Sick Gaza child caught in Israeli permit system dies alone

Muna Awad, mother of Palestinian preschooler Aisha a-Lulu, shows a photo of her daughter while in a Jerusalem hospital, at the family home in Bureij refugee camp in central Gaza Strip. (AP)
Updated 12 June 2019
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Sick Gaza child caught in Israeli permit system dies alone

  • The death of the Palestinian girl has drawn attention to Israel's vastly complex system for issuing travel permits to Gaza medical patients and their families
  • Instead of a family member, Israeli authorities had approved a stranger to escort Aisha from the blockaded Gaza Strip to the east Jerusalem hospital

JERUSALEM: When Palestinian preschooler Aisha a-Lulu came out of brain surgery in a strange Jerusalem hospital room, she called out for her mother and father. She repeated the cry over and over, but her parents never came.
Instead of a family member, Israeli authorities had approved a stranger to escort Aisha from the blockaded Gaza Strip to the east Jerusalem hospital. As her condition deteriorated, the child was returned to Gaza unconscious. One week later, she was dead.
A photo of Aisha smiling softly in her hospital bed, brown curls swaddled in bandages, drew an outpouring on social media. The wrenching details of her last days have shined a light on Israel’s vastly complex and stringent system for issuing Gaza exit permits.
It is a bureaucracy that has Israeli and Palestinian authorities blaming each other for its shortfalls, while inflicting a heavy toll on Gaza’s sick children and their parents.
“The most difficult thing is to leave your child in the unknown,” said Waseem a-Lulu, Aisha’s father. “Jerusalem is just an hour away, but it feels as though it is another planet.”
So far this year, roughly half of applications for patient companion permits were rejected or left unanswered by Israel, according to the World Health Organization. That has forced over 600 patients, including some dozen children under 18, to make the trek out of the territory alone or without close family by their side.
The system stems from Hamas’ takeover of Gaza in 2007, when it ousted the Western-backed Palestinian Authority. Israel and Egypt responded by imposing a blockade that tightly restricted movement in and out of Gaza.
The blockade, which Israel says is necessary to prevent Hamas from arming, has precipitated a financial and humanitarian crisis in the enclave. For years, Gaza’s 2 million residents have endured rising poverty and unemployment, undrinkable groundwater and frequent electricity outages. Public hospitals wrestle with chronic shortages of drugs and basic medical equipment.
In what it portrays as a humanitarian gesture to help Gaza’s civilians, Israel permits Palestinian patients to seek medical treatment at hospitals in Israel and the West Bank once they pass a series of bureaucratic hurdles. COGAT, the Israeli defense body that issues the permits, says it insists that all patients cross with an escort, usually a close relative, unless they wish to go alone or require immediate treatment that doesn’t allow time for security screening.
In order to get a permit, patients must first submit a diagnosis to the West Bank-based Palestinian Health Ministry, proving that their treatment is not available in Gaza. Then a Palestinian liaison requests exit permits from COGAT, which reviews the applications and passes them to Israel’s Shin Bet security agency for background checks.
According to WHO, the approval rate has plummeted in recent years.
It said that in 2012, Israel allowed in 93% of patients and 83% of their companions for treatment. For the month of April 2019, the figure stands at just 65% of patients and 52% of their companions.
A COGAT official disputed the figures, saying they don’t take into account that the number of permit applications has grown as Gaza’s health care system deteriorates, and that Israel has started issuing permits less regularly but for prolonged stays. The official, speaking on condition of anonymity under agency rules, said COGAT has tried to ease restrictions by designating a permit specifically for parents of child patients.
The agency said it issued 4,000 permits for patient escorts in the first quarter of 2019, including 1,398 for parents of sick children.
After being diagnosed with brain cancer, Aisha received immediate approval to get out of Gaza for what was hoped to be life-saving surgery. But when her parents approached the Palestinian Civil Affairs Commission for escort permits, their process ground to a halt.
To their bewilderment, Palestinian officials told them not to apply, saying it was too risky.
At 37, Waseem is below the age that Israel deems acceptable for swift entry on security grounds. Today, all men under 55 require extra screening, which means waiting, usually for months, according to Mor Efrat, the Gaza and West Bank director for Physicians for Human Rights Israel. As for Aisha’s mother, Muna, a quirk of her upbringing in Egypt left her without an official Israeli-issued ID card required to receive a permit.
“We tell families to find a companion that won’t give Israel any reason to refuse,” said Osama Najar, spokesman for the Palestinian Health Ministry. “We want to save the child and, yes, that can mean sending them alone.”
In this sense, the Palestinian Authority “acts as a subcontractor for Israel,” said Efrat, forcing parents to make a difficult choice: delay their child’s urgent care, or search for someone else that Israel would be more likely to let cross.
Aisha’s parents said they scoured for alternatives, applying for an aunt and her 75-year-old grandmother, but Israel rejected both.
The girl’s only remaining hope, the Palestinian office told them, was to apply for as many older women as possible from their extended social network. A permit for Halima Al-Ades, a remote family acquaintance whom Aisha had never met, was approved.
Muna said she had no choice but to sign COGAT’s consent form and whisk her daughter out of Gaza for immediate treatment. She said the frustration of the sprawling bureaucracy, and the painful memory of her 5-year-old daughter crying for her on the phone during her last days, haunts her.
“It was the hardest time of my life,” she said. “My heart was being ripped out every day and every hour.”
The Shin Bet declined to comment on the case. But in a statement, it emphasized Israel’s security concerns about Gaza patients and their companions. “The terrorist organizations in the Gaza Strip, headed by Hamas, are working tirelessly to cynically exploit the humanitarian and medical assistance provided by Israel,” it said.
This means that Palestinians are often turned down without explanation or for reasons out of their control. “I feel confident telling you that most of these rejections are arbitrary,” said Efrat, of Physicians for Human Rights Israel.
Israel denies any official change in policy.
Alon Eviatar, a former high-ranking official with COGAT, said the goal remains the same. “On the ground, this means to make daily life as difficult as possible for Hamas, without crossing the red line to humanitarian disaster,” he said.
Eviatar acknowledged that the Israeli permit system was ineffective, inefficient and overburdened. “We are desperate for an alternative, to get Gaza to take care of itself and stop relying on Israel,” he said.
Aisha’s doctor in Jerusalem, Ahmad Khandaqji, said he has treated countless lone patients from Gaza over the past year, but that Aisha’s story stuck with him. “She felt abandoned and betrayed,” he said. “We saw how that directly impacted her recovery.”


