Jud Awad can be cured of leukemia, but the Netherlands must allow her to be removed from Gaza

Jud Awad, a 15-month-old girl, has had a persistent fever for several weeks, a poor appetite, and is pale and listless. Her mother takes her to the general practitioner, who refers her to al-Aqsa Hospital in Gaza for tests. The diagnosis: acute lymphocytic leukemia. "A serious condition," says general practitioner Shakib Sana from Leerdam. "But it's easily treatable with chemotherapy." However, not at al-Aqsa, one of the few remaining functioning hospitals in an area where Israel—interrupted by a single ceasefire—has been bombing for 22 months.

Her GP does two things: he puts Jud Awad on the official list of people who need to be evacuated for medical reasons. And he asks a Dutch colleague, GP Shakib Sana, for help.

Sana has been in contact with his Gazan colleague for some time, he says. "With a small group of doctors, we do consultations by phone and WhatsApp." He also treats the doctor's father remotely, who has metastatic prostate cancer and needs palliative care.

Sana has been trying to get the girl out of Gaza since Saturday, with no results. That's why he decided to make an emergency appeal on his LinkedIn profile on Thursday morning. With her mother's permission, he posted a photo of Jud Awad online. "I deliberately chose the least confrontational one." The girl is covered in bruises due to her illness, and the swelling in her lymph nodes has left her partially paralyzed on the right side of her face. He also posted official documents from the Gazan Ministry of Health recommending chemotherapy.

Seven steps

Evacuation from Gaza can only be done through the World Health Organization (WHO), a seven-step procedure, starting with a diagnosis (1), an official recommendation from the Gaza Ministry of Health (2), placement on an evacuation list (3), and ending with actual evacuation (7). Jud Awad appears to be stuck at step 5, where the WHO offers the list of medical evacuees to countries willing to take in patients. The Netherlands is not on that list and, according to a spokesperson for aid organization Save the Children , has not treated a single Gazan patient in a Dutch hospital in the past 22 months. "We would like to be told if we are wrong."

WHO figures show that 7,507 patients have been evacuated from Gaza since October 7, 2023, including 5,201 children. Most ended up in hospitals in the region: Egypt, the United Arab Emirates, and Qatar. European hospitals treated 244 people over the past two years. Italy, Luxembourg, and Belgium have taken in people, but the Netherlands has not. This is because, according to a spokesperson for Doctors Without Borders, the Dutch government supports receiving people in the region. Of the 653 evacuations, cancer patients were treated.

Before Thursday's parliamentary debate on the war in Gaza, the Ministry of Foreign Affairs sent a letter acknowledging a "large-scale shortage" of medical infrastructure and medicines in Gaza. "The Netherlands supports recent medical evacuations" and "is exploring the possibility of financial and practical support for medical evacuations – including within the EU."

Money and bureaucracy

Family doctor Sana has so far been unsuccessful at Dutch hospitals. "The will is there, but hospitals keep running into the same two problems." Money and bureaucracy. "A chemotherapy treatment like this costs around 100,000 euros; a hospital can't afford that without government funding." He says, "We can fly kilos of food to Gaza, but getting one child this way is impossible."

Placing the girl in a hospital in the region has not yet been successful. This could be due to what aid organizations call the most difficult step (6) in the WHO evacuation plan: obtaining permission from the Israeli government to remove the patient from Gaza. Sana: "Or it will take so long that the patient has already died."

In Gaza, nearly 15,000 patients are waiting for medical evacuation.