Executive Summary   Children in the Gaza Strip are often unable to obtain adequate medical care because of the four-year Israeli-imposed closure of the border and Israel’s complete control over the movement of people and goods.
The severe lack of medicines and equipment coupled with the prevention of medical personal to travel to develop their skills and knowledge has created a situation where injured and ill patients often have to seek specialized treatment outside of the Gaza Strip.
Israel has an obligation to fulfil and make available the highest standard of health to those in the occupied Palestinian territories (oPt).
This duty is clearly outlined in international human rights law (IHRL).
Israel is also obliged under international humanitarian law (IHL) to allow access of medical staff and equipment, as well as patients’ access to adequate healthcare where it has control over their movement, such as the Gaza Strip.
Children seeking treatment in Israel, the West Bank (including East Jerusalem), or Jordan need a special permit to leave Gaza via Erez Crossing.
This permit is issued by the Israeli security authorities and people are never allowed to cross Erez crossing without it.
To obtain this permit, patients, including those with life-threatening illnesses, must go through a complex and lengthy bureaucratic process, which often leads to missed hospital appointments putting children’s lives at risk.
Many children have been denied permits to access medical treatment because their condition is not considered life-threatening; it only affects their ‘quality of life.
’ Children’s relatives who accompany them to hospitals outside the Gaza Strip have also been forced to collaborate and inform on family, friends and neighbours in exchange for a permit.
The permit policy and the policies which lead to their denials are not only a violation of IHL and IHRL; they are also a serious breach of medical ethics.
Israel also breaches children’s right to access medical care by denying ambulances access to certain areas of the Gaza Strip to treat those in need.
Children in or near the Buffer Zone[1] close to the border fence face the constant risk of being hurt by shrapnel from rockets or artillery fire, or being shot at by Israeli military.
However, Palestinian ambulances need prior coordination and approval from Israeli military authorities to enter.
These delays have resulted in the deaths of many children.

[1]The Buffer Zone is the Israeli-imposed no-go area of land which extends from the border fence into Gazan territory.
The area  is formally 300m (leaflets have been dropped by IOF plans telling Palestinians to stay out of this area else they be shot) but Palestinians have been shot at by the IOF up to 1,500 from the border fence in an effort to keep this area off limits from Palestinians.