On July 7, 2024, an Israeli bombing in Khan Younis, Gaza, killed the parents, brother, and sister of a three-year-old Palestinian boy named Adam. While Adam’s life was spared, he was severely injured and lost his right leg. Like tens of thousands of Palestinians with traumatic injuries, chronic illnesses, and other complex health conditions, Adam could not receive the care he needed in Gaza, where Israel’s war has nearly destroyed the health system.
A US-based nonprofit organization, HEAL Palestine, arranged and paid for Adam to travel to Chicago, Illinois, to receive medical care and a new prosthetic limb. Adam’s only companion in Chicago was his grandmother—his last surviving relative. A photo of Adam on the HEAL Palestine website shows a small boy with a sweet smile sitting in a wheelchair, his new prosthetic clearly visible.
In August 2025, the Trump administration suspended the visa process that organizations like HEAL Palestine had used to bring children such as Adam to the United States. After the far-right social media influencer Laura Loomer (who has described herself as a “proud Islamophobe” and has called Islam a “cancer on society”) reportedly contacted Secretary of State Marco Rubio, the Department of State announced that the process required a “full and thorough review.” Loomer claimed that a video of Palestinian children arriving at American airports for medical care showed the United States “importing” Gazans as “Islamic invaders” and that groups like HEAL Palestine were connected to Hamas.
HEAL Palestine clarified that it runs a “medical treatment program, not a refugee resettlement program,” and that these children and their escorts (usually parents or grandparents) were in the United States on temporary visas before returning to the Middle East—often to Egypt, given their inability to travel directly to Gaza. But the damage has been done. Since October 2023, more than 700 Palestinians have died in Gaza awaiting life-saving transfer for medical care. That number will undoubtedly grow.
More than 700 Palestinians have died in Gaza awaiting life-saving transfer for medical care.
As Israeli Minister of Defense Israel Katz boasted on social media, “Gaza is burning.” Indeed, Gaza has been burning for nearly two years. As it burns, nearly 16,000 people (including nearly 5,000 children) urgently need medical evacuations. Some, like Adam, require care for traumatic injuries caused by Israeli attacks. According to UNICEF, the Gaza Strip now has the highest number of child amputees per capita in the world.
Other children suffer from health conditions that are painful and disruptive but that would be treatable in a functional health system. Abdel Karim is an eight-year-old boy with acute kidney failure. Instead of being able to receive the treatment he needs, Abdel Karim suffers in Gaza. He received a referral for an evacuation months ago, but there is nothing that can be done to expedite the process. His mother told the Guardian, “The hospital has become his home. The doctors stand helpless and I can only watch and pray.” On top of his kidney failure, the shortage of food in Gaza due to Israel’s ongoing restriction of humanitarian aid means that Abdel Karim also suffers from malnutrition, which has hit record highs among Gaza’s children amid the ongoing famine. As conditions continue to deteriorate, greater numbers of Gazans will need urgent medical care.
For decades, Israel’s medical permit system for Gaza and the West Bank has been a mechanism of oppression—a blunt administrative barrier that routinely denies Palestinians—including infants, people with disabilities, and elderly adults—access to essential medical care that is unavailable in the under-resourced and heavily restricted Palestinian territories.
The new restrictions on the United States visa process are built on the same foundations upon which Israel has built its own system: namely, the dehumanizing idea that Palestinians are inherently dangerous. Israel has used this same justification to devastate nearly the entire humanitarian system upon which Palestinians have been forced to depend for decades.
The Complexity of the Medical Permit System
The need for medical evacuations from Gaza did not start with Israel’s response to the Hamas attack on October 7, 2023. Since the beginning of Israel’s military occupation in 1967, Israel’s restrictions on the movement of people and goods into and out of the occupied territories, as well as within them, have severely limited health system capacity. Hospitals cannot import vital pieces of medical equipment such as CT scanners and cannot maintain stocks of basic medical supplies and pharmaceuticals. Medical staff, including ambulance paramedics, cannot easily travel to patients within the territories, nor can they leave the territories to receive specialized training and certifications not offered in Palestine.