‘Hypocrite’ Rouhani rejects war as Iran’s drones target Saudi civilians

Updated 19 June 2019
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‘Hypocrite’ Rouhani rejects war as Iran’s drones target Saudi civilians

  • Tehran regime has fanned sectarian flames in region for four decades, analyst tells Arab News
  • IRGC chief says Iranian missiles capable of hitting "carriers in the sea" with great precision

JEDDAH: Iran “will not wage war against any nation,” President Hassan Rouhani said on Tuesday — hours after two drones launched by Iran-backed Houthi militias in Yemen targeted civilians in southern Saudi Arabia.

Rouhani's statement sounded a note of restraint after the United States announced more troop deployments to the Middle East.

“Iran will not wage war against any nation,” he said in a speech broadcast live on state TV. “Despite all of the Americans’ efforts in the region and their desire to cut off our ties with all of the world and their desire to keep Iran secluded, they have been unsuccessful.”

But he was also contradicted by the commander of the Islamic Revolutionary Guard Corps (IRGC), Gen. Hossein Salami, who said Iran’s ballistic missile technology had changed the balance of power in the Middle East.

“These missiles can hit, with great precision, carriers in the sea ... they are domestically produced and are difficult to intercept and hit with other missiles,” Salami said.

He said Iran's ballistic missile technology had changed the balance of power in the Middle East.

