DEIR AL BALAH, Gaza Strip — Rimas Abu Lehia was wounded five months ago when Israeli troops opened fire toward hungry Palestinians mobbing a food aid truck in Gaza and a bullet shattered the 15-year-old girl’s left knee.
Now her best chance of walking again is surgery abroad. She is on a list of more than 20,000 Palestinians, including 4,500 children, who have been waiting — some more than a year — for evacuation to get treatment for war wounds or chronic medical conditions, according to the Gaza Health Ministry.
Their hopes hinge on the reopening of the Rafah border crossing between the Gaza Strip and Egypt, a key point under the nearly 4-month-old ceasefire between Israel and Hamas. Israel has announced the crossing will open in both directions on Sunday.
The Israeli military body in charge of coordinating aid to Gaza said Friday that “limited movement of people only” would be allowed. Earlier, Prime Minister Benjamin Netanyahu had said Israel will allow 50 patients a day to leave; others have spoken of up to 150 a day.
That’s a large jump from about 25 patients a week allowed to leave since the ceasefire began Oct. 10, according to United Nations figures. But it would still take 130 to 400 days of crossings to move out everyone in need.
Abu Lehia said her life depends on the crossing opening.
“I wish I didn’t have to sit in this chair,” she said, crying as she pointed at the wheelchair she relies on to move. “I need help to stand, to dress, to go to the bathroom.”
Gaza hospitals are decimated
Israel’s campaign in Gaza after the Hamas-led October 2023 attack on southern Israel that triggered the war has decimated the territory’s health sector. The few hospitals still working were overwhelmed by casualties. There are shortages of medical supplies and Israel has restricted aid entry.
Hospitals are unable to perform complicated surgeries for many of the wounded, including thousands of amputees, or treat many chronic conditions. Gaza’s single specialized cancer hospital shut down early in the war, and Israeli troops blew it up in early 2025. Without giving evidence, the military said Hamas militants were using it, though it was located in an area under Israeli control for most of the war.
More than 10,000 patients have left Gaza for treatment abroad since the war began, according to the World Health Organization.
After Israeli troops seized and closed the Rafah crossing in May 2024 and until the ceasefire, only about 17 patients a week were evacuated from Gaza, except for a brief surge of more than 200 patients a week during a two-month ceasefire in early 2025, according to WHO figures.
About 440 of those seeking evacuation have life-threatening injuries or diseases, according to the Health Ministry. More than 1,200 patients have died while waiting for evacuation, the ministry said Tuesday.
A United Nations official said one reason for the slow pace of evacuations has been that many countries are reluctant to accept the patients because Israel would not guarantee they would be allowed to return to the Gaza Strip. The official spoke on condition of anonymity because he was not authorized to discuss the issue. The majority of evacuees have gone to Egypt, the United Arab Emirates, Qatar and Turkey.
He said it wasn’t clear whether that would change with Rafah’s opening. Even with “daily or almost daily evacuations,” he said, the number is not very high.
Israel has banned sending patients to hospitals in the Israeli-occupied West Bank and East Jerusalem since the war began, the official said — a move that cut off what was previously the main outlet for Palestinians needing treatment unavailable in Gaza.
Five human rights groups have petitioned Israel’s High Court of Justice to remove the ban. The court has not ruled. Still, one cancer patient in Gaza was allowed to travel to the West Bank for treatment on Jan. 11, after the Jerusalem District Court accepted a petition in his case by the Israeli rights group Gisha.
Also, Israel has said it will allow only around 50 Palestinians a day to enter Gaza, while tens of thousands of Palestinians hope to go back.
Thousands of cancer patients need evacuation
Gaza has more than 11,000 cancer patients and about 75% of the necessary chemotherapy drugs are not available, the Health Ministry said. At least 4,000 cancer patients need urgent treatment abroad, it added.
Ahmed Barham, a 22-year-old university student, has been battling leukemia. He underwent two lymph node removal surgeries in June, but the disease is continuing to spread “at an alarming rate,” his father, Mohamed Barham, said.
“There is no treatment available here,” he added.
His son, who has lost 77 pounds, got on the urgent list for referral abroad this last week but doesn’t have a confirmation of travel.
“My son is dying before my eyes,” the father said.
Desperate for Rafah to open
Mahmoud Abu Ishaq, a 14-year-old, has been waiting for more than a year on the referral list for treatment abroad.
The roof of his family home collapsed when an Israeli strike hit nearby in the southern town of Beni Suhaila. The boy was injured and suffered a retinal detachment.
“Now he is completely blind,” said his father, Fawaz Abu Ishaq. “We are waiting for the crossing to open.”
Abu Lehia was wounded in August, when she left her family tent in the southern city of Khan Yunis looking for her younger brother, Muhannad, she told the Associated Press. The boy had gone out earlier that morning, hoping to get some food off entering aid trucks.
At the time, when Gaza was near famine, large crowds regularly waited for trucks and pulled food boxes off them, and Israeli troops often opened fire on the crowds. The Israeli military said its forces were firing warning shots, but hundreds were killed over the course of several months, according to Gaza health officials.
When Abu Lehia arrived at the edge of a military-held zone from which the trucks were passing, dozens of people were fleeing as Israeli troops fired. A bullet hit Abu Lehia in the knee, and she fell to the ground screaming, she said.
At the nearby Nasser Hospital, she underwent multiple surgeries, but doctors were unable to repair her knee. Doctors told her she needs knee replacement surgery outside Gaza.
Officials told the family in December that she would be evacuated in January. But so far nothing has happened, said her father, Sarhan Abu Lehia.
“Her condition is getting worse day by day,” he said. “She sits alone and cries.”
Shurafa and Magdy write for the Associated Press and reported from Deir al Balah and Cairo, respectively. AP writer Lee Keath in Cairo contributed to this report.
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