Increased access need through Erez: The number of patients’ applications submitted in March to Israeli authorities for health access through Erez checkpoint was the highest since the WHO began monitoring access in 2005; in the first quarter of 2014 the number was 87% higher than for the same period in 2013. The increase in need reflects the continuing problems of access through Rafah border to Egypt and lack of drugs, especially chemotherapy and lack of medical disposables.
Drop in approval rates of permits: 85.99% of patient applicants received a permit in March 2014, 1.83% of applicants (33 patients: 12 females, 21 males, including 8 children) were denied permits, and 12.18% of applicants (220 patients: 69 females and 151 males) received no response to their applications, including 31 children whose medical treatment was delayed as a result.
18 patients interrogated: 18 patients (16 males, 2 females) were requested to attend interviews with Israeli security after applying for a permit to cross Erez. Only one patient had been granted a permit so far following security interviews in March.
Three referral patients died in March while waiting for approval to exit Gaza, including a young woman who died one day after being interviewed by Israeli security officials (see case studies p.5).
Further drop in access through Rafah: Only 40 Gaza patients were able to travel to Egypt through Rafah in March, compared to more than 4,000 in March 2013, before the closure.
Increase in MoH referrals: Total MoH referrals of Gaza patients (1,914) were the highest recorded and 37% higher than the monthly average in 2013. MoH referrals to health facilities in the West Bank and East Jerusalem hospitals were the highest recorded in recent years.
Medical reasons for referrals: The top ten needed specialties were for treatment in the following specialties: oncology--308 referrals (16.09%), MRI--286 (14.94%), nuclear medicine--154 (8.05%), orthopaedics--136 (7.11%), ophthalmology--119 (6.22%), heart catheterization--119 (6.22%), paediatrics--104 (5.43%), neurosurgery--91 (4.75%), haematology--85 (4.44%), and heart surgery --65 (3.40%). The remaining 23.35% of referrals were to 21 other specialities.
Gender gap: There was a gender gap in referrals: 53.87% male patients versus 46.13% female patients. 22.42% of all referrals were children aged 0-17 years and 18.55% were patients aged over 60 years.
Estimated cost of referrals for March 2014: NIS 15,233,101.