- High need for access through Erez: In April the volume of patient applications to Israeli authorities to cross Erez checkpoint for health access (1,677 patients) was 46% higher than the monthly average in 2013. April was the second highest month for applications since the WHO began monitoring access. The increase in demand reflects the continuing problems of access through Rafah border to Egypt and lack of drugs, especially chemotherapy and lack of medical disposables.
- 8% drop in permit approval rates: 78% of patient applicants received a permit in April 2014, down from 86% the previous month. 31 patients (13 females and 18 males, including 7 children) were denied permits (1.85%). 20.15% of patients who applied (338 patients: 135 females and 203 males, including 67 children and 30 elderly people over 60) received no response to their applications and their medical treatment was delayed as a result.
- 4 patients interrogated: 4 men, including one patient over 60 years, were requested to attend Israeli security interviews after applying for a permit to cross Erez. Two so far were granted a permit following the security interviews in April.
- A 6-month-old baby died after 4 unanswered applications to Israeli authorities for health access via Erez (see case study, p.5).
- Patient access through Rafah almost stopped: Only 7 Gaza patients were able to travel to Egypt through Rafah in April, compared to more than 4,400 in April 2013, before the closure.
- Increase in MoH referrals: Total MoH referrals of Gaza patients (1,880) to outside facilities were the second highest recorded and 34% higher than the monthly average in 2013.
- Medical reasons for referrals: The top ten specialties requiring referrals for treatment were: oncology--305 referrals (16.22%), MRI--275 (14.63%), nuclear medicine--155 (8.24%), heart catheterization--141 (7.5%), ophthalmology--123 (6.54%), orthopaedics--116 (6.17%), neurosurgery--94 (5%), paediatrics--93 (4.95%), haematology--69 (3.67%), general surgery --67 (3.56%). The remaining 23.52% of referrals were to 21 other specialities.
- Gender gap: The gender gap in referrals continued: 55.53% male patients versus 44.47% female patients. 22.23% of all referrals were children aged 0-17 years and 19.73% were patients aged over 60 years.
- Estimated cost of referrals for April 2014: NIS 9,256,169.