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Before both men spoke, Saudi air defenses intercepted and shot down two Houthi drones packed with explosives. One targeted a civilian area in the southern city of Abha, and the second was shot down in Yemeni air space. There were no casualties, the Saudi-led coalition in Yemen said.

Rouhani’s offer to avoid war was “the height of hypocrisy,” the Saudi political analyst and international relations scholar Dr. Hamdan Al-Shehri told Arab News.

“Rouhani is the biggest hypocrite in the world,” he said. “On the one hand, he is saying that Iran does not seek a conflict with anybody, and on the other it is launching attacks through its militias on oil tankers, oil pipelines, civilian airports and holy cities.

“This is nothing but the height of hypocrisy. Who does he think he is fooling with those words? Why are they enriching uranium? Why are they seeking nuclear bombs? What have they done over the past four decades? They have only caused trouble. They have only fanned sectarian flames in the region.”

The Saudi Cabinet, meeting in Jeddah, also condemned the Houthi attacks on Saudi civilians, and last week’s terrorist attacks on two tankers in the Gulf of Oman, widely blamed on Iran. 

 

Confrontation fears

Fears of a confrontation between Iran and its long-time foe the United States have mounted since Thursday when two oil tankers were attacked near the strategic Strait of Hormuz shipping lane, which Washington blamed on Tehran.

Iran denied involvement in the attacks and said on Monday it would soon breach limits on how much enriched uranium it can stockpile under a 2015 nuclear deal, which had sought to limit its nuclear capabilities.

Exceeding the uranium cap at the heart of the accord would prompt a diplomatic crisis, forcing the other signatories, which include China, Russia and European powers, to confront Iran.

The standoff drew a call for caution from China. Its top diplomat warned that the world should not open a “Pandora’s Box” in the Middle East, as he denounced US pressure on Iran and called on it not to drop out of the landmark nuclear deal.

Russia urged restraint on all sides.

On Monday, Iranian officials made several assertive comments about security, including the secretary of Iran’s Supreme National Security Council, Ali Shamkhani, who said Tehran was responsible for security in the Gulf and urged US forces to leave the region.

Acting US Defense Secretary Patrick Shanahan on Monday announced the deployment of about 1,000 more troops to the Middle East for what he said were defensive purposes, citing concerns about a threat from Iran.

The new US deployment is in addition to a 1,500-troop increase announced last month in response to tanker attacks in May. Washington previously tightened sanctions, ordering all countries and companies to halt imports of Iranian oil or be banished from the global financial system.


'Nuclear blackmail'

Iran’s announcement on Monday that it would soon breach limits on how much enriched uranium it can stockpile under the deal was denounced by a White House National Security Council spokesman as “nuclear blackmail.”

The move further undermines the nuclear pact, but Rouhani said on Monday the collapse of the deal would not be in the interests of the region or the world.

The nuclear deal seeks to head off any pathway to an Iranian nuclear bomb in return for the removal of most international sanctions.

Speaking in Beijing, Chinese State Councilor Wang Yi said the United States should not use “extreme pressure” to resolve issues with Iran.

Wang told reporters China, a close energy partner of Iran, was “of course, very concerned” about the situation in the Gulf and with Iran, and called on all sides to ease tension.

“We call on all sides to remain rational and exercise restraint, and not take any escalatory actions that irritate regional tensions, and not open a Pandora’s box,” Wang said.

“In particular, the US side should alter its extreme pressure methods,” Wang said. “Any unilateral behavior has no basis in international law. Not only will it not resolve the problem, it will only create an even greater crisis.”

Wang also said the Iran nuclear deal was the only feasible way to resolve its nuclear issue, and urged Iran to be prudent.

European Union foreign policy chief Federica Mogherini said the EU would only react to any breach if the International Atomic Energy Agency formally identified one.

The Trump administration says the deal, negotiated by Democratic President Barack Obama, was flawed as it is not permanent, does not address Iran’s missile program and does not punish it for waging proxy wars in other Middle East countries.