ministry, WHO and a few host international locations have at instances additionally submitted names independently, bypassing the Hamas-controlled authority.
“States just like the UAE can establish sufferers they want to obtain, add their names to the listing and ship them to Israel for approval,” Nitzan mentioned.
Folks test the injury outdoors the Kamal Adwan hospital in Beit Lahia within the northern Gaza Strip, following a reported Israeli strike that hit the medical advanced on December 6, 2024. (AFP)
Abu Rass instructed The Instances of Israel that the UAE has, at instances, despatched lists of sufferers’ names on to Israel with out WHO involvement, requiring solely safety clearance.
As soon as a case has been cleared medically, accepted by Israel’s safety authorities, and accepted by a receiving nation, WHO representatives in Gaza contact the household and set up the evacuation.
Most evacuees are girls and youngsters. In keeping with COGAT, about 80% of these evacuated throughout the conflict have been youngsters.
Nitzan mentioned this displays not solely the preferences of receiving international locations, but in addition the fact of Israeli safety vetting.
Egyptian ambulances cross the Rafah Border Crossing in the direction of Gaza on February 1, 2025, to move Palestinian sufferers out of the Strip.(Kerolos Salah/AFP)
“Anybody linked to fighters or armed factions in Gaza is not going to go,” she mentioned. “Ladies and youngsters are simpler to approve, and humanitarian organizations at all times prioritize them as a inhabitants to be faraway from battle zones.”
The method can take appreciable time. Nitzan mentioned although Israel had eased its personal approval course of, there was nonetheless a critical bottleneck to find international locations keen to host sufferers or fund remedy.
WHO instructed The Instances of Israel that some sufferers in Gaza have been ready greater than 18 months for evacuation. The group didn’t specify whether or not the delays had been as a consequence of logistical challenges, Israeli refusals, or the shortage of a keen host nation.
Escape to Norway
Immediately, Aisha is in Norway, however getting there from Gaza took some 20 months of pink tape and ready for numerous approvals, her sister-in-law Najm instructed the Instances of Israel.
The 35-year-old from Beit Lahiya in northern Gaza has suffered from a extreme degenerative illness from an early age, leaving her in fixed ache and struggling to stroll. For the final 15 years, she has relied on Najm as her main caregiver, bringing her along with her to Scandinavia when she was lastly in a position to go away the Strip late final month.
An aerial {photograph} taken by a drone reveals tents amidst the destruction from conflict in Beit Lahiya, northern Gaza Strip, on February 17, 2025. (Mohammad Abu Samra/AP)
“She has been sick for 30 years, and the remedy for her illness doesn’t exist in Gaza. From the day I obtained married, I’ve been serving to her — dressing her, caring for her,” mentioned Najm, additionally 35, who spoke for Aisha as a consequence of difficulties talking stemming from her situation.
Each girls requested to stay nameless for privateness causes. (Aisha and Najm are pseudonyms).
Najm mentioned that Aisha used to journey to Tel Hashomer hospital close to Tel Aviv for remedy, however later began going to Palestinian hospitals as a substitute. The final time Aisha left Gaza for medical care was eight years in the past, when she was handled at Al-Makassed Hospital in East Jerusalem.
The household utilized for Aisha’s evacuation in November 2023, simply weeks after the conflict started, as circumstances turned extraordinarily tough. Lower than per week after October 7, the household fled their residence close to Gaza’s border with Israel, which was later blown up in an Israeli strike.
“From that day till we left Gaza, we saved shifting from place to put. We had been displaced,” Najm recalled.
To get approval to go away, they submitted a type to the Gaza well being ministry, which was accepted and despatched to the WHO. But it surely was nonetheless a yr and eight months earlier than they had been in a position to go away.
“The method took a really very long time,” Najm mentioned.
Palestinians go away the Makassed hospital in East Jerusalem, September 9, 2018. (Mahmoud Illean/AP)
Because the conflict floor on, Aisha’s provide of pain-relief treatment ran out. “The wait was very laborious — Aisha was in horrible ache, surviving on painkillers,” Najm mentioned. “[The extended family] had been additionally ready for an opportunity to flee loss of life in Gaza — any option to get out of loss of life, starvation, and oppression for us and the kids.”
The NGO Gisha, which helped coordinate their departure, instructed The Instances of Israel {that a} hospital in Belgium had agreed to obtain Aisha as early as March 2025. However regardless of repeated WHO requests to rearrange the evacuation, there was no response from the Israeli aspect.
Solely after Gisha contacted COGAT immediately in late June did they obtain affirmation that “there is no such thing as a objection to permitting their exit.”
A month later, on July 30, Aisha, Najm and Najm’s 5 youngsters lastly left Gaza — although to not Belgium. For causes that stay unclear, they had been accepted as a substitute by a hospital in Norway.
The journey out had its personal collection of twists and turns. “On the day we left Gaza, we traveled from the place we had been staying in Gaza Metropolis to Shifa Hospital. From Shifa, they took us to the Pink Crescent headquarters in Khan Younis, the place we stayed in a single day. The subsequent morning, Wednesday, we went to the Kerem Shalom Crossing, then traveled by way of the desert to Ramon Airport — a four-and-a-half-hour drive. From there we flew to Romania after which on to Norway,” she mentioned.
Palestinians wait to board a bus at Al-Nasser hospital in Khan Yunis after permission from the Israeli authorities to go away Gaza by way of the Kerem Shalom Crossing to obtain remedy in Jordan. August 15, 2024. (Bashar TALEB / AFP)
“We took nothing however paperwork — ID papers, medical information and a cellphone. We weren’t allowed to take the rest — not even garments,” Najm famous.
Additionally left behind was Najm’s husband, whom Israel refused to let loose, regardless of having a US scholar visa.
“He’s in Gaza Metropolis now. I hope he can go away,” she mentioned, earlier than including, “My coronary heart is at all times in Gaza.”
COGAT didn’t reply to The Instances of Israel’s questions on the case.
Najm mentioned she doesn’t know what the long run holds for her, Aisha, or the kids, however she doubts she is going to return to Gaza.
“Proper now, we’re serving to Aisha, but when my husband arrives [in Norway], we’ll take into consideration what to do. Gaza is not livable,” she mentioned. “I don’t need to make such a household determination alone. If my husband comes right here — or if we meet someplace outdoors Gaza — we’ll determine collectively whether or not to decide on one place to reside or keep right here. Gaza has been destroyed utterly.”
