Out of 7,000 Gazans who are currently diagnosed with cancer, about 100 await permission to cross into Israel, according to Hamas, the group that has controlled Gaza since 2007.
For Tahani al Rifi, a 34-year-old Palestinian thyroid cancer patient, her twice-monthly trips out of Gaza for iodine radiotherapy has offered hope that she could beat the illness.
But restrictions imposed during the pandemic have made travelling for treatment to a hospital in the occupied West Bank impossible for her, leaving Rifi with few options as her health has worsened.
"My blood tests show that my condition has deteriorated," she told AFP, wearing a floral scarf while speaking through a pink protective mask.
"I'm living on sedatives, because of the pain in my feet and neck."
Gaza, a Mediterranean enclave controlled by Hamas since 2007, had a weak healthcare system before the coronavirus pandemic, due partly to an Israeli-enforced blockade.
Israel tightly controls the flow of goods and people in and out of Gaza, measures it says are necessary to contain Hamas and other groups in the strip.
Because radiotherapy is unavailable in Gaza, Rifi had been travelling to Hebron in the occupied West Bank for treatment, a journey that requires transit through Israel.
Since the Covid-19 pandemic was declared last year, crossings into Israel have been restricted further.
For Gaza cancer patients, the Jewish state has allowed gravely ill people to be transferred to the occupied West Bank or occupied east Jerusalem, the majority Palestinian part of the city it annexed following the 1967 Six-Day War.
Rifi said her case was not considered acute enough to qualify for an emergency transfer.
Her last radiotherapy session was in August, and she has felt too weak to exercise at the sports club near her home east of Gaza City, she added.
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Access to care
Gaza, which has a population of roughly 2 million, has recorded more than 51,500 coronavirus cases, including more than 520 deaths, according to Hamas's Health Ministry.
Poverty rates, which stood at nearly 50 percent before the pandemic, have increased – in part due to economic hardships exacerbated by the lockdowns that Hamas has imposed to stem transmission.
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Imane Shanane, who runs a patient advocacy organisation in Gaza, said cancer sufferers had been left "more fragile" by the pandemic.
According to her, 7,000 Gazans are currently diagnosed with cancer.
Hamas has said about 100 of them are awaiting permission to cross into Israel.
Cancer patients "deserve more access to medical care," said Shanane, herself a breast cancer survivor.
Gazans can also receive medical treatment in neighbouring Egypt by travelling through the Rafah crossing, but it also has only been open sporadically during the pandemic.
"The fragile health system, the Israeli blockade, the closure of crossings and the shortage of drugs and medical equipment: it is cancer patients who pay the price in Gaza," Shanane said.
Rim Fathi, an 18-year-old Gazan diagnosed with leukaemia, said she had received permission to travel to Jerusalem for treatment because of the severity of her case.
But she voiced fear of leaving home, being hospitalised and contracting coronavirus in Israel.
"I would rather suffer here," she said.
A study released on Wednesday led by researchers from the University of Bath said that fear of hospitalisation has increased in Gaza during the pandemic.
"People's reticence to be hospitalised is driven not only by the fear of being infected: it also reflects anxieties of incurring severe income losses, especially if it involves confinement," said the study, partly funded by Britain's Department for International Development.
It added that border closures had "left thousands (in Gaza) suffering from chronic diseases without access to adequate care."
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'We'll pay what it takes'
Rifi expressed the hope that her transit through the Erez crossing will be approved soon, allowing her to resume treatment.
"But I need 1,800 shekels ($545) to travel and stay in Hebron," she said, explaining that she intended to borrow the money if her transit is approved.
Typically the Palestinian Authority, based in the occupied West Bank, pays part of the costs for medical travellers.
But to ensure there are no delays in waiting for funding, Rifi's family said they would pay out of pocket as soon as the trip is approved.
"Her condition is no longer tolerable," her 70-year-old white-haired father, Radwan, told AFP.
"We will pay what it takes to keep her from dying."
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