There is little news coming out of Gaza right now. The war is over and the victims’ stories have been filed. The fickle attention of the world has moved on to the next catastrophe. Life in Gaza goes on of course, but the longer I live here the more I realize that normality does not exist in Gaza: there isn’t enough security for life to have anything more than a fragile semblance of normality. As anyone who has visited the Strip more than once will tell you, the situation inside the world’s largest prison is getting slowly worse.

Last week the Hamas Government took a political decision that will change the lives of hundreds, if not thousands of people inside Gaza. The Hamas Ministry of Health launched a take-over of the Department of External Medical Treatment in Gaza City, which processes all referrals for Gazans who need medical treatment outside the Strip. The Department director, Dr Bassem al-Badri, was suspended from his post, and a new Hamas-approved representative appointed.

Dr al-Badri had originally been appointed by the Fatah-led Government in Ramallah, but with the approval of Hamas. His dismissal is already having devastating consequences for people who need urgent medical treatment in the Palestinian West Bank, Israel or a third country. Hamas does not recognize Israel, which in turn regards Hamas as a terrorist organization, and so all referrals for patients to leave Gaza via the Israel-controlled crossing at Erez have now been suspended. The problem for these patients is that there is no other way out of Gaza. The crossing at Rafah, on the Egyptian border, is now also closed, and so they are trapped.

Those who desperately need to escape from Gaza for urgent medical care include people with cancers, and those who sustained horrific injuries during the recent Israeli military offensive. On 16 January, 18-year-old Mona was sheltering with her family in a UN school in Beit Lahia in northern Gaza, when the Israeli military shelled the area around the school. The school went up in flames, and Mona’s left leg was blown off in the attack. She now needs a prosthetic, including a new left knee, which is a delicate and complex procedure. She has been hoping to travel to France to receive a new leg and intensive physiotherapy, but is now unable to leave.         

Access to healthcare has been used by all sides as a stick to beat Palestinians, especially those inside Gaza, for years. Israel has frequently obstructed patients’ access to urgent, sometimes life-saving treatment. I have interviewed people facing lifelong illnesses because they had either been denied access to medical treatment outside Gaza by the Israeli authorities, or were slowly dying as they waited for their permits to leave Gaza to be finally approved by Israel. Now that Hamas has taken over the referrals department, these people have no access to medical treatment outside Gaza. Hamas must have known full well that this would be the immediate result of the takeover, but bludgeoned on anyway.

Even before Hamas put the boot in, the Government in Ramallah had recently announced it would no longer pay for Palestinians to be treated in Israeli hospitals. Israel had previously stipulated that the Ramallah Government cover all medical costs, or else Palestinians would lose access to medical treatment in the infinitely better Israeli hospitals.      

It is hard to think of another place in the world where life is ruled by such cruel absurdities. Hamas, Israel and Fatah are all playing with the lives and well-being of these patients, including 57 children from Gaza who need to complete complex, expensive treatments at Hadassah Hospital in Jerusalem. Their health is now hanging by a thread. The bombing of Gaza has almost stopped, but the war against the people goes on, from all sides.