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After months of obstacles, a Gaza man reaches a hospital in the West Bank for surgery


Things are quiet now at one of Jerusalem's holiest sites for both Jews and Muslims. But earlier today, the Al-Aqsa Mosque compound, known to Jews as the Temple Mount, was the scene of violence between Palestinians and Israeli riot police. It's a scene that's all too familiar.

My colleague, Daniel Estrin, who has been co-hosting ALL THINGS CONSIDERED this week, covers the ongoing violence between Palestinians and Israelis day in and day out. And this week, he's been bringing us a story that takes us behind the headlines and shows us how this simmering conflict shapes everyday life, even when there is no violence.

And, Daniel, this story you've been telling us takes place in Gaza, which is home to 2 million Palestinians.


Yeah, Ari. In Gaza, it is just so many aspects of life - routine life - that are affected by the ongoing conflict, including the health care system, and it's all the way down to the story of one father, named Yousef al Kurd, and his quest to get heart bypass surgery that could save his life.

SHAPIRO: And you've reported this week on why his case is too complicated for Gaza's health system, which has been degraded by war and a blockade by Israel and Egypt since Israel's enemy, Hamas, took over 15 years ago.

ESTRIN: Yeah, they can't do his surgery in Gaza, and his condition is getting worse. He's been waiting for more than two months. And finally, he gets his Israeli security clearance to leave Gaza and to go to a Palestinian hospital in the Israeli-occupied West Bank.

So today, we have the final chapter of our story. I travel with him on his journey from Gaza, through Israel, to the West Bank Hospital.


UNIDENTIFIED PERSON: (Non-English language spoken).

ESTRIN: The Erez Crossing is one of the world's most heavily fortified border crossings. It's Israel's one civilian crossing with Gaza. Hamas, committed to armed conflict with Israel, is contained on the other side. So are 2 million Palestinian civilians. Israel's policy is to keep the Palestinian territories divided to seal Gaza off from the West Bank.

I'm on the Israel side of this crossing, waiting for 70-year-old Yousef al Kurd, who's waited for months for this moment. A Palestinian lawyer pleaded with Israeli authorities to give him security clearance to get heart surgery. And finally, he is allowed to cross with his wife, Fayeza.

YOUSEF AL KURD: (Non-English language spoken).

ESTRIN: "I'm weak," he says.

At 5:30 a.m., he said goodbye to his children and left home - waited hours at the Hamas checkpoint leaving Gaza. Then, at the Israeli crossing, he had to raise his arms in a full-body scanner, and he crumpled to the floor. Israeli attendants rushed him a wheelchair. No one told his family they could arrange an ambulance.

But there is a driver here, and he's Israeli. He volunteers with a peace group called Road to Recovery. They're Israelis who drive Palestinian patients to their medical appointments. This driver is named Arnon Avni. He is nearly 70 years old. He's a graphic designer and a political cartoonist.

ARNON AVNI: OK. Let's get them in.

ESTRIN: And we are ready to go.


ESTRIN: Should we pull the car - the seat up a little bit? OK.

KURD: (Non-English language spoken, moaning).

ESTRIN: Yousef al Kurd is in pain.


AVNI: (Non-English language spoken).

ESTRIN: (Non-English language spoken).

AVNI: (Non-English language spoken).

ESTRIN: The Israeli volunteer driver puts the destination in his navigation app - a checkpoint in the Israeli-occupied West Bank.


ESTRIN: Do you speak any Arabic, Arnon?

AVNI: I know a few words - not really speaking it.

ESTRIN: (Speaking Arabic)? Do you speak English?

FAYEZA: Half-half.

ESTRIN: And, Yousef, (speaking Arabic)? Do you speak English?

KURD: Deutsch.

ESTRIN: Deutsch?

FAYEZA: Deutsch.


He studied to be an audio engineer in Germany decades ago. He and Avni don't share a language, but they do have some things in common. They're about the same age, and Avni's father died of a heart attack.

KURD: (Speaking Arabic).

FAYEZA: (Speaking Arabic).

KURD: (Speaking Arabic).

FAYEZA: (Speaking Arabic).

ESTRIN: Oh, he's complaining about his chest.

AVNI: It's - I can't help.

KURD: (Speaking Arabic).

ESTRIN: "The pain is severe," he says.

KURD: (Speaking Arabic).

FAYEZA: (Speaking Arabic).

ESTRIN: Kurd's wife, Fayeza, is in Israel for the first time in her life. She's 58. She says it's another world. It's clean. It's wide. It's open. It's not everyone is squished together, like in Jabalia refugee camp, where she lives.

AVNI: I see the eyes of all of my passengers on my travels. They - all of them feel the same.

ESTRIN: (Speaking Arabic)?

FAYEZA: (Speaking Arabic)?

ESTRIN: She asks, "what's that bridge?" She's never seen an overpass before.

FAYEZA: (Speaking Arabic, laughter).

ESTRIN: Her husband is one of thousands each year who have to reschedule their surgery and treatments over and over until Israel grants them a security clearance to leave Gaza for the hospital. Advocates have raised this issue for years, and volunteers like this Israeli driver try to help.

FAYEZA: (Speaking Arabic).

