For the fourth time in two months, Nevin Abu El-Jidian failed to cross the Erez checkpoint, which separates the Gaza Strip from Israel and the West Bank. Israeli authorities asked her to come back again with an updated radiograph of her breast cancer. “The officer told me I have to go back to Gaza and take an updated one.” But, even then, passage into Israel is not guaranteed, the officer told her.
However, getting that X-Ray is no easy feat for Nevin, 35. While waiting at the Erez crossing, her brother delivered the updated radiograph to the Palestinian side, who then passed it on to the Israeli side.
“The officer blackmailed me when he realized I have cancer,” Nevin said in a telephone interview.
According to testimony collected by the Physicians for Human Rights – Israel, officers at the Erez crossing often exploit vulnerable patients to obtain information, forcing them to inform on friends and family. Refusal to collaborate results in denying passage to these patients.
Three hours passed since the last call with Nevin, who was waiting at the crossing when she told me that the Israeli authorities had forced her to wait until the rest of Gaza’s ‘ordinary patients’ passed through. In spite of the intimidating journey, she was finally allowed to leave, but at a cost: “when I got out of the departure terminal I could not catch the bus, so I had to take a taxi and pay $81.” That’s five times more than she could afford.
In her fight against breast cancer, Nevin must receive 33 chemotherapy sessions at the Augusta Victoria Hospital in East Jerusalem every 60 days. She was diagnosed 18 months ago, and like more than 8,260 cancer patients, including 3,500 children, she faces grim prospects for sustained care in Gaza amid diminishing supplies of drugs.
“The lack of drugs and the long delays in letting patients pass imposed by the Israeli authorities mean more pain and dwindling hopes of recovering,” she added.
According to the Gaza Health Ministry, 1,500 people are diagnosed with cancer each year in Gaza, an alarmingly high rate according to health officials. And, with the Israeli and Egyptian blockade of the territory, seeking treatment abroad is often an arduous process.
Meanwhile, chemotherapy drugs have been prohibited from entering Gaza, along with other medical equipment needed to perform radiotherapy, molecular therapy, PET scans and isotope scans, according to the Executive Director of the Palestinian Society for Cancer Care, Rizk al-Soos. “Patients who can afford the journey are forced to travel to Israeli hospitals, and even Egyptian hospitals for treatment to avoid Israeli blackmail. But, most patients have no means to afford travel costs to either destination.”
The Palestinian Society for Cancer Care provides aid and support to 1,204 cancer patients and their families in the Gaza Strip, where nearly 16,000 cancer patients struggle to survive, especially as 80% of cancer drugs have been depleted, a life-threatening situation for many of the patients.
Last week, Dr. Ashraf al-Qedra, spokesperson of the Health Ministry in Gaza, announced that al-Rantisi Pediatric Hospital has run out of Neupogen, a drug that can help the body make white blood cells after receiving chemotherapy, which is essential for the immune systems of patients. As a result, health officials suspended all chemotherapy sessions at the hospital.
The diminishing drug supply comes with Israel tightening the noose on Gaza in recent years. Figures provided by the Israeli Ministry of Defense in response to a Freedom of Information Act request by Gisha indicate that in the first quarter of 2018 alone, 833 applications for travel permits by residents of Gaza were denied on the grounds that the applicant’s “first-degree relative is a Hamas operative.” For comparison, the Israeli authorities refused only 21 applications on these grounds throughout 2017.
Physicians for Human Rights – Israel and Al Mezan Center for Human Rights in Gaza report that as of June 2018, the Israeli authorities rejected applications by at least 13 patients in need of medical treatment unavailable in Gaza, including cancer patients.
Even if those denied patients were lucky to obtain travel permits, they might collide with another barrier: “Poverty,” Mr. al-Soos said while flipping through a patient’s file who died recently of cancer.
Jehad Abu Hasna, 30, died last May. Initially, Israeli authorities denied his application for a travel permit several times before finally allowing him to travel, al-Soos said. “Despite receiving the permission to cross the border to treat his brain cancer, Jehad failed to obtain the bus/taxi and accommodation expenses for 20-40 days in Jerusalem.” Then, Jehad’s wife informed the Society’s administration of her husband’s death after the family was not able to afford his treatment. “Every Neupogen dose costs $40.” Mr. al-Soos explained.
In Gaza, poverty and unemployment affect half of the population. The year-long energy crisis has left households with as little as four hours of power a day, putting enormous strain on health, water and sanitation systems as well as on all productive sectors. Salary cuts and payment delays for tens of thousands of public sector employees have curtailed people’s purchasing power and worsened their debt burdens.
“We were informed that the majority of the drugs that are required to manage care for cancer patients are depleted, which exacerbates the existing crisis,” Said Dr. Mahmoud Daher, the World Health Organization director in Gaza.
“The chronic drug shortage has been going on for several years; all the cancer patients are at risk of losing their lives because of this situation,” he added.
I met Joory Basheer, a three-year old eye cancer patient with her 36 years-old father who visited the Palestinian Society for Cancer Care to seek out support for his child.
According to Joory’s father, Israeli authorities denied her application for a travel permit after they claimed her mother, who would have accompanied Joory, has a Hamas relative.
Caught between Israel’s restrictions and crippling poverty, Gaza’s cancer patients find themselves in a grim reality with little reason for hope. Yet, despite her daily pain, Nevin feels lucky to have been be able to travel for treatment, but she is not sure whether the Israeli authorities will block her next time, as they did with the young Joory.