White phosphorous munitions are destroyed in the southern Gaza Strip during a controlled demolition in March 2010. There are concerns that such Israeli weaponry has contributed to a spike in cancer rates in the territory. Yousef Deeb APA images

Jihad is a boy with ambitions. “I want to grow until I become an astronaut and an engineer,” the 9-year-old said. “At the same time.”

Before he could achieve those goals, Jihad would have to recover from a major illness. About a year ago, he was diagnosed with cancer of the colon.

The diagnosis was made after he had been taken to hospital with food poisoning.

For his family, the news was the latest in a series of tragedies. Jihad’s twin brother was born with severe disabilities and died after just two months.

“I was so happy when the doctor told me I was pregnant with twin boys,” Jihad’s mother, Majda Ali, said. “I started to dream about how I would be mother to a doctor and an engineer. The dream has been destroyed.”

Majda does not know the cause of Jihad’s cancer. She fears, however, that it may have something to do with how she was exposed to a considerable amount of dust from buildings bombed by Israel during Operation Cast Lead, the attack on Gaza in late 2008 and early 2009.

What she does know is that Jihad requires urgent treatment. He has been referred to specialists working in Jerusalem. It is not clear when – or even if – Israel will allow him to travel.

Rates of cancer are rising in Gaza. Health ministry officials have estimated that there were 105 cases of cancer for every 100,000 residents in Gaza for 1998-2008. For 2009-2014, that had increased to 141 cases per 100,000 residents, 41 percent more than in the previous period.

Cancer rates are increasing worldwide, particularly in developing countries, due to an increase in risk factors like smoking, adoption of Western diets and sedentary lifestyles, as well as environmental pressures.

But in Gaza, there are particular concerns that Israeli weaponry may be a contributing factor.

Obstruction

Israel is known to have experimented with a number of weapons during the 2008 offensive. They included a US-supplied “bunker buster” missile called GBU-39 and white phosphorous, a weapon that causes severe burns.

Suspicions have been raised that some of the missiles used by Israel were coated with depleted uranium, a radioactive substance.

Khaled Thabet, head of the oncology department at al-Shifa hospital in Gaza City, has said that Israel’s use of depleted uranium may be linked to increased levels of cancer.

It has been reported, too, that Israel has been spraying pesticides on farms in Gaza for a number of years. The use of toxic pesticides and fertilizers by farmers may also be contributing to the rise in cancer rates. Colon cancer may be caused by the presence of pollutants in food, according to Thabet.

“Many services necessary for cancer patients are lacking” in Gaza’s health system, Thabet told The Electronic Intifada. “Surgical facilities are one of them.”

More than 15 percent of all cancer patients requiring surgery are recommended to travel outside Gaza, according to Thabet. Referrals are made to hospitals in Israel, the occupied West Bank, Egypt and, in some cases, to Jordan and Turkey.

Israel frequently obstructs efforts to ensure that cancer patients receive the treatment they require. In some urgent cases, Israel has blocked patients from traveling for periods of three or four months, Thabet added.

Ahmad al-Tannani is ambitious, too. He wants to be a football star.

“When I am better, I’ll play football and train hard,” the 8-year-old said.

Ahmad, a resident of al-Bureij refugee camp in central Gaza, has lymphoma.

Having undergone an operation, he now requires a form of radiation treatment which is not available in Gaza. He could be treated in an Israeli hospital but has not yet been allowed to travel by the Israeli authorities.

Blackmail

Recently published data indicate that Israel has tightened its restrictions on travel from Gaza.

Gisha, an Israeli human rights group, has reported that there was a 44 percent drop in the number of people who exited Gaza, via the Erez military checkpoint, in January 2017, when compared to the same month last year. Erez separates Gaza from Israel.

Medical patients and people accompanying them were among the categories of travelers affected by the decrease, according to Gisha.

The World Health Organization has also reported that Israel is allowing fewer Palestinians to travel for medical treatment.

In January last year, Israel approved 78 percent of all requests to travel for treatment made on behalf of people in Gaza. By December, that proportion had fallen to less than 42 percent.

That was the lowest rate of approvals recorded since April 2009.

More than 1,400 patients were delayed from reaching healthcare appointments in December last year. According to the World Health Organization, that was the highest number of such delays ever recorded.

Among those affected were 323 children.

Maram Aqil is an 11-year-with lung cancer. She has been receiving chemotherapy in an Israeli hospital. Her parents hope that they are not hampered from traveling through Erez.

“Delaying the next dose of chemotherapy will kill Maram,” said her mother Najah. “That’s what the doctor told us.”

A resident of Jabaliya refugee camp in Gaza, Maram is an only child. “When Maram arrived, we thought we owned the whole universe,” Najah said. “But I think cancer will take away the delight we felt.”

One major obstacle encountered by patients with serious conditions and people accompanying them is that they have subjected them to interrogations to Israeli troops at Erez. Physicians for Human Rights-Israel has stated “Israel is unethically and immorally exploiting the medical needs of Palestinian patients, making their transit for medical treatment conditional on [Israeli intelligence] questioning, in order to squeeze them for intel.”

In January this year, Nidal Elian brought his son, Muhammad, to the Erez crossing. Aged 6, Muhammad has lung cancer and requires urgent treatment.

The troops staffing the checkpoint tried to blackmail Nidal. They told him that they would allow him through Erez if he became an informer to the Israeli military. Nidal refused.

“I know that this refusal will cost me the life of my child,” said Nidal. “They will never allow me to pass now and they will not let my child complete his treatment. But I cannot sell my country to my enemy.”

Sarah Algherbawi is a freelance writer and translator from Gaza.