Waiting to leave Gaza becomes a death sentence for thousands of sick and wounded

Nine-year-old Youseff was diagnosed with blood cancer during Israel's war on Gaza after weeks of unexplained pain, swelling and extreme fatigue, as Israeli bombardment intensified and the enclave’s health system collapsed around him.

His mother, Amani Abu Salim, has been trying for months to secure medical evacuation for her son. Oncology services in Gaza are now largely unavailable, and doctors have warned her that his treatment cannot continue inside the besieged strip.

"After many tests, doctors told me clearly that his treatment cannot continue in Gaza," Abu Salim tells The New Arab. "There is no chemotherapy, no regular scans, and no stable electricity to preserve medicines. Every day we stay here, the cancer has more time to spread in his body."

The partial reopening of the Rafah crossing has provided a narrow and unpredictable window for medical evacuations. Thousands of Gazans are waiting for a chance to seek treatment abroad.

Despite repeatedly submitting Youseff’s name, Abu Salim says she is always told to wait. Approvals do not always come, and sometimes the crossing closes without warning.

"While we wait, his condition keeps getting worse," she says. "I feel time slipping away from us."

Thousands waiting

Youseff's case mirrors that of thousands of Palestinians, including children, trapped in medical limbo.

Although Rafah reopened after nearly two years of closure, departures remain tightly controlled. Israeli restrictions, last-minute refusals and limited daily exits mean only hundreds are allowed to leave, while thousands require urgent care.

"There are around 4,000 children in Gaza waiting for urgent medical evacuation, and thousands more who require healthcare and services that they can’t access," Max Slaughter, head of communications at Medical Aid for Palestinians (MAP), tells The New Arab.

Slaughter says humanitarian organisations are struggling to cope - 11 children have reportedly died this winter from hypothermia, and medical teams are losing patients because essential care cannot be provided amid severe shortages.

"All crossings into Gaza must now be fully reopened, restrictions on humanitarian organisations lifted, international medical teams allowed to enter, and medical evacuations facilitated at scale," he says.

Wounded and waiting

Mother of five, Huda al-Najjar, has been caring for her 14-year-old son, Mahmoud, since he was wounded when an Israeli airstrike near their home left him with severe shrapnel injuries to his leg and abdomen.

He survived the initial attack, but his recovery has stalled, and Gaza's shattered medical system lacks specialised surgery and rehabilitation services. For months, Huda has waited for his chance to travel.

"Doctors did everything they could, but they told me his treatment cannot continue properly inside Gaza," she says. "Each time the crossing reopens, we hope we will be called, but so far nothing has happened."

Doctors have warned her that untreated infections could spread and that her son may permanently lose mobility.

"Even if he survives, he could live with a disability for the rest of his life because he did not receive treatment in time," she says.

'That chance never came'

For some families, the prolonged wait for medical evacuation has already ended in tragedy, including seven-year-old Anwar al-Ashi, who died from acute kidney failure after spending months awaiting permission to leave Gaza for treatment.

The World Health Organisation has reported that nearly a thousand patients have died while waiting for approval to travel abroad for urgent care, as the enclave’s devastated health system struggles to cope.

Among them was 47-year-old Yousef al-Najjar, who had been diagnosed with colon cancer more than a year earlier and whose condition steadily deteriorated as doctors warned that the specialised treatment he needed was unavailable inside Gaza.

"Yousef knew from the beginning that his illness was serious, but he felt reassured because doctors told him treatment was available outside Gaza," his widow Sumaya tells The New Arab. "That chance never came."

He entered a cycle of waiting, moving between hospital and home, carrying his medical file and a small bag he kept ready in case permission arrived.

"I watched my father grow weaker day after day, and there was nothing I could do," his son, Mohamed, said.

"One night, just days before his death, he told me the disease was not what frightened him most, but the idea of dying while waiting."

Yousef died before he could leave Gaza.

"In his final days, he stopped asking about travel and started asking about the children," Sumaya says. "He was afraid of leaving them without securing their future. He died feeling that his death could have been prevented if he had been allowed to receive treatment in time."

For families like nine-year-old Youseff, that fear remains constant.

"If we can't leave Gaza, my son will not survive," his mother says. "I am living every day with the fear that I will lose him, not because his illness is untreatable, but because he is trapped."