After years of waiting and weeks measured in minutes, Noureddine Abu Ajoua crossed out of Gaza on 9 January for medical care that had long been denied to him. Diagnosed with colon cancer and weakened by respiratory complications, the 48-year-old arrived in the northern West Bank with his daughter after a journey that lasted less than half an hour but was shaped by years of paperwork, refusals and court challenges. It remains an exceptional case: since the onset of the genocidal war, such transfers from Gaza to the West Bank have effectively ceased.

At his brother’s home in Tulkarem, Abu Ajoua speaks softly, pausing to catch his breath. The illness has stripped weight from his frame and colour from his face. For months after 7 October, treatment in Gaza became impossible, hospitals overwhelmed and supplies scarce. Like many others with chronic disease, he survived on makeshift remedies while waiting for permission that rarely comes. “I love my home,” he says, “but there was nothing left there for someone who needs care.”

The approval finally arrived after a prolonged legal struggle led by relatives and advocates, arguing that the right to life-saving treatment could not be postponed indefinitely. Once across, Abu Ajoua was admitted to hospital in Nablus, where chemotherapy began immediately. Doctors there describe his condition as serious but treatable, an assessment that underscores what timely access might have changed months earlier.

His evacuation has become a quiet marker of what is otherwise absent: routine medical passage for civilians during a genocidal war. Families across Gaza continue to file requests for patients needing dialysis, cancer care or surgery, most unanswered. Abu Ajoua’s case offers no template, only a reminder that survival can hinge on a single signature and a narrow window of time.