‘We are looking for countries to accept more cases ..patients are dying inside Gaza’- MSF urges nations to facilitate medical evacuations

14 July 2025 - As the genocide in Gaza continues, more than 56,000 people have been killed and around 125,000 wounded since 7 October 2023. While thousands of people require specialised medical care due to the severity of their injuries and illnesses, they are unable to receive the care they need as the healthcare system has been decimated by Israeli forces. To make matters worse, Israel has reduced medical evacuations to a minimum.

Dr Hani Isleem, Médecins Sans Frontières/Doctors Without Borders (MSF) Project Coordinator for Medical Evacuations from Gaza, is urging the Israeli authorities to allow patients to leave and is calling for more nations to help.

"We are looking for countries, we really want them to open their doors, to accept more and more cases because those patients are dying inside Gaza. According to the WHO, at least 12,000 patients need to be evacuated outside Gaza to access vital medical care. The medical evacuation process is very complex and it is changing according to the [military] stages in Gaza. We can divide the phases into four.

Before the closure of the Rafah border on 7 May [2024], it was directly from Gaza to Egypt and from Egypt to a third country.

Then during the closure of the Rafah border, it was happening through Kerem Shalom [crossing point] directly from Gaza to Israel and from Israel with two options, either to EU countries or to Jordan, and then transiting to other countries. During the ceasefire, those stages changed again and [medical evacuations] went through the Rafah border. And after the collapse of the ceasefire, it went again through Kerem Shalom with very limited options.

Medical evacuation requires prior clearance from COGAT, the coordination body managing Israeli governmental activities in the occupied Palestinian territory. Decisions are often arbitrary and opaque. Many critical cases are either delayed or denied, regardless of medical urgency.

Severely injured cases plus all the chronic cases, cancer plus other congenital and cardiovascular diseases, are in need of medical evacuation from Gaza. You don't know what is the reason behind denying cases. Sometimes, when they approve a case, they refuse the companion. You are talking about separation of family, impacting people in need. And this has also impacted many countries that were very active and motivated to take cases out of Gaza, but were blocked because of refusal. And then many countries gave up trying again to take cases from Gaza.

Overwhelming medical needs and limited diagnostic capacity further complicates medical evacuations outside Gaza. We are talking about an overwhelmed health system, prioritising cases: which one really needs to go out and according to which conditions, which is also limited to the criteria, medical criteria and administrative criteria of the [host] country.

The limited options and limited destinations is one of the most difficult [challenges]. There is a majority of countries that are not open to taking cases from Gaza, and there are only a few countries that could take cases under conditions. Some countries are reluctant to take in patients, fearing they might be perceived as facilitating 'forced migration' or as taking on the burden of the patients’ extended stay.

With all the restrictions I mentioned, MSF only managed to evacuate 22 patients to different destinations, including the United Arab Emirates, France, Canada, Qatar and Australia. Those patients took a lot of coordination that started at the level of the countries accepting the medical files and then starting all the visa process, then coordinating with our colleagues from the WHO to get these patients out after getting the COGAT approval and letting them leave. This list originally [included] hundreds of patients and we were blocked with no response from the countries we were approaching.

A clear and predictable medical evacuation system, with safe corridors and without family separations, must be urgently established while ensuring Palestinians’ right to return to the Gaza Strip after treatment. We are calling on the Israeli authorities to allow patients to leave Gaza and to be more flexible in the approval of [medical] cases. We are asking all the countries to be on the side of the Gazan people by allowing more and more cases to have access to their health care systems, participating in the medical evacuations and saving the lives of people."