ESTRIN: She said, "bless you - it's humanitarian action, what you're doing."

AVNI: I guess it's important for me that the people in Gaza will know that there are people like me in Israel.

ESTRIN: Avni lives right next to Gaza. Mortar shells landed outside his home last year. And five decades ago, a Palestinian from Gaza planted explosives in their kibbutz, and his own brother died. Avni drives Gaza patients to the hospital to try to make things better.

AVNI: Some people call me a traitor.

ESTRIN: A traitor.

AVNI: We are in minority, but I believe that we do the right thing for Israel.

ESTRIN: An Israeli road sign warns Israelis not to enter the Palestinian territory, so Avni can't take them all the way to the hospital. We drop them off just on the other side of the checkpoint.

KURD: (Speaking Arabic, moaning).

ESTRIN: Yeah, the speed bumps at the crossing are a little - are hurting him.

AVNI: Yes, yes. He is suffering.

ESTRIN: We flag down a Palestinian driver and then help Kurd get out of the Israeli driver's car and into the Palestinian van. We say our goodbyes before they drive off to the hospital in the West Bank city of Hebron.

AVNI: Tell them I wish them all the best.

ESTRIN: (Speaking Arabic).

FAYEZA: (Speaking Arabic).

ESTRIN: She's happy to meet you, and she wishes you all the best.


ESTRIN: But this moment of hope quickly fades. Kurd doesn't end up getting the surgery he's been waiting for. Hours after he arrives in the hospital, he has multiple-system failure. Two days later, his son Ibrahim, in Gaza, gets a phone call from the hospital.


ESTRIN: "Ibrahim, how are you?" the doctor says.

IBRAHIM: (Speaking Arabic).

ESTRIN: "Oh, God," the son replies.


IBRAHIM: (Speaking Arabic).

ESTRIN: "I'm with your mother now," the doctor says.


ESTRIN: "Your father, may he rest in peace."


ESTRIN: He played this phone call for me when we were visiting the family in December, a few weeks after the funeral. For the first time, I see Fayeza cry.

FAYEZA: (Crying).

ESTRIN: I'm so sorry.

FAYEZA: (Crying).

ESTRIN: I turn to her son.

I'm so sorry about your father. I was so hopeful that he would get the treatment he needed and that this would be a happy ending.

IBRAHIM: (Through interpreter) I was just like you, Daniel. I was hoping for the happy ending.

ESTRIN: As we gather our belongings to leave, his 24-year-old son, Raji - who's been silent nearly the whole time - speaks.

RAJI: (Through interpreter) I just want to ask you - put yourself in my shoes. Would you like to face those circumstances? Would you like to see one of your beloved facing those circumstances?

ESTRIN: And since we reported this story, there have been more patients who have died going through the same ordeal as his father.

SHAPIRO: Reporting there from my co-host, Daniel Estrin.

Daniel, this is such a tragic case. Could anything have been done to get him out of Gaza sooner and save him?

ESTRIN: I asked health experts about that, and no one can really say for sure. There were a lot of factors. Kurd had diabetes. He was a smoker. He went a year without getting the surgery his doctor had ordered. Then, the medical system in Gaza is poor. There was very little patient follow-up when his condition got worse.

His son thinks it's the Palestinian doctor's fault - that the doctor should have marked the case as urgent, and then Israel would have let him in immediately. But when I asked the World Health Organization about that, they said even some urgent cases get delayed and denied by Israel.

What we do know, Ari, is that, in general, these kinds of delays can be deadly. The W.H.O. studied Gaza cancer patients and found that they have died at a higher rate when their Israeli permits were delayed or denied.

SHAPIRO: This system clearly fails a lot of patients. What can be done to fix it?

ESTRIN: Well, the World Health Organization says Israel can do a lot. Israel does let in thousands of Palestinian patients every year, but the W.H.O. says the permit process can be sped up, the criteria can be made clearer, and it says Israel should end its restrictions - which Israel says it needs for security - on importing some medical equipment into Gaza. The W.H.O. also says the Palestinian Authority can also help. It can get more medical supplies into Gaza.

And in my own reporting, Ari, I heard accusations of corruption in how Palestinian officials select patients for travel. So there are very, very specific things that can be fixed.

SHAPIRO: But the W.H.O. has been documenting these problems for years. Why hasn't the system changed?

ESTRIN: Well, each side blames the other. You know, if only Israel would end the blockade of Gaza, or if only Hamas would stop attacking Israel and cede control, then it wouldn't be this way. But you see, the system is just resistant to change.

What I learned following this one man's story is that, on a person-to-person level, you can bend the rules. You know, Palestinian advocates can send frantic WhatsApp messages to Israeli border authorities. They send photos of sick patients to Israelis and get their sympathy. And Israeli advocates even petition their own courts and manage to get patients through. So it's easier to win an exception to the rule than to change the rule. Really, Ari, it's just one way to summarize the entire dynamic between Israelis and Palestinians.

SHAPIRO: Daniel Estrin, thank you for your reporting.

ESTRIN: Thank you, Ari.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.

Daniel Estrin
Daniel Estrin is NPR's international correspondent in Jerusalem.