On 17 April 2017, Aya Khalil Abu Metalq, five, from Abasan Al Kabera in east Khan Younis died after her request to exit Gaza for medical treatment in East Jerusalem was denied by Israeli authorities. Al Mezan Center for Human Rights strongly condemns Israel’s practices and policies that form the basis of its closure of Gaza, and which hinder and prevent access of medical patients to adequate medical care.

According to Al Mezan’s documentation, five-year-old Aya was born with a metabolic disorder, the treatment of which required admittance to a hospital outside of Gaza. She obtained a medical referral from the Palestinian Ministry of Health to receive treatment at the Al Makassed Hospital in East Jerusalem. After receiving confirmation from the hospital for a medical appointment on 5 February 2017, Aya’s family applied for a permit through the Liaison Office to exit Gaza. She was forced to miss the appointment after the Israeli authorities at Erez crossing failed to reply to her request in time. Her family was then told to seek another appointment at the hospital, and received a new date of 19 March 2017. The family went through the same application procedure, and again received no answer from the Israeli authorities. Finally, Aya was scheduled a third time for an appointment, set for 27 April 2017. While the family was awaiting an answer concerning the permit request, Aya’s health deteriorated. She was rushed to Nasser Hospital in Khan Younis and died on 17 April 2017.

Al Mezan’s monitoring shows that in the first quarter of 2017, three patients died while waiting for permits to exit Gaza. Approval rate for permits has decreased 20% compared to the same period in 2016. Israel’s delaying and refusal to issue permits for medical treatment have led to severe deterioration of patients health, which is already undermined by a health sector crippled under Israel’s closure restrictions.

The closure practices amount to a grave violation of International Humanitarian Law which, according to the Fourth Geneva Convention, obliges Israel as the occupying power to ensure and maintain medical supplies and services, and public health, to the fullest extent of the means available to it and facilitate relief schemes on behalf of the protected population where necessary. International Human Rights Law also obliges Israel as the duty bearer to maintain the highest attainable standard of physical and mental health of the population, of which respecting the right to freedom of movement is required. Israel’s closure practices are in violation of Article 12 of the International Covenant on Political and Civil Rights and Article 13 of the Universal Declaration of Human Rights concerning freedom of movement, and Article 12/d of the International Covenant on Economic, Social, and Cultural Rights and Article 24 of the Convention on the Rights of the Child concerning the right to health.

Al Mezan strongly condemns Israel’s arbitrary restrictions imposed on patients in the Gaza Strip and holds Israeli authorities responsible for the death of Aya Abu Metleq. Al Mezan asserts that a continuation of Israel’s practice to delay and refuse medical permits will lead to an increase in the death toll. Al Mezan calls for a serious, independent investigation into Aya Abu Metleq’s death. Al Mezan also reiterates the necessity of lifting the closure and calls on the international community to promptly intervene with effective measures to do so. Al Mezan further calls on the international community to exert necessary pressure on Israeli authorities to adapt their policies regarding patients to international standards and to secure swift and unimpeded access to hospitals for every medical patient who is in need of treatment outside of Gaza.