GENEVA  —United Nations agencies warn that medical evacuations from conflict-ridden Gaza have essentially dried up, putting at risk the lives of thousands of people, including children, with serious illnesses and injuries because they are unable to get the treatment they need.

"Children are being medically evacuated from Gaza at fewer than one child per day. If this lethally slow pace continues, it would take more than seven years to evacuate the 2,500 children needing urgent medical care," UNICEF spokesperson James Elder told journalists Friday in Geneva.

"As a result, children in Gaza are dying," he said, noting that even when "miracles happen" and children survive the bombs, bullets and shells, "they are then prevented from leaving Gaza to receive the urgent care that would save their lives."

The World Health Organization reports 15,600 patients require urgent medical evacuations, with only 5,138 evacuated so far. Nearly half of them had cancer, 40% had war injuries, and 200 had kidney diseases. The WHO says only 231 patients have been evacuated since May 7.

UNICEF spokesperson Elder said that an average of 296 children were medically evacuated each month from January to May 7. Since the Rafah crossing closed on May 7 because of the ground offensive there, he said "the number of children medically evacuated has collapsed to just 22 per month."

"That is, just 127 children, many suffering from head trauma, amputations, burns, cancer, and severe malnutrition, have been allowed to leave since Rafah closed," he said.

Dr. Rik Peeperkorn, WHO representative for occupied Palestinian Territory, agreed that this situation cries out for "a proper medevac structure out of Gaza, an organized structure."

On a video link from Gaza, he recalled that before the crisis erupted a year ago, between 50 and 100 patients daily were referred from Gaza to East Jerusalem and the West Bank, and "those were 40% oncology cases - children, women and men with cancer - but also cardiovascular and all kinds of other diseases."

Between 12,000 and 14,000 critical patients must be medevaced outside Gaza, Peeperkorn said, "and we are constantly pushing for that."

"We want medical corridors. What would be needed would be to restore the traditional medical corridor, which is, of course, to the hospitals in East Jerusalem and West Bank, and they are very much ready to receive patients from Gaza," he said.

Peeperkorn said WHO always tries to prioritize children, who comprise at least one-third of patients on a medevac list, which subsequently goes through a security screening.

"It is really painful to see that many of these patients, which are on this list are not approved, including children," he said, adding there is "no explanation from Israeli authorities on why an evacuation is not granted."

Elder agreed with that assessment, noting that Israeli authorities do not say when applications for medical evacuations are declined, and "does not provide reasons for refusals."

"It is not known how many child patients have been rejected for medevac," he said. "Only a list of approved patients is provided by Israel's COGAT, which controls Gaza's entry and exit points. The status of others is not shared. When a patient is denied, there is nothing that can be done."

COGAT, the Israeli military body responsible for Palestinian civilian issues including medical evacuations from Gaza, has not commented on the question of evacuations.

'Mayhem and chaos'

Peeperkorn took part in a U.N. mission Thursday, which managed to reach Kamal Adwan hospital in northern Gaza, which is under siege by Israeli authorities. The team delivered a range of medicines and fuel to the hospital and transferred 23 patients and 26 caregivers to the Al-Shifa hospital.

Peeperkorn described a scene of "mayhem and chaos" at Kamal Adwan Hospital, where there were more than 200 patients, and the emergency wards were overflowing. He said he had received unconfirmed reports that soldiers were close to the hospital, "telling people that they needed to come out and separating people into groups of men, women, and children."

"Hospitals should not be attacked. People should be protected. Hospitals are supposed to be safe places where people could receive treatment and shelter," he said.

Optimism about vaccination campaign

Despite the ongoing attacks on civilian infrastructure, which continue to jeopardize people's safety and movement in northern Gaza, Peeperkorn said he remained hopeful that a polio campaign in the region "would be successful."

WHO and partners were forced to postpone a second round of polio vaccinations for more than 119,000 young children across northern Gaza due to the violence, intense bombardment, mass displacement orders and lack of assured humanitarian pauses.

Peeperkorn noted the second round of the campaign has gone off without a hitch in southern and central Gaza and that coverage in those two zones "surpassed 90%, putting the mission on the right track."

"We still have good hopes that we can do this campaign ... We have a window between the 28th of October and sixth of November to carry out the campaign," he said. "Over the coming week, the technical committee will engage in constant dialogue to ensure that the campaign can go ahead."

Underscoring the urgency of stopping the transmission of this crippling disease, he said, "You do not want to get more polio cases in Gaza, but you also do not want to see a spread of the poliovirus in surrounding countries. So, we do this not only for the children in Gaza, but for children all around."

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