Sick and wounded individuals began leaving Gaza for Egypt through the Rafah border crossing on Saturday for the first time in nine months, following a key provision of the cease-fire agreement between Israel and Hamas.
However, officials from the Gaza Health Ministry reported that only 50 of the thousands of ill and injured individuals in need of treatment abroad were able to cross on that day.
Al Qahera News, an Egyptian state-owned television channel, live-streamed ambulances arriving at the Egyptian side of the crossing, transporting some of the sick and injured.
The Rafah crossing had been closed since Israel's invasion of Rafah, the southernmost city in Gaza, in May. The ongoing conflict has severely impacted Gaza's health system, with hospitals struggling to provide adequate care.
The war has resulted in significant destruction of medical facilities in the region, including Al-Shifa Hospital in Gaza City. Israeli officials have accused Hamas of utilizing several medical facilities for military purposes, claiming that a raid on Al-Shifa in November 2023 uncovered a tunnel shaft beneath the facility. Hamas has denied these allegations.
Prior to Israel's control of the crossing, tens of thousands of sick and wounded Palestinians and foreigners had used the passageway to escape the conflict. Rafah also served as a vital entry point for aid trucks into Gaza.
An appendix to the cease-fire agreement stipulates that 50 wounded militants will be permitted to leave Gaza daily, contingent upon approvals from Israeli and Egyptian authorities.
The agreement also indicates that the number of ill and injured individuals crossing through Rafah will eventually increase, with restrictions being lifted and the resumption of goods and trade movement. However, the timeline for these changes remains unspecified.
The World Health Organization reported that 37 patients, including 34 children, were evacuated through Rafah on Saturday, although it was unclear if any wounded militants were among those who left.
Rik Peeperkorn, the World Health Organization's top official for Gaza and the Israeli-occupied West Bank, described the evacuation as a positive development but emphasized the need for an accelerated pace through all available exit routes. He noted that approximately 12,000 to 14,000 individuals require treatment outside Gaza for severe injuries and chronic illnesses.
Saed Abu Aita, a 44-year-old injured Palestinian from central Gaza, expressed concern over the limited number of evacuees, fearing he may have to wait months or longer for medical care. He described his situation as "frustrating and depressing," highlighting the difficulties he faced in finding a doctor to remove a shrapnel fragment lodged in his rib cage since an Israeli airstrike in October 2023.
Hamas had previously managed the Palestinian side of the border between Gaza and Egypt until Israel's invasion of Rafah.
The reopening of the crossing is accompanied by a new security arrangement involving Israel, Egypt, and the internationally backed Palestinian Authority, which is a rival to Hamas, according to officials from Israel, Palestine, and Europe who requested anonymity due to the sensitive nature of the discussions.
Israel has opposed the idea of the Palestinian Authority controlling postwar Gaza, despite previous encouragement from the former Biden administration. The future governance of the enclave following the conflict remains uncertain.
On January 21, the office of Israeli Prime Minister Benjamin Netanyahu stated that the Palestinian Authority's involvement at the crossing would be limited to "its stamp on the passports," with Israeli forces maintaining a presence around the crossing and requiring approval from Israel's security services for passage.
Brig. Gen. Louay Arzeikat, a spokesperson for the Palestinian Authority's police, indicated that some unarmed members of the Authority would be stationed at the crossing under the command of Maj. Gen. Allam al-Saqa, the police chief based in Ramallah in the Israeli-occupied West Bank. Their role would primarily involve administrative tasks, such as checking and stamping passports.
Although Hamas has controlled Gaza since 2007, the Palestinian Authority still retains some active employees in the region.