Lives in the Balance: Medical Evacuations from the Gaza Strip

with Stav Salpeter (Gisha – Legal Center for Freedom of Movement)What does it take to leave Gaza for life-saving medical treatment - and why is it so often impossible?Diana Safieh is joined by Stav Salpeter, Director of International Relations at Gisha, an Israeli human rights organisation working to protect the freedom of movement of Palestinians, particularly in Gaza.Drawing on legal cases, on-the-ground realities, and international law, Stav exposes the systemic barriers preventing critically ill patients from accessing urgent care - and why this is not a logistical failure, but a political one.From the collapse of Gaza’s healthcare system to the legal battles required for even a single patient to leave, this conversation lays bare a system where access to healthcare is controlled, delayed, and too often denied.The role of Gisha and its legal advocacy on freedom of movementHow Gaza’s healthcare system has been systematically degradedThe bureaucratic and political barriers to medical evacuationThe closure of the Gaza–West Bank medical corridorThe human cost behind the statistics: real patient casesThe role (and limitations) of third-country evacuationsIsrael’s obligations under international humanitarian lawWhat international pressure can realistically achievePatients often face weeks or months of bureaucratic delays for permits - even in urgent cases - despite conditions that require immediate treatment.Only 20 out of 677 health service points were fully functioning (March data)Severe shortages of medicine, fuel, electricity, and staffMedical professionals have been killed, detained, or denied entryThis creates a public health crisis where evacuation becomes essential - not optional.Despite claims otherwise, the obstruction of medical evacuations is rooted in policy decisions, not geography or capacity.At least 18,500 people are currently waiting for medical evacuationEven under “best case” scenarios, current systems would take over a year to meet existing needsEven when open, far fewer patients than promised are able to leave, and access remains inconsistent and unpredictable.Many cannot travel without a companion (often denied)Parents must decide whether to leave children behindFear of not being allowed to return discourages evacuationAccess to treatment often requires multiple court petitions, even for children.One cancer patient only accessed treatment after six legal petitionsHis son, with a similar condition, died waitingBefore October 2023, around 1,500 patients per month accessed treatment via the Gaza–West Bank corridor.This route is now completely closed due to policy decisions.Under the Fourth Geneva Convention, an occupying power must ensure access to medical care.Israel disputes its status as an occupying power, limiting its obligations in practice.“It’s much cheaper to kill people with bureaucracy than with bombs.”Pressure governments to reopen the Gaza–West Bank medical corridorAdvocate for increased third-country medical evacuationsChallenge restrictive visa and documentation requirementsContinue raising awareness and pushing for accountabilityStav Salpeter is Director of International Relations at Gisha – Legal Center for Freedom of Movement. Her work focuses on legal advocacy and policy change to ensure Palestinians’ access to fundamental rights, including healthcare.Key Topics CoveredKey Takeaways1. Medical evacuation is a life-or-death issue2. Gaza’s healthcare system is on the brink of collapse3. The biggest barrier is political - not logistical4. The numbers are staggering - and growing5. The Rafah crossing is not a sufficient solution6. Patients face impossible choices7. Legal battles determine who lives and dies8. A functioning system already existed - and was shut down9. International law is clear - but contested10. Bureaucracy is being used as a tool of control🎯 What Can Be Done?📢 About the Guest