Asrar, from Jabalia in the north of Gaza Strip, was diagnosed with a bone cancer called an osteosarcoma in her left lower leg in April 2018. She required radiotherapy, only available outside the Gaza Strip. From October 2018, Asrar attended Tel Hashomer Hospital, east of Jaffa, where she underwent extensive investigations, amputation of her leg, radiotherapy and chemotherapy, as well as subsequent physiotherapy to prepare her for use of her new artificial limb.

She continued to receive follow up at Tel Hashomer Hospital until February this year. After the start of the COVID-19 outbreak and limitations on movements, a local alternative for a selection of chemotherapy patients was established at Al-Haya Specialized Hospital in Gaza City. The centre began provision of a limited chemotherapy service on 21 April 2020, but is not equipped to replace the multidisciplinary and specialized services available at major Palestinian cancer referral centres.

Asrar was happy to receive care closer to home, but she missed the support of the multidisciplinary team that previously managed her care. Asrar said, “My aunt accompanied me at Tel-Hashomer but actually she did not have to do a lot in terms of care, because the health staff there do a lot for the patients, and they took care of me with respect. Even though I was far away from my family, I received good care and my family kept in touch with me every day by phone.”

In July, Asrar successfully completed her high school (tawjihi) exams and her family celebrated her success. Asrar’s father commented,

“She succeeded despite all the difficult circumstances and the long periods of treatment in and outside Gaza. I’m so proud of her and I hope she achieves all her dreams!”

Now Asrar is planning to study Information Technology (IT) at Al Quds (Jerusalem) Open University.  She said, “I think that this area of study would accommodate my current state of health, because it depends more on mental than physical ability.”

Currently there are severe barriers to access for patients requiring exit from the Gaza Strip for essential health services. The escalating numbers of COVID-19 cases in the West Bank and Israel mean continued restrictions on referrals and movement, while the end to coordination between Palestinian and Israeli authorities and of referrals to Israeli institutions have added difficulties to the already cumbersome and arbitrary permits process.

WHO is working with authorities for the protection of Gaza patients and for promoting their unhindered access to essential health services, even in the context of COVID-19.