On the war's third anniversary, 5,600 children are waiting to be evacuated from Gaza

Why are 5,600 children in Gaza waiting to be evacuated for medical treatment?

About 5,600 children are waiting because they need medical treatment outside Gaza, but evacuation requires several approvals. The process involves a Health Ministry referral, acceptance by another country, and Israeli security clearance. During a prolonged war, securing every step can leave seriously injured children waiting.

Raseel shows what this means in practice. The six-year-old was injured at the al-Mawasi displacement camp in July. She travelled to Egypt in late September with support from the World Health Organization. Witnesses blamed an Israeli helicopter strike, while Israel's military said it had no record of a strike there then.

The waiting list remains large, and doctors warn that delays can worsen recovery. Antibiotic-resistant infections are already complicating treatment. The article does not give a single reason for each child's delay, but it shows that evacuation depends on coordination among Gaza's Health Ministry, receiving countries, Israel, and humanitarian groups.

What approvals does a patient need to leave Gaza for treatment?

Patients need three approvals to leave Gaza for treatment. First, Gaza's Health Ministry must issue a referral. Second, a host country must agree to receive the patient. Third, Israeli authorities must provide security clearance. Without all three, the patient cannot complete the evacuation process described in the article.

Raseel's journey illustrates the system. After being injured at the al-Mawasi displacement camp in July, the six-year-old travelled to Egypt in late September. The World Health Organization supported her evacuation. Egypt therefore served as the receiving country, while the other required steps had to be completed before she could leave.

These requirements help explain why thousands remain waiting. About 5,600 children are currently awaiting evacuation for medical treatment. The system involves Gaza's Health Ministry, another country's health authorities, Israeli security officials, and sometimes humanitarian organisations. Delay at any stage can postpone treatment outside the territory.

How large is the humanitarian crisis described in the article, in terms of deaths, damaged infrastructure, and families without secure water?

The article describes a humanitarian crisis across health, water, and basic infrastructure. Gaza's Health Ministry reports more than 74,000 Palestinians killed since the war began, including 1,421 since the US-brokered ceasefire agreed in October 2025. Israel disputes those figures and says it tries to minimise civilian harm.

The physical damage is also enormous. According to the UN, almost 90% of Gaza's water and sanitation infrastructure has been destroyed or damaged. Those systems are essential for safe water and hygiene. Their collapse affects hospitals, wounded patients, and families living through displacement and war.

More than 80% of families face water insecurity. The combination of deaths, damaged infrastructure, and unreliable water creates conditions in which illness and difficult wound recovery can spread. The article links this destruction to antibiotic resistance, while Cogat says water supplies exceed the UN humanitarian threshold and medicines enter without restriction.

What is antibiotic resistance, and why is it making wounds harder to treat?

Antibiotic resistance occurs when bacteria no longer respond reliably to medicines used against them. An antibiotic that once controlled an infection may become less effective. Doctors then have fewer useful treatments, and recovery can take longer. This matters especially for people with serious wounds, whose infections can threaten healing.

A preliminary study examined almost 80,000 bacterial samples collected at 11 Gaza hospitals between 2015 and 2025. Researchers found widespread resistance to key antibiotics. The study was conducted by Gaza-based researchers with support from Imperial College London and the American University of Beirut, but it has not yet been peer-reviewed.

Doctors are already seeing the consequences. Awni al-Jaafarawi, a Médecins Sans Frontières doctor at Nasser hospital, warned that amputations could rise even if the war stops. The article connects the problem to damaged water and sanitation systems, while Cogat says antibiotics enter Gaza without restriction.

What could happen to injured patients if infections remain difficult to treat, even after the fighting stops?

If infections remain difficult to treat, injured patients may face longer recoveries and more serious complications. Antibiotic-resistant bacteria can make medicines less effective, leaving doctors with fewer ways to control wound infections. The danger does not automatically end when shooting stops, because existing wounds and infections may still need prolonged care.

The article gives a stark warning from Awni al-Jaafarawi, a Médecins Sans Frontières doctor at Nasser hospital. He said, “We will see the number of amputations rise, even if the war stops.” That prediction links treatment delays and resistant infections to possible permanent loss of limbs.

The problem could continue because almost 90% of water and sanitation infrastructure has been destroyed or damaged, according to the UN. More than 80% of families face water insecurity. A preliminary hospital study also found widespread resistance, although its findings have not yet been peer-reviewed.

How can the destruction of water and sanitation systems cause antibiotic-resistant infections to spread?

Water and sanitation systems normally help separate human waste from drinking water, hospitals, and living areas. When they are destroyed or damaged, contaminated water and poor hygiene can allow bacteria to spread more easily. This creates more infections among families and patients, especially where people are displaced or hospitals are under pressure.

The article links Gaza's antibiotic-resistance problem to this destruction. The UN says almost 90% of water and sanitation infrastructure has been destroyed or damaged, while more than 80% of families face water insecurity. In such conditions, cleaning wounds and controlling bacteria become harder. This explanation describes a general mechanism; the article does not detail every transmission route.

More infections also mean more opportunities for bacteria that resist treatment to circulate. A study of almost 80,000 samples from 11 hospitals found widespread resistance to key antibiotics. Its results are preliminary and not yet peer-reviewed. Cogat disputes part of the picture, saying water supplies meet the UN threshold and antibiotics enter without restriction.

Why does medical evacuation from a conflict zone depend on several different authorities and countries agreeing to cooperate?

Medical evacuation depends on several authorities because the patient must move from Gaza into another country's care. Gaza's Health Ministry identifies or refers the patient. A host country must provide acceptance, meaning it agrees to receive and treat the person. Israeli security clearance is also required before the patient can leave the territory.

Raseel's evacuation demonstrates this chain of cooperation. The six-year-old was injured at the al-Mawasi displacement camp and travelled to Egypt in late September. The World Health Organization supported the journey. Her case required a receiving country, Gaza's medical referral system, Israeli clearance, and humanitarian coordination.

This arrangement can create delays when any part is unresolved. About 5,600 children are waiting for evacuation for medical treatment. The article does not identify a separate delay for each child, but the required approvals explain why treatment abroad involves governments, health authorities, security officials, and aid organisations working together.

Key Facts:

📌 About 5,600 children are waiting for medical evacuation from Gaza.

📌 Patients need referrals, host-country acceptance, and Israeli security clearance.

📌 Six-year-old Raseel reached Egypt with World Health Organization support.

📌 A Health Ministry referral is required to leave Gaza for treatment.

📌 A host country must accept the patient.

📌 Israeli security clearance is also required.

📌 Gaza's Health Ministry reports more than 74,000 Palestinian deaths.