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Source: World Health Organization (WHO)
31 July 2014

Referral of patients from the Gaza Strip

Summary: July 2014

The sharp escalation of violence in Gaza after July 7 resulted in 1418 killed and 8265 injured (as of July 31), widespread damage to buildings and infrastructure, including health facilities, and remains ongoing. The number of patients referred for routine specialized medical care was low due to the severe security restrictions on patient access within Gaza and to outside facilities, as well as the Ministry of Health priorities of addressing the emergency health situation and treating casualtie.s


  • Casualty patients: 203 war-casualty patients were referred (and travel was coordinated as urgent):
      • 56 war-casualty patients crossed Erez: A total of 60 casualty patients who had initially been treated in hospitals in Gaza were referred to outside hospitals by the Ministry of Health during July, although access within Gaza to Erez checkpoint was difficult due to the security situation. (Out of the 60, 4 casualty patients had access difficulties through Erez: one patient changed the destination to Egypt, 2 patients did not yet receive approvals and one patient was asked to attend a security interview.)
      • 143 war-casualty patients crossed Rafah: Egypt permitted 143 patients and 149 companions to exit Gaza via ambulance at Rafah for treatment in Egypt.
  • Permit applications low and approval rate drops: 1,093 patients had applied for Israeli permits to exit Gaza via Erez to outside referral hospitals in July, a drop of one third. Only 65.51% of applicants were approved (down from the 2014 average of 84% for the first half of 2014. 70 patients (20 females and 50 males, including 14 children and 9 elderly) were denied permits (6.4%), the highest monthly number of patients denied in 4 years. 307 patients (122 females and 185 males, including 76 children and 27 elderly people over 60) 28.09% of applicants, received no response to their applications; their medical treatment was delayed as a result.
  • 9 patients interrogated: 8 patients (including 2 females) aged between 18-60 years and 1 male patient over 60 were requested to attend Israeli security interviews after applying for a permit to cross Erez.

  • Regular referrals down by 2/3rds: In July, especially following the escalation of violence after July 7, the number of patients referred to hospitals outside of Ministry of Health (MoH) facilities in Gaza by the Referral Abroad Department (RAD) dropped to 580, only 31% of the monthly average for 2014.
  • Gender gap: The gender gap in referrals continued: 53.45% male patients versus 46.55% female patients. 27% of all referrals were for children aged 0-17 years and 19.8% were for patients aged over 60 years.

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