Jerusalem – Jalal al-Masri and his wife spent eight years and their savings in infertility treatment to have their daughter Fatma. When she was diagnosed with a congenital heart defect in December, they waited another three months for permission from Israel to take her for treatment outside the Gaza Strip.
The permission never came. The 19-month-old died on March 25.
“When I lost my daughter, I felt that there was no more life in Gaza,” Al-Masri said in a trembling voice. “My daughter’s story will be repeated over and over again.”
Israel has given permission for what it sees as the life-saving treatment of Palestinians in the Gaza Strip, which has been under a crippling Israeli-Egyptian blockade since the Islamic militant group Hamas seized power there in 2007.
But families need to negotiate an opaque and uncertain bureaucratic process. Applications are submitted through the Palestinian Authority, the reports must be stamped, the documents processed. After all, all al-Masris received was a text message from the Israeli army saying the application was “under review.”
COGAT, the Israeli military body monitoring the permit system, did not respond to numerous requests for comment.
Of the more than 15,000 applications for authorizations for Gaza patients in 2021, 37% have been delayed or rejected, according to the World Health Organization.
Al-Mazan, a Gaza-based human rights group that has helped al-Masris and other families, says at least 71 Palestinians, including 25 women and nine children, have died since 2011 after pleas were made. rejected or delayed.
This does not necessarily mean that Israel’s decisions were responsible for the deaths – even the best hospitals cannot save everyone. But the families of the sick faced the added stress of negotiating a complex bureaucracy – and the uncertainty of whether things might have turned out differently.
In December, doctors in the town of Khan Eunice diagnosed Fatma with a defect in the atrial septum, a hole in her tiny heart. Gaza’s health system has been shattered by a 15-year blockade and four wars between Israel and Hamas. So she was referred for treatment at a Palestinian-run hospital in Israeli-annexed East Jerusalem, which offers pediatric heart surgery.
Her father took the medical report and ran to a small office in Gaza City run by the internationally recognized Palestinian Authority. Hamas expelled the BCP from Gaza in 2007, limiting its power to parts of the Israeli-occupied West Bank, but continues to serve as a link between Gaza and Israeli authorities.
A few days later, al-Masri was informed that the application had been approved. PA booked an appointment at Makased Hospital in East Jerusalem on December 28 and agreed to pay for the treatment. The little child’s grandmother would accompany her.
All they needed was a security clearance from Israel.
Israel captured Gaza, along with the West Bank and East Jerusalem, during the 1967 Middle East War. The Palestinians want all three territories to form their future state. Israel withdrew troops and settlers from Gaza in 2005, but still severely restricts the movement of people and goods in and out of the narrow coastal strip.
Israel says the blockade is necessary to seize Hamas, which Western countries see as a terrorist group because of its long history of deadly attacks on Israelis. Critics see the blockade as a form of collective punishment for the 2 million Palestinians in Gaza.
Israel is denying permits to Palestinians, whom it considers a security threat. But in the case of 19-month-old Fatma and her grandmother, it was simply said that the application was pending.
The hospital kept the meeting open until January 6. Jalal then applied again. Same story.
He held a third meeting on February 14. No permission yet.
He made the fourth, for March 6.
This time he was told that Israel needed another 14 days to process the application, so he postponed the appointment to March 27. The BCP’s financial coverage expired, so he applied again. The Israelis said they needed a new medical report because it had expired in December.
“I’ve spent the last three months running back and forth,” he said. “I told everyone I saw: Do the impossible, just take it out. Take her alone, unaccompanied, and take her to the hospital.
He made his sixth meeting on April 5th.
On Friday, March 25, Fatma woke up early. She played with her father and kissed her newborn brother. She wanted chicken wings for lunch, so her father went out to get it.
All about his little girl.
While he was out, his brother called and said that Fatma looked tired. When he returned, his relatives were waiting outside the ambulance. She was pronounced dead on arrival at the hospital.
The medical report states the cause of death as cardiac arrest caused by enlargement of the heart caused by a defect in the atrial septum.
Jalal would add Israel to the chain of events.
“This is a premeditated murder. “My daughter was a victim of a blockade and imprisonment,” he said. “What did she do to deserve this?” She had all the documents. “
Dr Merfek al-Fara, a pediatrician who has seen Fatma several times at his clinic, said the hole in her heart had caused pulmonary hypertension, putting her at risk for stroke.
“If the hole is 4 millimeters, we can treat her in Gaza, but the hole in her heart was big, 20 millimeters, and that requires specialized pediatric open-heart surgery, which is not available in Gaza,” he said. “That’s why the hospital has issued her at least four emergency referrals.”
Dr Abraham Lorber, a former head of pediatric cardiology at Israel’s Rambam Health Campus, said ASD alone is rarely fatal. Doctors often recommend elective surgery later in life to prevent symptoms. Sometimes a congenital defect is found in adults.
This may have led Israeli officers assessing Fatma’s course of treatment to conclude that her life was not in danger.
But Lorber, who has not treated Fatma, said ASD could worsen other heart and lung diseases. In this case, it should be treated quickly, especially if the patient has breathing problems.
“It would not be just a matter of adjusting the ASD. “Probably the patient would need other interventions than just surgery,” he said. “This patient most likely had a major illness.”
Regardless of the diagnosis, he said, her chances of survival would be much better at a Jerusalem hospital.
Jalal would try everything that day in the emergency room in Gaza.
“I told the doctor to take my heart and put it in it,” he said. “I had the feeling that I was dead, not her.
Ten days after his daughter’s death, he received another text message from Israel. The application was still pending.
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Akram reported from Hamilton, Canada.
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