After battling kidney failure for nearly the entirety of her short life, Inam al-Attar, 12, from the Gaza Strip finally obtained a medical permit issued by Israeli authorities to undergo surgery in one of Ramallah’s hospitals in the occupied West Bank.
Yet the experience was marred by heartbreak as she was forced to make the trip beginning from the Israeli Erez checkpoint, north of Gaza, without her parents by her side.
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Usually, a medical patient from the Gaza Strip is granted at least one guardian to accompany him or her to medically referred hospitals in the West Bank, Jerusalem or Israel. Inam had counted on her mother Salwa being with her every step of the way.
“The Israelis did not give us a reason for refusing to give me a permit to go with her,” Salwa al-Attar told Al Jazeera.
“The entire family tried to convince me and my daughter that we had no choice but to let her go by herself, but I was too distraught to allow it at first. Inam needs round the clock care and did not want to go without me.”
On Monday, Salwa accompanied her daughter on the short trip from their home in Beit Lahia to Erez checkpoint, also known as the Beit Hanoun crossing. Israeli soldiers allowed Inam to pass through, but said her mother had to turn back because she did not have a permit to cross.
“We were both inconsolable,” Salwa said. “Inam reached Ramallah’s Medical Complex after an hour and a half and kept crying for me.”
Inam’s story spread like wildfire. Local media converged at the complex and in response to the questions fielded by the crowd of journalists around her, the little girl broke down.
“I want my mother!” she cried. “I don’t want anything else, I just want my mother to be with me.”
The governor of Ramallah, Laila Ghannam, was among those who received Inam on Monday.
“We’ll get your mother here, don’t worry,” she told Inam, putting her arm around her. Turning to the media cameras, Ghannam declared, “The Attar girl is the daughter of every Palestinian family in the West Bank.”
She added the ministry of health and the Palestine Medical Complex are following Inam’s situation, and have taken the responsibility of all medical expenses.
Rare kidney condition
Inam was barely a year and a half old when she fell ill. Thinking it was just the flu, her parents took her to the hospital only to find out she had polycystic kidneys, a rare condition that was the first in the occupied Palestinian territories.
Over the years, Inam’s health deteriorated. Last year she began going to the hospital for kidney dialysis at least five times a week. Then her health took a turn for the worse due to the accumulation of water in her body, leaving doctors in Gaza no choice but to remove her left kidney after it had stopped working.
But doctors discovered her right kidney also suffered and was working at 16 percent capacity.
Inam had to drop out of school and was taking up to 28 pills on a daily basis, her mother said, but there was a silver lining on the horizon. A kidney transplant from one of her family members would vastly improve her condition, doctors said.
Subsequent tests revealed her maternal uncle, Khalid, as the best candidate, but Gaza’s collapse of medical institutions and decimation of supplies because of the 12-year Israeli and Egyptian blockade on the coastal enclave meant it would be impossible to perform the surgery there.
The Attar family then called on the ministry of health and Palestinian Authority President Mahmoud Abbas to intervene and provide Inam with a medical permit in order to undergo surgery at the Palestine Medical Complex in Ramallah, which has a 99 percent success rate in kidney transplants.
At the end of February, the permits for her and Khalid were granted.
Holding back permits
Last month, a joint statement released by human rights organisations such as Amnesty International, Medical Aid for Palestinians (MAP), Human Rights Watch, Al Mezan Center for Human Rights, and Physicians for Human Rights Israel highlighted the record low rate of Israeli issued medical permits for Palestinians in Gaza seeking essential treatment outside of the strip.
“Israeli authorities approved permits for medical appointments for only 54 percent of those who applied in 2017, the lowest rate since the World Health Organization (WHO) began collecting figures in 2008,” the statement said.
The approval rate in 2012 was 92 percent but had continuously dropped in subsequent years.
The statement also blamed “record-high delays” by the Palestinian Authority in issuing required approvals, as well as Egypt’s continued closure of the Rafah border crossing, for the further restricted movement and additional suffering of patients.
As a result, 54 Palestinians, 46 of whom had cancer, died in 2017 following denial or delay of their permits.
“The closure system must be abolished so that patients have safe access to healthcare in Palestinian hospitals in the occupied Palestinian territories and elsewhere,” said Issam Younis, the director of Al Mezan.
“The victims and their families must have their right to justice and redress upheld.”
Reunited in Ramallah
After Inam’s arrival in Ramallah, she refused to take medical tests without her mother by her side. The Palestinian civil coordination office liaised with the Israeli side and on Wednesday, Salwa was permitted to cross through Erez checkpoint.
“I was shocked,” Salwa said. “I received a phone call from the coordination office and they told me I had 10 minutes to get to Erez before it would close.”
Salwa said along with her brother Khalid and Inam, they spent most of the time at the medical complex. The date for the surgery has not yet been set, as they have to wait two weeks for the results of the medical tests that Inam and her uncle took.
“This is not a treatment, it’s a surgery,” Salwa stressed. “We don’t know when we will be able to go home. It might be a few weeks or a few months.
“I’m just glad I am here with my daughter,” she said.