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Israel has imposed new restrictions on medical volunteer missions it allows into Gaza while banning most critically ill and severely wounded patients from being evacuated for medical treatment, according to the United Nations, several aid agencies and an Israel-based group that has taken the evacuation case to Israel’s Supreme Court.

Aid officials involved in evacuations said this week that, for the first time in almost two months, the Israeli government is allowing a group of child patients and their guardians to leave Gaza for medical treatment. The sources asked to remain anonymous because of the sensitivity of the issue. 

On Wednesday, one of the nongovernmental groups involved in trying to arrange evacuations said it was told by Israeli officials that the groups had not been evacuated yet.

 has petitioned the Israeli Supreme Court on behalf of about 40 patients, most of them women and children. They include a 9-month-old girl named Sadeel who needs a liver transplant and had been cleared to leave before Israel stopped all evacuations in May, when Israeli forces 

 against Hamas in the southern Gaza city of Rafah, closing down the border with Egypt.

“Since May 7, the Rafah crossing was closed and no patients could go out,” said Adi Lustigman, an attorney with the human rights group. “We submitted the petition asking for immediate intervention to let the children and other patients, not only children, go out to get medical care.”

Israel’s Supreme Court is scheduled to hear the case next week. Lustigman said the group had deliberately chosen cases like the baby girl, where an argument could not be made that she is a security threat.

The aid organization funding the transplant, 

, said Wednesday that Sadeel had been given clearance by Israeli authorities for evacuation but had not yet been able to leave with her parents. One of the parents is the planned organ donor.

“Israel justifies everything with the general saying of ‘security grounds’ and indeed no one is denying that there is a security issue in our area in every direction you look,” Lustigman said. “But this argument is not a magical word and you cannot justify just ignoring human disasters that are happening.”

 a California-based aid group, has been lobbying members of Congress to pressure Israel to create a steady pipeline of medical evacuations and to lift restrictions on medical aid missions.

After the war in Gaza began with the Oct. 7 Hamas-led attack against Israel, Nisreen Malley, the group’s advocacy manager, said it was White House intervention that persuaded Israel to allow child cancer patients to leave for treatment and that pressure is needed again.

“This is barely cosmetic,” said Dr. Ghassan Abu Sittah, a prominent 

, of Israel’s limited resumption of medical evacuations.

“Forget about the pileup of cases that need to be taken out, what about the daily toll of wounded children? Where are they being treated?” he asked.

Malley said she hoped that the first small group of patients allowed out would be a test case allowing much larger numbers.

She said Israeli restrictions on volunteer medical missions since its Rafah offensive have severely limited the number and effectiveness of medical expertise going into Gaza, where most hospitals have been destroyed or heavily damaged and local medical personnel have been killed, wounded or repeatedly displaced.

The picture after Israel moved into Rafah

Israel stopped allowing medical missions in or out when its forces 

 and took over the border crossing with Egypt. A 19-person team of mostly U.S. doctors at the European Gaza Hospital were among those trapped when that happened. When they were allowed to leave, Israel did not allow other teams to replace them.

The missions recently started up again with Israel allowing much smaller teams to move through its Kerem Shalom crossing with southern Gaza. But there were significant restrictions — including banning any medical aid workers of Palestinian origin, doctors told NPR.

Dr. Ali Elaydi, an orthopedic surgeon, was among the volunteers in April at the European Gaza Hospital. He said he was able to do more than 20 surgeries, helped by medical supplies he and the rest of the team brought in. He signed up for another mission recently.

“Less than 48 hours before my supposed entry into Gaza, I was informed by the World Health Organization that I was rejected. I had already traveled to Jordan,” he said.

Elaydi is an American, from Texas, who was born in Gaza.

His email from the World Health Organization (WHO) advised that Israel’s new policy banned medical workers who had Palestinian parents or even grandparents.

Neither Israeli officials nor the WHO or the State Department responded to requests for comment.

Dr. Jomana Al-Hinti from Toledo, Ohio, was among the U.S. medical volunteers trapped at the European Gaza Hospital when the border closed in May.

Al-Hinti is Jordanian American, with Palestinian parents. The only neurologist, a fluent Arabic speaker, and a woman, she was invaluable to the hospital. Despite the heartbreaking conditions in Rafah, she signed up for another mission with the Palestinian American Medical Association.

“Everything was going fine. And then finally the news came out that they will not allow doctors or health-care workers with Palestinian origins to enter,” Al-Hinti said.

When Israel resumed the medical missions in June, it also banned medical missions from bringing in any medical supplies or equipment apart from personal medications being carried in, doctors said.

Townson Cocke, the medical advocacy coordinator for Rebuilding Alliance, said the 19-person volunteer mission sponsored by the 

 in May brought in 300 suitcases, most filled with medical supplies and said that all of them were carefully screened by Israel. Doctors said the supplies were used up in days.

When Israel resumed permission for the missions in June, no medical supplies at all were allowed, apart from personal medication.

“I know the current team there had to cancel an [operating] day just due to the lack of supplies,” said Elaydi. “My own cousin who needed an amputation was refusing care because they wanted to do it without anesthesia.”

“With the evolution of a lot of very small portable pieces of machinery like oxygen monitors and portable ECG machines and portable ultrasound, a lot of the teams were bringing these things in by hand because other routes are unreliable,” said Abu Sittah, the U.K. Palestinian surgeon. Under Israel’s new rules, he would likely be barred from returning to Gaza to treat patients.

The new Israeli rules require medical volunteers to spend a month in Gaza rather than the previous two weeks, making it much more difficult for medical specialists to participate. The numbers of doctors and nurses going in have dropped dramatically, according to the nonprofit group 

 and medical personnel who have gone in previously.

It has made treating patients even more difficult at the European hospital in Rafah, said Dr. Alaa Al-Masri, a Gaza physician who said he had learned how to diagnose Parkinson’s and other diseases from Al-Hinti while she was there.

Al-Masri graduated from medical school just last year. But with most of the hospital staff displaced, on Monday evening the young doctor was one of the few physicians in the emergency room when wounded patients were brought in from an airstrike. Medical staff had already had a difficult day because they ran out of kits for blood tests.

“Suddenly there were a lot of injured and most of the patients were on the ground because the resuscitation room has only four beds,” he said. 

It was so crowded and chaotic no one noticed a small boy with a brain injury lying unconscious on the floor.

“People were just walking and some of them were stepping on him,” he said.

Al-Masri said he resuscitated the child, who was 5 or 6 years old, and said he was still alive on Tuesday. The rest of his family had also been injured.

“That’s why there was no one to care for him. No one noticed,” he said.

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Jane Arraf

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Israel banned most Gaza patients from being evacuated for medical treatment, according to the United Nations and other groups. Now it could allow a group of child patients and guardians to evacuate.

Medical groups challenge Israel's ban on evacuations from Gaza. Is Israel relenting?

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