Despite the reopening of the Rafah crossing on Gaza's southern border with Egypt on Monday, 2 February, medical cases allowed to leave the Strip remain hugely disproportionate to the scale of the health catastrophe.
Only a few dozen sick and wounded Palestinians were permitted to leave, while others, including thousands of children suffering from chronic diseases or requiring urgent surgical procedures, have been stuck in Gaza as their conditions deteriorate amid severe shortages in medicine and medical equipment.
The crossing has largely been closed since the Gaza side was captured by Israel in May 2024, but was supposed to reopen in the first phase of the October ceasefire plan.
So far, around 180 Palestinians have left the Gaza Strip since the limited reopening, according to officials in the territory. According to the WHO, more than 18,500 patients in Gaza still require specialised medical care that is no longer available in the Strip, including people suffering from heavy trauma wounds, cancer and chronic diseases such as diabetes.
A 2025 report by Save the Children stated that more than 20,000 Palestinian children have been killed and at least 39,000 injured by Israeli forces, some requiring life-saving treatments and surgery.
Famine was also officially confirmed in Gaza, where children "are dying from malnutrition and other preventable causes."
Dr Mahmoud Al-Sheikh Ali, an internal medicine consultant and head of the internal medicine unit at the Gaza European Hospital, reiterates that the health system in Gaza is in a state of "complete collapse," noting that travelling abroad for treatment remains almost impossible for the majority of cases.
Dr Al-Sheikh Ali explains that before the crossing was recently reopened, travel was effectively forbidden except for a very limited number of cases, 50-100 cases per month.
"In October, only two groups were allowed to travel," he recalls, "the first included 41 cases, and the second 49 cases, despite the fact that we issue no less than 10 medical transfers for children's treatment abroad every day. There are at least 6,000 critical cases in need of urgent evacuation."
With limited permission to cross over to Egypt, the lives of thousands of children are suspended by an exit decision that may arrive too late.
Urgent care required
"My son Ali's body is always swollen," says Khitam Al-Yaziji, mother of five. Her 10-year-old son can't walk and is losing his hair, Khitam tells The New Arab.
"Three of the medicines he needs are not available anywhere in Gaza.”
Ali's ordeal began in June 2025, when his family was displaced in Al-Shati camp. "There was heavy bombardment," Khitam recalls, "and we ran."
Ali fell on a large rock and was hurt near his kidney. "He was in a lot of pain, and it turned out that he had a cyst."
Ali spent 12 days at the hospital, where the CT scan was broken, and he was misdiagnosed and given the wrong treatment, which deteriorated his condition. Eventually, the family learned that his condition was related to a thyroid gland disorder.
Despite receiving an urgent medical transfer request for treatment abroad, the family has yet to hear back from the Ministry of Health or the World Health Organization.
Five-year-old Yazan Musleh's paternal grandmother tells a similar story, her voice trembling as she sees him hanging between life and death.
"We were displaced in the Ministry of Labour building on 5 September," she recalls. "At 1 am, the building was bombed. My son, his wife and my other grandson were martyred. Only Yazan survived."
She describes how shrapnel entered his head from the front and exited from the back. "He spent 61 days at the hospital," she says, adding that he doesn't move, speak, or recognise anyone.
At Nasser Hospital in Khan Yunis, Yazan underwent two surgeries, but his condition did not improve. "He can't move his hands and feet, and he can only see with one eye," she says.
Less than a month ago, however, Yazan was allowed to travel to Jordan for treatment, accompanied by his maternal grandmother, who says he is improving gradually.
Fragile health system
Dr Al-Sheikh Ali says that the health system in Gaza was fragile even before the war, but today it is completely dilapidated.
"Patients with blood disease, complex heart disease, and immune diseases have no access to treatments in Gaza,” says Dr Al-Sheikh Ali, "so they require transfers for treatment abroad because most hospitals are out of service. The situation is catastrophic."
The Ministry of Health has recorded 970 patient deaths, including 300 children, who had already obtained a transfer request, but died because they were not allowed to travel, according to Dr Al-Sheikh Ali.
"These people could have been saved," he says.
The clinical burden on hospitals has increased by 400%, Dr Al-Sheikh Ali adds.
"Nasser Hospital has a capacity of 300 beds, but now serves 1,500 beds," he explains. "Operating rooms are occupied non-stop, doctors, nurses and staff are exhausted, and some radiology and laboratory units function with limited capacity, while other units no longer exist."
Timely treatment is a key element in saving lives, he adds.
"There was a patient who needed heart surgery within two months, but because he was not allowed to travel, his condition became chronic," says Dr Al-Sheikh Ali, noting the endless stream of appeals from families to save their children.
"But travel is in the hands of the occupation, and despite the so-called ceasefire, the existing healthcare crisis remains as it is; nothing has changed."
Lawyer and rights advocate Abdullah Sharshara says that what Gaza's wounded children are being subjected to is "a flagrant violation of basic human rights."
"Children's right to healthcare and protection is enshrined in basic international conventions, such as the Universal Declaration of Human Rights, and Article 24 of the Convention on the Rights of the Child," says Abdullah, noting that depriving children of treatment constitutes discrimination against the most vulnerable groups in society.
"Preventing children from accessing medical care is a violation of the right to life, as stipulated in Article 6 of the International Covenant on Civil and Political Rights (ICCPR), and of the right to health according to Article 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR)," he adds.
"These conditions can lead to death or permanent disability, and are a serious breach of international obligations," says Abdullah, emphasising that the occupation is legally responsible for the protection of children.
"Article 27 of the Fourth Convention stipulates the protection of civilians, and Article 56 obliges the occupation to ensure public health care for them," he adds.
"The Convention on the Rights of the Child also emphasises the necessity of protecting children during armed conflicts and providing urgent medical treatment."
"Withholding treatment from children is a flagrant violation of international humanitarian law and child protection rules," says Abdullah.
"If it leads to death or deliberate permanent harm, it is considered a war crime."
Ansam Al Qitaa is a freelance journalist based in Gaza. For years, she has covered the successive wars in Gaza and their humanitarian and social impacts for international and local outlets
This piece is published in collaboration with Egab