Explainer: How Israel’s Growing Entry Restrictions Are Blocking Doctors and Aid Workers from Gaza

The Increasing Restrictions on Humanitarian Access to Gaza

The Israeli military has recently intensified its restrictions on international doctors and humanitarian workers attempting to enter Gaza, rejecting their applications at unprecedented rates. Reports indicate that since early February-shortly after a temporary ceasefire came into effect-many medical professionals, who had initially received preliminary approval from the World Health Organization (WHO), were suddenly denied entry just hours before their scheduled arrival.

This marks a significant shift in policy, as many of these doctors had been granted access to Gaza on previous humanitarian missions over the past 17 months. The denials are being issued by the Coordinator of Government Activities in the Territories (COGAT), the Israeli military body overseeing Gaza and the West Bank.

A Dramatic Spike in Rejections

Dr. Nabeel Rana, a vascular surgeon who had volunteered in Gaza on two occasions in 2024, described the situation as "unprecedented." He was denied entry for the first time on February 24 and noted that the pattern of rejections has surged since the start of February. This has caused serious disruptions in humanitarian efforts, preventing much-needed medical personnel from assisting in a region where the healthcare system is on the brink of collapse.

A New Bureaucratic Hurdle for Humanitarian Organizations

In December, the Israeli government established an inter-ministerial team led by the Ministry of Diaspora Affairs and Combating Antisemitism to regulate international NGOs working with Palestinians. This new bureaucratic requirement has added another layer of control, effectively allowing Israel to prevent organizations from operating in Gaza until they undergo a stringent approval process.

The new criteria allow for the denial of registration for political reasons, including any organization that "denies Israel's status as a Jewish and democratic state," supports boycotts, questions the events of October 7, or is involved in legal actions against Israeli security personnel. According to Dorotea Gucciardo, director of development at the humanitarian organization Glia, these new restrictions are "crippling efforts to save and preserve life" in Gaza.

The State of Gaza's Healthcare System

The healthcare infrastructure in Gaza has been decimated by the ongoing conflict. Only one hospital remains fully operational, while 20 others are functioning at a limited capacity. Medical resources are scarce, and an estimated 111,000 Palestinians have been injured, with at least 14,000-including 4,500 children-requiring urgent medical evacuation. The inability to bring in new medical staff and supplies is exacerbating an already dire humanitarian crisis.

How the Entry Process Has Changed

Before October 7, 2023, humanitarian workers could coordinate their entry to Gaza through the United Nations and the Israeli military. Medical personnel traveled from Cairo to the Rafah border crossing, carrying essential medical supplies and other necessities. At that time, up to 15 healthcare workers could enter Gaza in a single convoy, staying for one or two weeks before being replaced by fresh volunteers.

However, after the Israeli military invaded Rafah in May 2023, the process changed drastically. Health workers now have to apply for entry through the WHO a month in advance. WHO then submits the applications to COGAT, which makes the final decision. Approved individuals must travel to Amman, Jordan, and wait for last-minute clearance from COGAT. This process now includes a color-coded system: green for approval, red for denial, and orange for partial approval-with no explanation given for any rejection.

Even for those granted access, severe restrictions apply. The number of aid workers entering must match the number exiting, preventing any increase in medical support inside Gaza. Volunteers can carry only one suitcase and a small backpack, and essential medical supplies are often barred. Recently, the cash allowance for each individual was reduced from $2,800 to just $280, making it nearly impossible for aid workers to sustain themselves in an economy suffering from extreme inflation.

The Impact of Recent Restrictions

Since early February, the rate of rejections has increased dramatically. While occasional denials occurred in the past, they have now become systematic, with multiple doctors and aid workers being turned away from nearly every convoy. There is no appeals process, leaving those who are denied stranded in Amman with no recourse.

Emergency medicine physician Dr. Thaer Ahmed, who was last in Gaza in January, was rejected on March 13, just hours before his scheduled departure. He noted that humanitarian workers applying through the United Nations Office for Project Services are experiencing similar rejection rates, further exacerbating the crisis.

The Silence from International Organizations

Despite the worsening situation, the WHO has not publicly addressed the rising number of rejections. Dr. Rana pointed out that the organization appears reluctant to challenge the Israeli government, likely fearing repercussions.

Arwa Damon, founder of the nonprofit INARA, had previously been cleared to enter Gaza four times in 2024 but was suddenly rejected on multiple occasions between February and March. She attempted to follow up with COGAT officials but received no response. Damon believes that the escalating restrictions are an attempt to "further cripple our ability to provide for the people of Gaza."

The Humanitarian Crisis Deepens

The recent phase of the ceasefire deal ended on March 2, and Israel has since reimposed a total blockade on Gaza. This has halted the entry of essential supplies, including food, fuel, and medicine, leading to skyrocketing prices and worsening shortages. Bakeries have shut down due to a lack of cooking gas, aid rations have been cut, and on March 17, Israel cut off Gaza's electricity supply, severely reducing access to clean drinking water for over 600,000 people.

Damon emphasized that while international aid workers play a critical role, the vast majority of humanitarian workers in Gaza are Palestinian. Many have been working tirelessly for 17 months without a break, and their ability to continue is being systematically crushed by these policies.

The Need for International Pressure

As the situation continues to deteriorate, many humanitarian workers are calling for increased international pressure on Israel to lift these restrictions. While past efforts have had limited success, there have been rare instances where sustained advocacy has led to improvements. Damon insists that "we have to keep fighting for access" to ensure that essential medical care and aid reach the people of Gaza.

Despite repeated inquiries from journalists, both the Israeli military and the WHO have declined to comment on the rising rate of rejections. The lack of transparency and accountability raises serious concerns about the humanitarian consequences of these policies.

For now, the outlook remains bleak, with aid organizations struggling against bureaucratic barriers that prevent them from doing their lifesaving work. As Gaza's humanitarian system teeters on the brink of collapse, the world is left wondering: how long can this continue before it becomes irreversible?