The weaponization of medical referrals and evacuations during the genocide in Gaza: a brief report and call to action

Abstract Background The Palestinian healthcare system has historically relied on referrals of patients to health facilities across Palestine’s borders. Patients referred typically suffered from chronic conditions or congenital anomalies for which the governmental health facilities in Palestine lacked treatment or diagnostic options. The ongoing Israeli genocide on the Palestinian population has destroyed much of the health system and facilities in Gaza and caused tens of thousands of traumatic injuries that need referral abroad, on top of the cohort of patients with chronic conditions and congenital anomalies. Findings Statistics published by the WHO-oPt show that 7,841 patients have been allowed medical evacuation and referral from Gaza between the start of the war in October 2023 and 29 September 2025. About two-thirds of all patients ( n = 5,000. 63.8%) were medically evacuated before the Israeli military forces occupied the Rafah border crossing with Egypt on 7 May 2024, and 1,702 (21.7%) patients were evacuated between 19 January 2025 and 17 March 2025 as part of the ceasefire agreement. Egypt has received the majority of patients ( n = 3,995, 51%) who have been medically evacuated. Excluding the two periods mentioned, a clear Israeli policy emerged since occupying the Rafah border crossing, which weaponized healthcare by preventing patients from Gaza from being medically evacuated to travel abroad to receive life-saving healthcare. Conclusions The Israeli policy of weaponizing the referrals and medical evacuations has resulted in excess mortality that merits further research and quantification, as patients succumbed to their medical conditions or injuries while waiting to exit Gaza. Action needs to be taken by host countries to step up their efforts to receive more patients from Gaza and put more pressure on Israel to facilitate the safe evacuation process of these patients.