RAFAH, Egypt — They arrived at the border by the busload: amputees and people with other disabilities by the dozens, in wheelchairs pushed by family members or friends. Others approached on crutches and canes, and many had patches over their eyes or head bandages and had to be guided by relatives.
They were Palestinians from Gaza, taking advantage of Egypt's decision to lift the blockade that it maintains jointly with Israel. They had come to Egypt for medical care, fleeing what U.N. officials call a public health shambles in Gaza.
At a busy checkpoint arrival hall Mohamed Hamdy sat in a wheelchair, waiting to cross the border and be taken to Cairo's Palestine Hospital for medical treatment.
Hamdy, 37, painted a bleak picture of the state of health care in Gaza. "A sick person going to a hospital in Gaza winds up dead," he said.
Hamdy's right leg was amputated, his left leg suffers from nerve atrophy and he has four pieces of shrapnel in his abdomen, injuries sustained during last year's Israeli attack on the Gaza Strip, which killed more than 1,300 Palestinians and 13 Israeli soldiers.
A member of the Gazan military police, he said he was one of only two men in his 120-member unit to survive a strike by an Israeli F-16 jet fighter.
Hamdy could be considered lucky, however, since the Hamas government, which seized control of the coastal strip in 2007, had issued the necessary form referring him to an Egyptian hospital, where he said he'd had 38 surgeries so far.
On Thursday, 577 Palestinians crossed into Egypt, while 153 were sent home because they didn't have the official papers, Egyptian border officials told McClatchy.
"It's only fair to say there is a public health care crisis in Gaza," Chris Dennis, a spokesman for the United Nations Relief and Works Agency in Gaza, told McClatchy. He said that the main hospital in Gaza — where 80 percent of the population lives on aid — was running one elevator, had limited fresh water supply and was battling with frequent power cuts.
Thousands of Palestinians lined up at the border after Egypt announced this week that it's opening its borders after a deadly Israeli raid on a flotilla that was carrying aid to the besieged territory, where an estimated 1.5 million Palestinians live in grim conditions.
Though pharmaceuticals are stockpiled in Gaza's drugstores, many people at the border complained that they'd been misdiagnosed or had been given medication to ease pain instead of curing their ailments. All of those McClatchy interviewed said they were coming to Egypt looking for better health care.
"I have a lump at the back of my head, and I don't know what it is," said Zeinab Selim, 57, who sobbed as she clutched her medical reports. She and her husband had been coming every day to the border since it opened Tuesday hoping to enter Egypt for medical care. Selim said her husband suffered from a fracture in his left thigh and soreness in his back.
"We benefit nothing from visiting the doctors in Gaza. And the pain never goes away," Selim said. They were both sent home again Thursday because they didn't have the necessary permits.
Another woman, Islah Eissa, 40, said she'd spent five years going to doctors in Gaza to no avail. Finally she was authorized to go to Egypt, where doctors determined that she had rheumatoid arthritis, which had severely worsened after years of neglect.
Mahmoud Fayed, an orthopedist at an government hospital in Egypt, Nasser Institute, where many Palestinians are referred, confirmed that he'd treated several cases in which misdiagnosis or neglect was apparent.
The World Health Organization said this week that medical equipment urgently needed in Gaza had been piling up for a year waiting for clearance from Israel. These include CT scanners, X-ray machines, fluoroscopes, infusion pumps, medical sterilization gases, laboratory equipment, UPS (uninterrupted power supply) batteries and spare parts for support systems such as elevators.
One U.N. official put the value of the equipment at $20 million.
"It is impossible to maintain a safe and effective health care system under the conditions of siege that have been in place now since June 2007," Tony Laurance, the head of the WHO's office for Gaza and the West Bank, said in the statement. "It is not enough to simply ensure supplies like drugs and consumables. Medical equipment and spare parts must be available and be properly maintained."
Hossam Abu Safiyah, a Palestinian pediatrician in Gaza, confirmed that the hospitals were suffering not only from a lack of supplies but also from a lack of training.
"A surgeon, for instance, needs to attend conferences, do workshops and work with his hands. It is not enough to read on the Internet," Abu Safiyah said. He added that before the siege doctors frequently attended medical conferences in Egypt and abroad. "All that ended after the borders were sealed."
Israel has come under strong international criticism for insisting on the blockade, while Egypt is being pressured by its neighbors and population to open its borders with the Gaza Strip.
Since the border opened, there's been a steady flow of humanitarian aid across the border into Gaza. The latest Thursday were 28 electric generators and 250 tents, donated by the Egyptian Red Crescent.
(Naggar is a McClatchy special correspondent.)
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