Upon the announcement of a ceasefire deal in Gaza, on January 15 the World Health Organization urged Israel to allow expedited evacuations for over 12,000 Palestinians in need of lifesaving care outside the Gaza Strip.
Older people needing such medical support should be among those evacuated.
Sarah Al Deiry, a 76-year-old Palestinian woman with a disability and multiple medical conditions, died in late September 2024 while waiting to be evacuated from Gaza for treatment.
Her death, described to me by her daughter, did not make the news. And it exemplifies the disregard for older people in armed conflicts, particularly in Gaza, where Israeli attacks have decimated the healthcare system during the 15 months of hostilities. It also highlights the ageist tendency to dismiss the deaths of older people, even when they’re medically preventable, as an inevitable consequence of their age.
The Faces of Forced Displacement
In February last year, HelpAge International said that approximately 111,500 older people in Gaza were among those most at risk of hunger, dehydration, illness, injury, and death amid Israel’s relentless military offensive. Given the devastation in Gaza, even with a ceasefire many older people will continue to lack access to essential medicines to treat chronic and potentially life-threatening health conditions such as diabetes, hypertension, and heart disease.
Human Rights Watch has been urging governments in Europe and North America to press Israel to lift its arbitrary and unlawful restrictions on medical evacuations and to accept patients from Gaza. Israeli authorities have controlled and limited who is eligible to leave for medical evacuation. These evacuations have slowed to a trickle, with only about 430 since Israel took control of the Rafah border crossing with Egypt in May.
Sarah Al Deiry had been displaced multiple times since November 21, 2023, when Israeli forces attacked al-Sabra, her neighborhood in central Gaza city. Since she had paralysis and used a wheelchair, she could not independently escape.
So her daughter, Raisat, 47, who has a disability herself and is a cancer patient, pushed her mother’s wheelchair. As they were frantically fleeing, Raisat didn’t notice that her mother’s feet were dangling from the wheelchair and scratching the sand and rubble below for two kilometers. And because of her paralysis, she couldn’t feel her toes and feet dragging on the ground.
Sarah, who also was diabetic, developed a serious infection — and doctors at the European Hospital in Khan Younis had to amputate her toe in early December.
Between the time of the amputation and her death, Sarah lived with Raisat and nine others in a tent, after having been displaced several times without access to adequate clothes, food, water, or sanitation. She could only use the toilet if both her children could help her out of her wheelchair, on and off the toilet seat, and back into her wheelchair.
Severe Restrictions on Medical Care
Human Rights Watch has documented multiple times that Israeli forces committed the war crime of forced displacement, amounting to a crime against humanity. Forced displacement disproportionally affects older people and people with disabilities.
Israel not only controls who can leave Gaza for medical treatment, but also what medical goods, including aid, can enter. Its severe restrictions, combined with the decimation of the healthcare system, restricted Sarah’s access to timely and appropriate medical care.
In August, Raisat texted me that Sarah had gone without dialysis for kidney disease for 80 days and also did not have regular access to medication necessary to treat her diabetes. Raisat sent me the medical referral from the Gaza Health Ministry indicating that Sarah needed to travel for treatment because it was not available in Gaza.
The restrictions on medical evacuations have been so severe that the United Nations children’s fund, UNICEF, estimated it would take seven years to evacuate 2,500 children in need of urgent medical care. It’s hard even to imagine what those figures may be for adults, especially older people.
When I recently talked to Raisat, I could sense the depth of her pain. Within two months of losing her mother, her 86-year-old father, Muhammad, who had pancreatic cancer, died on November 19. Like his wife and thousands of other Palestinian cancer patients, he couldn’t get the health care he required.
Raisat herself is a survivor of breast cancer and has been without the necessary hormonal therapy since the hostilities started. “Three months before the war, they told me I have a new problem with my right breast, but I didn’t get to do the scanning,” she told me. Unable to follow up, she’s afraid and worried about her own health.
No More Deaths
All Palestinians from Gaza I’ve interviewed, including Raisat, repeatedly said they want to be able to safely return home. This is true for medevacked Palestinians as well, whose right to return under international law must be respected. Israel should lift its arbitrary restrictions on medical aid entering Gaza and allow Palestinians to leave Gaza for medical treatment and return home afterward.
Governments in Europe and North America who can accommodate medical evacuations can play an invaluable role by helping to ensure Palestinians don’t die preventable deaths because they could not get medical care. They should also take persuasive measures, such as targeted sanctions against Israeli officials, to press the Israeli government to allow the entry of unfettered supplies and medical teams to Gaza and to allow Palestinians, including older people, to leave for medical care.
With a ceasefire in effect, no one else should die in this war — especially not children and older people waiting for medical care, medical evacuations, and safety.