Sick and Stuck in the Strip: How Leaving Gaza Became Mission Impossible

Less than 30 years ago, Palestinians could exit and enter the coastal enclave almost as they wished. That all changed in 1991, though, and things have only gotten more difficult since

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The Erez checkpoint between the Gaza Strip and Israel, 2006.
The Erez checkpoint between the Gaza Strip and Israel, 2006.Credit: Uriel Sinai
Amira Hass
Amira Hass
Amira Hass
Amira Hass

Gazans with life-threatening illnesses are currently fighting Israel to allow them to leave the coastal enclave. An Israeli directive that prevents those with alleged ties to Hamas from leaving the Strip for treatment was blocked by the High Court of Justice. But it is only the latest incident in the long history of movement restrictions imposed on Gaza.

Here is how leaving Gaza became a rare privilege:

1. A closure is born

Palestinians living in the Gaza Strip used to be able to enter and exit the enclave as they wished, notwithstanding some travel restrictions introduced during the first intifada. However, in January 1991, Israel cancels the blanket exit permit allowing Palestinians from both Gaza and the West Bank to cross the Green Line. Instead, it introduces a system of personal permits issued according to certain criteria.

The Erez checkpoint, 1992.Credit: Alex Levac

The number of permits and the criteria governing them have changed over the years, but the permits system remains intact to this day.

If before 1991 the rule was that all Palestinians could exercise their right to freedom of movement between the river and the sea, with some exceptions (on alleged political and security grounds), the reverse is true today: All Palestinians are barred from freedom of movement, with some exceptions determined by Israel.

2. Oslo and the limitations of ‘self-rule’

Palestinian policeman in Rafah, 1995.Credit: Alex Levac

The Oslo Accords’ “Declaration of Principles,” signed in September 1993, stipulate that Israel and the Palestinians “view the West Bank and the Gaza Strip as a single territorial unit, whose integrity will be preserved during the interim period.” Despite this, Israel continues to control and limit movement of people and goods between Gaza and the West Bank. Contrary to the Oslo interim agreement, Israel considers Gazans living in the West Bank as “illegal aliens,” and since 1996 has deprived the Palestinian Authority of its right to register those wishing to become West Bank residents.

The road connecting Jericho, in the southern West Bank, and Gaza in 1994Credit: Alex Levac

3. Intifada crackdown

In 2000, after the second intifada breaks out, Israel imposes further restrictions on Palestinian movement, which deepens the social and economic disconnect between the two parts of Palestinian territory. For example, students from Gaza are no longer permitted to travel to study in West Bank universities and marketing outside of Gaza is restricted.

Palestinians without work permits arrested in Lod in central Israel in 2002Credit: Nir Kafri

4. Economic disengagement

For years, Israel benefitted from Palestinian cheap labor. Even now, tens of thousands of Palestinians living in the West Bank have permits to work in Israel proper, and in Israeli settlements. In 2005, Israel pulls its settlers out of the Gaza Strip as part of its so-called Disengagement Plan, but Palestinians from Gaza are no longer allowed to work in Israel – dealing another blow to the Strip’s economy.

The Erez checkpoint, 2006.Credit: Nir Kafri

5. Birth of the blockade

Hamas, which won the Palestinian elections in January 2006, takes control of Gaza’s security agencies in June 2007, following a short civil war with Fatah. This creates dual rule for the Palestinians: the Palestinian Authority governing in the West Bank and Hamas in Gaza. In July 2007, Israel announces that in response to those developments, exit from and entry to the Gaza Strip of people and goods will be allowed only for humanitarian reasons – namely, the sick, medicines and food, albeit limited in quantities and types.

A masked Islamic Jihad militant standing guard next to the house used by Hamas during recent clashes between Fatah and Hamas, in Beit Lahiya northern Gaza Strip, Thursday, March 22, 2007. Credit: AP Photo/Adel Hana

6. Loosening the siege

Ironically, after the 2010 Mavi Marmara incident – in which a Turkish attempt to break the blockade ends in the killing of 10 Turkish activists by Israeli soldiers – Israel significantly loosens restrictions on Gaza. It allows more materials and goods, but also some more people, especially businesspeople, to leave the Strip.

The Mavi Marmara, as it sets sail from Turkey carrying aid and hundreds of pro-Palestinian activists to the blockaded Gaza Strip. Credit: אי־פי

7. Red tape

Starting from 2016, as Avigdor Lieberman assumes the position of Israeli defense minister, Israel slows down the process of issuing exit permit requests, increasing red tape for Palestinians – including in humanitarian cases. According to data, by 2017 roughly half of those seeking to exit the Gaza Strip to receive treatment in Israeli hospitals are denied. During this time, Israel also cuts the number of exit permits for businesspeople.

Palestinian Cancer patients take part in a protest to demand to travel for treatment, in Gaza city December 22, 2016. Credit: MAJDI FATHI / NurPhoto

8. Humanitarian leverage

In January 2017, in response to pressure from Israeli families whose sons were killed in Gaza and want their bodies returned, Israel decides to cut the number of humanitarian permits being issued to Palestinians. New criteria are introduced, barring those with first-degree familial ties to Hamas. One exception is made, though: Those with life-threatening illnesses can leave – but only on condition that Gaza’s medical facilities can no longer care for them.

Palestinians waiting at the Erez crossing with Israel, near Beit Hanun in the northern Gaza Strip, August 27, 2018.Credit: AFP

9. Turning to the High Court

In late 2017/early 2018, Defense Minister Lieberman decides that even those in need of life-saving treatment cannot leave Gaza, prompting a petition to Israel’s High Court of Justice by a number of Israeli nonprofits on behalf of Gazan patients who are to be treated in Palestinian hospitals in East Jerusalem. In August, the High Court nixes the directive.

A compromise proposed by Lieberman allows minors younger than 16 who are related to Hamas members to go to Israel for life-saving treatment and allows adult patients, including the women petitioners, to travel via Israel to receive treatment abroad. The justices rule that the second exception is only a theoretical gesture, since most Gazans and the PA cannot afford treatment abroad.

The justices rule that, while the goal of applying pressure on Hamas to release two Israeli civilians who entered the Gaza Strip a few years ago and also to return the bodies of two slain soldiers is appropriate, the end does not always justify the means.

Palestinians are seen crossing at the Erez crossing with Israel, near Beit Hanun in the northern Gaza Strip, August 27, 2018.Credit: AFP

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