Sick and wounded people left Gaza for Egypt through the Rafah border crossing on Saturday for the first time in nine months under a key provision of the cease-fire agreement between Israel and Hamas.
But officials in the Gaza Health Ministry said that only 50 of the thousands of ill and injured people in need of treatment abroad would be able to cross on Saturday.
Al Qahera News, an Egyptian state-owned TV channel, live-streamed ambulances arriving at Egypt’s side of the crossing, carrying some of the ill and injured.
The crossing had been closed after Israel invaded Rafah, the southernmost city in Gaza, in May. The war has devastated the health system in Gaza, leaving the hospitals still in service struggling to provide care.
Israel’s war in Gaza has caused immense destruction to medical facilities in the territory, including Al-Shifa Hospital in Gaza City. Israeli officials have accused Hamas of using a number of medical facilities for military purposes and have said that a raid on Al-Shifa in November 2023 revealed a stone-and-concrete tunnel shaft below the facility. Hamas has denied Israel’s accusations.
Before Israel took over the crossing, tens of thousands of the sick and wounded Palestinians and foreigners escaping the war left through the passageway. Rafah was also a crucial entry point for trucks carrying aid into Gaza.
An appendix to the cease-fire agreement between Israel and Hamas says that 50 wounded militants will be allowed to leave Gaza daily after receiving Israeli and Egyptian approvals.
Under the agreement, the number of ill and injured people crossing through Rafah will eventually be increased, restrictions will be lifted and the movement of goods and trade will restart. But the terms did not specify when such changes would go into effect.
The World Health Organization said 37 patients, including 34 children, were evacuated through Rafah on Saturday. It was unclear whether any wounded militants also left.
Rik Peeperkorn, the top World Health Organization official for Gaza and the Israeli-occupied West Bank, described Saturday’s evacuation as a positive step, but he said the pace must be increased through all possible exit routes. Some 12,000 to 14,000 people require treatment outside Gaza for severe injuries and chronic illnesses, he said.
Saed Abu Aita, 44, an injured Palestinian in central Gaza, said the small number of people who left on Saturday gave him cause to worry that he may have to wait months, if not longer, to receive care.
“It’s so frustrating and depressing,” he said. “Why is the world so unfair for us?”
Mr. Abu Aita said a fragment of shrapnel penetrated his rib cage when an Israeli airstrike hit his hometown, Jabaliya, in northern Gaza in October 2023. For more than a year, he said, he has failed to find a doctor in Gaza who can remove the fragment.
Hamas had overseen the Palestinian side of the border between Gaza and Egypt until Israel’s invasion of Rafah.
The crossing is being reopened with a new security arrangement between Israel, Egypt and the internationally backed Palestinian Authority, Hamas’s rival, according to Israeli, Palestinian and European officials who spoke on the condition of anonymity to discuss the sensitive diplomacy.
Israel has resisted the notion that the Palestinian Authority would control postwar Gaza, despite the urging of the former Biden administration in Washington. President Trump’s vision for who might rule the enclave after the conflict remains unclear.
On Jan. 21, the office of Benjamin Netanyahu, the Israeli prime minister, said that the “practical involvement of the Palestinian Authority” at the crossing would be only “its stamp on the passports.” Israeli forces would remain “positioned around the crossing” and no one would be allowed through without the approval of Israel’s security services, the prime minister’s office said at the time.
Brig. Gen. Louay Arzeikat, a spokesman for the Palestinian Authority’s police, has said that a number of unarmed members of the Authority’s officers would be working at the crossing under the command of Maj. Gen. Allam al-Saqa, the chief of the police based in the city of Ramallah in the Israeli-occupied West Bank.
He has said that the police’s role there would include administrative tasks, namely checking and stamping passports.
While Hamas wrested control of Gaza from the Palestinian Authority in 2007, the Palestinian Authority still has some active employees in Gaza.
Nick Cumming-Bruce, Aaron Boxerman and Johnatan Reiss contributed reporting.
