4 weeks into Israeli assault, 49 wounded Palestinians enter Egypt for treatment, foreign passport holders begin exit

Forty-nine injured Palestinians were allowed to exit the Gaza Strip and enter Egypt for treatment at hospitals, becoming the first people to leave the enclave four weeks into Israel’s retaliatory bombing campaign and total siege, which has wreaked havoc on Gaza’s already taxed health services and left over 22,000 wounded.

One-hundred and seventeen foreign passport holders — among a prepared list of 500 people who have been allowed to exit the strip,  diplomatic sources told Mada Masr — were confirmed to have entered Egypt on Wednesday as of the time of writing. 

The Rafah border crossing between Egypt and Gaza has been closed since the first days of Israel’s retaliatory onslaught following Hamas’s October 7 operation. Israel bombed the crossing facilities four times within the initial week of the war, and it took three weeks of fraught negotiations before Israel allowed a slow trickle of humanitarian aid convoys to cross into Gaza from Egypt.

The opening of the crossing for the wounded and pre-approved foreign passport holders came as part of a Qatari-brokered deal between Egypt, Hamas and Israel,  according to unnamed sources familiar with the talks who spoke to CNN.

Eleven of the injured Palestininans accompanied by at least seven relatives, were checked into Arish Hospital, while five others were admitted to Bir al-Abd Hospital, a source at the ambulance service in North Sinai governorate told Mada Masr on condition of anonymity.

A medical source at Arish Hospital told Mada Masr on condition of anonymity that most of the cases that arrived at the hospital had fractures and needed urgent surgical intervention, with the exception of one child who was transferred to intensive care.

The transfer of injured Palestinians into Sinai comes as Gaza’s Health Ministry warned last week that hospitals in the strip are in a state of “complete collapse.” Hospitals have been incapacitated as Israel has barred crucial fuel stocks — used to power hospitals in the strip — from being delivered. On Tuesday, the ministry issued a final warning that the power generators at the Shifa and Indonesian hospitals in Gaza are hours away from running out of fuel.

Aid deliveries supplying medical supplies and clean water are only trickling in, meanwhile, slowed by cumbersome security checks taking place over 100 km distance from the border crossing.

Meanwhile, the hospitals in Gaza are overwhelmed by an influx of Palestinians wounded in Israeli bombing, with over 22,000 injured in the offensive thus far. 

The 49 injured Palestinians are among a list of 81 selected on the basis of the severity of their health condition to be the first allowed to seek treatment in Egypt.

The list was put together two weeks ago, Shifa Hospital in Gaza director Mohamed Abu Salima told Mada Masr. “We sent a list of 150 wounded people to the Egyptian side, of which the Egyptians approved 81 names.” 

“Both Shifa and Orouba hospitals invited their emergency and surgery departments to name the most severe cases. They received a list of names and passed it along to the Health Ministry, which sent it to the Egyptian side,” he added. 

But the list is already out of date, as two weeks later some of those who were approved are now “martyrs,” Abu Salima told Mada Masr, and some of the patients doctors would now consider to be the most severe cases are not included. Only 70 of the original 81 are able to travel to Sinai. 

“But 70 cases is definitely a very small number amid the severe crowding of the wounded in hospitals” Abu Salima said. 

As for foreign passport holders, three diplomatic sources speaking to Mada Masr on condition of anonymity said the 500 people who are now permitted to leave Gaza today were put on a list delivered to the Egyptian Crossing Authority. Most of them are NGO workers and those holding foreign passports who were wounded in the war.

After this initial 500, the remaining foreign nationals are to be allowed to leave Gaza through Egypt according to the alphabetical order of their nationality to avoid any preferential treatment, the sources said. The Foreign Ministry informed embassies that they could send their personnel to the Rafah crossing to facilitate the treatment and transfer of people coming out of Gaza, and some of them have sent teams already, the diplomatic sources added.

Border Crossing Authority in Gaza head Hisham Edwan told Al Jazeera that the crossing authority in Gaza received two lists from the Egyptian side, one of the wounded and one of the foreign nationals. He noted that the Rafah crossing will stay open until the late hours of the day until both lists are cleared and until the ambulances, prepared with ICU equipment, all arrive and are ready to receive the wounded.

Though Egypt, the United Nations and other countries have called for a humanitarian pause to allow for the safe passage of aid into the enclave as well as the safe crossing of people out of the strip, Israeli airstrikes continued to pummel Gaza on Wednesday, targeting northern Gaza’s Jabalia refugee camp for a second consecutive day. The Gaza Health Ministry put the initial death toll from the Tuesday bombing at at least 50 people. 

Media outlets were restricted from accessing the Rafah crossing on Wednesday, with Egyptian security forces allowing only reporters from the Extra News and Alqahera News TV channels. The press, Extra News and Alqahera News excepted, were also barred from the hospitals in Sheikh Zuweid, Arish and Bir al-Abd where patients were set to arrive.

Health Minister Khaled Abdel Ghaffar said on Wednesday that he had overseen preparations at three hospitals in North Sinai to receive the first group of wounded Palestinians, while capacity had been increased at hospitals in Ismailia to receive more wounded in the future.

Abdel Ghaffar added that the ministry and ambulance services have raised their preparedness to maximum levels across all their agencies and services, with 40 ambulances allocated to line up at the Rafah crossing.

While a field hospital was being prepared in Sheikh Zuweid to receive the wounded from Gaza, the Palestinians entering today were not taken there as the field hospital is not yet ready to receive patients, a source in Sheikh Zuweid Hospital told Mada Masr on condition of anonymity.

Sources have also told Mada Masr that a field hospital in Rafah as well as a triage tent at the border  were being prepared.

A statement from the Military Production Ministry on Wednesday said it set up a field hospital produced by one of its factories as a temporary, mobile medical unit to be used to receive the wounded coming from Gaza. 

The relatives accompanying the wounded at Arish Hospital, most of whom are women, will stay in a tent set up inside the hospital prepared by the Social Solidarity Ministry and were given blankets, the ambulance service source said.

A North Sinai Governorate official said this week that “three places are ready to be allocated in Sheikh Zuwayed and Arish as housing for people accompanying the wounded.”