Global Research

Over the past few weeks, Israeli authorities have changed their tactics regarding medical exit permits for Gaza patients: Instead of issuing a permit or a rejection on “security grounds,” responses are delayed for weeks and defined as “pending.” Since appeals can only be filed after a formal rejection has been issued, the significance of this tactic is denial of the possibility of appeal.

1.      Eighteen urgent new medical cases are currently handled at our offices. The majority of these have waited for weeks without receiving any response – negative or positive – from the Israeli authorities. Since appeals can only be filed after a formal rejection has been issued, the significance of this tactic is denial of the possibility of appeal (see list of patients below).

2.      Large, unknown numbers of patients are not accessing care, due to delays in processing permits, lack of transparency in the process, rejections on security grounds, and last-minute interrogations. Palestinian MoH estimates over 800 patients whose cases are still pending.

3.      Access-related deaths are increasing. On the 9th of December alone, according to Palestinian MoH data, three patients died in connection with denial of access to care.

4.      Coercion/blackmail of patients by GSS (Israeli secret service, ‘shabac’) continues: Interrogations are increasingly employed against patients on a routine basis, and patients are required to inform on others before being permitted to access care.

5.      Passage to Egypt has been initiated but is inadequate.

Bureaucratic obstacles

Over the past few weeks, Israeli authorities have changed their tactics regarding medical exit permits for Gaza patients: Instead of issuing a permit or a rejection on “security grounds,” responses are delayed for weeks and defined as “pending.”
Since appeals can only be filed after a formal rejection has been issued, the significance of this tactic is denial of the possibility of appeal.

According to Palestinian Ministry of Health data, by the end of October over 200 cases were “pending” and by the end of November over 300 cases were “pending.” Palestinian MoH estimates over 800 patients whose cases are still pending.

PHR-Israel is of the opinion that this tactic, as well as recent attempts by the Israeli authorities to block the access of human rights organizations to the names of rejected patients, are a response to recent media exposure and legal scrutiny of serious life-threatening cases whose access to care was denied. Rather than changing its policy, the military is now attempting to veil it by blocking access to information.

GSS policies

Since late November, permits “pending interrogation” have become more frequent. This means patients must undergo interrogation before receiving a response to their request. Interrogations are often held close to or even after the date of the scheduled medical appointment, leading to disruption of care and repeated re-scheduling of appointments.

Before interrogation, patients often wait for many hours at the Crossing, and are sometimes turned back without interrogation and are obliged to reschedule with the GSS.

During interrogation they are requested to provide information, not only about themselves but also about members of their families, neighbors and acquaintances. Some are asked to act as informers on a regular basis. Since PHR-Israel’s intervention in court, threats that non-compliance will lead to denial of care are more veiled. However, non-compliance invariably leads to a negative response and rejection of permission to exit Gaza.
After interrogation, patients are requested to return home and to wait for an answer. Since December, patients are requested to file new requests after interrogation, and to start the process from the beginning, often leading to multiple interrogations.

Intimidation by GSS: One of the patients represented by PHR-Israel was interrogated after High Court petitions had secured his permission to exit. At the interrogation he was threatened by GSS officers and warned not to apply to external bodies and to the courts, with the implication that such actions would lead to denial of a permit.

Passage to Egypt

In December, following several High Court petitions, an arrangement was reached with the Egyptians to let out specific patients via Erez and Nitsana Crossings. However, patients were informed on the day of exit itself, 3.12.07, so that they had no time to reschedule appointments in Egyptian hospitals, to file for a passport, or to collect money for the journey. The crossing was closed on the afternoon of the next day. It was re-opened on 11-12.12.07, with no prior notification, and this time dozens of patients who arrived were turned back at the last minute: The Israelis claimed that the Egyptians denied their entry, but the patients claimed Israeli soldiers told them they were denied passage by the Israeli GSS. Currently the Israeli authorities say the passage  will be opened again, but cannot say when or for how long.

PHR-Israel is re-opening legal action:

–       Demanding exit permits for the 18 new cases.
–       Demanding that Israeli authorities stop the new tactic of non-response
–       Demanding the right of appeal and transparency in the bureaucratic process: patients must receive answers in writing within a reasonable period of time, and information on number of patients denied access should be available.
–       Demanding that the GSS stop its routine use of patients and their intimidation for the collection of intelligence.
–       Repeating its demand for a policy ensuring access of patients to medical care outside Gaza.
Additionally, PHR-Israel has not closed its previous court petition, in which it challenges the practice of deliberate withholding of medical care by GSS as a form of coercion against patients, to compel them to act as informers. A third hearing on this petition is pending.

PHR-Israel repeats its minimum demands

–       That the State of Israel ensure access of all patients who need care unavailable in Gaza to external medical centers in Israel, West Bank, Jordan or any other country, as a matter of policy
–       That the GSS immediately stop coercing patients at the crossing. According to the British Medical Association and others this may constitute cruel, inhuman and degrading treatment as defined under the UN Convention Against Torture and related instruments.

Patients waiting for exit from Gaza:
       
    Gender  Age     Condition              Referred to     appointments missed    

1       m       18      Brain tumor             Nablus, WB      29.11  
2       m       36      Pancreas cancer    Tel Aviv             since 3.12     
3       m       64      Lung cancer             East Jerusalem  2.12   
4       m       50      Eye cancer              Jerusalem            2.12   
5       m       28      Liver tumor             Jerusalem            26.11  
6       f       37        Lymphoma                Nablus, WB      since 21.11    
7       m       52      Bone cancer             East Jerusalem  5.12   
8       m     26     Eye tumor                  East Jerusalem    30.10, 14.11, 17.12    
9       f       28      Thyroid cancer          Egypt   6.12    
10      m       54   Heart: bypass surgery   Nablus, WB      since 1.10     
11      m       2       Congenital heart disease        Holon, Israel   since 11.9     
12      f       25      Infection in both kidneys       Ramallah, WB    since 5.12     
13      f       2       Congenital adrenal hyperplasia
                           w.history of meningitis        Tel Aviv        21.11, 5.12, 12.12     
14      m       20      Rapid weight loss and  suspicion of cancer    
                                in digestive system     Tel Aviv        since 24.10    
15      m       47      Infection of tissues
                                in spinal cord          East Jerusalem  since 25.11    
16      m       28      Eye bleed               Jordan  6.12   
17      m       48      Vascular complications  Jordan  9.12   
18      m       31      Giant hernia            Jordan  since 11.11