Khitam Doghmosh, a Palestinian cancer patient in Gaza battling lymphoma and breast cancer, fears she will die before getting any chance to seek treatment outside the war-torn enclave.
Despite receiving an urgent medical referral, the 45-year-old mother of five remains stranded in the besieged territory, where shortages of medicines and medical equipment have left her without the treatment she needs because of Israeli policy.
On 5 February 2024, the Israeli army killed Doghmosh's husband in an airstrike. Two months later, in April, she was diagnosed with lymphoma and breast cancer and spent more than two months in hospital without receiving adequate treatment.
"The doctors did everything they could, but there are no medicines or treatments available for my condition, which is why they issued an urgent medical referral," she described to The New Arab. "Since that day, I have been waiting in vain. Only a small number of patients manage to leave Gaza, and there are others ahead of me in the queue. I am terrified I will die before my turn arrives."
Doghmosh has lost more than 40 kilograms because of her illness. "I am in my forties, yet I look like I am in my sixties as if I was an elderly woman worn down by disease," she said, sharing fears about what would happen to her children if she died.
Her ordeal reflects the plight of thousands of patients awaiting medical evacuation as Israel continues to prevent sick and wounded Palestinians from leaving through the Rafah crossing, which has remained closed to patient evacuations for more than two weeks, according to Gaza's Ministry of Health.
Mohammed Abu Afash, director of Medical Relief in Gaza, told TNA that 2,027 patients had died while awaiting treatment and medical evacuation since October 2023, amid the continued Israeli closure of crossings and restrictions on the entry of medicines and medical supplies.
"More than 21,000 patients require medical evacuation," Abu Afash said, adding that no patients had left through Rafah in the preceding five days.
"Those awaiting travel include cancer patients, people with kidney failure and heart disease, and others with chronic illnesses requiring specialised care unavailable in Gaza. Delays can worsen their conditions and lead to potentially fatal complications," he explained.
The healthcare system is also struggling with severe shortages of medicines, medical supplies and diagnostic services, including laboratory tests, radiology and operating theatres.
Out of more than 574 healthcare centres operating before the war, only 227 remain functional, many with limited resources, undermining services for pregnant women, children and other patients, he explained.
Thousands face years-long wait
Beyond the illegal Israeli closure itself, the scale of the waiting lists and the limited number of patients permitted to leave have deepened the crisis.
Gaza's Medical Referral Committee at the Ministry of Health warned that evacuating the more than 21,000 patients and wounded people currently awaiting travel could take four years under the existing mechanism, even if no new cases were added.
With new medical referrals continuing to be approved each month, clearing both the accumulated backlog and incoming cases could take approximately eight years, the committee said.
For patients whose conditions require urgent intervention, such delays could prove fatal.
In a press statement, the Ministry of Health said the closure of Rafah was depriving patients and wounded people on approved travel lists of access to medical treatment, while adding to the burden on hospitals already struggling to accommodate critical cases.
The closure also prevents patients from departing on the three days each week designated for coordinating medical evacuations, disrupting travel schedules and prolonging waits for those who have already completed medical and security procedures.
The ministry called on international, UN and human rights organisations to pressure Israel to ensure the sustainable reopening of Rafah and other crossings and facilitate the immediate departure of critically ill patients and those with severe injuries.
War survivors stranded without care
The crisis also affects Palestinians wounded during the war who require specialised treatment abroad, including survivors who have lost entire families and are now struggling to secure care for themselves and their children.
Tamer Mahmoud was injured in an Israeli strike on his home in al-Nuseirat refugee camp in central Gaza in May 2024. The Israeli army attack killed his mother, sisters, nieces and nephews, wife and three children. He survived alongside one of his children and his father.
Mahmoud requires treatment abroad for his injuries, while his surviving child, who is already a disabled child, requires spinal cord-related therapy that was unavailable in Gaza even before the war.
"I survived alongside my child, who has special needs. I used to travel with him constantly to Egypt for spinal cord treatment therapy that wasn't even available in Gaza before the war, let alone now," he told TNA.
Both have received medical referrals, but neither has been able to travel.
About two weeks ago, Mahmoud received a call from the World Health Organisation telling him to prepare for travel, reviving his hopes of obtaining treatment for himself and his child.
The crossing's closure soon dashed those hopes, leaving him uncertain about when they could leave.
"A few days ago, I felt that relief was near and that I would finally be able to travel and receive treatment, but the crossing was shut," he said. "Today, I do not know whether we will travel or not."
The wait continues for Doghmosh, Mahmoud and thousands of others as their health deteriorates and treatment remains out of reach due to Israeli restrictions.
With more than 21,000 people awaiting medical evacuation and thousands of patients facing conditions that cannot withstand prolonged delays, the continued Israeli closure of Rafah threatens to turn the wait for treatment into a death sentence.