Understanding Gaza — care, education, protection

Each pathway depends on a chain of decisions taken by different bodies: doctors, health authorities, international organisations, receiving States, hospitals, universities, border authorities, diplomatic and consular services. Part of the solution may exist without the full pathway being possible. Understanding this chain means understanding why some cases succeed, why others remain blocked — and why coordination can sometimes matter as much as the solution itself.

These three pathways can sometimes intersect, but they should not be confused.

In the Rafah pathway described by WHO, the Palestinian Authority shares the priority lists with the Israeli and Egyptian authorities for security clearance. Once these clearances are obtained, the approved list is shared with WHO. Since October 2023, the routes have used Kerem Shalom / Karam Abu Salem and Rafah in particular, depending on the period and operational conditions.

A medical evacuation is a chain, not a single decision. Each step depends on a different actor. None of these actors alone controls the entire pathway.

1. Referral and decision by the Referral Committee.
2. A country, programme or facility must agree to receive the patient.
3. The necessary security clearances and authorisations must be obtained.
4. An operational route must exist.
5. WHO coordinates the medical and logistical aspects of the supported transfer.
6. Continuity. Entry, treatment, accommodation, follow-up and the next stage of the pathway must be secured.

The European Union can support certain evacuations under the EU Civil Protection Mechanism (UCPM). This mechanism can coordinate offers of transport or treatment made by participating States. It is not, however, a mandatory European quota: offers of reception are a matter for States. The principle is essential: WHO can coordinate and present patients; it cannot, on its own, create the receiving capacity offered by States.

Evacuation is not the end of the pathway.

Crossing the border does not automatically resolve the whole problem. After departure, further issues may still arise: transport to the receiving country, administrative status in a transit country, the visa or entry permit, actual admission to the medical facility, funding for treatment, accommodation, companions’ needs, translation, medical appointments, social protection, continuity of treatment and the situation of family members who remained in Gaza.

Leaving Gaza can be a decisive step without being the end of the pathway. The added value does not necessarily lie in a single act, but in the ability to maintain continuity between the person, institutions, decisions, resources and time.

A university admission is an essential step, but it is not sufficient. A student may therefore be admitted to a university and have funding without yet having an effective route to reach the country concerned. Conversely, an opportunity to leave without admission, a visa or a funding solution is not sufficient either. One open door does not mean that all the others are open.

International protection: an essential distinction.

International protection is not an evacuation mechanism from Gaza. It answers a different question: can a person be protected against return to Gaza when they come within a State’s asylum procedure? In France, case law has undergone a major development.

On 13 September 2024, the French National Court of Asylum (CNDA) recognised that Palestinians from Gaza normally receiving UNRWA assistance could obtain refugee status, the Court considering that this assistance could no longer be effectively provided in the Gaza Strip. On 11 July 2025, the CNDA, sitting in Grande Formation, also recognised refugee status for Palestinians from Gaza who were not covered by UNRWA.

What this case law does not mean: it does not, on its own, create an automatic right to leave Gaza, an evacuation mechanism, an automatic visa or a general right of admission to French territory.

We do not guarantee evacuation, visas, admission or funding. We commit to rigorous casework, honest information and continuity of support.

As of 23 February 2026, WHO recorded more than 18,500 patients urgently needing treatment unavailable in Gaza, while 11,124 had been evacuated since October 2023. WHO explicitly recommends rebuilding and rehabilitating Gaza’s health system, reopening medical referral routes to the West Bank, including East Jerusalem, increasing the number of patients accepted by Member States for treatment abroad, and enabling patients to return to Gaza in dignity once their treatment is complete.

Human Sea Bridge supports these recommendations and considers that the reception capacity currently available remains insufficient in relation to the documented needs.

This shortfall cannot, however, be reduced to the question of crossing borders alone. An evacuation requires that a patient be correctly referred and prioritised, that a country agree to receive them, that a medical solution be available, that the necessary clearances be obtained, that the transfer can be organised and that continuity of the pathway can then be ensured.

We consider that States with suitable hospital capacity — particularly in Europe — can and should increase their contribution. This means not only more receiving places, but also better coordination between health, diplomatic and consular authorities, hospitals and the organisations responsible for coordination.

This is not about ignoring legitimate requirements of security, border control, hospital organisation or administrative verification. It is about preventing a succession of legitimate procedures, when insufficiently coordinated, from itself becoming a lasting barrier to access to lifesaving care.

Human Sea Bridge also considers it legitimate to compare national arrangements when the data are sufficiently robust. The aim is not to label States as “good” or “bad”. It is to identify what enables some pathways to succeed, what slows them down elsewhere and what could be replicated to increase the number of effective solutions. Advocacy should focus on results and solutions, not on the political affiliation of the actors.

This page relies primarily on primary institutional sources: WHO and WHO EMRO, the CNDA, the Conseil d’État, the European Commission and components of the International Red Cross and Red Crescent Movement. Secondary information is used only when data are not available directly from the authority concerned.

When data cannot be cross-checked robustly enough, they are not presented as consolidated fact. Periods, definitions of “patient”, the distinction between patients and companions, and the separation between medical, family, academic or humanitarian evacuations are preserved.

Last editorial verification: 28 August 2026. Data change rapidly.