Only with the creation of the Palestinian Authority (PA) after the 1993 Oslo Accords did medical coordination between Israel and the PA begin, introducing the medical permit system that exists today. Israel’s blockade on Gaza, which began in 2007, restricted imports of ‘dual use’ goods (those that Israel says have potential military as well as civilian applications). This caused the severe limitation, and even prohibition, of medical supplies needed in Gaza. Under the blockade, Gazans had to obtain travel permits to leave or enter the territory for any reason, including medical treatment or training.
Prior to October 2023, many of the medical transfers from Gaza were to hospitals in Israel or the West Bank, especially in East Jerusalem (patients from the West Bank also required permits for travel to Israel or East Jerusalem). World Health Organization data show that only 8,123 patients received medical referrals in 2000, the first year for which data is available. By 2010, the number exceeded 53,000—an increase of 560 percent in just ten years. As the Palestinian population has increased, capacity in the Palestinian health system has not grown to match it; restrictions imposed by Israel have also expanded, leading in large part to this dramatic increase in patients needing referrals. The only years with no increase were times when financial constraints prompted the PA to reduce the number of referrals (as happened in 2006) and during the COVID-19 pandemic, when Israel effectively shut down the medical permit process.
The process for patients from Gaza to receive permits is often long and taxing, posing a serious challenge for people who are physically and mentally vulnerable. Patients must first receive a referral from a physician that indicates that they need treatment not available locally. The referral must then be medically approved by a purchasing unit in Gaza’s Ministry of Health before receiving financial approvals from a similar unit in the Ministry of Health in Ramallah (the PA typically pays for medical transfers). Only then does the patient receive an appointment at their host hospital—and it is only at that point that the patient can apply for a travel permit. The application goes to the Israeli Coordinator of Government Activities in the Territories, whose own policies mandate a maximum response time of 23 days (a deadline that is supposed to be expedited for urgent cases). In reality, patients often wait much longer for a response, if they receive one at all.
If the permit is approved, the patient may then travel out of Gaza. Yet from 2008 to 2022, Israel delayed or denied more than 70,000 (about 30 percent) of medical permit applications. A patient’s escort (such as a child’s parent) must go through a similar process and receive her or his own permit, a requirement that can cause additional travel delays for patients. Further, patients must secure permits for each appointment, which causes severe difficulty for patients with ailments that require multiple treatments and follow-up visits. Eventually, humanitarian agencies began to flag a new trend in the permit process: excessive delays (beyond the mandated 23 days) that, for urgent medical cases, amounted to denial. In 2017, 54 Palestinians—46 of whom had cancer—died waiting for their permit.
Until October 2023, most patients left Gaza for treatment through the Erez crossing into Israel, with a small proportion occasionally leaving through Rafah into Egypt, though this border crossing was frequently closed. Many patients then traveled on to third countries that were willing to accept them for treatment.
Israel has significantly clamped down on permitting any medical transfers from Gaza at all.
Since the war, the medical permit system has collapsed. Israel has significantly clamped down on permitting any medical transfers from Gaza at all. For example, as of July 2025, Médecins Sans Frontières (MSF) reported that it has only been able to medically evacuate 22 patients (13 of whom were children) to their reconstructive surgery hospital in Amman, Jordan since 2023. MSF documented several distinct phases in which the process changed significantly. From October 7, 2023, to May 7, 2024, Palestinians could travel to Egypt through Rafah and then travel from Egypt to their destination. But after Israel closed the Rafah border on May 7, 2024, medical evacuations were restricted to the Karem Abu Salem crossing to Israel, from where patients would travel primarily to Europe or to Jordan.
While humanitarian agencies were relatively successful in getting more patients out when Rafah was open, permit denials and delays increased once Israel seized and later destroyed the crossing. Often, patients would receive no reason for a denial; sometimes, the permit of a patient (especially a child) would be approved, but the permit of their adult escort denied. A further challenge for patients requiring medical evacuations was the unwillingness of other countries to accept these patients. This is where the recent disruption of the US visa process comes in.
