Children's Lives in Limbo: The Humanitarian Crisis of Medical Evacuations from Gaza

The ongoing conflict in Gaza has severely impacted its healthcare system, leaving thousands of critically ill patients, including children, waiting for medical evacuations to access life-saving treatments outside the territory. For many, the wait becomes a matter of life and death.  

One harrowing example is the story of Islam al-Rayahen, a 12-year-old boy battling leukemia. Despite his family's repeated applications for permission to transfer him to receive a stem cell transplant, Israeli authorities denied the requests six times, citing unspecified security concerns. Islam's life ended in a hospital bed in Gaza, just days after being visited by UNICEF official Rosalia Bollen. His case is one among thousands highlighting the devastating human toll of these delays.  

Medical Evacuation Crisis  

UNICEF reports that at least 2,500 children urgently need evacuation for medical treatment. The World Health Organization (WHO) estimates a total of 14,000 patients of all ages in critical need, while Gaza’s Health Ministry places the figure at 22,000, including 7,000 at imminent risk of death. The war, which began on October 7, 2023, has exacerbated these challenges. Since the closure of the Rafah crossing in May 2023, the rate of evacuations has plummeted, with fewer than two patients transferred per day, compared to pre-war averages of around 100 daily evacuations.  

The restrictions are compounded by Israeli authorities rejecting evacuation requests on vague or unexplained security grounds. Caregivers, including mothers and grandmothers, are often denied permission to accompany sick children, further complicating the process. The lack of transparent criteria for these decisions has drawn criticism from humanitarian organizations, with Doctors Without Borders describing the system as arbitrary.  

The Impact on Children  

Osaid Shaheen, a two-year-old boy with retinoblastoma, a rare eye cancer, exemplifies the tragic consequences of these delays. Diagnosed in April 2023, his condition worsened while awaiting permission for treatment. By November, the cancer had spread to both eyes, reaching stage four. With treatment options dwindling in Gaza, doctors are now considering removing his eyes to prevent the cancer from spreading further.  

For families like Osaid’s, the emotional toll is immense. “He’s just a child. How will he live his life without seeing?” asked his mother, Sondos Abu Libda, reflecting the anguish of many parents.  

Another mother, Nima al-Askari, fears paralysis for her four-year-old son Qusay if he does not receive timely surgery for a heart defect. Similarly, Asma Saed worries for her two-year-old son, Al-Hassan, who suffers from kidney failure and cries through sleepless nights in a squalid refugee camp.  

 A Collapsing Healthcare System  

Gaza’s health infrastructure has been decimated by the ongoing conflict. Only 17 of the original 36 hospitals remain partially operational, struggling to cope with waves of war casualties alongside chronic illnesses. Specialized treatments, such as cancer care and surgeries, are nearly impossible due to destroyed equipment, shortages of medical supplies, and the loss of skilled healthcare professionals. Gaza’s only cancer hospital has been shut down after being damaged and seized during the conflict.  

The scale of the crisis is staggering. Since October 7, 2023, more than 44,500 Palestinians have been killed, and over 105,000 wounded. Among the dead are children who might have survived had they received timely medical interventions.  

Humanitarian Efforts and Urgent Calls for Action  

Organizations like WHO and Doctors Without Borders are working to evacuate patients, but the process remains fraught with delays and rejections. For instance, in November 2023, out of eight children Doctors Without Borders sought to evacuate, only five were approved, and their caregivers were rejected. This bureaucratic labyrinth endangers the lives of those who cannot wait.  

The international community must urgently address this crisis. For children waiting in Gaza, time is running out, and each delay represents a potential death sentence. UNICEF’s Bollen summed it up: “These children will die. They’re dying in waiting.”  

• The stories of children like Islam, Osaid, and countless others underscore the dire need for a more humane and efficient medical evacuation process. Without immediate intervention, the world risks allowing an ongoing tragedy that could have been prevented through timely and compassionate action.