Continued decline in approvals for patients' permits
• Erez crossing: 2,275 patient aplications were submitted for permits to exit Gaza through Erez checkpoint for hospital appointments in October. According to the Palestinian District Liaison office in Gaza, only 69.85% of patients were approved, 11.21% were denied permits (255 patients, including 7 children and 15 elderly patient over 60 years old) and 18.94% received no response to their applications (431 patients, including 133 children). Approval rates have dropped since May; the cause of decline is not clear. 10 (8 males; 2 females) patients were requested to attend Israeli security interviews after applying for a permit. 93.93% of permit applications were from referral patients financed by the MoH, 4% by NGOs and other donors, and 2% self-funded.
Rafah: No exit during October
• Rafah border: Rafah terminal was closed for exit to Egypt during October but was open for residents to return to Gaza on 3 days during October allowing 4,198 stranded pilgrims and travellers, including patients, to return to Gaza. No medical aid and no medical delegations were allowed to enter Gaza during the month. The border was open on only 24 days so far in 2015, 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 access.
MoH referrals in October
• Ministry of Health referred 1,979 Gaza patients* in October for outside care. According to the Ministry of Health Referral Abroad Department (RAD), the main referral treatments needed were in oncology, hematology, nuclear medicine, ophthalmology and orthopaedic surgery specialties. Drug shortages drive many referrals; 35% of essential medicines and 41% of medical disposables were at zero stock at end of October in Gaza Ministry warehouses.
• Estimated cost of referrals for October: NIS 9,387,550.
*Note: Beginning with this report, referral data used in the WHO monthly reports will reflect the financial decision-based data for Gaza patients received from the MoH central referral office in Ramallah. This data includes renewals for expired referrals to Egypt for Gaza patients waiting for access, additional financial coverage needed for in-patients in hospital, and special additional referrals; numbers are therefore higher than the patient-based data from the Gaza referral office previously used in the monthly reports. The data has been adjusted in the tables below so that trends can be evaluated. WHO's annual reports already reflect published data from the MoH in