Although HEAL Palestine was founded quite recently, in 2024, organizations such as the Palestine Children’s Relief Fund (PCRF), have operated for more than 30 years, used temporary visitor visas to bring more than 2,000 Palestinian children to receive free care in hospitals across the United States, Europe, and Asia. Many Palestinian children also receive care in hospitals across the Middle East (the WHO dashboard shows that at least 2,400 people have gone to Egypt, Jordan, or the United Arab Emirates since July 2024). The United States, by contrast, has not received a sizable number of medical cases from Palestine. Since July 2024, the WHO has documented only a few dozen evacuations to the United States (although this number is likely incomplete, as HEAL Palestine has reported evacuating 63 children to the United States).
Prior to Secretary Rubio’s visa stop order, the United States had issued more than 3,800 B1/B2 visitor visas for Palestinians to seek medical care in 2025. In May 2025, the New York Times profiled some of these children, including a six-year-old boy with cystic fibrosis who weighed 25 pounds due to malnutrition, an eleven-year-old boy whose head was damaged in a bombing that killed his mother and brother, and a three-year-old girl whose face suffered third-degree burns after her home was hit by Israeli airstrikes.
Italy is the Western country that has accepted the most patients from Gaza, with the Italian Ministry of Foreign Affairs claiming that their country has treated more than 180 children. A pediatric surgeon there described to The Media Line the harrowing process of receiving a child:
Among those evacuated was a 12-year-old girl with severe fractures from a mine explosion, traveling only with her brother, and a 4-year-old boy with an autoimmune blood disease…The medical reports we receive are incomplete, sometimes outdated. Often, we meet the patient for the first time when the ambulance arrives under the aircraft.
It is these children and their families—who have suffered unimaginable conditions and somehow survived—who are suffering from the visa pause, or even potentially facing the termination of the visa system that could save their lives. Organizations like HEAL Palestine have lobbied against the move by seeking to communicate what these visas mean for the patients. “Our mission gives children a renewed chance at life, whether through lifesaving surgery or the ability to walk again,” the organization told the New York Times.
The Dismantling of Humanitarianism in Gaza
As many have argued, the failure of the international community to intervene in any meaningful way in Gaza, especially as the global recognition of genocide grows, shows that the system of international law and norms put into place after World War II to protect human life is not functional. The ability of Israel to control the humanitarian response in Gaza, to the degree that famine is expanding and dozens of people are being killed each day at the few food distribution sites that Israel has permitted, is shocking—even when considering the previous decades of impunity afforded to Israel.
The argument that Palestinians are inherently a threat requiring surveillance and control and a people who deserve unquestioned violence and unending degradation has resulted in one of most deadly periods of Palestinian history. Aside from Israel’s actions across Gaza and the West Bank, the global community’s tepid humanitarian response has its foundations in the same dehumanizing dynamics. The argument that Palestinians traveling for medical care represent a “national security risk” is false. But apparently that is not enough to compel a rich, powerful country like the United States—which is heavily backing the very government that is creating such a humanitarian toll—to at least provide medical care to children suffering from those policies.
There is a clear moral obligation for countries that financially and politically support Israel, including Germany and the United Kingdom, to accept more patients from Gaza needing medical care. The United Kingdom just received its first two Palestinian children for medical treatment in May 2025. As one of them explained, “Here I’ll get treatment and get better and be just like any other girl.” More children from Gaza deserve that chance. They also deserve the chance to, someday, return to Gaza when it is safe.
Gaza is burning. For nearly two years, and under two different presidential administrations, the United States has been Israel’s most steadfast ally as countless tragedies and atrocities unfold in Gaza every day. US support comes in many forms: billions of dollars in military aid, vetoes of ceasefire resolutions at the UN Security Council, and punitive measures against the International Criminal Court and the International Court of Justice because they are investigating Israeli officials for violations of international law. Preventing Gazan patients with severe medical needs from receiving care in the United States is another indication that the US government does not see Palestinians as fully human—and that even more cruel policies may be yet to come.
The views expressed in this publication are the author’s own and do not necessarily reflect the position of Arab Center Washington DC, its staff, or its Board of Directors.
Featured image credit: Shutterstock/Anas Mohammed
