How would you feel if, heaven forbid, you were to fall ill with cancer but be unable to get to the site of treatments that could save your life? A case in point is Dr. Mazen Tiatana, 50, an economist who studied in Poland, is married without children and lives in the village of Abu Qash, north of Ramallah in the West Bank. He had an appointment to get chemotherapy yesterday, but once again, he didn't get there.

Tiatana was diagnosed with lung cancer last October. Surgery was performed in Ramallah and initially he needed radiation treatment. Radiology is unavailable in the territories, and the Israeli option, which had been available all along, is now closed to cancer patients from the territories owing to security considerations. Tiatana went to Jordan. When he returned, chemotherapy was recommended. Chemotherapy is available at only one medical center in the territories: Al-Hussein Hospital, in Beit Jala. Normally, it is about an hour's drive from Abu Qash to Beit Jala, which is located at the southern tip of Jerusalem; these days, though, they are separated by the hills of darkness.

The first treatment was in March: Tiatana got into Beit Jala by the usual combination of walking and a series of taxis, proceeding from one checkpoint to the next, two exhausting hours each way, both before and after the debilitating treatment. Still, he managed to get there. Between March 19 and May 11, he did not manage to get to the hospital, because of Operation Defensive Shield. For two months he went without the treatment, even though any delay is liable to seriously aggravate his condition. Ramallah and Beit Jala were under occupation and a strict curfew was in force. The pains in his back and chest grew worse. His doctor said the situation was dangerous.

At the conclusion of the Israeli army operation he tried to get back to the treatments. From his house to the first checkpoint, at Surda, is 15 to 20 minutes by foot. Tiatana says walking is very hard for him. In some cases he called an ambulance that waited for him on the other side of the checkpoint. Most times the soldiers barred his escort, a brother or a cousin, from continuing with him. At the Qalandiyah checkpoint the ambulance was sometimes allowed to pass, sometimes not. It was a totally arbitrary decision by the soldiers. On May 25, for example, the soldiers carried out a thorough one-hour search and then didn't let him through. He tried to get across by foot and luckily an ambulance passed by, carrying patients from Bethlehem to the checkpoint, and Tiatana went with the vehicle to Beit Jala, which lies just north of Bethlehem. That journey took about three hours. Four permanent checkpoints separate Tiatana and the hospital he has to get to: Surda, Qalandiyah, A-Ram and the Bethlehem checkpoint. Apart from A-Ram, there is a long wait at each of the barriers. In addition, there are sometimes surprise roadblocks.

Tiatana needs a permit in order to get to the hospital. Every treatment requires a new permit. The Civil Administration issues only one-day permits, perhaps due to the danger posed by cancer patients who will be given permits for a longer period. At the end of last week, following the intervention of Physicians for Human Rights, the spokesman of the Civil Administration, Peter Lerner, promised the permit (good only for Saturday, July 6) would be waiting for Tiatana at the office of the District Coordination and Liaison Office at Beit El. Tiatana went there on Thursday, walked for half an hour and waited two hours in the baking sun, but the soldier on duty refused to let him in. Why? Just because. Angry and bitter, Tiatana returned home. The next day Lerner again promised the permit would be there, but curfew was imposed. Tiatana knew that even if the curfew in Ramallah were to be lifted, curfew might be imposed on Beit Jala, in which case he would not be able to get to the hospital even with a permit. If he got lucky and neither place was under curfew for a few hours - for "humanitarian" reasons - he might be able to get to the hospital, though he might be stuck on the way back. The prospect of getting a permit, getting through all the checkpoints, getting to the hospital for treatment and getting back home safely is negligible - a situation that has an obvious adverse effect on his prospect for overcoming his cancer.

There are thousands more like Tiatana in the West Bank - cancer and kidney patients, pregnant women and people with heart ailments - who cannot get to hospitals for treatment, despite all the righteous pronouncements that those who are ill have freedom of passage. The prime minister and the defense minister occasionally say they intend to make life easier for the population in the West Bank, but their policy has the exact opposite result. Ariel Sharon and Benjamin Ben-Eliezer cannot exculpate themselves: They are directly responsible for this terrible suffering. Some of the patients will die, others will endure great agony. There is no connection between this abuse and Israel's security needs. There is undoubtedly no intention to be cruel to these particular individuals, but the occupation is now so rigorous that it is making life unbearable even for the very ill in a way that can only be described as inhuman.