• Approval rate for patients' permits declines: Of 2,260 patient aplications were submitted for permits to exit Gaza through Erez checkpoint for hospital appointments in November, 71.5% were approved. Approval rates have dropped 15% since May. 6.86% were denied (155 patients, including 8 children and 16 elderly patient over 60 years old) and 21.64% received no response (489 patients, including 144 children). (Source: Palestinian District Liaison office in Gaza.)
• Arrests: A 31-year-old patient with a valid travel permit was arrested at Erez crossing on his way to his appointment at a West Bank hospital (p. 6).
• Patients injured near border fence denied access permits (p. 6).
Rafah: No exit during November
• Rafah border: The Rafah border terminal was closed to travellers, including patients, during November. The border has been open only 24 days this year, allowing only 148 patients to cross into Egypt for health care. Before the July 2013 closure, more than 4,000 Gaza residents crossed Rafah monthly for health-related reasons.
MoH referrals in November
• Ministry of Health referred 2,020 Gaza patients* in November to outside care. According to the Ministry of Health Medical Referral Directorate in Ramallah, the main reasons for referral were in oncology, ophthalmology, MRI, heart catherterization, nuclear medicine, orthopaedic surgery, paediatrics, hematology, neurosurgery, and urology. Drug shortages drive many referrals; 33.3% of essential medicines and 40.6% of medical disposables were at zero stock at end November in Gaza Ministry warehouses.
• Estimated cost of referrals for November: NIS 9,574,204.